What is Histamine Intolerance: Symptoms, Causes, Diagnosis, and Treatment

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Have you ever noticed that certain foods or drinks make you feel unwell, with symptoms like headaches, rashes, or digestive issues? If so, you may be experiencing histamine intolerance, a condition that affects the body’s ability to metabolize histamine, a chemical that occurs naturally in many foods and is also produced by the body in response to various stimuli.

In this article, we’ll explore what histamine intolerance is, its symptoms, causes, diagnosis, and treatment options, as well as tips for preventing it. Whether you’re already aware of this condition or are just learning about it for the first time, we hope this article will help you better understand how to manage histamine intolerance and improve your overall health and well-being.

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Histamine is a chemical compound that plays several important roles in the body. It is produced by specialized cells called mast cells and basophils and is involved in many physiological processes, including:

  • Regulation of immune responses
  • Control of stomach acid production
  • Constriction and dilation of blood vessels
  • Regulation of sleep-wake cycles

However, histamine can also be produced by certain foods and beverages, such as fermented foods, aged cheeses, wine, and beer. In some people, consuming these histamine-rich foods can lead to an excess of histamine in the body, which can cause a variety of symptoms.

Histamine intolerance is different from a true allergy to histamine. In an allergy, the immune system overreacts to a harmless substance and produces antibodies that trigger an allergic response. In histamine intolerance, the body has a reduced ability to break down histamine, leading to an accumulation of the chemical in the body and resulting in a range of symptoms.

The symptoms of histamine intolerance can vary widely between individuals and can depend on factors such as the amount of histamine consumed, the individual’s ability to metabolize histamine, and other underlying health conditions. Some of the most common symptoms of histamine intolerance include:

  • Headaches and migraines
  • Nasal congestion and sneezing
  • Skin rashes and itching
  • Digestive problems such as nausea, diarrhea, and abdominal pain
  • Flushing and redness of the skin
  • Fatigue and brain fog

These symptoms can be mild or severe and can occur within a few minutes to several hours after consuming histamine-rich foods or beverages. In some cases, the symptoms may be delayed and may not appear until several hours or even days later.

It’s important to note that these symptoms can be similar to those of other conditions, such as food allergies, so it’s important to get a proper diagnosis from a healthcare provider. Additionally, some people with histamine intolerance may not experience any symptoms at all or may only experience symptoms intermittently.

Histamine intolerance can have several contributing factors, including genetics, diet, and gut health. Here are some of the main causes of histamine intolerance:

  • Reduced activity of the DAO enzyme: One of the main enzymes responsible for breaking down histamine in the body is diamine oxidase (DAO). Some people may have a genetic predisposition to reduced DAO activity, which can lead to histamine intolerance.
  • Histamine-rich foods: Consuming foods that are naturally high in histamine, such as aged cheeses, cured meats, and fermented foods like sauerkraut and kombucha, can lead to an excess of histamine in the body.
  • Alcohol: Many types of alcoholic beverages, such as beer and wine, contain high levels of histamine and can trigger symptoms in people with histamine intolerance.
  • Medications: Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and some antidepressants, can interfere with the body’s ability to break down histamine and may worsen symptoms of histamine intolerance.
  • Gut health: The health of the gut microbiome can also play a role in histamine intolerance. Conditions that disrupt the gut microbiome, such as small intestinal bacterial overgrowth (SIBO), can lead to increased histamine production and impaired histamine breakdown.

It’s important to note that other conditions, such as coeliac disease and leaky gut syndrome, can also contribute to histamine intolerance as a secondary effect.

Diagnosing histamine intolerance can be challenging, as there is no definitive test that can confirm the condition. However, there are several tests that can be done to help diagnose it, such as blood tests to measure histamine levels and DAO (diamine oxidase) levels, as well as urine tests to measure histamine metabolites.

However, relying solely on test results can be misleading, as histamine levels can fluctuate depending on many factors, such as diet, stress, and medication use. Therefore, keeping a symptom journal is an important tool for diagnosing histamine intolerance.

A symptom journal involves tracking your symptoms over a period of time and noting any potential triggers, such as certain foods, medications, or environmental factors. By keeping a detailed record of your symptoms, you and your healthcare provider can better understand the underlying cause of your symptoms and determine if histamine intolerance is a possible explanation.

It’s important to work with a healthcare provider who is knowledgeable about histamine intolerance, as they can help you interpret your symptom journal and test results, and develop an appropriate treatment plan.

In addition to medical tests and symptom tracking, it’s also important to rule out other conditions that can cause similar symptoms, such as food allergies, autoimmune disorders, and gastrointestinal disorders. Your healthcare provider may recommend additional tests or referrals to specialists, such as an allergist, gastroenterologist, or immunologist, to help with diagnosis.

Overall, while diagnosing histamine intolerance can be challenging, a combination of medical tests, symptom tracking, and ruling out other conditions can help provide a clearer picture of whether histamine intolerance is the cause of your symptoms.

The goal of treating histamine intolerance is to reduce the intake of histamine from food and other sources, as well as to manage symptoms. The following approaches may be helpful:

  1. Histamine-restricted diet: A low-histamine diet involves avoiding foods that are high in histamine, as well as those that can trigger the release of histamine, such as alcohol, fermented foods, and certain fruits and vegetables. Working with a registered dietitian who is knowledgeable about histamine intolerance can help ensure that you’re getting all the nutrients you need while following a low-histamine diet.
  2. Supplements: Supplements such as DAO (diamine oxidase) and vitamin C can help improve histamine metabolism and reduce symptoms. Probiotics and prebiotics may also be helpful for improving gut health.
  3. Medications: Antihistamines and mast cell stabilizers can be helpful for managing symptoms, although they may not be effective for everyone. Your healthcare provider can help determine which medications may be appropriate for you.
  4. Stress management: Stress can trigger the release of histamine, so stress management techniques such as meditation, deep breathing, and yoga may be helpful for reducing symptoms.

It’s important to note that everyone’s experience with histamine intolerance is different, and what works for one person may not work for another. It may take some trial and error to find the right combination of treatments that work for you.

While some people may be genetically predisposed to histamine intolerance, there are several steps you can take to reduce your risk of developing it. These include:

  1. Eating a balanced diet: Consuming a variety of nutrient-dense foods can help support overall health and reduce inflammation, which may help reduce the risk of histamine intolerance.
  2. Reducing histamine intake: Avoiding or limiting foods that are high in histamine, such as aged cheeses, cured meats, and fermented foods, may help reduce the risk of developing histamine intolerance.
  3. Maintaining gut health: Taking care of your gut health through a healthy diet, probiotics, and prebiotics may help improve histamine metabolism and reduce symptoms.

Histamine intolerance is a complex condition that can be challenging to diagnose and treat, but with the right approach, it can be managed effectively. If you suspect you may have histamine intolerance, it’s important to work with a healthcare provider who is knowledgeable about this condition to determine the underlying cause of your symptoms and develop an appropriate treatment plan.

By following a low-histamine diet, taking supplements, managing stress, and maintaining gut health, you can reduce your risk of developing histamine intolerance and manage your symptoms effectively. Remember to be patient with yourself and to work closely with your healthcare provider to find the right treatment approach for you.

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