Histamine Intolerance

Histamine intolerance is when your body has trouble breaking down histamine. Histamine is a chemical your body makes on its own. Many foods also have it. Your body uses it to help with digestion. You also use it to help with your immune response and nerves. This is different from food allergies. Those are usually the immune system overreacting. Research on this condition is ongoing.

Symptoms

Histamine intolerance can look like other conditions. The symptoms overlap with allergies, digestive issues or skin conditions. You’ll probably see symptoms after you eat.

Common histamine intolerance symptoms:

  • Headaches
  • Migraines
  • Flushed skin
  • Hives
  • Itching
  • Runny nose
  • Stuffy nose
  • Bloating
  • Belly pain
  • Diarrhea
  • Nausea
  • Fast heartbeat
  • Dizziness
  • Watery eyes
  • Feeling tired

The pattern is different with each person. You may mainly notice headaches and congestion. Another person might have more stomach-related symptoms. Some women also find that symptoms change around their monthly cycle.

Causes

Histamine breaks down in your gut. An enzyme called DAO plays a major role. When your body does not make enough DAO, it can build up. This can also happen if the enzyme is not working well.

Possible contributing factors:

  • Genetics. Some people may make less DAO. Or they may make enzymes that do not work well.
  • Gut problems. Conditions that irritate or damage the gut can affect DAO. Examples might be inflammatory bowel disease or celiac disease.
  • Certain medicines. Some medications can affect how well DAO works. These can be water pills, pain pills or other meds.
  • Diet. If you eat too many foods with high levels of histamine, you can overwork your body.
  • Gut bacteria. If the bacteria in your gut are out of balance, this can increase histamine production in your body.

Alcohol can be another factor. Alcohol can contain histamine. It blocks DAO from doing its job.

Foods That Can Trigger Symptoms

Some foods naturally have more histamine. Others may not contain much of it. But they can still signal the body to release more of it. You may hear these foods called “histamine liberators.”

Foods with more histamine:

  • Aged cheeses
  • Cured meats
  • Smoked meats
  • Fermented foods
  • Alcohol
  • Vinegar
  • Pickled foods
  • Fish

Fish that is not fresh usually has more of it. Wine and beer are usually types of alcohol with higher levels.

Foods that may trigger histamine release:

  • Tomatoes
  • Spinach
  • Eggplant
  • Avocado
  • Citrus fruits
  • Strawberries
  • Chocolate
  • Nuts

Freshness can matter with more than just fish. Not every food may be a problem for every person. It’s helpful to notice the kinds of foods that lead to symptoms.

Diagnosis

There is not a single, simple test for the condition. Remember, the symptoms can seem like several other health issues. Your allergist will probably start by ruling out these other conditions. They might ask you to keep a diary to track your symptoms. You also write down the foods you eat and things you drink. They might also ask you to stop eating foods high in histamine. Your allergist might order a blood test to check DAO levels.

Treatment

Treatment focuses on finding triggers and easing symptoms. It might also address related health issues that are making the problem worse.

Potential treatment:

  • Low histamine diet. A dietitian can help you manage trigger foods and get the nutrients you need.
  • DAO supplements. These are taken before meals. They can help reduce symptoms for some people. However, they should not replace seeing your allergist.
  • Allergy medicines. Certain medication can ease symptoms. Antihistamines are one example.
  • Treating other conditions. Taking care of related conditions may help reduce symptoms.
  • Medicine review. Some of your medicine might be affecting your histamine levels. Your allergist can help you figure out if there are any medications you should stop or change.
  • Limiting alcohol may also be part of the treatment plan.

Baptist Health is Here to Help

If you have ongoing symptoms, see your Baptist Health primary care physician. They can help you figure out if you have histamine intolerance. They can also rule out other causes and build a treatment plan that fits your needs.