Are you suffering from histamine intolerance?

If you’re experiencing some unexplained, allergic style symptoms, you may have developed an intolerance to histamine. Symptoms include sinus problems, hives, dizziness, headaches and/or migraines, flushing or itchy skin, heart palpitations or changes in blood pressure. Whilst almost everyone with histamine intolerance experiences bloating, other symptoms are wildly diverse and with no standard testing, it can be difficult to diagnose. And ladies if you experience these symptoms around your period, or indeed very painful periods, it could be because oestrogen and histamine are very closely connected. When oestrogen is elevated, histamine is elevated.

So, what’s going on?

Histamine is an essential chemical produced by our mast cells and basophils which carries out lots of different functions in the body including immune response, hence anti-histamines for over-exuberant histamine in allergies. Histamine is formed when histidine, an amino acid,  meets histidine decarboxylase. This is an enzyme which our bodies produce but is also found in lots of different bacteria which we get from our food.

So far so good. Our bodies use another enzyme in the gut, Diamine Oxidase (DAO), to break down histamine and maintain balance, protecting the gut lining from histamine crossing the barrier and wreaking havoc. But if equilibrium is lost we can become overwhelmed by histamine and build an intolerance to it. This happens because:

1. We consume too much histamine (fermented foods, aged cheeses, deli meats, alcohol, vinegar and chocolate. Oh dear.)

2. We stimulate our own cells to produce too much histamine (citrus foods, strawberries promote this)

3. We have inadequate DAO to break down histamine. Most digestive conditions will reduce DAO. It is also inhibited by drugs including a variety of medications (including things like paracetamol and ibuprofen) and alcohol as well as some foods. 

4. Gut microbiome disturbances leave the gut wall compromised, reducing DAO and opening the gaps between the cells of the gut lining.

Ahhh that explains some of those odd hangover symptoms e.g. sneezing and flushing.

Alcohol is a double whammy when it comes to histamine overload. It both contains histamine and inhibits DAO. Oh and it also damages the gut lining, so triple whammy.

What to do if you suspect this could be you:

As I mentioned before there isn’t a standard test for histamine intolerance and the best way to see if this is the issue for you is to dramatically reduce your histamine intake for 2-3 weeks and see if your symptoms improve.

It’s impossible to go ‘histamine free’. It’s in all foods to a certain extent and in any case we need it for our normal bodily functions. But we can reduce our histamine levels considerably for a period in order to regain balance, we can also work to improve DAO levels and work on healing the gut. If you have a gut condition then you’ll need to work on that at the same time if you are to regain balance.  

Foods that contain high levels of histamine

The moment we harvest a natural food it starts to form histidine decarboxylase, so eating foods in their freshest form possible is key. Freezing and refrigerating slow down the process of enzyme formation, as does freeze drying. So foods frozen at harvest are great as are foods you know are freshly picked. In terms of beans and lentils, use dried beans over canned and eat them as soon as you have cooked them, or freeze them once cooked. Meats and fish should be as fresh as possible. This isn’t the time for batch cooking and leftovers, fermented foods, including things like kombucha, kimchi and sauerkraut are not your friend. In fact forget everything you’ve learnt about gut health and go back to basics. Canned sardines and anchovies with all of their anti-inflammatory powers are out for now!

Foods that stimulate our own histamine production

These foods include citrus fruits, pineapple and strawberries and should be avoided. This sounds very restrictive I know, but how I frame it with clients is to really concentrate on the foods you CAN eat, rather than the foods you are avoiding. Reframe ‘I can’t eat…’ with ‘I’m avoiding… right now because it’s not doing me any favours’. Focus on simple foods, fresh fruits and vegetables, beans and legumes, and fresh fish and meats, whole grains.

And make use of recipes already designed with low histamine in mind rather than trying to adapt old favourites. I’ve added some resources at the end of this blog to give you some ideas. Take the opportunity to discover new foods. For a full list of foods to avoid click here.

Now’s probably a good time to mention that you won’t need to remove these items forever. You can regain tolerance but it does take patience and perseverance. I’d be lying if I said there is a quick fix for this. If, after 2-3 weeks you are feeling much better with diminished symptoms, you can start to reintroduce foods. This is a SLOW process. You need to start with very small quantities of foods. You are in fact training your body to tolerate them, it’s like training for a marathon. You’d feel pretty awful if you started with a 15 mile run. 

Dr Will Bulsiewicz, renowned gastroenterologist and author of Fibre Fuelled, recommends reintroducing foods in this order (see below), starting with very small amounts (like the size of your thumb) and increasing after 3-4 days. If your symptoms return then back off, slow down and try to re-introduce that food later.

1. Citrus fruits, strawberries, papaya, kiwi, pineapple

2. Bananas, plums, mushrooms, spices

3. Nuts, teas, coffee

4. Vinegar, avocado

5. Spinach, tomatoes, aubergine

Go slow, this will take you weeks and months rather than days, but if it means being migraine free, it’s well worth it. In the meantime make sure you are getting all the nutrients you need.

As this protocol is pretty restrictive you might want to work with a nutritional therapist to make sure that you are getting all of the necessary nutrients required. Watch out for magnesium, calcium and iron as well as B6. If you are getting plenty of green leafy vegetable (not spinach) then you’ll have the magnesium, Calcium and iron pretty much covered, but you may want to include a B6 or B complex supplement, particularly since B6 is important for DAO synthesis. It’s important to boost that DAO.

Low histamine foods to up your DAO

1. Fresh meat and fish

2. Most fresh vegetables — except spinach, tomatoes, avocado, and eggplant

3. Most fresh fruit — except citrus and some berries

4. Oils like coconut and olive oil

5. Grains, including rice, quinoa, corn, teff, and millet

If this is ringing some bells then experiment with reducing your histamine intake and boosting your DAO and see if you note a difference. If you’re struggling you might want to get a professional on board to help you out. While such a strict restriction is aimed at people who have lost tolerance for histamine I do think histamine build up is something for us all to be aware of especially if you experience some of these symptoms from time to time, have difficult periods or are peri-menopausal. Alcohol is an offender to be particularly aware of and it’s something that we tend to overdo. If you sometimes experience mild symptoms or notice them after particular bouts of eating or drinking, you may want to be more conscious of your histamine intake in order to soften symptoms without needing to follow a very strict diet.

Resources:

List of foods to avoid on a low histamine protocol

Recipes: The Fibre Fuelled Cookbook, Dr Will Bulsiewicz

Recipes: https://www.throughthefibrofog.com/low-histamine-recipes/

Recipes: BBC Good Food

Recipes: Happy without histamine