Histamine intolerance diagnosis: What happens next?
The path to a histamine intolerance diagnosis is often very long, and there are many different ways to reach a diagnosis. In the following blog article, you will find some tips and guidance for your first steps after receiving a diagnosis.
What is a histamine intolerance?
A histamine intolerance (HIT), also known as histaminosis or histamine sensitivity, is a metabolic disorder or impaired breakdown of histamine. Histamine is a biogenic amine that is naturally contained in both animal and plant cells and can also be produced and released by our own bodies.
TIP: If you would like more basic information about histamine intolerance, it is best to check out the article "Histamine Intolerance – Symptoms, Causes & Therapies" on our website.
Histamine is primarily broken down via the DAO enzyme (diamine oxidase), which is located in the small intestine. There is a second enzyme, located in the liver, the bronchial mucosa, and the central nervous system: histamine N-methyltransferase (HNMT).
Even though there are two main enzymes responsible for the breakdown of histamine, the "histamine barrel" can still overflow, meaning there is more histamine in the body than can currently be broken down. This can have various causes.
How a histamine intolerance is diagnosed
Because the symptoms of a histamine intolerance can manifest in many different ways, reaching a diagnosis is unfortunately not as simple as it is for lactose, fructose, or gluten intolerance. This is because, regrettably, histamine intolerance cannot currently be reliably tested medically, as there is no single value that is 100% conclusive. Therefore, doctors generally provide the diagnosis of "HIT probable or improbable."
You can currently be tested for the following values:
- Histamine level in blood and stool
- DAO level in blood, stool, or urine
- HNMT level in urine
- Histamine breakdown products in urine
- THAK value: Total Histamine Degradation Capacity in the blood
Diagnosis via elimination diet
To be sure whether you suffer from a histamine intolerance, it is recommended to carry out an elimination diet in addition to the laboratory diagnostic findings with the doctor you trust. For this purpose, you avoid histamine-rich foods for at least 4-8 weeks and observe the progression of your symptoms.
With an elimination diet, it can also be helpful to keep a food and symptom diary, as other biogenic amines can also cause severe discomfort. You can also find a helpful list of low-histamine and high-histamine foods here.
Your first steps after the diagnosis
Feeling overwhelmed after a histamine intolerance diagnosis is absolutely normal. Below you will find a step-by-step guide that will help you master the first phase after the diagnosis well.
Step 1: Remove histamine triggers
First, you should switch your diet to a low-histamine and anti-inflammatory diet. You should avoid histamine-rich foods such as ham or red wine, histamine liberators such as citrus fruits or cocoa, foods with competing biogenic amines such as bananas, and DAO inhibitors such as alcohol. To support you in this, you can find a list of low-histamine foods and many delicious low-histamine recipes here.
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Another important factor is adjusting your entire lifestyle; you should keep the following things in mind:
- Reduce stress in everyday life
- Get enough sleep: approx. 7-9 hours
- Observe the extent to which exercise has a negative influence on your symptoms and reduce it if necessary
- Avoid extreme heat and cold
- Drink enough water (histamine is water-soluble, so drinking water can help flush out some of the excess histamine.)
Step 2: Researching the causes
A histamine intolerance can be genetically determined as well as acquired during the course of life. If it was acquired during the course of life, it can improve with targeted therapy of the underlying causes and may even disappear completely. In most cases, those affected have a disorder of one of the two or both enzymes responsible for histamine breakdown. These are, on the one hand, the DAO (diamine oxidase) and, on the other hand, the HNMT (histamine-N-methyltransferase).
The following disorders and diseases can reduce DAO activity:
- Gastrointestinal infection
- Leaky gut (permeable intestinal mucosa)
- Intestinal flora dysbiosis (imbalance of intestinal bacteria)
- SIBO (small intestinal bacterial overgrowth)
- Candidiasis
- Infections
- Overgrowth of histamine-producing and disease-promoting bacteria
- Parasites
- Liver overload or fatty liver
- Reactivated viruses (e.g., EBV)
- Nutrient deficiency
- Medications
- Allergies
- Asthma
- Autoimmune diseases
- Inflammatory diseases such as rheumatism
- Nutrient deficiency
- Lack of exercise
- Stress
At this point, it is important to mention that the symptoms can be very diverse. They can occur individually, but also in combination. Therefore, you should approach things thoroughly.
Step 3: Getting to the root of the causes
In addition to a low-histamine diet, it is sensible to support the main metabolic organs for the breakdown of histamine: the gut and the liver.
With the following tips, you can relieve and detoxify your metabolic organs:
- Use natural low-histamine foods, such as fruits, vegetables, nuts, and seeds
- Avoid processed products
- Avoid industrial sugar and added sugars
- Reduce stress
To strengthen the gut after relieving and detoxifying it, we recommend a gut-specific low-histamine diet, the use of prebiotic foods, avoidance of industrial sugar and added sugars, the use of low-histamine bacterial strains, and reducing stress in everyday life.
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BioticFit S is vegan, lab-tested, and contains no unnecessary additives. Furthermore, it is suitable for a low-histamine, low-fructose, gluten-free, and lactose-free diet.
To support the liver in the long term, we recommend the use of unprocessed foods, a reduction of animal-based foods, a reduction of fats in the morning or evening, and the use of antiviral foods.
Conclusion
In summary, receiving a histamine intolerance diagnosis can be very overwhelming for those affected. However, with the right approach, the path after the diagnosis can be made much easier. In the beginning, it is important to remove histamine triggers from your everyday life; after that, you should begin researching the causes, and finally, get to the root of the causes and treat them holistically to ensure improved well-being.
Sources
- https://www.ndr.de/ratgeber/gesundheit/Histaminintoleranz-erkennen-und-behandeln,histamin100.html
- Histamine Intolerance Cookbook & Guide
- n.a. (2018): Histamine intolerance. (online) Available at:
https://www.gesundheit.gv.at/krankheiten/stoffwechsel/nahrungsmittelunvertraeglichkeit/histaminintoleranz.html#:~:text=die%20Diagnose%20gestellt%3F-,Wie%20wird%20die%20Diagnose%20gestellt%3F,bei%20der%20Diagnosestellung%20einer%20Histaminintoleranz, last accessed on 16.07.22 - Schönefeld, Gernot/ Schröder, Andreas (2021): Histamine intolerance. (online) Available at:
https://dasgastroenterologieportal.de/Histaminintoleranz.html, last accessed on 16.07.22.
