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Histamine intolerance diagnosis: What happens next?

The path to a histamine intolerance diagnosis is often very long, and there are many different diagnostic methods. In the following blog article, you'll find some tips and support for your first steps after diagnosis.

What is histamine intolerance?

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 occurs naturally in both animal and plant cells and can also be produced and released by our bodies .

TIP: If you would like to know more (basic) information about histamine intolerance, it is best to take a look at the article " Histamine Intolerance - Symptoms, Causes & Therapies " on our website.

Histamine is primarily broken down by the DAO enzyme (diamine oxidase), which is located in the small intestine. There is also a second enzyme, histamine N-methyltransferase (HNMT), which is found in the liver, bronchial mucosa, and central nervous system.

Even though there are two main enzymes responsible for breaking down histamine, it's possible for the "histamine barrel" to overflow, meaning there's too much histamine in the body for it to break down. This can have various causes.

Hands over belly

This is how histamine intolerance is diagnosed.

Because the symptoms of histamine intolerance can be so varied, diagnosis is unfortunately not as straightforward as with lactose, fructose, or gluten intolerance . Currently, there is unfortunately no reliable medical test for histamine intolerance, as no single value is 100% conclusive. Therefore, doctors typically diagnose "HIT probable or unlikely."

The following values ​​can currently be tested:

  • Histamine levels 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
To obtain the most meaningful diagnosis possible, it is recommended to have several of these values ​​tested.

Diagnosis through elimination diet

To be sure whether you suffer from histamine intolerance, it is recommended that you consult your doctor about your lab results and try an elimination diet . For this, you would avoid histamine-rich foods for at least 4-8 weeks and monitor how your symptoms develop.

When following an elimination diet, it can also be helpful to keep a food and symptom diary, as other biogenic amines can also cause severe symptoms. You will also find a helpful list of low-histamine and high-histamine foods here.

Fruits and vegetables as the basis of an elimination diet

Your first steps after diagnosis

Feeling overwhelmed after a histamine intolerance diagnosis is perfectly normal. Below you'll find a step-by-step guide to help you navigate the initial phase after your diagnosis .

Step 1: Remove histamine triggers

First, you should switch to a low-histamine and anti-inflammatory diet . This means avoiding high-histamine foods like ham or red wine, histamine liberators like citrus fruits or cocoa, foods with competing biogenic amines like bananas, and DAO inhibitors like alcohol. To help you with this, you'll find a list of low-histamine foods and many delicious low-histamine recipes here.

Another important factor is adjusting your entire lifestyle ; you should consider the following things:

  • Reduce stress in everyday life
  • Get enough sleep: approximately 7-9 hours
  • Observe how much exercise negatively affects your symptoms and reduce it if necessary.
  • Avoid extreme heat and cold
  • Drink plenty of water (histamine is water-soluble, so drinking water can flush out some of the excess histamine).


Step 2: Root cause analysis

Histamine intolerance can be genetic or acquired later in life . If acquired later in life, targeted treatment of the underlying causes can improve and even resolve it completely. In most cases, those affected have a deficiency in one or both of the enzymes responsible for histamine breakdown. These are DAO (diamine oxidase) and HNMT (histamine N-methyltransferase).

The following disorders and diseases can reduce DAO activity:

  • Gastrointestinal infection
  • Leaky gut (increased intestinal permeability)
  • Intestinal flora dysbiosis (imbalance of intestinal bacteria)
  • SIBO (small intestinal bacterial overgrowth)
  • Candidiasis
  • Infections
  • Overgrowth of histamine-producing and disease-promoting bacteria
  • parasites
The following factors can restrict HNMT activity:
  • Liver overload or fatty liver
  • Reactivated viruses (e.g. EBV)
  • Nutrient deficiency
Additionally, the following influences and behaviors can inhibit histamine breakdown or promote histamine release:
  • Medications
  • Allergies
  • asthma
  • Autoimmune diseases
  • Inflammatory diseases such as rheumatism
  • Nutrient deficiency
  • Lack of exercise
  • stress

It's important to mention at this point that the symptoms can be very diverse. They can occur individually or in combination . Therefore, you should carefully investigate the cause.

Woman lies in bed with her hands over her face

Step 3: Tackling the root causes

In addition to a low-histamine diet, it is advisable to support the main metabolic organs for the breakdown of histamine: the intestines and the liver.

The following tips can help you relieve and detoxify your metabolic organs:

  • Opt for natural, low-histamine foods such as fruits, vegetables, nuts, and seeds.
  • Avoid ready-made products
  • Avoid refined sugar and added sugars
  • Reduce stress

To strengthen the gut after relief and detoxification, we recommend a gut-specific low-histamine diet , the use of prebiotic foods , avoidance of refined sugar and sugar additives , the use of low-histamine bacterial strains , and the reduction of everyday stress.

To sustainably support the liver, we recommend the use of unprocessed foods , a reduction in animal products, a reduction in fats in the morning or evening, and the use of antiviral foods.

Conclusion

In summary, a histamine intolerance diagnosis can be very overwhelming for those affected. However, with the right approach, the journey after diagnosis can be made considerably easier. Initially, it's important to eliminate histamine triggers from daily life. Next, you should investigate the underlying causes and finally address them holistically to improve your well-being.


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