Histamine intolerance - symptoms, causes, therapies

Histamine intolerance is a metabolic or breakdown disorder of histamine, a biogenic amine that is naturally contained in animal and plant cells, but is also taken in through food. It is involved in many (metabolic) processes in the body.

These include appetite, sleep-wake rhythm, learning ability, concentration and memory – and even our emotions. In addition, histamine acts as a tissue hormone and as a neurotransmitter. It stimulates our gastric acid secretion and has a vasodilator effect, but histamine also plays a central role as a mediator in inflammation, allergic reactions, bronchial asthma, hay fever or hives.

Histamine breakdown, histamine levels and the histamine bucket

The enzyme diamine oxidase (DAO) in the small intestine and histamine N-methyltransferase (HNMT), which is located in the liver, the bronchial mucosa and the central nervous system (CNS), are primarily responsible for breaking down histamine. Both can have their functions disrupted by various factors. For example, consuming histamine-rich food or the release of too much histamine from mast cells can lead to an increased "histamine level" in the blood. This condition is also called histamine intolerance.

Unlike an allergy, symptoms only occur when a certain level of histamine in the body is exceeded. We call it the "histamine bucket", which then overflows. This imbalance or dysregulation of histamine breakdown can lead to a wide range of symptoms in the body, because if there is an excess of histamine, an increased amount of histamine enters the bloodstream and distributes throughout the body.

Symptoms of histamine intolerance – many symptoms are possible, from nausea and migraines to depression

We all take in histamine through food and each of us also produces histamine in the body's own mast cells – and that is a good thing. Because histamine is involved in many important metabolic and regulatory processes, such as our sleep-wake rhythm. In addition, it influences our appetite, our emotions, our memory and our learning ability and regulates a part of our hormone balance.

However, if our histamine metabolism is disrupted and we have too much histamine in the body, a wide range of symptoms can occur that can limit our well-being on a physical and mental level.

You can find out what symptoms histamine intolerance can cause and how best to deal with them in our detailed article on histamine intolerance symptoms.. Enjoy browsing!

Histamine symptoms can vary greatly in their type and intensity: possible symptoms of histamine intolerance

Gastrointestinal tract:
Nausea, stomach cramps, bloating, constipation, diarrhea, intestinal cramps

Skin:
Itching, hives, nettle rash, swelling, skin redness, extreme reactions to insect bites, acne, skin blemishes, rash

Autonomic nervous system:
Difficulty concentrating, memory problems, brain fog, drowsiness, exhaustion, insomnia, loss of appetite or constant hunger, tingling in the limbs, headaches, inner restlessness

Cardiovascular system:
Low blood pressure, dizziness, hot flashes, nausea, palpitations, heart rhythm disorders

Respiratory tract:
Sore throat, runny nose, stuffy nose, cough, increased mucus production, feverish feeling

Psychological:
Depression, depressive moods, seasonal affective disorder, mood swings, states of exhaustion

Other:
Increased PMS symptoms, recurrent bladder infections, muscle tension, hypersensitivity. 

Sources:
Dirk Schweigler: Histamine intolerance from a completely new perspective
Swiss Interest Group Histamine Intolerance (SIGHI)
Nutrition & Medicine: Dietary therapy of histamine intolerance

Diagnosis of histamine intolerance – why a dietary change is the best way to make a diagnosis

Making a diagnosis is not that easy, because unfortunately histamine intolerance cannot currently be tested medically with certainty, as there is no value that is 100% conclusive. The easiest way here is a dietary change to a low-histamine diet.

But why is that?
There are various methods with which the concentration or activity of histamine or the histamine-breaking down enzyme diamine oxidase (DAO) in the body can be measured. However, the determination of the concentration of the enzyme diamine oxidase (DAO) in the blood is most commonly used to diagnose histamine intolerance. However, the conclusiveness of this test is rather limited, as the production of the enzyme can be subject to large fluctuations over time due to external influences.

The DAO value in the blood actually hardly allows any conclusions as to whether too little DAO is also being produced in the intestine. Another testing option is, among others, the measurement of histamine in the stool, but here no certain diagnosis can be made, but rather the statement "histamine intolerance likely" or "unlikely" can be made. 

The elimination diet
To be completely sure whether you suffer from histamine intolerance, the elimination diet is best suited. For this, you avoid histamine-rich foods for approx. 4-12 weeks and monitor your symptoms. It is also recommended to keep a food-symptom diary.

Based on the symptoms, a therapist can then identify the foods that trigger the symptoms.

Histamine-free diet – unfortunately, histamine-free does not exist

Eating completely histamine-free is hardly possible, as almost every food contains histamine in small amounts. It is important that you avoid "histamine bombs" such as alcohol, tomatoes, chocolate, sauerkraut, aged cheese or smoked ham. You can find a list of low-histamine foods here. If your symptoms improve during this period, it is very likely that you are affected by histamine intolerance. If your suspicion of histamine intolerance is confirmed, it is important to change your diet in the long term and find out or address the causes.

Especially at the beginning of a low-histamine diet, it can be helpful to have suitable foods and products at hand. With our HistaStarter-Set, you receive a carefully curated selection that can make it easier for you to start your daily life with histamine intolerance.

What to do if your symptoms do not improve despite the elimination diet?
If your symptoms hardly or not at all improve through a strict low-histamine diet, there is probably another cause. In this case, further medical tests are recommended. For example, contact your family doctor, internist, naturopathic doctor or allergist to have other possible triggers for your symptoms investigated.

Diseases with similar symptoms can be, for example:

• Mast cell activation disorder (MCAS)
• other food intolerances (gluten, lactose, fructose, sorbitol, salicylate, lactate, oxalate)
• Food allergies or cross allergies
• SIBO (small intestinal bacterial overgrowth)
• Heliobacter Pylori and E.Coli
• Leaky Gut Syndrome
• HPU / KPU (metabolic disorder)

In conclusion, it can be said that if the following points apply, histamine intolerance is relatively certain:

• You have at least two symptoms that are typical for histamine intolerance
• The symptoms overall improve through a strict low-histamine diet
• Acute symptoms subside after taking antihistamines

To get an initial assessment of whether you could be affected by histamine intolerance, we can recommend our free 2-minute histamine test. Important: This test does not replace a medical diagnosis.

 

Causes of histamine intolerance – and what your hormones, your intestine or your liver may have to do with it

The causes of histamine intolerance can be just as varied and extensive as its symptoms. For this reason, it is often a real challenge for doctors and those affected to make the diagnosis of histamine intolerance – and to find out the causes.

These are possible causes of histamine intolerance:

1. Disrupted intestinal metabolism

• Leaky Gut
• Dysbiosis
• SIBO
• Candida
• Gastrointestinal infection

2. Disrupted liver metabolism

• Heavy metal exposure
• Sluggish liver
• Fatty liver

3. Hormonal imbalance

• Estrogen dominance
• Puberty, pregnancy, menopause

4. Disrupted thyroid metabolism

• Hashimoto

5. Other causes

• Nutrient deficiency (e.g. vitamin B6)
• Medication intake (e.g. antibiotics)
• Bacteria, such as Heliobacter Pylori or E.coli
• Unbalanced diet
• Unstable cervical spine or CMD
• Stress

Would you like to understand histamine intolerance better?

With all the information, it can be difficult to keep an overview. Our histamine masterclass helps you to deepen your knowledge step by step and better understand the connections. You can expect easy-to-understand explanations, practical tips for your daily life as well as workbooks for reading up and deepening your knowledge.

Treatment of histamine intolerance – why a low-histamine diet is the basis for greater well-being

Perhaps you were sent home by the doctor after the diagnosis with the sentence "Histamine intolerance is not curable, you have to live with it." We could not come to terms with this statement even back then and started researching.

Today we can give you hope based on our studies, our training and experiences. You can do something about histamine intolerance and become symptom-free again through certain tools. In addition, histamine intolerance even has the potential for healing, but here it always depends on the cause(s)!

Possible causes and therapies
The most common cause of histamine intolerance lies in our metabolism, so it mostly affects the intestine, the liver and the thyroid. In addition, medication, stress or high psychological and physical stress have a major influence on our histamine level as well as on our digestion and metabolism. It is therefore important to view and address histamine intolerance holistically on different levels.

In addition to conventional "therapy" through antihistamines as well as a low-histamine diet, we have developed a holistic approach through which you can tackle the causes at the root and become sustainably symptom-free.

You do not have to accept your current condition any longer, but can actively work on your health and experience improvement!

Learn more about the next steps now!

These three steps are essential to become symptom-free again despite your histamine intolerance

Histamine intolerance is an acquired (or sometimes also congenital) non-immunological metabolic disorder, which in the vast majority of cases is based on one or more underlying causes. We therefore want to encourage you to address your histamine intolerance holistically and in a natural way.

Because we stood – just like you – at the point where we no longer wanted to accept our diagnosis and symptoms as a permanent condition. We therefore researched, studied and gathered experiences for years – and found a way to become symptom-free – and even to eat histamine-rich food again without problems.

To this end, you can take the following steps:

1. Dietary change

2. Cause identification

3. Natural metabolic relief

Learn now how to achieve greater symptom relief in a few steps – and take your health back into your own hands.

1. Dietary change

The dietary change towards a low-histamine and anti-inflammatory diet is the first step towards greater symptom relief and is essential for the relief of symptoms. Here, you should avoid the following food groups:

• Histamine-rich foods (e.g. ham, red wine or Parmesan)
• Histamine liberators (e.g. citrus fruits or cocoa)
• Foods with competing biogenic amines (e.g. bananas)
• DAO inhibitors (e.g. alcohol)

At the beginning of the dietary change, a elimination phase of 4-12 weeks should be implemented to keep the histamine level low in the long term. During this phase, all food groups should be avoided that are either histamine-rich, considered liberators, contain other biogenic amines or can inhibit DAO. You can end the elimination phase if you are symptom-free for at least one week. It is also not unhealthy for the body if the elimination phase lasts longer than 12 weeks.

After this phase, you can gradually integrate new foods to see which foods are tolerable for you. You can find a food list here.

Please note that this food list only serves as a rough overview and does not have to apply to every body. The tolerability of foods in histamine intolerance is very individual. To find out which foods you tolerate well and which you do not, you can keep a food-symptom diary.

2. Cause identification

Histamine intolerance can have various causes. As long as histamine intolerance is not genetically determined (enzyme defect from birth), it is acquired and can be improved or even disappear again with a targeted therapy of the causes.

For cause identification, it is first important to know where histamine breakdown mainly takes place in the body.
There are two main enzymes for this that break down histamine into an inactive histamine breakdown product:

• Diamine oxidase (DAO): located, among others, extracellularly (unprotected outside the cell) in the intestine
• Histamine N-methyltransferase (HNMT): located, among others, intracellularly (protected inside the cell) in the liver

Since DAO is particularly susceptible to external influences, the first possible cause is found in the intestine. Here there are the following disorders and diseases that can reduce DAO activity or histamine breakdown, which you can have tested by a gastroenterologist, internist or naturopathic doctor:

• Gastrointestinal infection
• Leaky Gut (permeable intestinal mucosa)
• Intestinal flora dysbiosis (imbalance of intestinal bacteria)
• SIBO/IMO (small intestinal bacterial overgrowth)
• Candidiasis (yeast infection)
• Viral infections (e.g. Covid-19 or Epstein-Barr virus)
• Bacterial infections (e.g. Helicobacter Pylori or E.coli)

Furthermore, the activity of HNMT can be restricted by certain factors:

• Liver overload
• Heavy metal exposure
• Fatty liver

One reason why women are particularly affected by histamine intolerance is the hormones. You can have a hormonal imbalance tested by a gynecologist or endocrinologist. In this context, a metabolic disorder of histamine can arise in the following phases:

• Puberty
• Pregnancy
• Menopause
• in other hormonal fluctuations

In addition, the following influences and behaviors can inhibit histamine breakdown or metabolism:

• Medication
• Allergies/cross-allergies
• unbalanced diet (e.g. processed foods, fast food, nutrient-poor foods)
• nutrient deficiency
• lack of exercise
• unstable cervical spine or TMD
• stress

3. Metabolic Relief

Since acquired histamine intolerance is due to an overloaded metabolism in the vast majority of cases, in addition to a low-histamine diet, we recommend intensively supporting the main metabolic organs responsible for histamine breakdown. The first main enzyme for histamine breakdown, diamine oxidase (DAO), is located, among other places, extracellularly (i.e. unprotected from external influences and changes) in the intestine. The second main enzyme, histamine N-methyltransferase (HNMT), is located intracellularly (protected), among other places, in the liver. These two organs should therefore absolutely be brought back into balance. To this end, we follow the sequence below:

1. Detoxification of the metabolic organs (intestine and liver)
2. Intestinal restoration (prebiotics, probiotics, intestine-specific diet)
3. Liver support (liver-specific diet and supportive supplements)

If you want to specifically focus on a combination of a low-histamine diet and selected dietary supplements for histamine intolerance, our DarmFit-Set could be just right for you. It combines Bio BioticFit, MucosaFit and DaoFit in one practical set.