Histamine intolerance - symptoms, causes, therapies

Histamine intolerance is a metabolic or degradation disorder of histamine, a biogenic amine that is naturally found in animal and plant cells and is also ingested 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 a neurotransmitter. It stimulates our gastric acid secretion and has a vasodilating effect. Histamine also plays a central role as a mediator in inflammatory processes in the body, such as allergic reactions, bronchial asthma, hay fever, or hives.

Histamine degradation, histamine levels, and histamine barrel

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

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

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

We all ingest histamine through food, and each of us also produces histamine in our body's mast cells – and that's a good thing. Because histamine is involved in many important metabolic and regulatory processes, such as our sleep-wake rhythm. It also affects our appetite, our emotions, our memory, and our ability to learn, and regulates part of our hormone balance.

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

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

Histamine symptoms can vary greatly in their nature and intensity: possible symptoms of histaminosis

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

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

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

Cardiovascular system:
Low blood pressure, dizziness, sweating, nausea, racing heart, heart rhythm disturbances

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

Psychology:
Depression, depressive moods, winter depression, mood swings, states of exhaustion

Further:
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: Nutritional therapy for histamine intolerance

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

Diagnosis is not that easy, because histamine intolerance cannot currently be reliably tested medically, 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 that can be used to measure the concentration or activity of histamine or the histamine-degrading enzyme diamine oxidase (DAO) in the body. Most often, however, the determination of the concentration of the enzyme diamine oxidase (DAO) in the blood is used to diagnose histamine intolerance. However, the informative value of this test is rather limited, as the production of the enzyme can be subject to large temporal fluctuations due to external influences.

The DAO value in the blood also hardly allows any conclusions as to whether too little DAO is produced in the intestine. Another testing option is, among other things, the measurement of histamine in stool, but a reliable diagnosis cannot be made here; rather, the statement "histamine intolerance probable" or "improbable" can be made. 

The elimination diet
To be absolutely sure whether you suffer from histamine intolerance, the elimination diet is best. For this, you should avoid histamine-rich foods for about 4-12 weeks and observe your symptoms. It is also advisable to keep a food-symptom diary.

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

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

It is almost impossible to eat a completely histamine-free diet, as almost every food contains small amounts of histamine. It is important to avoid "histamine bombs" such as alcohol, tomatoes, chocolate, sauerkraut, mature cheese or smoked ham. A list of low-histamine foods can be found 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 to find and eliminate 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 get a carefully selected assortment that can make it easier for you to get started with everyday life with histamine intolerance.

What to do if your symptoms do not improve despite the elimination diet?
If your symptoms do not improve significantly or at all with a strictly low-histamine diet, another cause is likely. In this case, further medical tests are recommended. For example, consult your family doctor, internist, naturopath, or allergist to have other possible triggers for your symptoms investigated.

Diseases with similar symptom profiles can be, for example:

• Mast Cell Activation Syndrome (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, if the following points apply, histamine intolerance is relatively certain:

• You have at least two symptoms typical of histamine intolerance
• Symptoms generally improve with a strictly low-histamine diet
• Acute symptoms subside after taking antihistamines

To get a first assessment of whether you might 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 gut, or your liver can have to do with it

The causes of histamine intolerance can be as diverse and extensive as its symptoms. For this reason, it is often a real challenge for doctors and affected individuals to diagnose histamine intolerance – and to find out the causes.

These are possible causes of histamine intolerance:

1. Disturbed intestinal metabolism

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

2. Disturbed liver metabolism

• Heavy metal burden
• Sluggish liver
• Fatty liver

3. Hormonal imbalance

• Estrogen dominance
• Puberty, pregnancy, menopause

4. Disturbed 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 TMD
• Stress

Therapy for histamine intolerance – why a low-histamine diet is the basis for more well-being

Perhaps after the diagnosis, you were sent home by the doctor with the sentence "Histamine intolerance is incurable, you have to live with it." We couldn't agree with this statement back then and started researching.

Today, based on our studies, training, and experience, we can give you hope. 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 this always depends on the cause(s)!

Possible causes and therapies
The most common cause of histamine intolerance lies in our metabolism, mostly affecting the intestines, liver, and thyroid. In addition, medication, stress, or high psychological and physical burdens have a great influence on our histamine levels as well as on our digestion and metabolism. It is therefore important to approach histamine intolerance holistically on different levels.

In addition to conventional "therapy" with antihistamines and a low-histamine diet, we have developed a holistic approach that allows you to tackle the root causes and become sustainably symptom-free.

You no longer have to accept your current condition, 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 congenital) non-immunological metabolic disorder, which in most cases is based on one or more deep-seated causes. We would therefore like to encourage you to approach your histamine intolerance holistically and naturally.

Because we – just like you – were also at the point where we no longer wanted to accept our diagnosis and symptoms as a permanent condition. That's why we spent years researching, studying, and gaining experience – and found a way to become symptom-free – and even to be able to eat histamine-rich food again without problems.

You can take the following steps:

1. Dietary change

2. Identifying the causes

3. Natural metabolic relief

Learn now how you can achieve more symptom-free living in just a few steps – and take your health back into your own hands.

1. Dietary change

The change in diet to a low-histamine and anti-inflammatory diet is the first step towards greater well-being and essential for alleviating symptoms. Here, the following food groups should be avoided:

• 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 cessation phase of 4-12 weeks should be observed to keep histamine levels low in the long term. During this phase, all food groups that are either histamine-rich, considered liberators, contain other biogenic amines, or can inhibit DAO should be avoided. You can end the cessation phase when you have been symptom-free for at least one week. It is also not unhealthy for the body if the cessation phase lasts longer than 12 weeks.

After this phase, you can gradually integrate new foods to see which foods you tolerate. You can find a list of foods here.

Please note that this food list is only a general overview and does not necessarily apply to everyone. 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. Identifying the causes

Histamine intolerance can have various causes. Unless histamine intolerance is genetically determined (enzyme defect from birth), it is acquired and can improve or even disappear with targeted therapy of the causes.

To identify the causes, it is first important to know where histamine is mainly broken down in the body.
There are two main enzymes that break down histamine into an inactive histamine cleavage product:

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

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

• Gastrointestinal infection
• Leaky Gut (permeable intestinal lining)
• 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 in particular are affected by histamine intolerance is hormones. A hormonal imbalance can be tested by a gynecologist or endocrinologist. In this context, a metabolic disorder of histamine can occur 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 intake
• Allergies/cross-allergies
• Unbalanced diet (e.g. convenience foods, fast food, nutrient-poor foods)
• Nutrient deficiencies
• Lack of exercise
• Unstable cervical spine or TMD
• Stress

3. Metabolic relief

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

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

If you want to specifically rely 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 convenient set.