Histamine Intolerance Natural Treatments
Anti-histamines like Zyrtec, Allegra and Benadryl have almost become staples in every American’s medicine cabinet. (Even though they cause liver damage.) Whether its seasonal allergies or food allergies most people are familiar with the relief one gets from taking an antihistamine. In the case of histamine intolerance, medications often seem to do little about the symptoms associated with it. This is especially true when someone is dealing with food intolerances related to histamine intolerance.
What most people don’t know is that histamine is an important transmitter in the nervous system & immune system (allergies) and is also required for proper digestion. But what happens when this system gets out of control?
The role of histamine is to produce an immediate inflammatory response.
In a health body, histamine is designed to produce an inflammatory response. This may come as a surprise, but it is actually a good thing. Histamine acts as a signaling molecule that helps blood vessels to dilate and signals other cells to come and attack infection or repair local damage that may have occurred in an injury. In the case of the digestive tract, when the gut lining is injured or irritated, histamine remains close by in order to bring healing nutrients nearby. In fact histamine is so critical that without enough histamine, infection can occur more often and injuries can last longer with poor healing.
The new term histamine intolerance has been circulating the internet, but this is something any nutritional biochemist has known about for many years. Histamine intolerance refers to elevated levels of histamine which can affect your gut, lungs, skin, brain and heart and is often the cause of many vague symptoms that are hard to pinpoint and histamine is especially in difficult cases of migraines. Histamine intolerance can be broken down into two major components:
- Overproduction of histamine (an unhealthy situation)
- Improper breakdown of histamine (an unhealthy situation)
So how do you know if you have histamine intolerance?
Signs
Red rash
Hives
Tissue swelling
Heated tissue
Symptoms
Headaches or migraines
Difficulty falling asleep and easily aroused
Hypertension
Vertigo or dizziness
Anxiety
Nausea or vomiting
Flushing
Fatigue
Seasonal allergies
Nasal congestion, sneezing, difficulty breathing
Asthma
2 Major Root Causes of Overproduction of Histamine
Food Allergies – IgE reactions are common to people with true food allergies. When allergists do skin prick tests and you see red spots or swelling, these are histamine responses.
Bacterial Overgrowth & Leaky Gut – Leaky gut also known as intestinal permeability can allow certain proteins to get passed your protective gut lining and then your immune system creates a histamine response in order to neutralize those proteins and protect your body. Unhealthy gut bacteria and parasites create histamine and can create very high levels of histamine in the digestive tract, sinuses and bladder.
Treating Your Own Histamine Intolerance
In my office I have found that histamine intolerance is most often developed over a period of time. I also find that most often it is secondary to an improper functioning immune system, nutrient depletion over time or as a result of poor digestive health.
In order to give the immune system and the digestive tract a chance to recover, a low histamine diet can be beneficial for many individuals and is one of the best ways to treat yourself at home.
Histamine-Rich Foods (bad)
Eliminating histamine rich foods is something that can be done at home as either a test or in addition to treating your root causes with a physician. Most of my patients don’t usually require a low histamine diet after root causes are treated, but because treating things like bacterial overgrowth, small intestine fungal overgrowth, parasitic infection, leaky gut and hidden food allergies can be difficult to treat on your own, following a low histamine diet can provide a lot of relief when you are at your worst.
Foods to avoid
Many types of alcohol like beer, champagne and wine contain high amounts of histamines and should optimally be eliminated from your diet. Fermented foods like sauerkraut, vinegar, soy sauce, kefir, yogurt and kombucha also contain high histamine levels.
Cured meats, soured foods (sour cream, sour bread), dried fruits, citrus fruits, walnuts, avocados, spinach, tomatoes and smoked fish also contain high levels of histamine.
Histamine Poor Foods (good)
When thinking about what foods to eat, in general the fresher the better. Freshly cooked meat, freshly caught fish, eggs, rice, real peanut butter, fresh fruits, fresh vegetables (except those listed above) coconut milk, almond milk, coconut oil, olive oil, herbs and spices can all be consumed.
Breaking Down Histamine – Step 2
Once you have treated infection, healed leaky gut and properly identified any food sensitivities, the next step is to help your body to properly break down histamine when it is created. The process of breaking down histamine requires many vitamins, nutrients and 3 specific enzymes.
Two of these enzymes occur more at the system wide full body level and one is more prevalent in the nervous system. Aldehyde oxidase and DAO (diamine oxidase) are more systemic in nature while HMT (histamine N-methyltransferase) is more prevalent in the central nervous system.
DAO is the main histamine degrading enzyme responsible for the metabolism of foods that you consume. Unfortunately DAO can get low due to gluten intolerance, leaky gut, dysbiosis, SIBO, alcohol, IBS, IBD, NSAIDs, antidepressants, and histamine (H2) blockers like Pepcid, Zantac and Tagamet.
You would think that histamine blockers would help, but in reality they can deplete the DAO enzyme leaving you with only the option to take antihistamines for the rest of your life.
Some of the major nutrients needed for these enzymes to work properly include:
HMT – Mg, Zn, B6 (P5P), MethylB12, Methyl Folate
DAO – Iron, Folic Acid, B12, Vitamin C, Iron, P5P
AO – NAD (B3), FAD (B2), Molybdenum, Iron, Vitamin K
In my practice I would say that the top 2 depleted nutrients from long term high histamine are B6 (P5P) and B9 (methyltetrahydrofolate).
How to Treat Histamine Intolerance Naturally
As discussed above decreasing high histamine foods for 1 to 3 months can be beneficial for decreasing symptoms. Other physicians often recommend using a DAO enzyme supplement, but if you choose this route it should only be temporary.
To be completely honest, using a DAO supplement is not totally natural and holistic. You see this is a natural enzyme that the body should make itself if it has the right basic ingredients. The vitamins and minerals listed above should be assessed to see which ones are lacking in the individual patient.
Going back to the holistic picture it is important to address root causes first. Hidden food allergies can be discovered by finding a physician trained in the nuances of food allergies or going on an a very specific elimination diet.
If you have any hidden gut infections, SIBO, SIFO, leaky gut or any gastrointestinal symptoms at all, those must be addressed first before trying to overcome histamine intolerance. The reason why is because if you are producing an excess of histamine, you will run out of DAO enzyme, or better stated you will deplete the vitamins and minerals necessary for the DAO and other enzymes to work properly. Until you eliminate the root causes that are creating your high histamine, no amount of supplementation will cure histamine intolerance.
So yes, you may have low DAO and a DAO enzyme may help, but if you are missing something like magnesium, zinc, B6 or methylated B12 in your system, you will have many more problems too that don’t go away even though you go on an antihistamine diet.
Conclusion
Rarely is histamine intolerance a lifelong sentence. It is more often a manifestation of dysfunction somewhere else in the body that needs to be investigated. Even though some people may have a genetic predisposition towards histamine intolerance, the body can almost always compensate so that a low histamine diet is not required for an entire lifetime.
Resources
- https://www.hindawi.com/journals/isrn/2011/353045/
- https://academic.oup.com/ajcn/article/85/5/1185/4633007
- https://www.mayoclinic.org/tests-procedures/allergy-tests/about/pac-20392895
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806734/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346110/
- https://jandonline.org/article/S2212-2672(14)01454-3/fulltext
- https://link.springer.com/article/10.1007/s00011-009-0134-3
- https://www.karger.com/Article/Abstract/237333
- https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2222.1993.tb00287.x
If you need help finding an expert in histamine intolerance, please don’t hesitate to email us at doc@drhoustonanderson.com
UPDATE! See my latest article on a 3rd major factor that can cause histamine intolerance. (Click here)
Unfortunately you did not mention people that genetically lack the enzyme. This occurs enough in people not to have mentioned this and I am not sure vitamins will help this population of people.
Margaret, this is an interesting comment to address. Definitely individuals can have genetic susceptibility to certain enzyme deficiencies that decrease the rate of any given process in the body. But there are a few things to consider here. First, you can’t change your genetics…ever. So we have to treat real people that have these genes. There are 2 other things I like to consider when looking at genetics. One, have you ever been “normal” before. For example if you didn’t know what histamine intolerance was 5 or 10 years ago and you could eat a semi-typical american diet at any time in your life, then it is not genetic. If you were born with a condition that required medication from birth or documented physical abnormalities, (or anything else similar) then it is definitely possible, that you may have faulty genetics. Two, if you have ever had an injury and recovered from it, then your genetics are adequate to decrease large amounts of histamine in a short period of time. If you scratch your skin and the redness goes away within a minute or so, then you have good enough histamine genetics. So the reality is that most doctors and “internet gurus” are putting heavy weight on genetics because it gives them a good excuse for not healing. As a last note, vitamins are how the body does it regardless of genetic influences. Each body uses different processes and different vitamin quantities, but vitamins/minerals/nutrients are the only weapons the body has.
I have been pouring through all of your website for days now – thank you so much for all you’ve studied!! I have two questions: first, do you recommend a low-histamine diet while I am treating SIBO/SIFO even though I have no symptoms of histamine intolerance? And second, can you recommend a doctor near me – Southern Maine? Thank you!
Michele, thanks for the supportive comments! In general I don’t require my patients to follow a low-histamine diet specifically, but definitely if you are battling small intestinal fungal overgrowth we recommend a zero processed food diet with a max carbohydrate intake somewhere between 60 to 100 grams per day. Even if you aren’t histamine intolerant, you can have elevated histamine due to vitamin deficiencies for sure. Homocysteine markers are usually a good investigation into those. And…unfortunately I don’t have a doctor I can recommend in Maine at this time. We hope to expand our training in the future.
Thanks again for the comment!
Your reply is SO helpful – you really have no idea how much your website information has helped me – thank you, thank you, thank you! I will likely schedule a phone consult with you at some point soon.
Margaret, you may be oversimplifying the human genome. If you thought that DAO was the only enzyme to break down histamine, that is incorrect. If you thought the AOC1 gene was the only gene that encoded for DAO, that is also incorrect. B6 is a cofactor in the three major histamine detoxification pathways , namely aldehyde oxidase, diamine oxidase and methyltransferase. It is also required in the pathway from histidine to histamine. Determining if you have methylhistamine intolerance or imidazole acetic acid intolerance is another step in this process. Assuming that the majority of people suffer from low DAO is a mistaken assumption. Don’t limit your health to your genetics, rather use your genetics to thrive!
Looking for info on histamine intolerance, I came across your article. I have various health problems but my chronic hives and dermatographia are what brought me here. I’ve been dealing with these my whole adult life, I’m 46. I developed an allergy to the sun at around 20. Shortly after, I started getting hives all the time, even without sun exposure. It’s a miserable way to live. No doctor will acknowledge it other than to prescribe antihistamines. I have major digestive issues now, extremely dry skin, nails and hair. I’ve lost over half my hair at this point. Idk what’s related and what’s not. I feel like the root cause has never been addressed which may have led to many of my other problems over the last 26 years.
I read your reply to an earlier comment regarding genetics. You said if you can scratch yourself and the redness disappears in a few minutes you have good enough histamine genetics. If I scratch myself it lasts hours and sometimes days. And with hives that can be a problem. What do you suggest?
By the way I’m homozygous MTHFR C677T mutation, in case it matters.