Histamine intolerance: causes, symptoms & treatment
Histamine intolerance is a condition that occurs when the body is unable to effectively break down histamine consumed through food. This leads to a range of symptoms, including digestive issues, skin irritations, and respiratory problems, which are often mistaken for other food intolerances or allergic reactions. In this article, we provide you with a comprehensive overview of histamine intolerance—from its causes and typical symptoms to treatment options and practical tips to help you manage daily life despite histamine intolerance.
Table of contents
- What is histamine?
- What is histamine intolerance?
- What are the symptoms of histamine intolerance?
- What are the causes of histamine intolerance?
- How is histamine intolerance diagnosed?
- How is histamine intolerance treated?
- Summary
What is histamine?
Histamine is an organic compound that occurs naturally in the human body as well as in many foods. It belongs to the group of biogenic amines and is formed from the amino acid histidine. Histamine plays an essential role in many bodily functions.
What functions does histamine serve in the body?
Histamine is involved in several important bodily processes, including:
- Immune response and inflammation: Histamine plays a key role in regulating immune responses and inflammatory processes in the body. It is released in response to various stimuli such as infections, injuries, and allergens. This leads to the dilation and increased permeability of blood vessels, allowing immune cells to quickly reach the site of inflammation. This causes typical signs of inflammation such as redness, swelling, and warmth.
- Allergic reactions: In allergies such as hay fever, dust mite or food allergies, excessive histamine release results in symptoms like sneezing, runny nose, and respiratory issues. Antihistamines help relieve these symptoms by blocking the action of histamine.
- Regulation of stomach acid: Histamine stimulates the stomach lining to produce gastric acid, which is essential for digestion and for fighting off pathogens.
- Neurotransmitter function: As a neurotransmitter, histamine affects important brain functions, including sleep, wakefulness, appetite regulation, and emotional responses.
Source: Britannica, 2024
What is histamine intolerance?
Histamine intolerance is a condition in which the body has difficulty breaking down histamine effectively. Normally, histamine is broken down in the intestine by the enzyme diamine oxidase (DAO). In people with histamine intolerance, the activity of this enzyme may be insufficient, leading to an excess of histamine in the body and a wide range of symptoms (Cleveland Clinic, 2023).
What is the difference between histamine intolerance and a food allergy?
The main difference between these two conditions lies in the cause of the reaction: Histamine intolerance results from a problem with histamine degradation and does not involve the immune system. In contrast, food allergies are direct immune responses to specific food proteins, during which large amounts of histamine are released, causing typical allergy symptoms such as skin rashes, swelling, and respiratory issues (Cleveland Clinic, 2023).
What are the symptoms of histamine intolerance?
The symptoms of histamine intolerance are varied and can easily be mistaken for other health issues such as allergic reactions or other food intolerances. They are dose-dependent, meaning they worsen with the amount of histamine consumed, and usually occur shortly after eating histamine-rich foods. Depending on individual sensitivity, symptoms can last from a few hours to several days. The main symptoms include:
- Diarrhea
- Nausea & vomiting
- Headaches
- Irregular heartbeat
- Runny, blocked nose
- Shortness of breath
- Itching, skin rash, hives
- Swollen lips, tongue, throat
Sources: NHS, 2022; Schnedl, 2019
Would you like to assess the situation yourself?
If you suspect that you may have histamine intolerance, it can be helpful to carry out further tests to better understand your symptoms. The allergy test extensive and the inhalation allergy test from Homed-IQ can identify specific allergens that cause symptoms similar to histamine intolerance. In addition, inflammatory bowel diseases can impair the function of the enzyme diamine oxidase, leading to a buildup of histamine in the body and worsening symptoms. The gut inflammation test from Homed-IQ can play an important role in identifying such conditions.
What are the causes of histamine intolerance?
Histamine intolerance can be attributed to several factors that impair the body's ability to process histamine. The main causes include:
Enzyme deficiency (Diamine oxidase)
The most common cause of histamine intolerance is a deficiency or reduced activity of the enzyme diamine oxidase (DAO), which is responsible for breaking down histamine that enters the body through food. Several factors can lead to a DAO deficiency:
| Cause | Explanation |
|---|---|
| Genetic predisposition | Some people have a genetic tendency that results in reduced activity of the DAO enzyme, impairing histamine breakdown. |
| Gastrointestinal disorders | Digestive issues such as leaky gut syndrome, inflammatory bowel diseases (e.g., ulcerative colitis), or irritable bowel syndrome can impair DAO function by damaging the cells that produce DAO or triggering chronic inflammation that reduces enzyme activity. This interferes with histamine breakdown in the body. |
| Medications and alcohol | Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), and regular high alcohol consumption can inhibit DAO activity. |
| Zinc deficiency | A deficiency in zinc, a vital mineral, can reduce the effectiveness of diamine oxidase, thereby impairing histamine breakdown. |
Excessive histamine intake
Excessive consumption of histamine-rich foods can also trigger or worsen histamine intolerance. Examples of histamine-rich foods include aged cheese, smoked fish, and fermented products. See the graphic at the end of the blog for more.
Bacterial imbalance
An imbalance in the gut flora can also play a role. Certain gut bacteria can produce histamine, and if these bacteria become dominant, they may contribute to an increased histamine load.
Source: Schendl et al., 2021; Maintz & Novak, 2007
How is histamine intolerance diagnosed?
Diagnosing histamine intolerance is often challenging because its symptoms resemble those of other conditions and there is no standardized test for it (Schendl et al., 2021). The following methods are commonly used:
- Medical history and symptom diary: Keeping a detailed record of food intake and subsequent symptoms can help identify patterns suggestive of histamine intolerance.
- Elimination diet: Under medical supervision, histamine-rich foods are eliminated and then gradually reintroduced to observe whether symptoms improve or worsen.
- Provocation test: Under controlled conditions, histamine-rich foods or pure histamine are administered to observe the body’s response and assess histamine sensitivity.
Source: Soliman, 2024
How is histamine intolerance treated?
Treatment for histamine intolerance aims to reduce circulating histamine in the body and alleviate symptoms. This can be achieved through a combination of dietary changes and the use of medication.
How can I adjust my diet for histamine intolerance?
Adjusting your diet to control histamine levels is one of the most effective methods of managing histamine intolerance. Key points include:
Avoid foods high in histamine. These include:
- Smoked sausages such as salami and chorizo
- Aged cheeses like cheddar, gouda, camembert
- Smoked fish, sardines, tuna, mackerel
- Sauerkraut, kimchi, soy sauce, fermented tofu
- Red wine, beer
Be cautious with histamine-releasing foods. These include, among others, tomatoes, spinach, strawberries, and citrus fruits.
Prefer fresh products. Avoid consuming ready-made meals or foods that have been stored for a long time.
Source: Hrubisko et al., 2021
Are there medications for histamine intolerance?
In some cases, medical treatment can help alleviate the symptoms of histamine intolerance:
- Antihistamines: These medications help block the effects of histamine in the body and can relieve symptoms such as skin rashes, itching, and gastrointestinal discomfort.
- DAO enzyme supplements: For people with a DAO deficiency, dietary supplements containing the enzyme diamine oxidase can be helpful. These are taken before meals to support histamine breakdown.
- Probiotics: These products can help improve gut health and promote DAO production in the intestine.
All medical treatments should be discussed with a physician to ensure the best approach for your individual needs (Cleveland Clinic, 2023).
Summary
Histamine intolerance is a non-immunological condition that occurs when the body is unable to properly break down histamine from food, leading to symptoms such as digestive issues, skin irritation, and respiratory problems. Diagnosis is challenging, as there is no specific standard test; common diagnostic methods include medical history, symptom diaries, elimination diets, and provocation tests. Treatment aims to reduce histamine levels in the body through dietary changes and medication.
