It is common for someone with histamine intolerance to struggle for years to find answers to their problems. It can seem like every part of your body is affected.
You might have a runny nose, a persistent cough, or itchy skin with hives from time to time. You may suffer from irritable bowel syndrome (IBS) or bloating or reflux. Sometimes your blood pressure drops so low, you feel like you are going to faint.
No doubt, in this wonderful world full of information that is available at your fingertips, you have been doing your research. You have slowly put all of the pieces of the puzzle together. And you finally have an idea of what is going on with your body.
You think you have histamine intolerance. And you may be right. But it is important to get a proper diagnosis. Who do you turn to?
Histamine intolerance as a diagnosis
Histamine intolerance is often missed by patients and doctors alike.
You may go into your appointment with your doctor thinking only of your current complaint. He looks back on his notes from your last visit two months ago when you were there with a completely different set of symptoms. Neither of you thinks to consider that these two seemingly separate sets of symptoms may be related to one another.
Sometimes, the everyday symptoms are very subtle and you have just learnt to live with them. It is only when you have a big flare up that you start to get concerned that there might be something more serious going on (1).
My story of searching for a histamine intolerance diagnosis and treatment...
As you may know, I've been in your histamine intolerant shoes and I am familiar with the struggles. I became histamine intolerant very suddenly when I was 23. It took me the best part of a year to self-diagnose. And that only happened by mistake!
Because of the general lack of information available on histamine intolerance, I knew that getting treatment was going to be yet another struggle. So, as a nutritional scientist, I put myself on a low histamine diet and I started to notice symptomatic improvement within the first 10 days. If you haven't already started one or would like a comprehensive list and guide for minimizing symptoms, please click below to get the low histamine diet guide.
This improvement following the low histamine diet confirmed to me that there was indeed cause to keep looking further into histamine intolerance treatments, that could perhaps improve my body-wide symptoms.
After finding an effective bandaid for my condition, I set out to find the cause so that I could treat it. I discovered that there are many causes of histamine intolerance, but that gut health is an undoubtable contributor (2). I knew that probiotics would play a big role in improving gut health but, as many common bacteria produce histamine, I ensured I was taking only low histamine probiotic strains in order to treat the issue, rather than making it worse (3).
I also discovered that certain nutrient deficiencies can inhibit the production of diamine oxidase enzymes, which are responsible for degrading histamine. Addressing these shortfalls is important (4).
Learning to manage stress was also a big factor (5). Managing stress didn't just mean 'calming down' - which is easier said than done - but it meant a lot of bigger things than that for physically and mentally improving my wellbeing. Everything from balancing more rest days from the gym, to finding more enjoyment in hobbies to even cutting out toxic people alongside toxic chemicals in foods.
Look, there were a lot of other factors here that helped me along the way, and it wasn't an easy journey. It took some time to get better and it was a gradual process that I put a lot of research and effort into. If you do want to explore it in-depth, you can check out the How I Solved My Histamine Intolerance Course - but, for now, that's my story in a nutshell. I have spent the last few years sharing my knowledge in order to help other people find their way back to health.
Causes of histamine intolerance
Histamine is a chemical that occurs naturally in the body. It is primarily involved in the immune system. When your body perceives that it is under threat by bacteria, a virus or even a food molecule, the cells that store histamine are activated (4).
Histamine is released in order to start the process of neutralizing the threat. It binds to one of four histamine receptors - H1, H2, H3 or H4. The response you get depends on which receptor the histamine binds to4.
In a healthy person, histamine is then quickly deactivated. There are two enzymes that are responsible for this process - diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT). In the healthy person there is enough of both of these enzymes and they are able to function properly (4).
If you are histamine intolerant, something has gone wrong with these enzymes. DAO is the one that is most important for preventing histamine from being absorbed into the blood where it causes problems. The level and function of this enzyme can be affected by your genes, medical conditions such as renal failure, and nutrient deficiencies, namely vitamin B6, vitamin C, copper and zinc4.
Why do histamine levels rise?
Histamine comes from sources both within the body (endogenous) and from outside the body (exogenous). Histamine continues to be produced in the body and stored in the mast cells. We also continue to consume foods and beverages that either contain histamine themselves or stimulate the release of histamine from the mast cells (6).
If your DAO is problematic, and you continue to eat these foods, the histamine does not get deactivated and your levels continue to rise. The higher your histamine levels, the more likely you are to have a flare up of your symptoms. You are constantly sitting on the verge of a histamine reaction.
How to get a proper diagnosis of histamine intolerance
You have done your homework and you have self-diagnosed histamine intolerance. But, you have also learned that there are some medical conditions that could cause secondary histamine intolerance. It is therefore a good idea to make an appointment with your doctor to discuss your condition.
The best place to start is with your GP. He needs to give you a differential diagnosis to rule out the possibility of any underlying health conditions. He will check for any diseases that are known to cause histamine intolerance (7).
Once these have been ruled out, he may order a DAO test to check the activity of DAO in your blood (7).
Apart from the DAO test and ruling out other possible diseases, your doctor will need to take an extensive medical history. He will try and establish if your symptoms can be reproduced when you eat foods that you suspect to be a problem for you. A food and symptom diary is a very useful tool to make the diagnosis easier to make (7).
It's important to keep in mind that there is not a definitive test for histamine intolerance - so, using a combination of tests to rule out other conditions plus histamine-associated tests that act as strong indicators (although not firmly definitive) you can end up reaching a conclusion of histamine intolerance.
Dieticians and nutritionists can help manage histamine intolerance
Once you have your official diagnosis it is important to find out what you need to do to treat it. A registered dietitian or a nutrition professional who is familiar with food allergies and intolerances is the right person to consult. `
They will help you with an elimination diet where you will likely be asked to avoid foods that have a high histamine content as well as those that stimulate the release of histamine. You can access such foods list below:
Working with a doctor to address histamine intolerance: the first step
If you suspect that you may have histamine intolerance, start by booking an appointment with your general practitioner. Once you have a diagnosis according to the criteria and discussion above, meet with a registered dietitian or nutrition professional who can put you on the path to health with a low histamine diet.
By using a combination of your general practitioner and your nutrition professional, you may likely also be referred to other specialists that can best support your case.
As histamine intolerance symptoms are multi-faceted, someone with hormonal issues may be referred to an endocrinologist while someone experiencing digestive distress may be referred to a gastroenterologist, as well.
These two professionals will be your touch point for your diagnosis, referrals and dietary support, which will be essential steps along your histamine healing journey.
References
- Comas-Basté O, Sánchez-Pérez S, Veciana-Nogués M, Latorre-Moratalla M, Vidal-Carou M. Histamine Intolerance: The Current State of the Art. Biomolecules. 2020;10(8):1181.
- Schnedl W, Enko D. Histamine Intolerance Originates in the Gut. Nutrients. 2021;13(4):1262.
- Gao C, Major A, Rendon D, Lugo M, Jackson V, Shi Z et al. Histamine H2 Receptor-Mediated Suppression of Intestinal Inflammation by Probiotic Lactobacillus reuteri. mBio. 2015;6(6).
- Kovacova-Hanuskova E, Buday T, Gavliakova S, Plevkova J. Histamine, histamine intoxication and intolerance. Allergologia et Immunopathologia. 2015;43(5):498-506.
- Grumach A, Staubach-Renz P, Villa R, Diez-Zuluaga S, Reese I, Lumry W. Triggers of Exacerbation in Chronic Urticaria and Recurrent Angioedema—Prevalence and Relevance. The Journal of Allergy and Clinical Immunology: In Practice. 2021;9(6):2160-2168.
- Worm M, Fiedler E, Dölle S, Schink T, Hemmer W, Jarisch R et al. Exogenous Histamine Aggravates Eczema in a Subgroup of Patients with Atopic Dermatitis. Acta Dermato Venereologica. 2009;89(1):52-56.
- First Steps | Histamine Intolerance [Internet]. Histamine Intolerance. 2021 [cited 23 June 2021]. Available from: https://www.histamineintolerance.org.uk/about/first-steps/
Anita Tee
My name is Anita Tee. I'm a nutritional scientist specializing in histamine intolerance. I hold a Master of Science in Personalized Nutrition and a Bachelor of Science in Human Biology and Psychology.
For the past ten years, I have used my experience in nutritional and medical health sciences to create a scientifically backed, natural approach to healthcare that relies 100% on evidence-based research.
As I previously suffered from - and overcame - histamine intolerance, my focus is to increase recognition and expand the available resources and protocols available for resolving this particular disorder. To date, I have helped over 4,000 individuals fully resolve or better manage their histamine intolerance symptoms.
