Are you experiencing unexplained headaches or a lot of anxiety? Do you experience irregular menstrual cycles? Does your face blush when you drink red wine? Do you get an itchy tongue, throat, or runny nose when you eat bananas, avocados, or eggplants? If the answer is yes to any of these questions, then you most likely have a histamine intolerance.

Having a histamine intolerance can be very frustrating, as you may feel like symptoms often come out of nowhere. Fortunately, thanks to functional medicine, many people are able to identify histamine intolerance as the source of their sudden symptoms, and then determine the underlying causes of this condition.

What is histamine

Histamine is a chemical involved in the immune system , proper digestion, and your central nervous system. It works as a neurotransmitter, communicating important messages from your body to your brain. It is also a component of stomach acid, which is what helps you break down food in your stomach.

You may be very familiar with histamine from its relationship to the immune system. If you have suffered from seasonal allergies or food allergies, you may have noticed that antihistamine medications such as Zytrec , Allegra or Benadryl provide quick relief from symptoms.

This is because the role of histamine in the body is to provoke an immediate inflammatory response. It serves as a red flag in your immune system that notifies your body of any potential attackers. It causes blood vessels to swell, or dilate, so your white blood cells can find and attack the infection or problem quickly.

This is part of the body’s natural immune response, and enzymes usually break down histamine so it doesn’t build up. If for some reason your body can’t break it down properly, it starts to build up and you start to develop what we know as histamine intolerance.

Because it travels through the bloodstream, it can affect your gut, lungs, skin, brain, and the entire cardiovascular system, contributing to a wide range of symptoms, and very often an intolerance can be difficult to determine and to diagnose.

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Most common symptoms of histamine intolerance

  • Headaches / migraines
  • Difficulty to sleep
  • Hypertension
  • Vertigo or dizziness
  • Arrhythmia or fast heartbeat
  • Difficulty regulating body temperature
  • Anxiety
  • Nausea, vomiting
  • Abdominal cramps
  • Blush
  • Nasal congestion, sneezing, shortness of breath
  • Abnormal menstrual cycle
  • Urticaria
  • Fatigue
  • Swelling of the tissues

What Causes High Histamine Levels

• Allergies (IgE reactions)
• Bacterial overgrowth (SBI)
• Leaky gut •
Gastrointestinal bleeding
• Diamine Oxidase (DAO) deficiency
• Foods rich in histamine

In addition to the histamine produced within your body, there are also a wide variety of foods that naturally contain it, cause its release, or block the enzyme that breaks it down, Diamine Oxidase (DAO).

If you have a histamine intolerance, it is advisable to avoid the following foods until you have addressed the underlying cause of the intolerance.

Foods to avoid if you have a histamine intolerance

Histamine-rich foods

  • Fermented alcoholic beverages, especially wine, champagne, and beer
  • Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc.
  • Foods that contain vinegar: pickles, mayonnaise, olives
  • Cured meats: bacon, salami, pepperoni, cold cuts and hot dogs
  • Acidic foods: sour cream, sour milk, buttermilk, sourdough, etc.
  • Dried fruits: apricots, prunes, dates, figs, raisins
  • Most citrus
  • Cured cheese, including goat cheese
  • Nuts: walnuts, cashews and peanuts
  • Vegetables: avocados, aubergines, spinach, and tomatoes
  • Smoked fish and certain species of fish: mackerel, dorado, tuna, anchovies, sardines

Histamine-releasing foods

  • Alcohol
  • Bananas
  • Chocolate
  • Cow milk
  • Walnuts
  • Papaya
  • Pineapple
  • Seafood
  • Strawberries
  • Tomatoes
  • Wheat germ
  • Many preservatives and artificial colors

Foods that block DAO

  • Alcohol
  • Energy drinks
  • Black tea
  • Yerba mate
  • Green tea

Foods you can eat if you have a histamine intolerance

After having seen that long list of foods you are surely wondering what you can eat, so below is a list of foods low in histamine. Remember that the freshness of the food is the key when you have an intolerance.

Low histamine foods

  • Freshly cooked meat or poultry
  • Fresh fish
  • Boiled eggs
  • Gluten-free cereals: rice, quinoa, corn, millet, amaranth, teff
  • Pure peanut butter
  • Fresh fruits: mango, pear, watermelon, apple, kiwi, melon, grapes
  • Fresh vegetables (except tomatoes, spinach, avocado, and eggplant)
  • Dairy substitutes: coconut milk, rice milk, hemp milk, almond milk
  • Cooking oils: olive oil, coconut oil
  • Green leafy herbs
  • Herbal teas

How to break down histamine

Once formed, histamine is stored or broken down by an enzyme. This, in the central nervous system, is mainly broken down by histamine N-methyltransferase (HMT), while in the digestive tract it is broken down mainly by diamine oxidase (DAO). Although both enzymes play an important role in the breakdown of histamine, DAO is the main enzyme responsible for metabolizing ingested histamine. So if you have a DAO deficiency, you likely have symptoms of histamine intolerance.

The causes of low DAO

  • Gluten intolerance
  • Leaky gut
  • El SBI
  • Alcohol, energy drinks, tea, and foods that block DAO
  • Genetic mutations (common in people of Asian descent)
  • Inflammation from Crohn’s disease, ulcerative colitis, and inflammatory bowel disease.
  • Non-steroidal anti-inflammatory drugs (ibuprofen, aspirin)
  • Antidepresivos (Cymbalta, Effexor, Prozac, Zoloft)
  • Immunomodulators (Humira, Enbrel, hydroxychloroquine)
  • Antiarrítmicos (propanolol, metoprolol, Cardizem, Norvasc)
  • Antihistamínicos (Allegra, Zyrtec, Benadryl)
  • Histamina (H2) (Tagamet, Pepcid, Zantac)

Although histamine blockers, a class of acid-reducing drugs, seem to help prevent intolerance, they can actually only lower DAO levels in your body.

How to know if you have a histamine intolerance

Elimination / Reestablishment
Remove the high histamine foods listed above for 30 days and then reintroduce them one at a time.

tests You can have blood tests done in a laboratory to measure histamine levels and DAO levels. A high ratio of histamine to DAO means that you are ingesting too much histamine and that you are not having enough DAO to break it down.

Increase DAO
If blood testing is not available to you, you can simply try a low-histamine diet and add DAO supplements to every meal. If your symptoms resolve, it means you had low DAO levels.

How histamine intolerance is treated

Relieve your symptoms with diet and supplements
If you have an intolerance to histamine, the first step is to minimize it in your diet by adopting a diet low in histamine and avoiding foods that block DAO. Taking a DAO supplement, such as Histazyme , is also recommended for immediate relief.

Address the cause of your histamine intolerance
The real key to overcoming intolerance is identifying and treating the root cause of the problem. Many times this is caused by a gut health problem, especially SBI. Other common causes are leaky gut and gluten intolerance.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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