Could you be suffering Histamine Intolerance?

Symptoms like headache, dizziness, itchy skin and IBS are very often related to food intolerance or allergy. While immediate allergies (mediated by IgE antibodies) are pretty easy to identify due to symptoms appearing minutes after ingestion of the trigger food, IgG-mediated food intolerances often remain undiagnosed due to the late appearance of symptoms. Symptoms of delayed-onset IgG intolerance can sometimes occur hours or even several days after consuming the offending food. 

ImuPro specialises in identifying delayed IgG food intolerance, with avoidance of the intolerant foods often bringing significant relief to the patient, however sometimes symptoms can persist even if all IgG-positive foods are avoided.

In these cases, either the patient’s symptoms are not related to IgG food intolerance or there may be another underlying cause.  As well as IgG testing, ImuPro Australia also offers testing for other causes of food-related symptoms. Histamine intolerance, for example, can also be associated to symptoms including gastro-intestinal disorders, hypotension, headache, nasal congestion, fatigue, arrhythmia, skin disorders, including itching, hives or rash. 

What is histamine?

Histamine is a natural and important compound of the human body, regulating blood pressure, the immune system, and also having involvement in the nervous system. In general, the body is able to balance histamine release with no negative impact on the body. In allergic reactions, excessive release of histamine brings on allergic symptoms and, usually, an anti-histamine will help to reduce the released histamine.

However, histamine is also present in high concentration in certain foods. Another source of histamine may be your gut flora, particularly when you have SIBO (small intestinal bacterial overgrowth) with the participation of putrefaction flora.

What is histamine intolerance?

Most people naturally produce an enzyme called Diamine Oxidase (DAO) which is present in the gut and breaks down the histamine ingested with food. 3% of the population have a genetically-determined severe DAO deficiency which can manifest into histamine intolerance, and around 20% of the population have a milder form of histamine intolerance. In this case, symptoms mainly depend on the amount of histamine ingested or if DAO inhibitors are present.

A potent DAO inhibitor is alcohol. For a lot of people, symptoms of histamine intolerance present when they consume alcohol, particularly red wine. Certain medications are also potent DAO inhibitors. Histamine intolerance can be caused by deficiency in vitamin B6, copper and inflammation of the intestinal mucosa.

How can you detect histamine intolerance?

Histamine intolerance must not be confused with histamine release from allergic reaction. Neither IgE nor skin prick tests are able to diagnose histamine intolerance and histamine intolerance will not respond to anti-histamines.

Histamine intolerance can only be identified by testing the activity of Diamine Oxidase (DAO) in blood. A test such as the DAO Histamine Intolerance Test offered by ImuPro Australia will measure your level of DAO activity to determine if histamine intolerance is present.  Your diet can then be adjusted based on the findings and appropriate supplementation can be discussed with your practitioner.

Am I susceptible to histamine intolerance?

If you have any of the symptoms listed above, and they don’t disappear after an ImuPro guided IgG-exclusion diet, you should consider checking your DAO activity.  Other signs of histamine intolerance include chronic low blood pressure, excessive night sweating (particularly after drinking alcohol), arrhythmia,  severe premenstrual cramping, or a low tolerance to alcohol (particularly red wine).

Foods rich in histamine

  • Alcohol, esp. red wine and champagne
  • Cheese
  • Sea food, fish (particularly tuna, swordfish) and fish sauces
  • Raw meat sausages (e.g. salami, speck)
  • Sauerkraut
  • Vegetables (e.g. tomatoes, spinach and eggplant)
  • Fruits (e.g. strawberry, pineapple, banana)
  • Chocolate
  • All fermented foods are susceptible to be rich in histamine
  • Potent DAO-inhibitors
  • Alcohol
  • medications such as acetylcysteine, ambroxol, aminophylline, amitryptine, chloroquine, clavulanic acid, isoniazid, metamizole, metoclopramide, propafenone, verapamil

References

Jarisch, R.,2004: Ärztemagazin 08/2004, Histamin-Intoleranz
Jarisch, R. “Histaminunverträglichkeit”, Thieme Verlag TB 2. Auflage
Schmutz Helmut (Autor); Abbot, G.; Lieners C.; Mayer, I.; et.al; “Nahrungsmittelunverträglichkeit (Histamin Intoleranz)”,
Sachbuch, Wien 2006
Sattler, J; Hafner, D; Klotter, HJ; et.al; “Food-induced histaminosis under diamine oxidase (DAO) blockade in pigs: Further evidence of the key role of elevated plasma histamine levels as demonstrated by successful prophylaxis with antihistamines”; Agents and Actions; Volume 27, Numbers 1-2 / April 1989
Maintz, L.; Noval, N.: “Histamine and histamine intolerance”, American Journal of Clinical Nutrition 2007 (85)1185-1196