histamine rich foods
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Could you have a histamine intolerance?

Histamine intolerance is a condition in which a person’s body is unable to break down histamine, a chemical that occurs naturally in the body and in certain foods. This can lead to symptoms such as headaches, skin flushing, and gastrointestinal distress after consuming histamine-rich foods or drinks. Some common histamine-rich foods include fermented products, aged cheeses, smoked meats, and certain types of fish.

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 DAO deficiency and how does it relate to 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. In this case, symptoms mainly depend on the amount of histamine ingested or if DAO inhibitors are present.

A potent DAO inhibitor is 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 it 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.  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 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
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