Histamine Intolerance

Histamine intolerance is very common among people with gut issues.

There are three main reasons why people may develop a histamine intolerance:

1- Certain bacteria which often overgrow in an unhealthy gut actually causes an increase in histamine (via an increase in the degradation of histidine to histamine). The main bacteria that are known to do this are: Enterobacter, citrobacter, E.coli, Klebsiella, Proteus, Salmonella, Shigella, Staphylococcus, Pseudomonas. 

* Note: certain bacteria in many popular probiotics can also have this effect. These are mainly Lactobacillus strains, such as L.acidophilus, L.aribonosse, L.buchneri, L.bulgaricus, L.Casei, L.helveticus and L.Sakei. For this reason, it's best to opt for a probiotic specifically designed for people who have histamine intolerance, such as HistaminX, or a bifido only probiotic. Read more about probiotics here.

2- The enzyme which helps degrade histamine (DAO) is produced mainly in the small intestine. When there is gut inflammation and damage to the small intestine lining (which is especially common with SIBO, but also with other inflammatory gut conditions) there will be a reduction in DAO production, resulting in an overload of histamine. This is especially problematic when eating a high histamine diet. A snp in your DAO genes can also affect DAO production, coumpounding the effect.

*Tip: taking a DAO enzyme like HistaHarmony can be a game changer if you have histamine intolerance (buy here in Australia or here in the USA)

3- Some people are also genetically predisposed to histamine intolerance. For instance, some genes to watch out for are DAO, HNMT, NAT2, COMT and MAO. The expression of those genes is influenced by your health and your environment. Exposure to chemicals, mould, gut bacteria toxins, etc, can make those genes 'dirty' and lead to histamine intolerance.

MCAS (Mast Cell Activation Syndrome): MCAS is different than histamine intolerance but is worth mentioning here as it can cause very similar symptoms. MCAS occurs when the mast cells (a type of white blood cell) release histamine into the body at an accelerated rate. Usually, the mast cell will contain histamine until it receives a strong signal to release it. Science is now showing that mast cells can be more susceptible to releasing histamine due to chemical exposures, genetic abnormalities, and even nutrient deficiencies. Mould toxicity can also lead to MCAS.

SYMPTOMS OF HISTAMINE INTOLERANCE

Histamine intolerance is unlike other food allergies or sensitivities in that the response is cumulative, not immediate. In other words, until your ‘bucket’ is full, you won’t have any symptoms, which makes it especially hard to pin point which foods are causing specific symptoms.

  • Pruritus (itching especially of the skin, eyes, ears, and nose)
  • Urticaria (hives)
  • Tissue swelling (angioedema) especially of facial and oral tissues and sometimes the throat, the latter causing the feeling of “throat tightening”
  • Hypotension (drop in blood pressure)
  • Tachycardia (increased pulse rate, “heart racing”), especially after eating
  • Symptoms resembling an anxiety or panic attack
  • Chest pain
  • Nasal congestion, runny nose, seasonal allergies
  • Conjunctivitis (irritated, watery, reddened eyes)
  • Some types of headaches.
  • Fatigue, confusion, irritability
  • Digestive upset, especially nausea, heartburn, “indigestion”, and reflux

Not all of these symptoms occur in any single individual and the severity of symptoms varies, but the pattern of symptoms seems to be consistent for each person.

If you think that you might have histamine intolerance, we recommend first emptying your bucket by following the Supersafe or Safe Diets. To learn more about how to test for histamine intolerance, go to the 'Test Your Tolerance to Food Chemicals' section.

HISTAMINE AND OESTROGEN

It's also worth noting that oestrogen increases histamine, so reactions to histamine can fluctuate during women’s menstrual cycle. Headaches and migraines before your periods or around ovulation can be signs of histamine intolerance. Reducing your histamine load around these times can greatly reduce those symptoms.

Histamine overload, if not broken down, can also lead to oestrogen dominance, as histamine increases oestrogen.

HIGH HISTAMINE FOOD

As a general rule, anything aged or fermented is very high in histamine. However, just to make things even more complicated, there are certain foods which, although not high in histamine, will trigger a release of histamine in the body. These are often referred to as histamine liberators and/or DAO inhibitors.

Here’s some examples of aged and fermented foods that are very high in histamine:

All vinegars (including apple cider vinegar), soy sauce, tamari, kimchi, sauerkraut, cultured vegetables, pickles, yogurt, kefir, kombucha, aged cheeses, aged/smoked/cured/processed meats and fish (bacon and especially smoked salmon).

Leftovers are also very high in histamine.


Avoiding aged and fermented foods (including bone broth and leftovers) can significantly reduce overall histamine consumption and therefore histamine load in the body.

EXAMPLES OF FOODS VERY HIGH IN HISTAMINE

Some people can feel a lot better simply by avoiding foods that are very high in histamines.

Fruits - very ripe avocado, tomato, dried fruit (which typically contain sulphites unless they are certified organic - sulphites can release histamine). Berries such as strawberries, raspberries and cranberries contain benzoates which release histamine. Blueberries still contain benzoates, but are lower.

Vegetables - capsicum/peppers, eggplant, olives, mushrooms, spinach, tomato, seaweed (such as nori), pickled vegetables, sauerkraut, kimchi, cultured vegetables, canned vegetables, store bought vegetable juices, store bought vegetable stocks (cubes, powders, liquids).

Herbs and spices - chilli, cayenne, all spice, anise, cardamon, cinnamon, cloves, nutmeg can cause your body to release histamine. Thyme can be a problem for some people.

Meat - all aged, smoked, cured and processed meats - corned beef, bacon, ham, salami, pepperoni, jerky, some sausages, chicken nuggets etc; offal - liver, kidneys, brains, tripe etc; store bought meat stocks (cubes, powders, liquids); commercial gravy; bone broth that has been cooked for a long time (for more than 6 - 8 hours); all leftover meats - after meat is cooked, histamine levels increase due to microbial action as the meat sits - freezing leftovers slows this process down and results in lower histamine levels. Extra long hung beef can also be very high in histamine. Sulphites can release histamine and many supermarket meats contain unlabelled sulphites. Some meat packaging, especially vacuum packed meat will increase histamine levels. Refer to the Histamine Success Food Handling and Preparation Guide for more information about these important issues.

Seafood - Fish rapidly accumulates histamine once it is gutted and therefore needs to be eaten on the day it is caught or frozen on the day it is caught. Otherwise, fish, crustaceans, molluscs and shellfish can be very high in histamine. Dried, tinned or smoked seafood (anchovies, tuna, smoked salmon) are always very high in histamine.

Other seafood products - fish sauce, shrimp paste and oyster sauce

Legumes - bean mixes with sauce, canned baked beans, falafel, hummus.

Nuts and seeds - almond meal, hazelnut meal, peanut butter.

Baking aides and condiments - all fermented products, pastes (shrimp, tomato, meat), store bought stocks (cubes, powders, liquids) all vinegars, yeast extracts and spreads (Vegemite, Marmite), chicken salt, mustard, mayonnaise, soy sauce, tamari, miso, tempeh, tomato sauce/ketchup/paste, coconut aminos.

Fats and oils - commercial salad dressings and mayonnaise.

Jams, sugars, syrups and sweets - chocolate/cocoa/cacao contain histamine and some jams/jellies/conserves (made out of the fruits listed here) can cause your body to release histamine.

Drinks - all alcohol - apple cider, beer, wine, champagne, spirits, liqueurs - (except gin and vodka), all chocolate drinks (e.g., hot chocolate), tomato juice, ginger beer, aged or fermented teas, chai tea (because of the spices).

Dairy - all aged cheeses (such as brie, camembert, parmesan, blue cheese), any flavoured cheeses, cultured butter, yogurt.

CLICK HERE FOR A COMPLETE LIST OF LOW, MEDIUM, HIGH & VERY HIGH HISTAMINE FOODS

FOODS THAT CAN CAUSE YOUR BODY TO RELEASE HISTAMINE

Banana, citrus fruits (including orange juice, marmalade, lemon/lime flavoured drinks), berries mentioned above, pineapple, passionfruit, papaya, egg whites, sulphites, peanut butter, strawberry jam/jelly, spices mentioned above.

EXAMPLES OF HISTAMINE NIGHTMARES

  • Typical antipasto - smoked/cured meats, liver pâté, aged cheese, olives, sun dried tomatoes with a glass of red wine. :-O
  • Bacon and eggs with roasted tomatoes and baked beans.
  • Smoked salmon omelette with avocado, wilted spinach and cherry tomatoes.
  • Peanut butter and jelly sandwich.
  • Champagne with strawberries and chocolate.
  • Thai prawn red curry - ingredients often include - capsicum, chilli, tomato, fish sauce, shrimp paste, prawns (with sulphites).
  • Pizza - ham and pineapple, pepperoni, meat lovers (even worse if you have it with a glass of wine or beer).

If you react to any of the combinations above, it is highly likely that you have histamine intolerance issues. Remember that histamine accumulates in the body and that symptoms may not appear immediately. It can take a few days or even several days to reach your threshold. You are safe until you exceed your own level of tolerance (your threshold). This means that you may be able to enjoy one of the combinations above once a week, but if you had one a day for a week, you'd go way over your threshold and would experience symptoms.

To learn more about managing histamine intolerance, go to the 'Managing Food Chemical Sensitivities' section.

A FEW OTHER TIPS WHEN FOLLOWING A LOW HISTAMINE DIET

  • Food processing, handling, preparation and hygiene are all very important when it comes to histamine intolerance. You must freeze any foods that you prepare that will not be eaten on the same day. Care must also be taken when thawing foods. Defrost foods in cold water and then transfer them to the fridge while they are still partially frozen. Refer to the Histamine Success Food Handling & Preparation Guide for more information.
  • Do not eat leftovers.
  • Super fresh is always best. Buy the freshest meat you can and either cook it or freeze it on the day of purchase. Find a good butcher that you can trust and ask if you can either pick up your meat on the day that they receive their delivery; or have your butcher freeze your order on the day that they receive their delivery. Enquire as to how long beef has been hung.
  • Fish must be either frozen or cooked on the day it is caught. Find a seafood provider that can offer either of these options. Do not eat defrosted fish that has sat in your fridge overnight.
  • Only cook bone broth for 2 to 4 hours otherwise it will become very high in histamine.
  • Avoid sulphites. Sulphites can be found in fresh seafood, fresh and packaged meats, processed meats, dried fruits (if not organic), shredded coconut (if not organic), cornstarch (if not organic) and wine.
  • Your body may produce more histamine during pollen/allergy season and your threshold may therefore lower.
  • Most women find that at certain times of the month, their threshold will be lower. Tracking your menstrual cycle along side your histamine consumption in your food journal can be extremely helpful.
  • Stress results in the release of histamine and therefore stress around food can make histamine intolerance issues even worse. It's important to remain calm and positive while making dietary changes. Make sure to do the daily energy sequence, yoga sequence and belly massage to help manage stress.

FOODS & HERBS WITH ANTI-HISTAMINE EFFECT

  • Apples: rich in quercetin
  • Watercress: inhibits histamine release
  • Broccoli and ginger: H2 receptor antagonist
  • Turmeric: stabilises mast cells and inhibits histamine release
  • Nigella Sativa
  • Stinging nettle
  • Chamomille

USEFUL SUPPLEMENTS FOR HISTAMINE INTOLERANCE

Taking supplements is really only a band-aid solution when it comes to histamine intolerance. Whilst they may help manage some of your symptoms initially, it's much more important to focus on learning how to adjust your diet according to your own unique threshold while you heal your gut . This way, you will eventually be able to safely add some of your favourite foods back into your diet and enjoy your life more.

  • Reishi
  • Vitamin C/ascorbic acid - anti-inflammatory and modulates histamine response.
  • Lactobacillus plantarum - can degrade histamines and oxalates.
  • Zeolite - can 'mop up' a histamine reaction. Revisit the Binders section for more information.
  • Phosphatidylcholine - fortifies cell membranes (buy here in Australia or here in the USA)
  • Quercetin - stabilises mast cells (it's often combined with bromelain, which is actually a histamine liberator, so we recommend getting one without bromelain)
  • DAO enzymes (buy here in Australia or here in the USA)
  • Methionine, SAMe, Calcium, Magnesium and vitamin B2 and B6 are important cofactors for the elimination of histamine.

Sometimes people can become 'food phobic' through dealing with extensive and seemly complicated food lists, elimination diets and food challenges. However, this process is really about you becoming empowered about your food choices and around continuing to challenge foods by periodically trying to add very small amounts of excluded foods back into your diet. If you ever feel frustrated or overwhelmed, gently bring your awareness back to the fact that you are healing your gut with the intent to broaden the range of foods that you can safely consume. Know that all of this is only temporary and that with time, you will get better.

To learn more about managing histamine intolerance, go to the 'Managing Food Chemical Sensitivities' section.


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