Histamine intolerance What you need to know

What is histamine intolerance?

Histamine intolerance is a condition in which the body has difficulty processing histamine in food. This condition is caused by a deficiency of the histamine-degrading enzyme, diamine oxidase (DAO), or by a mismatch between dietary histamine and DAO levels.

Allergic conditions such as hay fever, asthma, as well as sensitization to mold allergens or mites, also increase histamine levels in the body.

Histamine is produced from the amino acid L-histidine by the enzyme histidine decarboxylase (HDC). It is produced in the human body as well as found in some foods.

Is histamine intolerance the same as food allergy?

No! Histamine intolerance is not an allergy, however, clinically it may present with symptoms characteristic of allergies.

Histamine intolerance affects 100 in 1 people. However, its diagnostics is often quite complicated.

Symptoms of histamine intolerance

Manifestation of histamine intolerance is individual in every person. It often includes symptoms such as:

• Diarrhea
• Bloating
• Nausea-vomiting
• headache
• Measles
• Shortness of breath
• Itching
• A rash or hives
• Redness of the skin (hyperemia)
• Decreased blood pressure (hypotension)
• Heart rhythm disorder (arrhythmia)
• Quincke's edema

Symptoms of histamine intolerance develop as a result of its accumulation in the body. Histamine dilates blood vessels, constricts the airways and digestive tract, and causes mucus to form. Mucous membrane mast cells secrete histamine to fight infectious processes and regulate organ function.

The transformation of histamine in the body takes place with the participation of enzymes N-methyltransferase and mainly diamine oxidase (DAO).

Deficiency of histamine-converting enzymes, mainly diamine oxidase, in the body is determined by various factors:

• genetic factors
• Inflammatory bowel diseases, parasitic infections, intestinal dysbiosis
• Kidney and liver diseases - chronic kidney diseases, viral hepatitis, liver cirrhosis
• Some drugs inhibit the activity of diamine oxidase
• Age – the risk of developing diamine oxidase deficiency increases with age.

Foods that cause histamine intolerance

Some food products contain large amounts of histamine, especially those products in which fermentation processes take place: wine, beer, cheese, and others.

Some foods themselves trigger the release of histamine from mast cells.

Both of these types of food can increase the concentration of histamine in the body and form the clinical picture of histamine intolerance.

These products are:

• alcohol (wine, beer)
• Processed meat products
• cheese
• Marinades
• Vegetables (tomato, eggplant, spinach)
• Tropical fruits (pineapple, banana, papaya, citrus)
• Fish (tuna, sardines, herring, mackerel) and shellfish
• visible
• chocolate
• Pork
• egg white
• Food colorings and preservatives
• Medicines - antibiotics, diuretics, local anesthetics, pain relievers, muscle relaxants, blood pressure regulating agents, antidepressants and others.

Diagnosis of histamine intolerance

Diagnosing histamine intolerance is often quite difficult. Diagnosis is based on anamnesis and laboratory data.

• Allergen skin tests
• Histamine skin test
• Determination of diamine oxidase

Management and treatment of histamine intolerance

Treatment primarily involves limiting the foods and drinks in the diet that cause an increase in the concentration of histamine.

Medical treatment is mainly symptomatic and includes:

• H1 and H2 antihistamines – which block histamine receptors in tissues. Treatment with this group of drugs alone does not give great results, combined drug therapy is more effective.
• Diamine oxidase replacement therapy
• Stabilization of mast cells - with specific drugs that block the release of histamine.

Prevention of histamine intolerance

Since the cause of the development of histamine intolerance has not been completely clarified, it is impossible to prevent the disease. The most important thing is timely identification of the condition and symptomatic treatment.