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How much do you know about histamine intolerance? Whether you are new to the term, have heard about it around, or have been diagnosed with it, I want to uncover a little bit more about what we mean when we talk about this concept – and what it means to be on the spectrum of issues surrounding histamine and mast cell regulation. Ready to get started? Let’s go.
Is histamine intolerance a real thing?
This is the number one question that always comes up with this concept. People often wonder if histamine intolerance is a real thing, or if it is some sort of fad diagnosis. What I would tell you is that, yes, there is clear data indicating that histamine intolerance is real (1).
By that same token, histamine intolerance has had a history of being underdiagnosed in many patients. There are those who have had it, and suffered from symptoms but no concrete explanation for them. This is something that I think we should get away from, obviously, but it also leads me to my next point.
Key Insight: Since many symptoms that come alongside histamine intolerance are vague, and no tests are able to definitely rule it out, it can also be overdiagnosed or misdiagnosed.
The first thing that I would tell you is that I think the term “histamine intolerance” is a horrible phrase to use. It can be very misleading, because it is definitely not an intolerance to histamine. It is not an allergy or an autoimmune response against histamine, even if it sounds like it!
Histamine is a normal part of our bodies, and to date, no humans have been documented as being intolerant or allergic to histamine. So, above all else, I think that this term really gives off an unclear – and ineffective – first impression for those learning about it.
Key Insight: The body forms histamine as an important part of brain cell communication and immune regulation – what’s not to love about that? This normal part of our body is not something that we should fear, instead, we should be more concerned about the level of it (rather than its overall presence).
So, what is it? It is probably more accurate to coin this term as “histamine overload.” This is based on the fact that anyone who gets too much histamine, ultimately starts developing these symptoms.
What are the specific symptoms?
When we think of symptoms involved with this overload of histamine, we are primarily looking at some of the classic “allergy” symptoms, such as:
- Nasal congestion
- Difficulty breathing
- Swelling (and tongue swelling)
- Skin rash
These are classic symptoms. You could take anyone, give them a mega dose of histamine, and they will start developing these issues. It is bound to happen, and most importantly of all, they can be life-threatening.
Bottom Line: What is happening with histamine intolerance is that people are running with a higher foundational level of histamine then necessary. It is not that they are “intolerant” of it, it is that they simply have too much of it. They have more than they need circulating throughout their body, and that is where these symptoms take root.
What are the vague symptoms?
Remember when I mentioned earlier that one of the tricks of histamine intolerance, where it has become overdiagnosed, is the fact that vague symptoms are often present. A lot of vague symptoms can be born from chronic, elevated levels of histamine.
This is where things get murky, but here is what one might expect:
- Changes to the menstrual cycle
- Generalized fatigue
- Headaches and migraines
- Difficulty sleeping
- Having a hard time waking
- Struggling to feel energized
- High blood pressure
- Vertigo and dizziness
- Cardiac palpitations
- Poor regulation of body temperature
- Anxiety, nausea, vomiting, and cramps
Bottom Line: These are all possible symptoms that can be associated with histamine intolerance. It does not mean that they are definitely going to happen – they are only a possibility. Because they are so general, it is difficult for us to think of them too specifically in terms of histamine intolerance. It is important, though, to be aware of them.
Why would someone have too much histamine?
Going back to the idea that histamine intolerance is less of being intolerant, and more of having an overload of histamine – how would someone end up with more histamine than they need?
Think about it like this: your body has histamine coming in, and histamine going out. These are the main two things that your body is in charge of. From there, two issues can arise: you could either have too much coming in, or two little coming out. There would have to be a deficiency on one end or the other, and typically starts with the amount that you are taking in.
Let’s pull back even more, and start from the beginning. When we think about histamine, we can understand it as a natural response to:
- An allergy
- A chronic infection
- Some sort of chemical trauma to your body
Histamine leaves your body by way of various enzymes in your body that are in charge of breaking down histamine in your body. Histamine is known as a biogenic amine, which means that it triggers an inflammatory response in your body to make this happen.
Key Insight: The problem is that you could easily have too many of these being made, and not enough being unloaded – or having your body eliminate. The former is more likely, and the latter (due to gene defects) is quite rare.
Understanding DAO Deficiency
A DAO deficiency is what we might understand as the gene defect which makes it difficult for your body to “unload” histamine from your body – causing a histamine overload, and triggering all of those nasty symptoms that we previously mentioned.
While they are possible, they are not very probable. From the populations that I have seen, from people who think that they have a lack in that ability, I would argue that it is being overly-suspected and overdiagnosed.
One of the reasons why is because all of those symptoms, the vague ones, could be attributed to many other conditions. The thing about the DAO deficiencies is that they are completely measurable – you can take a test and find out if you have it.
Key Insight: When it comes to high histamine in the blood, you might be able to see it present, but you cannot always see it present – even if it is happening. That is where things get difficult, and cause a lot of issues.
What it takes is a lot of judgement, and there is no standard answer that satisfies people across all situations. It is just not that easy. The thing is that when you are entertaining a diagnosis that you cannot objectively affirm in some way, you have to tread very lightly. The last thing you want to do is settle on an answer when you are misattributing symptoms that are coming from another cause altogether.
Bottom Line: There could be something different, and unrelated, causing the exact same symptoms that you might have thought were being caused by histamine intolerance.
There are even instances where the other symptoms, like hives and flushing, can come from stress and anxiety. One can have very real physical symptoms, but misattribute them to a genetic defect (as opposed to something like generalized anxiety).
In the end, these things cut both ways. There are many that do have these problems that remain undiagnosed, and there are others who fall in the overdiagnosed camp. Reading yourself into three or four symptoms does not mean that you can jump to conclusions, and it always helps to test – suspend judgement, until you know the whole story.
How do you diagnose histamine intolerance?
First, you can do it empirically. What that means is that if you take histamine blockers, and feel better, it is not unreasonable to think that histamine intolerance was the root of the problem. The difficulty here is that histamines have a great deal of influence on your body. It can affect:
- Your overall mood
- Your state of anxiety
- Your stress or panic levels
These are all things that histamines effect, and that histamines lower! This all goes back to the fact that things like anxiety can trigger responses like rashes, and in taking an antihistamine we can sedate ourselves and feel better (and less anxious). Even though anxiety was our overall issue, we might attribute it to a histamine intolerance instead.
The other difficulty with histamine has to do with its production in the body. Your body makes histamine in response to allergies, infections, stress, or trauma, but we also do get it from some foods in our diet.
Certain bacterial events can even make the amine levels in foods lethal, and have caused issues in the past. This thinking, though, has led people to believe that the levels of histamines in certain foods can act as a trigger.
Key Insight: While it is plausible, there have been many studies looking at quantifying the level of histamines in foods. These studies, after all their research, and in no way in agreement over what constitutes a “high-histamine food.”
Even though we have no data on specific foods, some trends have emerged about foods that are higher in histamines:
- Cured or smoked meats
- Aged cheeses
- Fermented foods
These are categories of food that have been known to be higher in histamines. Does this mean you should avoid them? Well, if they clearly cause symptoms they could be relevant. But, I really cannot endorse any sort of “histamine food list” because they are just way too many contradictions. The science is just not there yet.
For that reason, I would also not recommend diets that are designed to cut down on histamine ingestion just yet. Due to the fact that there is so much conjecture around what constitutes a “high-histamine food,” if you went on a low-histamine diet you would be cutting out a lot of food – and you might not be doing your body any good.
Otherwise, we might look to things like DAO replacement compounds (which you can take in pills), or mast cell stabilizing compounds (which are quite high in bioflavonoids). The cycle is that when mast cells are more stable, and less likely to “pop open” with histamine, you are simply less likely to get symptoms.
Bottom Line: Whether it comes from your diet or from other compounds, it is important to know that histamine intolerance might not be the end of the story. While it might make you feel better, it is just as important to know the root cause of whatever issues you are dealing with – because it might even be more than one.
Histamine Intolerance: Test
The mindset that I would encourage for histamine intolerance, and that I often encourage when it comes down to figuring out root causes for issues, is all about testing. If you test, and something is obviously there, it is worth treating and pursuing further.
On the other hand, if it is not there, consider a trial of lowering histamine (in terms of the obvious foods that we detailed earlier), and think about things that help stabilize your mast cells.
Most importantly, look deep into any hidden infections, gut issues, airborne allergies, food intolerances (2). Those are the more likely culprits, and are certainly worth your time.
Bottom Line: If you continually “chase” the diagnosis of histamine intolerance, and it is not measurable in your body, you are playing a losing game. Even if you strongly suspect it, you will never know if you have gotten a handle on it. So, please, expand your perspective and try to treat these other issues – they could also be the root cause of your symptoms.
Expand Your Knowledge, Improve Your Life
More than anything else, I always want you to feel happy and vibrant. That starts with learning more about your body, whether it has to do with histamine intolerance or your thyroid. When it comes to getting a better hold on your health, please consider taking the Thyroid Quiz (3) today. It will give you a lot more information than you might have even thought possible, and can put you on the right path to leading a healthier life.
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, and regain energy. Learn more about the surprising story that started his quest.