Food intolerances have always been a rather neglected factor in western healthcare and only in recent years, as more attention has been paid to it, has the great extent of food intolerances in our society become more prominent. However, there is still a lot we do not know about them. It can be assumed that especially with the following intolerance the number of unknown cases is high: Histamine intolerance (HI), also called ‘histaminosis’.
This condition is hardly ever diagnosed by medical practitioners. This means that those affected are often left to their own devices and have to live with impairing symptoms for a long time before they get a diagnosis. It can be assumed that due to its many comorbidities, histaminosis is prevalent in – and can aggravate – health issues, such as depression, anxiety, atopic eczema, chronic fatigue and IBS.
Histamine in our body
A food intolerance is unlike a food allergy. A food allergy is a learned allergic reaction from our immune systems to proteins in foods or environmental allergens (pollen, dust, mold). During an allergic reaction, some of our body’s cells (mast cells) release histamine into their surroundings. The effect can be compared to that of a flame thrower: it eradicates all foreign substances and ‘intruders’ – inflammation is the result. On the outside this can be seen as urticaria or a wheal which is a local swelling and inflammation, very much like when getting stung by a stinging nettle (bot. name: Urtica). When that happens the stinging nettle injects histamine into our skin through the fine hair sitting on the surface of the plant.
A food intolerance on the other hand, is caused by a lack of digestive enzymes. As soon as a person is not able to digest the food of a ‘healthy’ and varied diet, and suffers from discomfort related to this, we can speak of a food intolerance. There might be times when one person can eat certain amounts of foods without problems, which would at other times cause them great discomfort. Stress is one factor that causes these fluctuations.
When it comes to histamine intolerance – which is also classified as a pseudo-allergy – the boundaries between allergy and intolerance are not as obvious. This is because the substance one is intolerant to is histamine, the same as involved in an allergic reaction and therefore symptoms are very similar; the causes however, different. This intolerance means that without being inactivated by the enzyme Diamine oxidase (DAO) or Histamine N-methyltransferase, the histamine which is in foods is absorbed into the body and runs there wild.
Another mechanism that plays a role is that some foods do activate the release of histamine in our body cells through a chemical reaction. People with low enzyme levels then may suffer more consequences due to these histamine liberators than people with normal enzyme activity.
The following symptoms can be caused by high histamine levels. They can especially appear after a meal or the consumption of certain beverages:
- Sneezing
- The need to clear your throat a lot, coughing and asthma
- Tense muscles
- Headaches and migraine
- Fatigue and chronic fatigue
- Low blood pressure
- Dysmenorrhoe: Very painful periods
- Skin problems like Urticaria, wheals (local swelling max. ca 0,3-0,5cm) often in the face, sore and dry lips, atopic eczema
- Digestive problems: Diarrhea, Irritable Bowel Syndrome, bloating, gas, heartburn, lower abdominal pain
- Irregular or sudden increase of heart rate and intensity of the heartbeat
- Bruxism (clenching and grinding of the teeth day or night) can cause frequent tension headaches
- Sleep problems, light sleep, and hyperactivity
- Frequent and urgent urination
- Depressive episodes
Histamine in our foods
Sadly the enzymes, that are deficient in HI are responsible not only for the breaking down of histamine, but also for other biogene amines like Tyramine and others.
Foods are either naturally containing a high amount of biogene amines, or they develop these by fermentation, maturation, curing, ripening etc. This means that any food that is matured or old is potentially rich in biogene amines and is likely to cause problems. These amines are not destroyed by cooking! As a consequence, any older leftovers should be avoided. Those affected should make sure the meat, vegetables and fruits they consume are fresh.
Not all people affected by HI react to the same foods in the same intensity. So I advise you to get a feel for your own limits. This depends on the individual tolerance and the amount eaten. The following foods, food additives, and drugs, can cause some symptoms due to their high histamine/ biogenic amine content, histamine liberating, or enzyme inhibiting properties:
- Any kind of alcohol – especially matured, like wine, champagne, whiskey, sparkling wine etc.
- Cocoa and chocolate
- Coffee, black and green tea, mate, energy drinks (anything containing caffeine, taurine, and theobromine)
- Pickled or canned foods – sauerkrauts
- Matured cheeses (Mozzarella and young cheeses as an alternative)
- Smoked meat products – smoked salmon, sausages, salami
- Certain fish – Tuna, mackerels, sardines, shellfish
- Beans and pulses – chickpeas, soybeans, peanuts
- Nuts – walnuts, cashew nuts
- Vinegar (apparently spirit vinegar is a good alternative)
- Preservatives and artificial colorings – benzoate, phosphates, sulphites, nitrites, glutamate (flavor enhancer), food dyes
- Strawberries, raspberries
- Tomatoes
- Baking powder – Sodium bicarbonate, natriumhydrogencarbonate
- Yeast
- Most citrus fruits – kiwi, lemon, lime, pineapple
- Nettle tea
- Drugs – Aspirin, Morphine, and others
The intake of vitamin B6, vitamin C, and copper can help, because it increases the DAO enzyme activity. Some find the intake of the enzyme DAO in capsule form helpful. DAO enzymes are however very expensive and they do not work with histamine liberating foods. The use of antihistamines (Cetirizine etc.) can also offer relief.
People who suffer from mastocytosis or mast cell activation disorder are also likely to be intolerant to histamine.
Is the solution to cut out all histamine foods?
Have you ever noticed that whenever you cut out a food that you respond to, you react to smaller amounts much stronger than before the diet change? That is because avoidance doesn’t build tolerance, but it can increase sensitivity. It is never possible to have a diet completely free of histamine, however a low-histamine diet is possible and relieves many of the symptoms mentioned above. Since the list of potential problem foods is quite extensive, nobody should keep a strict low-histamine diet for the rest of their lives. When combined with a gut-friendly diet, lower stress lifestyle, maybe even a cleanse, your gut will have time to heal. Thereafter it is important and possible to slowly reintroduce the previously problematic foods. Most will find that they become much more tolerant and therefore flexible.
Stress is often a strong mediator in gut-health. Just because you reacted badly to a food once doesn’t mean you have to cut it out again, just eat less and don’t get discouraged or see bad reactions as set-backs. They are part of a learning curve to listen to your bodies limits at that moment in time.
Gut health is a holistic issue. Relaxation is very important in restoring your gut health. So while you are in the process of figuring out your needs consider seeing an alternative health professional. Ideally, they help you cope with the stress that a limited diet can bring and look at the stresses in your life that could have brought on the sensitivity in the first place. Visit a spa, get a massage, or see a hypnotherapist to help you break the vicious cycle of stressing about food and reacting to it.
