Even though your nose is running, your stomach churning, and your skin itching, you may be experiencing something that’s not exactly an allergy. It could be histamine intolerance.
Histamine Intolerance
Histamine intolerance, also known as enteral histaminosis, is a disorder that arises because of a body’s inability to degrade histamine due to diminished diamine oxidase (DAO) enzyme activity which leads to histamine accumulation in plasma and the appearance of adverse effects. That means when a person with histamine intolerance eats foods high in histamines (or that trigger their production) they’ll have an excess of histamine in their system just like they would if an allergic reaction triggered their body to release histamines. Unsurprisingly, the resulting symptoms are similar.
Symptoms
Symptoms of histamine intolerance include headache, dizziness, nasal congestion, sneezing, bloating, diarrhea, abdominal pain, nausea, itching, swelling, eczema, tachycardia, and hypotonia. The most common are gastrointestinal followed by dizziness, headaches, and palpitations, then respiratory and finally, dermatological. An Austrian study found an average of 11 symptoms per patient. That’s a lot of discomfort.
And while histamine intolerance may be causing a lot of unpleasantness, the lack of consensus for a diagnostic algorithm makes diagnosis a dicey proposition. Patients often end up seeing multiple physicians in an effort to get a diagnosis and treatment that will reduce symptoms.
Treatment
The primary strategy for treating histamine intolerance is to follow a low-histamine diet. Foods to avoid include spinach, eggplant, tomatoes, fermented foods, and meat or fish that is not fresh. It is also possible for papayas, kiwis, strawberries, pineapples, and plums to trigger the release of histamine so they should be consumed with caution.
DAO supplements have been proposed as an additional treatment. In Europe, regulations authorize a DAO supplement of enteric-coated porcine kidney protein extract to be marketed as food for special medical purposes.
More to Come
Multiple symptoms in multiple systems, a condition that’s difficult to diagnose, dietary treatment – these probably sound familiar to anyone with celiac disease. And it’s possible there is a connection. DAO activity increases progressively from the duodenum to the ileum and is located mainly in the intestinal villi. What is the effect when the villi become damaged from celiac disease?
Studies showing lessened DAO enzyme concentrations in untreated celiac patients vs those on a gluten-free diet could be an indicator that there is a relationship to be explored. Other connections to IBS and non-celiac gluten/wheat sensitivity (NCGWS) have been established. But studies of histamine intolerance are relatively new. We have much to learn and many connections to make.
In the meantime, if you suspect that histamine intolerance good be causing your allergy-like symptoms, keep a food/symptom diary. This will give you a written history to share with your physician. Don’t be afraid to ask whether they have considered histamine intolerance. You are a valuable part of your medical team.
Together with your doctor, you may develop a diagnostic plan that includes some of the following: skin-prick test; histamine elimination diet; analysis of blood, urine, and stool samples. Once a diagnosis is established, dietary change can eliminate most or all of the symptoms.
While a dietary change may not be your preference, fewer symptoms will bring you relief. And relief is what most of us are looking for even if what we have is not exactly an allergy.
