As if having GI issues like IBS, SIBO and IBD isn’t bad enough, many of my clients have some degree of histamine intolerance and it’s likely one of the causes of their digestive symptoms, especially bloating.
So what is histamine intolerance and what do you do about it?
There are two major players involved in histamine intolerance – histamine (obviously) and DAO enzyme.
What is Histamine?
- Your immune system releases a bio-chemical called histamine as part of a normal inflammatory response. It’s a neurotransmitter associated with allergic reactions. It sends a signal to the immune system that it’s time to react to a perceived invader.
- We need histamine for proper immune function but sometimes our body can have too much or it can’t be cleared out of the body the way it should be.
- Histamine can also be found in food. More on that below.
What is DAO Enzyme?
- Your body produces the DAO enzyme, which breaks down histamine so it can be excreted from the body.
What Does Histamine Intolerance Have to do with IBS, SIBO or IBD?
- Histamine intolerance results from increased levels of histamine and decreased production of DAO enzyme. Guess where those DAO enzymes are produced. Mostly in your gut. Guess where histamine is produced. Mostly in your gut. So you can see how digestive health is so important for regulation of histamine in the body.
- Having GI conditions like IBS, SIBO or IBD may increase the levels of histamine in the body.
- When you eat foods that contain histamine and you can’t break them down efficiently because of a lack of DAO enzyme then histamine is produced in excess and not fully excreted by the body. The result – your histamine levels increase and you may present with symptoms of histamine intolerance.
- Keep in mind everyone has different histamine thresholds
What are Symptoms of Histamine Intolerance?
Symptoms of histamine intolerance can be digestive or occur elsewhere in the body. A study of those with histamine intolerance shows that the most common digestive symptom is bloating and most people have three or more of the following symptoms (1).
Headaches/migraines
Difficulty falling asleep, easily arousal
Hypertension
Vertigo or dizziness
Arrhythmia, or accelerated heart rate
Difficulty regulating body temperature
Anxiety
Nausea, vomiting
Bloating
Abdominal cramps
Flushing
Nasal congestion, sneezing, difficulty breathing
Abnormal menstrual cycle
Hives
Fatigue
Tissue swelling
How is Histamine Intolerance Diagnosed?
Determining if you have a level of histamine intolerance is tricky since there are no tests and symptoms don’t always appear immediately. In fact, histamine symptoms appear after your body reaches its capacity to degrade histamine by the DAO enzyme. So you may be able to tolerate some higher histamine foods until you reach your personal threshold.
Which Foods are High in Histamine?
This is the list of main offenders:
· Aged foods – cheese, meats
· Cured foods; canned meats/fish; deli meats
· Fermented foods – yogurt, soy sauce, miso, kimchi, sauerkraut, wine, champagne, beer (sorry, folks)
· Avocado
· Banana
· Dried fruit
· Nuts
· Lemon, Mandarin
· Pineapple
· Yeast (this includes leavened bread)
Sadly, the picture above featuring a gorgeous spread is full of high-histamine foods such as aged cheese, cured meat, red wine, olives. But not to worry, we can have you eating these foods again.
How to Resolve Histamine Intolerance?
Step 1: Heal the Gut
Like Hippocrates said “All disease begins in the gut”. So we start by resolving your GI issues like IBS, SIBO and IBD. A gut-healing diet can help lower the amount of histamine produced by the gut and help repair the small intestine where the DAO enzyme is produced. In fact, a study shows that the low-FODMAP diet can result in an eightfold decrease in histamine levels (2).
Step 2: Reduce High-Histamine Foods
If necessary, you may get even more relief by reducing the amount of high-histamine foods you are eating. Take a look at the above list of high-histamine foods. Are you eating them on a regular basis? If so, try reducing your intake for a short amount of time. Or spread them out throughout the day. If I have too much avocado toast with smoked salmon, I may bloat later in the day from a double dose of high histamine food.
If you fear having to give up your favorite foods for good, just remember that gut-healing diets are not forever diets. As your gut heals, you should be able to tolerate more and more high histamine foods.
Do you need help determining if you have histamine intolerance issues? Contact me to develop a customized approach to get relief ASAP.
Resources:
1. Schnedl, W. J., Lackner, S., Enko, D., Schenk, M., Holasek, S. J., & Mangge, H. (2019). Evaluation of symptoms and symptom combinations in histamine intolerance. Intestinal Research. https://doi.org/10.5217/ir.2018.00152
2. McIntosh, K., et al., . (2017). FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial. Gut, 66(7), 1241–1251. https://doi.org/10.1136/gutjnl-2015-311339
I had allergies my whole life and I know I’m releasing a lot of histamines for my body it causes joint pain nausea sinus headaches bloatedness
We have a lot of clients with some degree of histamine intolerance. Improving gut health can improve histamine clearance from the body. Hope you can get some relief!
I was diagnosed with SIBO last fall and have been following low fodmap which is helping a lot but have noticed every morning that I am getting stuffier and stuffier and having major sneeze attacks. I think I might be developing a histamine intolerance and I am at a point where I don’t even know what to eat anymore!
Histamine intolerance is quite common in those with SIBO. We have found that when we address SIBO and improve gut health function along with supporting the immune system, allergies can improve.
Rhonda- Could there be an environmental component? For instance, being indoors during the winter months with the dryness of a heating system can lead to significant stuffiness. Soot can be an irritant too, whether from an oil-burning furnace or wood-burning fireplace. Whatever kind of furnace you have, try replacing your current furnace filter with a higher-filtration filter. Mold may also grow more quickly with a sealed-up house in winter. Indoor air quality is overall worse when our houses are sealed up tightly in winter.
Good points, Carol! Rhonda, have you been evaluated for environmental allergies? We have many clients with numerous environmental allergies who have some degree of histamine intolerance.
I’m just learning about histamine intolerance. I was on the carnivore diet for about a month. On Monday I had avocado and fell asleep. I woke up about 2 hours later cramping and completely bloated. The next day I was feeling slightly better and had a glass of soy milk. I immediately bloated back up. Yesterday, I had no appetite and my wife I insisted I at least have a mug of bone broth and once again I bloated right back up. Gas so painful that it pressed against my lungs and made it hard to breathe. I went to the hospital and the doctor just told me to take Mylanta and said he had no idea what was wrong. After research i found out that all three of the things I mentioned above were high histamine foods! Thank you so much for taking the time to write this page! The gas has “ slightly “ decreased. How long do these symptoms last for typically? Is it best to refrain from eating completely till you are symptom free?
Determining triggers of symptoms is tricky. The carnivore diet can be high in histamine, as well, since histamine levels increase in meat as it ages. Avocado and soy milk are also high in FODMAPS. Have you been evaluated by a gastroenterologist? Histamine or FODMAP intolerance are associated with many GI conditions. The key to resolving these intolerances is to address the underlying condition in the gut. Hope you feel better soon!
Great post! I also reevaluated my probiotics, finding that some bacteria strains increase histamine or decrease DAO. I also found some foods and beverages inhibit DAO. So, I avoid those too.
Lots to consider when managing histamine intolerance. We find when our clients address the underlying issues (gut health, allergies, immune support, hormone balance, etc.) their histamine tolerance improves.
Hi,
I’ve been experiencing hive outbreaks for the last three months- sometimes they’re gnarly and sometimes it’s minor. I’m on a homeopathic med along with traditional antihistamines and even sometimes that doesn’t work successfully. I eat most of the foods you listed in this article and have had stomach issues in the past. Do you think I’ve reached my “threshold” and need to heal my gut? Sounds like it! I’m just shocked my doctor has recommended I visit a gastro specialist.
Hi Matt, do you know what is triggering your hives? Have you seen an allergist for environmental and food allergy testing? If not, that is where we would start with our clients. You may be allergic to something and therefore increasing your load of histamines in the body. Removing the triggers should help as well as supporting gut and immune health.
Hi,I I having histamine related symptoms from over year but now its in stage that once its starts its hard to even control them.from.mast cell stabiliser.This starts mostly in morning or later depending what I ate.Been on mast cell stabilizer for 3 months and taking cetrizine 10mg.I had a history of Ibs.Blaoting,Flatulence is a main symptoms after eating.No weight gain.Feel hungry most of the time.currently taking homeopathic medicine as well but waiting if actually it’s gonna do miracle.If earing any spices then I could feel the taste hours later amd fells like its not digested properly.Flatulence after eating rice and potatoes sometimes which I noticed too.Any Advice pls.
Hi Rishiraj – we find that working on gut health improves histamine intolerance because many mast cells are in the gut. Bloating and gas after eating are symptoms of so many digestive conditions. You may want to visit a gastroenterologist to determine what is causing this.
Hello. I happened upon your site when looking up information on histamine intolerance. I have had immune system issues since birth. During my childhood, I had asthma, had to get shots for pollen allergies, chicken pox twice, scarlett fever, bell’s palsy, pneumonia, and other issues. In my 20’s I was diagnosed with hemanioendotheliomatosis of the skull, long bones, and the liver at the Mayo Clinic. My tumor grew until it was nearly 40 pounds, and I had a liver transplant in 1996. My gall bladder was removed.
My bell’s palsy returned permanently when I was 32. About five years ago, I had cat scratch fever which led to granulomatous hepatitus, and I was hospitalized seven weeks. Three years ago, I developed an ulcer on old scar tissue. Surgery was performed to fix the issue. The doctor removed the fluid pump early, which led to wound leakage and infection. It took a year for the wound to heal. I was on Linezolid three times and reacted poorly to it (swelling of the face, extreme fatigue). I also developed bullous pemphigoid. I was on prednisone for a short time and reacted poorly to it. I was able to eat a pretty normal diet after my transplant. I had some issues, but it wasn’t until I was on Linezolid and took prednisone the serious issues started.
I started having reactions to food I never had issues with before. If I ate gluten, I developed a thick yellow fluid in my ear and fluid filled blisters on my stomach. I ate a grilled cheese about six weeks after being off the antibiotics and my blood pressure and pulse spiked. I called 911, because I didn’t know what was happening. The same thing happened when I ate Sauer kraut. I started having flushed skin, hives, swollen wrinkled hands and fingers. I have developed neuropathy in my feet. My joints pop constantly. I now have severe tinnitus.
I have been to a couple doctors, allergist, emergency room, urgent care, etc., and I have been told that it was anxiety, and one doctor told me maybe walking around the mall might help me. The allergist kept saying, “Uh huh” when I explained to him my problems. He did some tests for allergies and said it wasn’t food related and come back in six months. When I mention food intolerance and maybe histamine intolerance, they look at me like they don’t know what I am talking about and give me a new medication. I have been frustrated and in pain for a couple years. I was getting ready to tell my family doctor I need to be tested when the Covid pandemic started. Every time I think I have figured out what to eat, something changes. Some days my tinnitus is so bad that it sounds like I am on a plane getting ready to take off. I am just looking for some help or someone to point me in the right direction.
I’m sorry you have been going through so much. With so many health conditions and medications it’s hard to say exactly why you are experiencing histamine intolerance but it’s possible that the medications and overall level of inflammation has caused some degree of GI distress, which could in turn, lead to histamine intolerance. Consider limiting the high histamine foods listed in this article as a first step.
Will the bloating cause temporary weight gain? I am very histamine intolerant at the moment (have SIBO) and notice that my weight goes up and down alot. I get bloated from many foods and am finding it hard to control this at the moment !
Thankyou
We find that many clients experience bloating and weight gain because of the inflammation related to SIBO and GI issues. It’s not likely fat gain but water weight associated with inflammation. When we heal the gut, we see that weight often rebalances.
For the past year, I have had a lot of acid reflux and some heartburn. My doctor put me on ppi’s and I was on them for 8 months. While taking the ppi’s, my stomach was worse than ever. I had chronic indigestion, more acid reflux than ever before, and trouble swallowing. I also became very anemic. I was starting to worry about the anemia and did some research. I came across an article that linked PPI’s with anemia. I slowly stopped taking the ppi and then finally went completely off of it. Almost immediately, the chronic indigestion stopped, and I felt better overall. I was not randomly falling asleep in the middle of the day from iron deficiency as well. But, I did still have some coughing after eating and some trouble swallowing. I could feel acid creeping up my throat every once in a while. One day, I had very bad allergies and decided to take a Claritin. I had never taken Claritin before. It helped right away, so I took it for a couple of weeks. It took me a few days to realize that my acid reflux, trouble swallowing, and coughing after eating had stopped as well. I’m wondering if it is the Claritin that is helping me and have made these symptoms finally go away.
Hi Jackie – We hope you are feeling better! Yes, histamine intolerance can cause reflux. You may have discovered a helpful clue!