Histamine intolerance

Histamine intolerance

Histamine is a substance with a regulatory function in the body. Mast cells and immune cells contain histamine. Histamine plays a role in the production of stomach acid and acts as a neurotransmitter. An increase in histamine in the body manifests itself as allergic symptoms. An increase in histamine in the blood or intestine can have several causes. Excessive histamine levels in the intestine are caused by histamine intolerance or by a deficiency of the enzyme that breaks down histamine (DAO).

Symptoms of histamine hypersensitivity

Causes of increased histamine in the body

There are various reasons why histamine levels in the body may rise. Many cells in the body already contain histamine; when these cells are stimulated, the histamine can be released.

• During an allergic reaction, histamine is released in the mucous membranes, skin and blood. An allergic reaction occurs when antibodies come into contact with mast cells that contain histamine, causing the histamine present in the cells to be released.
• Histamine levels increase during inflammatory reactions.
• Certain foods, for example sauerkraut, can contain a great deal of histamine.
• Histamine levels in the intestine may rise because of foods that release histamine: red wine, chocolate, mature cheese and nuts.
• Enzyme deficiency. Under normal circumstances, histamine levels in the intestine remain fairly low. This is because the enzyme diamine oxidase (DAO) breaks down histamine. Some people lack this enzyme. When you consume foods that contain a lot of histamine, or when you consume red wine and chocolate, histamine levels in the intestine rise sharply. People with a DAO-enzyme deficiency then develop symptoms. This is referred to as histamine intolerance.
• People with a DAO deficiency who eat the same foods every day, for example tomatoes, nuts and fish, may develop high histamine levels and therefore allergic symptoms.

We recommend the following tests:

Causes of DAO deficiency and pseudo-allergy

A DAO deficiency may be congenital, may develop as a result of medication use, or may be caused by an infection of the small intestine. A deficiency of the enzyme diamine oxidase (DAO) results in high histamine levels in both the intestine and the blood. A characteristic symptom of DAO deficiency is developing blotchy skin or red cheeks after drinking red wine and then being unable to fall asleep. You do not need to drink much to experience this; one glass of wine is often enough. Not only red wine, but also chocolate, mature cheese and nuts increase histamine levels. With a DAO deficiency, people may experience itching, a blocked nose or headache after consuming these foods. These symptoms may occur immediately, but may also develop a day later. Other symptoms include:

• Insomnia
• Palpitations
• Diarrhoea
• Headache
• Itching
• Asthma-like symptoms
• A blocked or runny nose.

An increase in histamine can cause an accelerated heart rate and palpitations. The diarrhoea often occurs at night or a day after eating the foods mentioned above. An increase in histamine resembles an allergy, which is why it is referred to as a pseudo-allergy.

Available tests for histamine hypersensitivity

Testing for histamine hypersensitivity is recommended when someone has gastrointestinal complaints and allergic reactions. The test is always recommended when certain foods make you tired, when drinking red wine causes blotches on the neck, or when the cheeks or ears turn red after drinking red wine. The test is also recommended for people who have a combination of gastrointestinal complaints and insomnia. (See also: how the histamine test is performed). Normally, histamine levels in stool are below 600. When elevated, this value is doubled, and in some cases it even exceeds 3000.

Treatment of histamine intolerance

Treatment of histamine intolerance mainly involves adjusting the foods that are consumed. More specifically:

• Do not eat chocolate, cheese, wine and nuts.
• Avoid products to which you are allergic or intolerant.
• Avoid products with a high histamine content, for example sauerkraut.
• Follow a rotation diet, meaning: try to develop a weekly schedule and do not eat the same foods every day. This helps keep histamine levels low.

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