Histamine intolerance is a condition in which the body cannot efficiently break down histamine ingested through food, which leads to its accumulation and the appearance of various symptoms. Histamine is a chemical substance present in the body that plays an important role in the immune system, in the regulation of stomach functions and in the communication between nerve cells.
The main cause of histamine intolerance is enzyme deficiency, especially diamine oxidase (DAO), which breaks down ingested histamine. This deficiency can be caused by genetic factors, certain drugs or intestinal diseases. Another enzyme involved, but less significant, is histamine-N-methyltransferase (HNMT). Also, the consumption of foods rich in histamine, such as fermented foods, canned or smoked fish, and certain vegetables and fruits, can contribute to this condition. Contributing factors include allergies, gastrointestinal disorders and drugs that inhibit DAO activity.
Symptoms of histamine intolerance are varied and may include headaches, migraines, nasal congestion, rhinorrhea, digestive problems, hives, skin rashes, hypotension, palpitations, tachycardia, fatigue, and allergy-like symptoms such as itching and swelling.
Treatment for histamine intolerance is mainly based on diet and avoiding foods rich in histamine. It is recommended to eat fresh foods and avoid processed or canned foods. DAO supplements can help break down histamine in food, and vitamins and minerals, such as vitamin C and B6, can support DAO activity. Antihistamines can reduce symptoms, but do not address the underlying problem of histamine breakdown. Probiotics can help restore intestinal flora and improve digestion.
It is essential to manage underlying conditions, such as gastrointestinal disease, that may contribute to histamine intolerance. Consulting a doctor for a correct diagnosis and to develop a personalized treatment plan is crucial. Histamine intolerance can significantly affect the quality of life, but through a correct approach, including dietary changes and appropriate treatments, the symptoms can be effectively managed. Diagnosis and treatment must always be supervised by a medical professional.
What is histamine and what role does it play in our body?
Histamine is a natural chemical substance in the body that has an important role in various physiological processes. Learn more about what histamine is and how it affects our body.
What is histamine intolerance?
Histamine intolerance is a condition in which the body cannot break down and eliminate histamine properly, leading to various unpleasant symptoms. Find out more about this condition and how it can be managed.
Causes and risk factors of histamine intolerance
Causes and risk factors for histamine intolerance include deficiency of enzymes such as diamine oxidase (DAO) and deficiency of enzyme cofactors, histamine-rich diet, use of certain drugs that inhibit DAO activity, and gastrointestinal conditions such as Crohn's disease, all of which contribute to the accumulation of histamine in the body and when specific symptoms appear.
Enzyme problems (enzyme deficiency and deficiency of enzyme cofactors)
The main cause of histamine intolerance is enzyme deficiency, especially diamine oxidase (DAO). DAO is responsible for the breakdown of histamine ingested through food. If the body does not produce sufficient amounts of DAO or if the enzyme is inhibited, histamine accumulates and causes the characteristic symptoms of intolerance. DAO deficiency can be determined genetically, but it can also be secondary to certain drugs that inhibit the activity of this enzyme, such as antidepressants, antihistamines and antibiotics.
Another important aspect is the deficiency of enzyme cofactors. Enzymes require certain vitamins and minerals to function properly. For example, vitamin B6 and vitamin C are important cofactors for DAO activity. Deficiency of these vitamins can reduce the efficiency of histamine decomposition.
Incorrect food or diet
Diet plays a crucial role in managing histamine intolerance. Eating foods rich in histamine or that release histamine can exacerbate symptoms. Fermented foods, such as wine, aged cheeses and sauerkraut, are particularly rich in histamine. Also, canned or smoked fish, tomatoes, spinach and eggplant are significant sources of histamine. Alcohol is another major factor, because it inhibits the activity of DAO and contributes to the accumulation of histamine.
To manage symptoms, it is important to adopt a low-histamine diet, focusing on fresh foods and avoiding processed or canned foods. In some cases, DAO supplements can also be useful to help break down histamine from food.
Other gastrointestinal diseases
Gastrointestinal disorders can contribute to histamine intolerance by affecting the production and activity of DAO. A significant example is Crohn's disease.
Crohn's disease is a chronic inflammatory disease of the intestine, which can affect any part of the gastrointestinal tract, from the mouth to the anus. The chronic inflammation associated with Crohn's disease can damage the cells that produce DAO in the intestinal mucosa, thus reducing the body's ability to break down histamine. Also, inflammation and intestinal injuries can lead to a reduced absorption of nutrients, including the vitamins and minerals needed for optimal enzyme activity. This aggravates the symptoms of histamine intolerance even more.
Management of Crohn's disease and other gastrointestinal conditions is essential to control histamine intolerance. Treatment for these conditions may include anti-inflammatory medications, dietary changes, and, in some cases, surgery to reduce inflammation and improve bowel function. In addition, probiotics can help to restore the intestinal flora and improve digestion, thus contributing to the improvement of symptoms.
You can read more here about Crohn's Disease, a form of inflammatory bowel disease
Medication
Medications can play a significant role in the development of histamine intolerance by inhibiting the activity of the enzymes responsible for breaking down histamine, particularly diamine oxidase (DAO). Several types of medications can negatively affect DAO levels, including:
Antidepressants: Some antidepressants, especially monoamine oxidase inhibitors (MAOIs), can inhibit the activity of DAO, leading to histamine build-up.
Antihistamines: Although they are used to treat allergy symptoms by blocking histamine receptors, they can also influence the activity of DAO.
Antibiotics: Certain antibiotics can affect the intestinal flora, which can lead to decreased production of DAO.
Analgesics and anti-inflammatories: Drugs such as aspirin and diclofenac can inhibit DAO, thereby increasing histamine levels.
Diuretics: These can affect the electrolyte balance, necessary for optimal enzyme activity.
Bacterial causes
The intestinal flora plays a crucial role in the metabolism of histamine. Bacteria in the gastrointestinal tract can produce histamine or influence the activity of enzymes that break it down. An imbalance of the intestinal flora, known as dysbiosis, can lead to an overproduction of histamine or to its insufficient breakdown.
Bacterial causes that contribute to histamine intolerance include:
Small Intestine Bacterial Overgrowth (SIBO): This condition is characterized by an abnormal growth of bacteria in the small intestine, which can produce excess histamine.
Bacterial infections: Gastrointestinal infections can disrupt the normal balance of intestinal bacteria, leading to increased histamine production.
Probiotics and prebiotics: The inappropriate use of probiotics and prebiotics can lead, paradoxically, to dysbiosis, aggravating the symptoms of histamine intolerance.
To manage the bacterial causes of histamine intolerance, it is important to maintain a healthy balance of intestinal flora. This can be achieved through a balanced diet, avoiding the excessive use of antibiotics and, in some cases, taking appropriate probiotics and prebiotics. It is essential to consult a doctor to determine the best approach for each individual.
Symptoms of Histamine Intolerance
Symptoms of histamine intolerance include digestive symptoms such as abdominal pain, diarrhea, nausea and bloating; skin symptoms such as urticaria, rashes, itching and angioedema; and respiratory symptoms, including nasal congestion, rhinorrhea, sneezing, breathing difficulties and cough.
Digestive symptoms
Histamine intolerance can cause various digestive symptoms, due to the accumulation of histamine in the gastrointestinal tract. These symptoms include:
Abdominal pains: They can vary from mild to severe and are often associated with general discomfort in the abdominal area.
Diarrhea: Frequent and watery, diarrhea is a common symptom that can lead to dehydration and loss of electrolytes.
Nausea and vomiting: Histamine can stimulate nausea receptors in the stomach and brain, causing nausea and, in some cases, vomiting.
Bloating: The accumulation of gases and liquids in the intestine can lead to the sensation of bloating and discomfort.
Heartburn and acid reflux: Histamine can stimulate the secretion of gastric acid, which can lead to heartburn and gastroesophageal reflux.
Skin symptoms
Histamine plays an important role in allergic and inflammatory skin reactions. Skin symptoms of histamine intolerance include:
Urticaria: Appears in the form of red rashes, itching and bumps that can be of different sizes and shapes.
Rashes: Red spots or areas of irritated skin may appear, which are often accompanied by itching.
Itching: Itching can be intense and can affect any part of the body, including the scalp and mucous membranes.
Angioedema: Deep swelling of the skin and subcutaneous tissues, often affecting the face, lips, eyes and neck.
Respiratory symptoms
Histamine intolerance can also affect the respiratory system, causing symptoms similar to those of respiratory allergies. These symptoms include:
Nasal congestion: Blockage of the nose caused by inflammation of the nasal mucosa.
Rhinorrhea: Excessive nasal secretions that may be clear and watery.
Sneezing: Episodic and frequent, sneezing is a common response to histamine exposure.
Breathing difficulties: In severe cases, histamine can cause constriction of the airways, leading to breathing difficulties and sometimes to asthma attacks.
Cough: A persistent, dry or productive cough may occur due to irritation of the respiratory tract.
Testing intolerance to histamine and establishing the diagnosis
The diagnosis of histamine intolerance requires a comprehensive approach, which may include blood tests for histamine and DAO, histamine challenge tests, and elimination diet tests. These methods help identify the cause of the symptoms and develop a personalized management plan.
Blood tests for histamine
Blood tests can be used to measure histamine levels in the blood, giving clues about the body's ability to handle this substance. Diamine oxidase (DAO) levels, the enzyme responsible for breaking down histamine, can also be measured. A low DAO level may indicate a reduced ability to break down histamine and thus a predisposition to histamine intolerance. These analyzes include:
Histamine levels: Measuring histamine in the blood can provide information about its accumulation in the body.
DAO levels: A test to determine the concentration of the DAO enzyme in the blood, which can indicate how efficiently histamine is being broken down.
Histamine challenge tests
Histamine challenge tests involve the administration of histamine or histamine-rich foods under medical supervision to observe the body's reaction. These tests are useful to confirm the diagnosis of histamine intolerance and to assess the severity of the reaction. The procedure involves:
Controlled administration of histamine: The patient receives histamine or foods rich in histamine in controlled quantities, and the doctor monitors the occurrence and severity of symptoms.
Clinical observation: Symptoms are carefully monitored, and any adverse reaction is promptly managed.
Elimination diet tests
Elimination diet tests are another way to diagnose histamine intolerance. This method involves eliminating histamine-rich foods from the diet for a period of time and then gradually reintroducing them to observe the body's reactions. The steps include:
Elimination phase: The patient avoids all foods known to have a high histamine content for 2-4 weeks. During this period, the symptoms are monitored to see if they improve.
Reintroduction phase: Foods are gradually reintroduced, one by one, to identify which ones cause symptoms. The reactions are documented to establish a clear link between certain foods and the symptoms of histamine intolerance.
Therapeutic approaches for histamine intolerance
Therapeutic approaches for histamine intolerance include working with a specialist for proper evaluation and diagnosis, developing a personalized treatment plan that may include a low-histamine diet, diamine oxidase (DAO) supplements, antihistamines, and probiotics, as well as managing stress through stress management techniques. relaxation and behavioral therapy.
Collaboration with a specialist
Effective management of histamine intolerance requires working with a health care professional, such as an allergist, gastroenterologist, or dietician. These professionals can provide accurate diagnosis and personalized advice to manage symptoms. The benefits of working with a specialist include:
Professional evaluation: A specialist can perform appropriate tests to confirm the diagnosis of histamine intolerance and to exclude other conditions with similar symptoms.
Nutritional counseling: A dietician can help plan a low-histamine diet, offering healthy and balanced food alternatives.
Monitoring and adjustment: Specialists can monitor the patient's progress and adjust the treatment plan based on the response to therapies and changes in symptoms.
Development of a personalized treatment plan
A personalized treatment plan is essential for the management of histamine intolerance and must take into account the individual needs of the patient. Elements of a personalized treatment plan may include:
Low histamine diet: Identifying and avoiding foods rich in histamine or that release histamine. This may require adjustments to eating habits and learning new recipes and cooking techniques.
DAO supplements: Using diamine oxidase supplements can help break down histamine from food, thus reducing symptoms.
Medicines: Antihistamines can be used to control the symptoms, although they do not treat the main cause of the intolerance. In some cases, medications that support digestive function or reduce inflammation may also be recommended.
Probiotics and prebiotics: These can help balance the intestinal flora and improve digestion, thus contributing to the reduction of histamine production by intestinal bacteria.
Managing stress: Stress can worsen the symptoms of histamine intolerance. Relaxation and stress management techniques, such as meditation, yoga or cognitive-behavioral therapy, can be beneficial.
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Conclusion
Histamine intolerance is a complex condition that requires a multidisciplinary approach to be effectively managed. Collaborating with health specialists, developing a personalized treatment plan and adopting appropriate dietary and lifestyle changes are essential to improve symptoms and improve quality of life. Correct diagnosis, continuous monitoring and treatment adjustments are fundamental to ensure optimal management of this condition. Patients are encouraged to seek medical help and follow the recommendations of professionals to obtain the best results.
