Histamine Allergy - Causes, Symptoms and Therapy

Histamine intolerance signs, causes and treatment
If you suffer from histamine allergy, a balanced diet can be a challenge. Because any foods that contain histamine as an ingredient - including many fruits and vegetables - cause those affected extreme physical defense reactions. These may sometimes be reminiscent of completely different allergies or even completely different clinical pictures.

contents

• definition
• Histamine in the diet as the main cause
• Histamine in plant and animal foods
• These foods can interfere with histamine breakdown
• Deficiency symptoms and impaired enzyme activity
• Medicines and other trigger stimuli
• Symptoms of histamine allergy
• Diagnosis in histaminosis
• Therapy with a histamine allergy
• Tips for a histamine-poor diet:
• Change of habits
• Naturopathic treatment
• Medical therapy

definition

The term "histamine allergy" is actually a bit misleading. Proper would be the official, medical term Histamine Intolerance (Histaminosis) Because although the defense reactions of the body in this disease are triggered by food ingredients, this is not a food allergy in the true sense. In contrast to "real" allergies, which are triggered by mis- or overreactions of the immune system to certain allergens, an incompatibility with histamine is more likely due to an enzyme deficiency. In detail, these are the enzymes diaminoxidase (DAO) and or Histamine N-methyltransferase (HNMT), which are responsible for the breakdown of histamine in the body.

It does not have to be histamine allergy. A test can detect allergies. Image: Gerhard Seybert-fotolia

Useful information:

In case of histaminosis, there is not necessarily a deficiency of both enzymes.

The enzymes responsible for histamine degradation are also referred to in medicine as biogenic amines, because they are produced by splitting off molecules (Decarboxylation) come from amino acids. While diamine oxidase doing so for the extracellular (taking place outside the cell) Histamine N-methyltransferase is responsible for the intracellular breakdown of histamine (taking place inside the cell) Histamine degradation. However, if there is a deficiency of one or even both enzymes, the histamine remains in and around the cell tissue, causing the organism to react with allergy-like symptoms.

DAO and HNMT are formed in the intestine as well as in the kidneys and in the placenta. The latter place of production is of particular interest because histaminosis often declines temporarily in pregnant women. However, after pregnancy, or placental repulsion, histamine allergy usually germinates. It can be surmised that the temporary increase in production of histamine enzymes can remedy the course of the disease, at least in the short term.

Speaking of women:

A good 80% of all patients with histaminosis are middle-aged women, which shows a clear sexual accumulation. An international study suspects among other things hormonal peculiarities of the female sex.

Reasons for the body's overreaction can be found in histamine intolerance in the role of the histamine itself. The substance actually occurs naturally in the body and takes over numerous functions, including:

• • Dilation of the blood vessels
  • Function as tissue hormone
  • Messenger substance for inflammatory reactions
  • Defense of the immune system
  • Regulation of gastric acid production
  • Regulation of the sleep-wake rhythm
  • Regulation of the feeling of hunger
  • Signal line in the central nervous system

It is not difficult to see that a disturbed histamine balance can quickly plunge the body into chaos. In this regard, the excess of histamine present in histaminosis primarily causes exaggerated defense and inflammatory reactions, which in fact amount to an allergic reaction. A good example of this is the disease typical hives (Urticaria). The irritative skin reaction does not take its name from the stinging nettle in vain, because, like touching this medicinal plant, hives also cause itchy red wheals on the skin.

It is interesting to note that the stinging nettles also cause the histamine-rich stinging hair of the plant to be responsible for the skin reaction. Similar histamine loadings are also various insect poisons, such as that of bees. A circumstance that once again strongly suggests allergies to natural substances in histaminosis. Some other allergy-like symptoms of histamine intolerance include diarrhea, allergy-like colds, difficulty breathing, asthmatic seizures, high blood pressure, and palpitations. Read more about this in our section on symptoms of histamine allergy.

Histamine in the diet as the main cause

As mentioned earlier, histamine is hiding in numerous foods is histamine. On the one hand, natural foods that are rich in amino acids can easily be identified as a by-product of molecular degradation. But also finished products sting thanks to relevant additives and preservatives not with histamine.

Blood collection with histamine intolerance can help in the diagnosis. Picture: ghazii-fotolia

Histamine in plant and animal foods

In the field of plant foods, the range of histamine-rich products is also surprisingly large. It is often wrong to think of other food intolerances such as soy or nut allergy when first signs of histaminosis appear. This is not surprising, because especially soy and cereal products can cause allergic or allergy-like symptoms due to other ingredients. In order to minimize or at least clarify the likelihood of confusion, here is an overview of histamine-rich fruits, vegetables and cereals:

• avocado
• peas
• strawberries
• Soybeans and soy products (for example tofu)
• spinach
• Tomatoes and tomato products (e.g., ketchup or tomato paste)
• walnuts
• wheat products

When it comes to animal foods, when it comes to histamine allergy, avoid raw meats such as chicken breast or beef. However, raw fish and seafood such as salmon and mussels also contain considerable amounts of histamine. Furthermore, animal products such as chicken eggs, cow's milk and cheese are mentioned. With cheese in particular, there is another aspect of nutrition that plays an important role in terms of the histamine content of foods: the fermentation. The longer a cheese matures during fermentation, the higher its histamine content. Particularly critical in this context are very long matured hard cheeses such as Parmesan or Emmentaler.

Fermented and preserved foods are particularly treacherous

Basically, patients with histamine intolerance cause almost all fermented food problems. In the course of the fermentation process, the amino acid histidine is often increasingly converted into histamine, which further increases the already existing histamine content of certain foods. Especially products whose fermentation was carried out by the addition of vinegar or lactic acid, as is the case for example with mustard, sauerkraut, sour cucumbers and other pickled vegetables have due to their special manufacturing process a high content of histamine.

This also applies to alcoholic beverages such as beer or red wine, which are also produced by fermentation or fermentation. Beer also shows the tendency of yeast and yeast products to release more histamine through fermentation. For this reason, yeast-containing baked goods such as white bread or stollen are not entirely safe for patients with existing histamine allergy. There are also smoked meat products such as dried meat, salami, ham or smoked fish.

Preserved foods should also be treated with caution if existing histamine intolerance, if not eliminated altogether. Because the preservative additives, for example, in canned and ready meals (for example, canned tuna or canned vegetables) also give the products a high histamine content.

These foods can interfere with histamine breakdown

The body's histamine is normally trapped in various cell types such as the mast cells, the epidermis and mucosal cells, and the nerve cells. If the release of histamine is necessary, for example, if a foreign substance is detected, the bubbles burst (Vesicles) These cells are released and a large amount of histamine is released. This process is actually known from allergies in which histamine is involved as an antibody. However, it is now known that not only allergens, but also other processes in the body can provoke an unnaturally high level of histamine. These include foods such as pineapple, legumes, papayas, cocoa products and citrus fruits, which slow down the breakdown of histamine in the body either by blocking the enzyme receptors or, as so-called histamine liberators favor an increased release of histamine.

In this context, the double effect of alcohol is mentioned. In addition to the fact that alcoholic beverages such as beer and red wine already bring a considerable amount of histamine into the organism, alcohol is also considered a so-called DAO blocker, which inhibit the activity of diamine oxidase in the body and thus affect the histamine degradation.

Deficiency symptoms and impaired enzyme activity

The production and functionality of diamine oxidase in the body can be affected by numerous health factors. To play stress factors for example, an important role in the body's hormone and enzyme production. As a result, stressful situations, such as anxiety, panic and shock, can cause disturbances in the DAO budget. Similarly, everyday stress-related metabolic disorders are conceivable as trigger factors of histamine allergy.

Also certain bowel disease, including celiac disease, ulcerative colitis and gastroenteritis can not be ruled out as the cause of an enzyme-forming disorder. Beside that, too Vitamin and mineral deficiencies mentioned as possible triggers. Because in addition to corresponding enzymes, the organism also requires certain nutrients for the degradation of histamine, which ensure the enzyme functionality. These so-called excipients include primarily vitamin C, vitamin B6 and copper.

Medicines and other trigger stimuli

In addition to chemical substances such as nicotine and alcohol, certain medications are also suspected of triggering or at least promoting histaminosis. For example, an incompatibility of analgesic and antirheumatic agents such as acetylsalicylic acid, diclofenac, indometracin and mefenamic acid is known. Furthermore, some muscle relaxants, contrast agents, antibiotics apply (e.g., Metrodinazole), Asthma, blood pressure and heart medications as complicating for patients with histamine intolerance. Unsecured, but still discussed are physical stimuli such as cold, heat, wind and friction, which are considered as possible triggers.

Symptoms of histamine allergy

Since many symptoms of histamine intolerance erroneously remind of a true allergy, medicine also speaks of a pseudo-alergy. For example, due to symptomatic respiratory complaints such as hay fever, asthma-like shortness of breath, itching, skin and mucous membrane irritation, the disease is easily confused with pollen allergy. Digestive complaints such as diarrhea, abdominal pain, nausea and vomiting, however, rather remind of a food allergy. Even illness-related blood pressure and heart complaints are repeatedly associated with allergies and can therefore be misleading.

Itching on the skin may be an indication of histamine allergy. (Image: Gina Sanders / fotolia.com)

In addition to these alleged allergic symptoms, there are also some symptoms that clearly differentiate histaminosis from other allergies. These include, for example, the disease-typical nerve disorders and cognitive impairments. From dizziness and fatigue to nervousness, confusion and sleep disturbances, to severe depression and migraine attacks, histamine intolerance can cause many ailments. In women, the increased histamine level also causes an increase in estrogen production, which can bring the cycle events out of balance. Overall, the following symptoms are conceivable in histaminosis:

• respiratory symptoms

e.g. Asthma symptoms, general breathing problems, sore throat, hay fever, stuffy / runny nose

• indigestion 

e.g. colicky abdominal pain, bloating, diarrhea, stomach pain, heartburn, constipation, nausea and vomiting

• heart problems

e.g. High blood pressure, low blood pressure, rapid heart rate, cardiac arrhythmia

• Skin and mucous membrane irritation

e.g. Eczema, skin and mucous membrane redness, swollen mucous membranes, itching, hives, inflammatory mucosal irritations in the bladder, urethra and female genitalia

• Tissue and skeletal complaints

e.g. Edema (water retention), bone marrow edema, joint pain

• Head and nerve complaints

e.g. Hot flashes, headaches, depression, migraines, nervousness, dizziness, confusion, trouble concentrating and sleeping, fatigue and fatigue

• Mrs complaints

e.g. disturbed menstrual cycle, vaginal inflammation

Useful information: Histamine intolerance apparently also promotes the onset of seasickness. This is closely related to the perception of balance, which again underlines the impairment of the cognitive brain area in histaminosis.

Diagnosis in histaminosis

Histamine intolerance is diagnosed in several steps. First, the attending physician will conduct a detailed interview with the patient within which existing complaints will be queried and any possible triggering situations will be revealed. However, as already indicated, many of the symptoms are relatively nonspecific and may just as well indicate an allergy or other underlying disease. For this reason, an exclusion diagnosis must be made after the anamnesis. This happens on the one hand via a provocation test, in the patient to be tested for various allergens. If allergic reactions fail here, histamine intolerance is likely.

The histaminosis itself can unfortunately not be determined by targeted provocation, because concentrated amounts of histamine cause easily lethal symptoms in histaminosis. Doctors therefore resort to one Food Test back. This is done in the form of a 14-day, histamine-free diet, in the course of which histamine, as well as the DAO values ​​regularly by a blood test be measured. In addition, certain markers can be added (e.g., vitamin and copper concentration) also in urine test determine.

Therapy with a histamine allergy

The treatment of histamine allergy is multi-level. The affected person can do a lot of things himself. It is primarily about a reduction of histamine intake and release by changes in lifestyle.

dietary changes

As stated above, the diet has a high impact on the histamine concentration in the body. Patients with histamine intolerance can and should therefore review and change their diet for histamine-rich foods and histamine-liberators. At first glance, it looks like you can not eat anything in the future, except for selected raw foods and unmodified foods. But that need not be.

First and foremost, it depends on the amount of food consumed. A piece of chocolate or a bit of parmesan on the pasta is usually no cause for concern here. On the other hand, daily lush units of unfavorable foods permanently increase histamine output in the organism. It is therefore important that the meals in their sum are selected histaminearm. You should also try and test a bit because some histamine-rich foods are often better tolerated than others.

Tips for a histamine-poor diet:

• With the exception of smoked or preserved products, most types of meat and fish are considered relatively low in histamine. Harmless are commonly fresh meats (with the exception of beef and chicken breast) as well as freshly caught fish, whereby salmon should rather be left outside.
• In the case of fruits and vegetables, of course, relevant histamine carriers such as pineapple, strawberries, legumes, spinach and tomatoes should be avoided. Otherwise, however, affected people can take courage in the selection of herbal food. Whether fruits such as apples, apricots, berries, cherries, tropical fruits such as mango and melons or traditional vegetables such as cucumbers, potatoes, cabbages, squash, leeks, carrots, rhubarb, salads and Spragel - the range of foods that are well tolerated in histaminosis, is very big here.
• The situation is similar with cereals. Although soy and wheat products are more likely to be removed from the diet when histamine intolerance occurs, there are plenty of alternatives, such as spelled, oatmeal, millet, lupine or corn and rice products, the latter being tested as a precautionary measure should be.
• For dairy products, an initial test phase is also recommended. Quark, yoghurt, soft and fresh cheeses may be tolerated under certain circumstances. Alternatively, there are milk substitutes such as oat, coconut or rice milk. Lupines are another recommendation here. The cereal is now used for a range of dairy and meat substitutes and is recommended not only for vegetarians and people with lactose or gluten intolerance, but also for people with histaminosis.
• Supplements of sufficient amounts of vitamin C, vitamin B6 and zinc may require dietary supplements if histamine intolerance is present. But here, too, can be done on the right food choices normally way. Potatoes, lamb's lettuce, wholemeal products, fresh fish and all types of cabbage, with the exception of sauerkraut, are recommended for good vitamin intake. With zinc, things could get a little more tricky, as many sources of zinc in the diet (such as nuts, wheat and beef), are unsuitable for patients with histaminosis. Sunflower seeds, corn and oats, however, can at least support the zinc balance in support of food supplements.
• In addition to these specific nutritional recommendations, there are a few other tricks to prevent intolerance reactions in histaminosis. For example, food that has many additives such as the flavor enhancers glutamate E 620 to E 625 should not be on the menu. Finished products, as well as soft drinks and energy drinks are therefore largely taboo. Furthermore, when buying meat and fish, always ensure that there is sufficient freshness and basically freeze food instead of storing or warming it to avoid unwanted fermentation processes. When buying groceries, cooler bags, coolers and a special food intolerance app for quickly gathering information about the histamine content of individual foods are also a good tip.

Change of habits

Stress and histamine are closely related, because a lot of stress leads to an increased histamine load on the body. For this reason, it is important to adopt a stress-free lifestyle as possible. Although life can hardly be accomplished without stress, there are ways to make everyday life a bit calmer and more relaxed. You can start with the reduction of addictive and stimulants, such as alcohol, nicotine, coffee and energy drinks. In addition, the learning of relaxation measures such as meditation or yoga offers special courses. Patients with histamine intolerance should also provide adequate and restorative sleep. How about, for example, an evening sound and aroma ritual to improve your own sleep hygiene?.

Naturopathic treatment

In the field of herbs and spices must be paid attention to histaminosis, unfortunately. There is a whole list of spice herbs that are not tolerated here because they are considered Liberators. These include anise, chilli, curry, eucalyptus, spice broth (due to the flavor enhancers and preservatives), Nutmeg, cloves, paprika, pepper, peppermint, mustard, cinnamon and seasoning sauces, e.g. Soya, Tabasco or fish sauce. Basil, dill, tarragon, chamomile, cardamom, coriander, turmeric, caraway, ginger, lovage, mint, oregano, parsley, rosemary, saffron, sage, chives, thyme, vanilla and juniper are particularly suitable for histaminosis. The herbs can be used for metabolism and immune boosting teas or spice blends and relieve the troubled hormone balance.

Medical therapy

Particularly pronounced histamine allergies with extreme symptoms may need to be treated with medication. This is the case, for example, when a change in dietary and lifestyle habits shows only moderate to no success and the symptoms continue to be severe. Altogether there are 3 starting points for the drug treatment:

1. Alleviation of allergy symptoms through the use of antihistamines
Antihistamines are medicines that block those receptors to which the released histamine would normally dock. As a result, the tissue hormone can no longer bind at these sites and trigger its reaction cascade. Typical symptoms such as itching, runny nose, abdominal pain, diarrhea, redness, headache and water retention are alleviated in this way.

2. Compensation of the enzyme deficiency by supplements
The enzyme diamine oxidase can also be supplied externally to bridge deficiencies. However, the study situation is still more than thin in this respect and supplementation is only advisable under medical supervision.

3. Supply of cofactors to increase the activity of diamine oxidase
DAO needs Vitamin B6 and Vitamin C to work well. A supply of these two vitamins on dietary supplements is therefore to be considered useful in a histamine allergy.

Diseases of histamine allergy: Bowel disease, celiac disease, ulcerative colitis, enterogastritis, deficiency symptoms. (Ma)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)