Histamine intolerance symptoms and treatment

In the case of histamine intolerance or histamine intolerance, the ratio between the accumulating histamine and its degradation is disturbed. Histamine intolerance is not an allergy, but an intolerance. It occurs mainly in women between the ages of 35 and 40 years. We show how complaints can be expressed and what treatment can be considered.

contents

• histamine
• How histamine works in the body
• Cause: decreased DAO activity
• Cause: decreased HNMT activity
• Discomfort with elevated histamine levels
• symptoms
• Histamine intake by food
• Substances that inhibit diamine oxidase
• Substances that increase intestinal permeability
• Hyperacidity - Histamine-related
• Additives containing histamine
• diagnosis
• treatment

histamine

Histamine belongs to the group of biogenic amines, which have the most diverse tasks in the human body. So this substance is released in allergic reactions and inflammation, it controls the gastric juice production, leads to an enlargement of some large vessels and is also present in the central nervous system.

Histamine is broken down by two different ways. The enzyme DAO (diamine oxidase), which is mainly produced in the intestinal mucosa, breaks down extracellular histamine. This can be used to eliminate the hormone in the food pulp. HNMT (histamine N-methyltransferase), on the other hand, occurs intracellularly and is mainly involved in the liver in combating histamine.

Histamine intolerance may lead to allergic reactions after consumption of certain foods and beverages. (Image: DOC RABE Media / fotolia.com)

Typical of a histamine intolerance is a rapid reaction in the form of complaints, such as diarrhea, rash, stomach cramps. Especially with the help of the diarrhea, the body wants to try to get rid of the histamine as soon as possible. But long-term symptoms, such as fatigue or mood swings are possible.

How histamine works in the body

The histamine is a completely natural substance that is formed in the body and does indeed take on important functions. So this is mainly involved in inflammatory and allergic reactions. Histamine causes swelling, dilates blood vessels and makes vascular walls more permeable. In this way, the place of the event is better supplied with blood and the immune cells can find the way easier and faster.

In an allergy, a lot of histamine is released, which leads to the known allergy symptoms. However, this is different with histamine intolerance. Here the body can not break down the accumulating histamine. The necessary mechanisms no longer work properly. In particular, histamine-rich foods that are added lead to an excess of histamine, as a result of which various symptoms can develop.

This is how histamine works in the human body. (Image: designua / fotolia.com)

Cause: decreased DAO activity

Various causes are responsible for the development of histamine intolerance. The enzyme DAO, which is particularly active in the gut, is normally able to break down the histamine that is no longer needed. However, if this is reduced, histamine intolerance may result. The excess of histamine enters the bloodstream, which can cause various physical symptoms.

There are also DAO-blocking drugs, or drugs that can inhibit the activity of the important enzyme. These include, for example, metoclopromid, which is included in motility-affecting drugs. Likewise, alcohol and nicotine can inhibit the activity of DAO. Vitamin C and copper are important for the synthesis of this enzyme. If these micronutrients are reduced, this may eventually lead to histamine intolerance as well.

As mentioned, DAO is mainly found in the intestinal mucosa. If this function is impaired, this can lead to histamine intolerance. For example, after antibiotic therapy, the intestinal flora is often in an imbalance. Bowel disease, such as ulcerative colitis, Crohn's disease, sprue or celiac disease or the Leaky Gut syndrome are also held responsible and may be the cause of HIT. Intestinal dysbiosis, triggered by fungal infestation or imbalance of the physiological gut bacteria, is equally among the possible causes of a disturbed intestinal mucosa.

Another reason for histamine-induced complaints is the presence of a so-called estrogen dominance. This often occurs in the premenopausal phase but also in conjunction with other hormone changes in a woman's life. Conversely, the existing histamine stimulates the production of estrogen. In this context, it has also been found that in women who suffer from histamine allergy, their symptoms during pregnancy are lower because at this time the female body produces a lot of progesterone, which is the antagonist of estrogen.

In addition, a histamine intolerance, due to a disrupted activity of the enzyme DAO, may in rare cases be congenital.

Cause: decreased HNMT activity

HNMT is responsible for the intracellular degradation of histamine and is found mainly in the liver, but also in the skin, in the respiratory tract and in the central nervous system.

Vitamins B 9 and B 12 are cofactors for the synthesis of HNMT. Due to undernourishment or malnutrition, a pancreatic insufficiency or diseases of the gastrointestinal tract these substances may be missing. Similarly, liver weakness or even liver disease may be "to blame" for the presence of histamine intolerance. In addition, the decreased activity of HNMT may be innate.

Symptoms of histamine intolerance include headache, indigestion, respiratory problems, and skin irritation. (Image: Rob Byron /fotolia.com)

Discomfort with elevated histamine levels

Histamine, especially in food, can cause a variety of ailments. So are diseases in the head area, such as migraine or headache possible. In addition, the respiratory system, the digestive tract or the cardiovascular system may respond to elevated histamine levels. Likewise, edema, fatigue, joint problems, skin diseases or immune deficiency are possible.

symptoms

The symptoms of histamine intolerance are differentiated by the underlying cause. Is there too little DAO or is the enzyme HNMT rather missing or are both affected? If only DAO is diminished, this is called acute form. If there is too little of HNMT, the experts speak of the chronic form. The symptoms are relatively sudden or intermittent in the acute form; in the chronic form they begin very slowly and gradually increase. The complaints are very individual. Typical symptoms include a swollen nasal mucous membrane with runny nose, sneezing attacks, coughing and difficulty breathing. In addition, there are problems in the digestive tract, such as sudden or relapsing diarrhea, bloating, distended abdomen, abdominal pain, nausea and vomiting. The skin often reacts with redness and itching, in the face by so-called flushes, sweating, palpitations and cardiac arrhythmias. Low blood pressure, headache, migraine, fatigue, menstrual disorders and edema are also possible. Patients may be affected by multiple complaints at the same time, but only one symptom is possible. The expression is very individual.

If the diet is heavily burdened with histamine, abdominal cramps and acute diarrhea sometimes occur within fifteen minutes of food intake. Other possible complaints related to histamine intolerance include skin blemishes, retardation, oral mucosa, chronic throat irritation, nettle rash, eczema, difficulty concentrating, sleep disorders, restlessness, melancholy, muscle twitching, flu-like symptoms, tonsillitis, lump in throat, and much more.

Often, alcohol is not tolerated at all or only in small amounts. First and foremost, red wine is the cause of complaints, as it is rich in histamine.

Histamine is found in numerous foods, such as cheese and red wine. (Image: steinerpicture / fotolia.com)

Histamine intake by food

Histamine intolerance is a rather complicated and ambiguous disease. Thus, the tables on the histamine-containing foods published in connection with the disease also differ. Foods that have been subjected to a fermentation, ripening or fermentation process using bacteria, yeast or alcohol usually contain high levels of histamine. Finished products, preserves and foods that have been stored for a long time are also included. Other foods that can cause discomfort with histamine intolerance are cured, smoked, dried, but also heavily minced or even pureed meat, such as is contained in some spreads. Offal and egg yolk are also among the possible causes of the complaints. There are different opinions about the egg white.

In fish, fresh produce is considered to be poor in histamine. Older fish, smoked, marinated or salted, in contrast, has a significantly increased histamine content. Marine animals, such as mussels, crayfish, shrimp and crabs are also among the "contaminated" foods.

For cheeses, the rule is that the riper the cheese, the more histamine is present. Yeasty pastries and wheat are also histamine-containing. Vegetables such as sauerkraut, tomatoes, aubergines, spinach and avocados as well as legumes such as beans, lentils and soybeans should be avoided if there is histamine intolerance. In addition, citrus fruits, bananas, pineapple, kiwi, strawberries and papaya and nuts are among the "dangerous" foods. Cocoa, alcohol, black tea, chocolate and spicy spices should not be left unmentioned.

Substances that inhibit diamine oxidase

The substances which inhibit diamine oxidase include, as already mentioned, some active substances such as pancuronium, thiopental, dobutamine, aminophylline. Alcohol and certain biogenic amines - contained in pineapple, pear grapefruit, raspberries, legumes, wheat germ, papaya, oranges and bananas - are also included.

Substances that increase intestinal permeability

If the intestinal permeability is increased, macromolecules can enter the body via the digestive tract. Thus, it is believed that spicy spices make the intestine more permeable and thus histamine is better absorbed.

Hyperacidity - Histamine-related

Histamine is produced in the gastric mucosa. The more acids have to be processed, the more is produced by this substance. In this way, hyperacidity is also associated with histamine intolerance. The excess of histamine also leads to increased allergy and increased tendency to inflammation.

Additives containing histamine

Additives identified by E numbers may also contain histamine. Examples include certain preservatives, nitrates or dyes.

diagnosis

For the diagnosis of histamine intolerance, a detailed history is important. Complaints, possibly related to the intake of certain foods, should be described in detail. Diseases such as irritable bowel, lactose intolerance, fructose intolerance and celiac disease are differentiated by differential diagnosis. Blood and urine tests are carried out. An elimination diet that avoids all histamine-containing foods for a few weeks is important in order to make a safe diagnosis. The lack of one of the vitamins B9, B12, C or the trace element copper could be indicative of histamine intolerance. Existing liver disease or existing bowel disease may be related to the onset of HIT.

treatment

In many cases, avoiding certain foods is sufficient. Otherwise, after an elimination diet, which lasts several weeks, one or the other food will be back on the menu. Here help doctor and dietitian. During the diet, rice and potatoes are recommended, as this reduces the histamine content in the blood. It may be necessary to administer medications such as antihistamines and / or enzymes. Substitution with the vitamins B 9, B 12, C or the trace element copper is also possible.

Present diseases and disorders that are considered to cause histamine intolerance are treated as much as possible. For example, after prolonged use of antibiotics may be advised to a colon cleansing, in a hyperacidity present, the diet covered and created a diet plan with low-base diet. In addition, agents such as daosine can also be taken. These additionally break down histamine. However, Dao should be taken at least 10 minutes before a meal in order to achieve a corresponding effect. (Sw)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)