What are Histamines and Should You be Concerned?

Histamine naturally occurs in the human body, but also exists in the food we eat. These foods include seafood, fermented soybean products, aged cheese, avocado, and chocolate. Histamine is an inflammatory mediator in the body and acts as a regulatory amine to return the body to homeostasis after a stressful event. Histamine causes allergic-like reactions that have a variety of symptoms depending on the interactions with the four histamine receptors in the body. Your own sensitivity to histamines are influenced based on your gut bacteria, gender, age, autoimmune disease, inflammation, presence of cancer, gut, or pulmonary diseases. Histamines have a major influence on our immune system and have a dual purpose of both promoting inflammatory responses AND homeostatic functions like regulating intestinal function. 

Histamine intolerance occurs when the body’s capacity to eliminate histamine is exceeded by the rate of histamine accumulation. We often use a bucket analogy to explain why dietary and environmental histamines may trigger symptoms sometimes, but not 100% of the time. Imagine the bucket below in your gut. This bucket is filled with any type of stress: work, lack of sleep, exercise, poor diet, relationships, constipation… you get the picture. Healthy individuals have intestinal diamine oxidase (DAO), enzymes that eliminate histamine eaten from food. However, when our bucket is filled, DAO enzymes are unable to clear histamine from the body fast enough to prevent reactions. These DAO enzymes are inhibited by an overload of histamines from food, or an overload of stress in the bucket. 

So, should you be concerned about histamines in your diet? First, think about your current symptoms. If you have no allergy-like symptoms after eating then have no fear! You do not need to fear dietary histamines. However, if you have one or multiple of the following symptoms around meals, you will want to keep reading…

Histamine Intolerance Symptoms

Respiratory

- Short of breath, runny nose, congestion, sneezing, tight chest 

Skin

-Rash, hives, redness/rosacea, itchiness, swelling, dermatitis

Cardiovascular

-Heart palpitations, rapid heart beat, lethargic, short of breath

Digestive

-Bloating, constipation, diarrhea, discomfort, distention, nausea

Nervous system

-Headaches, migraines, brain fog, anxiety, irritability, insomnia 

Correcting histamine intolerance includes reducing your "stress bucket" so the body is not overwhelmed by histamines, supporting DAO production, and temporarily following a low histamine diet. Examples of foods low in histamine foods include fresh poultry, eggs, white fish, potatoes, rice, fresh or frozen vegetables, blueberries, coconut, and honey. 

Let’s start first with addressing your stress bucket. This step requires taking a look at your lifestyle and assessing five key areas. Sleep, nutrition, exercise, environment, and stress management. 

Sleep:

• Focus on quality and quantity! Aim for 7-8 hours of uninterrupted sleep each night. If you are waking exhausted even after 8+ hr of sleep, it’s time to contact us to investigate why! Hint: yes, histamines could be playing a role!

• Adjust hydration schedule to prevent waking in the middle of the night to use restroom

• Implement a pre-bed snack 1-2 hours before bed with 15-30g of protein and 15-30g of carbohydrates to avoid waking between 2-4am from low blood sugar

  • Ex: Greek yogurt with handful of almonds and blueberries 

Diet:

• Make sure you are eating enough calories to support daily activities. Contact us to help you figure out how many calories you really need to thrive!

• Focus on including the three main food groups in each meal: Protein, starchy carbohydrates, and fruit/veggies

• Aim for 3 meals per day + 1-2 snacks 

Exercise:

• Prevent over-exercising. Make sure you have 1-2 rest days per week, minimum!

• Always eat a pre-workout snack before eating

• If you have histamine intolerance, you may be more sensitive to high intensity or heated workouts 

• If you are new to exercise, start with a daily walk!

Stress Management:

• Develop other stress relief strategies besides exercise

• Begin working with a therapist 

• Deep breathing, meditation, arts and crafts 

• Food freedom 

Environment:

• Think back to when your symptoms first started… had your environment recently changed? New house? New workplace? Recent vacation?

• Sometimes mold exposure or recurring toxin exposure can be the root cause of histamine intolerance. If you suspect this, test your environment

• Promote a peaceful and calm living environment

• Pay attention to how symptoms change when you eat at home vs. work. Vs. on vacation. Do they get worse or better?

After addressing the five areas above (the most important!), we support our clients who have ongoing symptoms with a temporary low histamine diet and supplements to support DAO production to help the body clear excess histamines. A great resource of a low histamine diet is the SIGHI Histamine Elimination diet, a short term elimination guide created by the Swiss Interest Group Histamine Intolerance. We implement a temporary diet like this for 6-8 weeks, sometimes longer, while working on lifestyle changes, identifying root causes, and supporting histamine elimination in the body. This may look like adding in DAO enzymes or Histadigest, a supplement containing the DAO enzyme. While histamines are breaking down better in the body with this supplement, it is important to make sure detox pathways are open for elimination. This means going to the bathroom regularly and sweating. 

It is important to note that any restrictive diet, like the SIGHI diet, is for symptom management but it is NOT a cure. Restrictive diets are temporary, meant to give our clients relief while we identify root causes and work on solutions. Histamine intolerance protocols end with re-introducing high histamine foods into our clients diet as their bodies are now primed to digest and eliminate histamines on its own. If you have been experimenting with low histamine diets on your own as a cure to manage your symptoms, reach out to our team! We are here to support you in this process, identify your triggers, and get you on the path to healing.

Resources:

Branco ACCC, Yoshikawa FSY, Pietrobon AJ, Sato MN. Role of Histamine in Modulating the Immune Response and Inflammation. Mediators Inflamm. 2018 Aug 27;2018:9524075. doi: 10.1155/2018/9524075. PMID: 30224900; PMCID: PMC6129797.

Jochum C. Histamine Intolerance: Symptoms, Diagnosis, and Beyond. Nutrients. 2024 Apr 19;16(8):1219. doi: 10.3390/nu16081219. PMID: 38674909; PMCID: PMC11054089.