Contrary to common belief, histamine intolerance is not a sensitivity to histamine, but an indication that you’ve developed too much of it. Histamine is a chemical that sends messages to your brain as well as triggers release of stomach acid to aid digestion. Histamine Intolerance 101. “Histamine intolerance” is a collection of signs and symptoms a person experiences when the immune system is triggered—releasing a high amount of histamine into the body. Histamine is an organic nitrogen compound found in our body cells involved in the “immune response”, such as a runny nose or sneezing during allergy season. Histamine also regulates physiological functions in the gut and acts as a neurotransmitter for the brain, spinal cord, and uterus. If a person is allergic to a particular substance, such as a food or dust, the immune system mistakenly believes that this usually harmless substance is actually harmful to the body. In an attempt to protect the body, the immune system starts a chain reaction that prompts some of the body’s cells to release histamine and other chemicals into the bloodstream. Histamine Response: Signs & Symptoms Headaches/migraines. Shortness of breath. Asthma. Insomnia or difficulty falling asleep. Hypertension. Arrhythmias/rapid heart rate. Anxiety. Body temperature dysregulation. Hives or skin breakout. Eczema Low blood pressure/high blood pressure. Tissue/lymph swelling. Hair loss. Dizziness or vertigo. Abnormal periods. Sinus congestion. Irritability. Sweaty feet. Seasonal allergies. Sneezing. GI distress, IBS, stomach cramps, diarrhea. GERD/Acid reflux. Histamine is Not Necessarily a Bad Thing…But Too Much is… All people have histamine and histamine isn’t “bad” per say. In fact, a “histamine response” a normal biochemical produced by immune cells during certain immune responses that produces some unpleasant but necessary effects. Histamine is only bad when: a.) your body makes too much histamine, OR, b.) when your body can’t break histamine down fast enough—resulting in too much histamine in the body. Either of these two things results in the lingering or chronic histamine symptoms (a.k.a. “histamine intolerance”). a.) Why you may make too much histamine? Reason 1: Bad gut bacteria: Many gut bacteria produce histamine themselves. If these histamine-producing strains are overrepresented in your gut, you may suffer negative symptoms from any extra histamine. Histamine intolerance diet is a factor. Reason 2: Mast cell activation syndrome: Mast cells are immune cells that produce histamine as part of the immune response. In the recently-identified-but-still-relatively-mysterious mast cell activation syndrome, a person’s mast cells release excessive amounts of histamine. b.) Why your body may not be able to break down histamine… Reason 1: Bad gut bacteria: Many gut bacteria also degrade histamine. Dysbiosis or lack of these histamine-degrading strains in the gut may lead to impaired histamine degradation and increased histamine load. Reason 2: Diamine oxidase (DAO) deficiency: Some people have a deficiency in diamine oxidase— the enzyme that breaks down histamine in the body. Without adequate diamine oxidase, histamine builds up. A shortage of DAO can be caused by a genetic defect, by medication, or by intestinal disorders such as Crohn’s disease, ulcerative colitis, leaky gut, or other damage to the intestine Reason 3: HNMT deficiency: We produce another histamine-degrading enzyme called HNMT, or histamine N-methyltransferase. HNMT deficiency is largely genetic. If your microbiome is producing too much histamine or exceeding your body’s ability to break it down, it has to go somewhere: Blood. Once it hits your blood, goes everywhere. How to improve histamine intolerance + immune function. Step 1: Eat a Low Histamine Diet: Avoid high histamine and stick to low/occasional intake of histamine-rich foods for 4-6 weeks and see how your symptoms improve or change. Top histamine foods include:* Fermented Foods (all) Canned fish, shellfish and non-fresh seafood Smoked, cured, processed meats and deli meats Dairy (yogurt, cheese, kefir) Veggies Eggplant. Pickles. Tomatoes. Pumpkin. Spinach. Mushrooms. Sweet potatoes. Olives. Fruits Avocado. Citrus. Strawberries, raspberries, blackberries. Apricots. Tropical fruits (pineapple, papaya, ripe banana) Cherries. Dried fruits. Grapes. Vinegars and salad dressings Nuts: walnuts, cashews, and peanuts. Soured foods: sour cream, sour milk, buttermilk, soured bread, etc. Artificial preservatives and dyes Cacao, cocoa & chocolate Egg whites Alcohol & wine, green tea, black tea Preservatives in vitamins/supplements Certain probiotics Of these foods, some food types contain histamine themselves, whereas others “release” histamine in cells (such as chocolate, nuts, pineapple, berries and tomatoes). Regardless of the type, both categories can trigger a histamine response. Low-Histamine Foods: DO Eat List It can be easy to get caught up in foods you can’t have, but it’s also important to remember the foods you can have: Freshly cooked meat or poultry Freshly caught fish Cooked eggs + pastured egg yolks Gluten-free grains: rice—white, wild, Jasmine, brown; quinoa (soaked and dried) Lentils, split peas & mung beans Coconut flour & flaxseed flour Pure peanut butter* & sunflower butter (small amount) Fresh fruits: mango, pear, watermelon, cranberry, blueberries, apple, kiwi, green banana, cantaloupe, honeydew, peaches. Fresh vegetables (all except tomatoes, spinach, and eggplant), especially: Bok choy. Brussels sprouts. Broccoli. Bell peppers. Cabbage. Carrots. Cauliflower. Collards. Cucumbers. Garlic. Kale (not curly) Kholrabie. Leeks. Most lettuce. Onion. Radish (red, daikon) Rutabaga. Seaweed. Shallots. Squash (butternut, kabocha, spaghetti, yellow, zucchini) Turnip/turnip greens. Watercress. Dairy substitutes: coconut milk, rice milk, hemp milk, almond milk* Cooking oils: olive oil, coconut oil. Fats: ghee, tallow, duck fat. Leafy herbs (basil, cress, ginger, chives, coriander, peppermint, rosemary) Herbal teas Sweeteners: Rawcoconut nectar. *See complete food list (below) Step 2: Focus on Healing Your Gut Take Probiotics + Choose Formulas Wisely Certain probiotics are histamine-producing (which may worsen your symptoms including L. casei, L. delbrueckii, and L. bulgaricus), histamine-neutral (which will have no direct effect), or histamine-degrading (which should improve your symptoms). If the histamine-producing ones colonize your gut, that’s bad news. Look for the following strains: Avoid Histamine-Producing Strains Lactobacillus bulgaricus. Lactobacillus casei. thermophilus. Lactobacillus delbrueckii. B Lichenformis. Bacillus Coagulans SL5 Take Histamine DEGRADING Strains Plantarum. rhamnosus. salivarius. gasseri. reuteri. Paracasei. Bifidobacter strains (infantis, bifidum, longum, lactis, breve) Soil Based Organisms. Saccharomyces-Boulardii (raises DAO enzymes) Histamine Neutral Strains Lactobacillus acidophilus. Lactobacillus Lactis. Lactococcus Lactis *I recommend Bifido Maximus for your next round of probiotics. Eat 1-2 Prebiotic Fibers + Resistant Starch Daily Prebiotics feed probiotics. Cooked and cooled potatoes. Green bananas/plantains. Onion. Garlic. Artichoke. Asparagus. Dandelion greens. Leeks. Soluble fibers: Butternut squash, rutabaga, cooked carrots, broccoli, turnips, etc. (roots) Apples & pears. Flaxseeds & sunflower seeds. Support Liver Detoxification Since HNMT (the other enzyme that nullifies histamine) activity takes place in the liver, a healthy liver is crucial for histamine intolerance: Start the day off with 8-16 oz celery juice. Eat color rich fruits and veggies high in polyphenols Sweat daily. Avoid alcohol (a major DAO inhibitor and taxes the liver) Drink 80-100 oz. water daily. Consider a round of “Liver Rescue” support supplement to love the liver. Step 3: Supplement Smart In addition to probiotics, add the following to the mix: Quercetin (up to 1 gram) + Stinging Nettle (D Hist by Orthomolecular) DAO Enzymes (with meals) Liposomal Vitamin C (1000 mg) Antihistamines as needed for big flares (like Claritin) Trizomal Glutathione (liposomal) Liposomal Curcumin. Step 4: Practice an Immune-Boosting Lifestyle (i.e. watch stress) Corticotropin-releasing hormone (CRH) stimulates mast cells to release histamine. On the flip side, CRH also releases cortisol, which can inhibit (prevent) histamine secretion. In normal circumstances, with acute, short-lived stress, this works positively to oppose excessive histamine. However, in chronic stress, things change. We become resistant to stress hormones, and cortisol loses a bit of its histamine-inhibiting luster. We release massive amounts of histamine-stimulating CRH, but the cortisol is unable to stem the tide. So: watch stress. Sleep 7-9 hours per night. De-screen at night or use blue blocker glasses. Move daily is recommended by the doctors who treat histamine intolerance. Connect (with people, hobbies, fun—outside of just work) Use an effective adaptogen/herbal histamine intolerance supplements to get yourself over the hump when needed (1 dose, 1-2 times per day) Written & Scientifically Reviewed by Dr. Lauryn Lax, PhD, OTR/L.