Most of us have heard of histamine. Histamine is that thing we are trying to "block" when we take an "antihistamine" tablet for typical allergy and hayfever type symptoms.
Some people experience allergies due to a sudden encounter to something they have not been exposed to before or for a long time, such as contact dermatitis after use of a new body product or household cleaning chemical or after inhaling an allergen such as being gifted a big bunch of flowers or being stuck in a sudden dust storm.
Allergies can also be seasonal (say in springtime with pollen exposure and more frequent grass mowing) or can occur for someone all year round without much change in symptoms, perhaps driven by daily food choices, their home environment (pets, dust or mould exposure) or occupation (which may involve excess dust and chemical exposure).
Histamine - What is it and why do we need it ?
There is a complex chemical signalling cascade that occurs when someone has been exposed to an allergen, and this is where the histamine comes in.
The allergen enters the body via the airways, skin or eyes (let’s say its pollen). IgE mast cells imbedded in the tissues (such as the gut and mucous membranes) along basophil immune cells circulating in the bloodstream trigger off inflammation (which causes swelling and excess fluids) and release of histamine in an attempt to protect cells and the body from further exposure (running nose and watery eyes are a direct response to try and flush the allergen out tissues).
Believe it or not, histamine release is actually a critical physiological way the body is trying to bring about balance - it triggers a stress response to help us get away from danger and alert us to the exposure, it makes our gut move faster to get out anything we have ingested, and it triggers the secretion of extra fluids from our eyes and nose to gastric acid in an attempt to neutralise any trigger further. But ideally, its effects should be temporary and short lived.
In a healthy person, it’s normal to have a sudden yet minor reaction that lasts a few hours, such as being bitten by an ant and then getting on with your day.
But what if it’s not as simple as this? What if excess histamine keeps getting produced daily, and there doesn’t seem to be an "off switch"? Or what if we can't clear histamine out of the body properly and it keeps getting "recycled" through the tissues. In such cases, allergy symptoms can be chronic and systemic and not just local (i.e. Not just on the parts the pollen touched but an uncomfortable complete body response).
In such cases, histamine production becomes too much of a good thing!
Histamine Intolerance - When too much of a good thing can make life miserable.
There are several reasons why someone may produce too much histamine; it could be due to:
continual exposure to triggers without identifying what they are and removing them (think of pet owners who are allergic and keep their pets indoors and allow them on furniture and bedding - their body never gets a break or ability to get histamine production under control),
Increased or excessive intake of histamine producing foods (yes, some of your daily favourites may be adding to your histamine burden!),
Genetic abnormalities in histamine metabolism (you were born with it because your parents had allergies and problems with excess histamine),
A nutritional deficiency leading to an acquired abnormality in histamine metabolism (deficiencies occur not just from insufficient intake and poor diet, drug and alcohol use, but excess stress, long term use of medications, illness, natural aging and pregnancy)
Histamine Intolerance refers to a situation when the body either overproduces (say because we have higher than normal mast cells in tissues, or long term inflammation and bleeding in the gut) or just can't clear out histamine properly (due to excess consumption and/or lacking enzymes to break it down). It is reported to affect approximately 1% of the population. It is very much a "modern day epidemic" in my opinion. As a naturopath, I would say it occurs in an exaggerated number of cases I see by default because naturopaths tend to deal with all the quirky, rare and strange symptoms and conditions that modern medicine just can't help with and medical academics are so busy looking and individual symptoms and sending us off to specialists, the bigger picture so these type of conditions or collection of symptoms that make a "syndrome" are largely unacknowledged.
I hear it all the time !
It is so common for someone to see me after they have had all the medical testing and screening and multiple trips to see doctors and specialists because they have been experiencing frequent sudden episodes of face or throat swelling, extreme reactions to insect bites, random skin itching, severe and debilitating tummy aches and migraines and say "but I've never had allergies before!"
The reason for this is varied, but it is my observation that nutrient deficiency, the increased stress of modern life and indoor air pollution are huge contributors. Essentially histamine levels build up faster than we have the capacity to clear it, and it’s not one thing or the other contributing to the problem; it is always a combination of factors.
It is estimated by data researchers who have observed rapid rises in allergy reporting across all age groups at the Australasian Society of Clinical Imunollogy and Allergies that by 2050, over 70% of Australians will be experiencing some level of allergy that impacts their daily life. This is scary !
Your daily diet can affect the way you respond to histamine by leading to a histamine overflow.
High histamine foods are those that are aged, cured, smoked, fermented, pickled, and contain naturally occurring preservatives like sulfites.
Examples include:
- aged cheese,
- cured meats (ie. salami, ham and bacon!),
- canned or processed fish, smoked fish, thawed fish and prawns
- brewed fermented alcoholic beverages such as beer and wine, but also non alcoholic fermented beverages like kefir, kombucha, and probiotic drinks.
- fermented foods such as soy sauce, sauerkraut, pickled veg, vinegar and yogurt,
- all nuts,
- Foods that contain high levels of histamine-releasing compounds, such as chilli and some other spices like cinnamon, chocolate and cocoa, avocado, bananas, tomatoes, eggplant, citrus fruits, strawberries and spinach, can also lead to high histamine levels.
- artificial flavours, colours and various additives (often but not always listed as numbers on packaged foods, watch out too for those listed as "antioxidants")
- Many individuals with histamine intolerance also have problems metabolising sulphur containing foods such as eggs, onions, garlic and sulphur based preservatives such as those commonly found in dried fruits and dried coconut (coconut milk, cream and oil can sometimes be made from sulphur dried coconut instead of fresh coconut so be wary of this)
Modern Day Living - The perfect storm for histamine intolerance reactions.
Why are histamine reactions so prevalent? Think of histamine being drip fed into our system every day, like drops in a bucket. Over time histamine levels build up and can have full-blown, sudden and scary effects; it’s up to us as individuals to understand where histamine triggers are being introduced and be mindful of limiting our exposure in order to manage our health better. This is where a naturopath can help.
It is my observation from clinical practice that the Histamine Storm gets brewing via a cumulative of the following :
1) Never before, for example, as a culture, have humans been so "pet friendly" our pets are like "furry children" that go everywhere with us. While domesticated pets have been around since Egyptian times, lets be reminded our living spaces were more well ventilated then and we spent more time outdoors !
2) We also have never had such a toxic burden in our environment before this point, and chemicals are used as additives and preservatives in our food. High stress depletes core nutrition and degrades gut health.
3) Combine this with our obsession with "superfoods" like coconut, spinach, yoghurt, Kombucha, chocolate and apple cider vinegar - we eat foods in vast quantities without variety because we can (if we want to eat chocolate every day of the week, we can and if we want to drink orange juice or eat strawberries every day we can as we can access foods that traditionally would be out of season at some times of the year). Hello weekends filled with "insta-inspired" charcuterie boards and grazing platters combined with sparkling wine, smashed avo toast and unicorn coloured birthday cake ! We may not have an awareness that these are high histamine producing foods and eat them frequently because they taste good and think we are being "healthy".
4) We are spending more and more time indoors as we have made our home environments very comfortable, which means airconditioning, less need to open windows for natural ventilation,
5) all this combined with busy lifestyles meaning higher cortisol levels which disrupts normal gut health and healthy immune regulation and less time for proper cleaning, meaning mould and dust levels can build up.
And there we have a perfect storm for producing rising histamine levels.
Symptoms of Histamine Intolerance - How to know if its impacting you.
Histamine intolerance is relatively easy to identify for an experienced practitioner via a comprehensive case history due. Unfortunately there is no direct diagnostic testing but there is a range of symptoms that usually occur together in varying intensity.
This can present as a "syndrome" of inflammation like Mast Cell Activation Disorder or Fibromyalgia or Mould illness (sick building syndrome), Chronic Inflammatory Response Syndrome (CIRS) Multiple Chemical Sensitivity or Tick-Borne illness like Lymes Disease. Or sometimes none to this extent.
These symptoms include but are not limited to:
Hayfever, itchy eyes and watery nose, sneezing,
Diahorrea,
Headaches and migraines,
Food sensitivities,
Chronic fatigue and low mood,
Skin flushing and redness,
Low blood pressure or dizziness and fainting spells,
Itching skin and hives,
Asthma,
Joint and muscle aches and pains
Chronic pelvic and abdominal pain
We require adequate nutrition to be able to either break down and clear (methylate) histamine. Genetically some people have dysfunction in their methylation processes (a vital enzyme in the methylation pathway is histamine-N-methyltransferase or HNMT), often due to blocks preventing the uptake of certain nutrients like B6, B9 and B12. And in the gut, we need an enzyme called diamine oxidase or DAO to work on breaking down histamine from foods or triggers we have swallowed (through foods or mouth breathing). We need adequate vitamin C, B6, zinc, and copper stores to produce DAO.
How can a naturopath help ?
Naturopathically, there are many factors to consider when treating the whole body symptoms related to possible Histamine Intolerance.
We need to identify possible triggers - where do you live, eat, work and sleep and what are you being exposed to daily. How can we limit this exposure? This may involve having a building biologist assess your house for mould and other toxic exposure and then remedying the issues with repair and cleaning.
Do you have pets? It could mean changing the way you interact, limiting the impacts of hair and dust mite exposure (getting someone to do grooming for you, not taking them on road trips in the car with you or allowing them to sleep on your bed)
Investing in tools like quality HEPA air filters and daily use of vacuum cleaners designed for allergy reduction and regular dusting and changing bedding and pillows to allergy friendly fibres.
Minimise use of chemical cleaning products and synthetic perfumes in the home. Opt for chemical free cleaning techniques like Enjo and other microfibre cloths and using natural cleaners like vinegar and bicarb or eco friendly products and brands like Earth Choice and Koh. Look for naturally derived ingredients in body products and beauty care also.
Support your DAO enzyme activity and histamine regulation with supplements that contain Zinc, B6, Copper and vitamin C as well as mast cell stabilising agents like Palmitoylethanolamide or PEA, Quercetin and Rutin and herbal medicines like Betaglucans, Medicinal mushroom extracts, Albizia, bupleurum, baical skullcap and Black seed oil. Not all supplements are created equal. Ask me about how to access therapeutically active natural medicines prescribed based on what is driving your condition. You can book a supplement review here .