Histamine Intolerance: Symptoms, Diet, and More

What is histamine?

Histamine is a molecule derived from an essential amino acid, histidine, which is found in food, but also in different organs and tissues of our body since it participates in many biological functions and triggers pathophysiological responses in allergic or inflammatory processes as part of an immune response to external pathogens.

Therefore, when there is an excess of histamine at the plasma level (histaminosis) it is due to a imbalance between its manufacture or intake and its excretion intestinally by the enzyme DiamineOxidase (DAO), whose function can be altered by certain digestive diseases or by taking alcohol or certain drugs (acetylisalicylic acid).

Furthermore, the DAO enzyme also helps excrete waste after extracellular histamine release, as well as regulate cell division or differentiation in rapidly proliferating tissues (bone marrow and intestinal mucosa). It should be noted that the activity of this enzyme in pregnant women is much higher (500 to 1000 times higher) due to the additional formation in the placenta as a protection measure for the fetus, ensuring proper histamine metabolism and avoiding hyperistaminosis in these cases.

What are the effects of hyperistaminosis?

Excess levels of histamine in the blood can cause different symptoms depending on the receptor that is activated (histamine contains four types of receptors located in different tissues):

• H1: allergic responses, smooth muscle contraction, hormone release, and regulation of the wake-sleep cycle.
• H2: stimulation of gastric acid secretion, smooth muscle relaxation.
• H3: inhibition of the synthesis and release of histamine and other neurotransmitters.
• H4: immune responses, eosinophil and mastoid cell chemotaxis, cytokine and chemokine production.

In addition, histamine intolerance is related to other autoimmune, inflammatory diseases:

• , systemic juvenile idiopathic arthritis, ulcerative colitis, intestinal dysbiosis, mastocytosis, myasthenia gravis, multiple sclerosis, etc.
• It participates in the pathophysiology of more frequent diseases such as allergy and whose treatment is based on antihistamine drugs that block the action of histamine receptors.

On the other hand, histamine causes scomboidosis, an intoxication derived from the massive ingestion of histamine from bad fish.

Diagnosis

The diagnosis of hyperistaminosis is made by determination of DAO enzyme activity and its treatment is based on minimize histamine intake by performing a diet with foods low in histamine or that aid in its release.

Low histamine foods

To carry out a diet that allows to reduce the effects of histaminosis, which can appear at concentrations of 15-20mg of histamine / kg, those foods that have concentrations higher than 20 mg / kg should be avoided, this limitation being much stricter in more severe cases.

In general, the eating fresh food and avoiding canned food and highly processed and mature foods.

Histamine-rich foods

• Tuna.
• Chocolate.
• Strawberries and strawberries.
• Tomato.
• Spinach.
• Eggplant.
• Kiwi.
• Mushrooms.
• Egg white.
• Alcoholic beverages (wine, cava, beer, etc.)
• Sauerkraut (sauerkraut).
• Sausages (bacon, chorizo, fuet, etc.)
• Very mature and moldy cheeses (roquefort, blue cheese).
• Milk
• Canned fish (sardine tuna, etc.)
• Fermented soy derivatives (tempeh, tofu, etc.)
• Additives such as glutamate, benzoate, sulfites and nitrites.

On the other hand, in hyperistaminosis tthey also influence those foods that are microbiologically deteriorate easily (meat, fish, fermented or aged foods), as well as those that release endogenous histamine or that help to block the action of the DAO enzyme.

How long do I have to follow a low histamine diet?

Under these premises, we can carry out a low histamine diet which can last from two to six months and gradually introduce more food as symptoms decrease. In certain cases, if a total improvement is not observed with the diet, supplements of zinc, copper,, vitamin B6, beta-glucans, bromelain (present in pineapple), quercetin (present in broccoli, apples, and tea) can also be administered. which act as a cofactor for DAO and can enhance its activity.

• Histamine intolerance occurs when there is some alteration in the ability to metabolize or catabolize histamine ingested through food.
• Histamine is a molecule derived from an essential amino acid, histidine, which is found in food, but also in different organs and tissues of our body.
• In general, it is recommended to consume fresh foods and avoid canned foods and highly processed and ripened foods. Some foods with hyperhistamine action are: strawberries, tomato, spinach, eggplant, mushrooms ...

Judith Torrell