This week we’re doing a deep dive on a topic that is impacting more and more people these days, and that’s histamine intolerance.
We’re going to talk all about why it happens, who is most at risk for it, and, most importantly, what you can do if you suspect you have it.
The Big Picture
Histamine is a chemical that the body naturally produces and is involved in many different pathways. And it’s not just involved in allergies and the immune system; our brain, digestion, and circadian rhythm use histamine too.
That means histamine isn’t inherently bad, but some individuals can produce more of it and have a harder time breaking it down.
When histamine isn’t broken down and removed in a timely manner, it starts to overflow (think of it like an overflowing cup). It’s not the histamine itself, but the overflow of histamine that prompts symptoms—and these symptoms look differently for those who are more affected by it.
Because histamine intolerance affects susceptible individuals differently, its symptoms tend to be all over the map and can be overlooked by conventional medicine or confused with things like allergies.
Here are four of the most commonly reported symptoms associated with histamine intolerance:
- Unexplained headaches and migraines
- Frequent brain fog
- Runny nose, especially after eating
- Chronic recurring rashes and hives
And although these are the most common, many individuals also report suffering from:
- Nasal congestion
- Watery eyes
- Itchy skin
- Stomach pain
- Poor digestion
- Acid reflux
Just to be clear, you can have the above symptoms but not have histamine intolerance.
Our goal for today’s newsletter is to help you get into the nuances of it all so you can decide for yourself if trying a low-histamine protocol is the right fit for you.
Speaking of protocols, for today’s Try This protocol I’m handing it over to my cowriter and Functional Nutritionist, Taylor Groff, to share the diet and supplement plan she uses for her clients who suffer from histamine intolerance.
Let’s jump in!
An Overview of Histamine Intolerance
Histamine acts as a signaling molecule that’s produced by immune cells in response to allergens. But histamine has other jobs too. It acts as a neurotransmitter and is involved in digestion, the sleep-wake cycle, regulating blood pressure, and more (1).
Our bodies produce histamine all the time. It’s a completely normal biological process. Where we start to run into problems is when we make too much histamine and can’t clear it away properly. This is where diamine oxidase (DAO) comes in, the enzyme that’s responsible for degrading excess histamine in the body.
Approximately 1 percent of the population doesn’t make enough DAO. Middle-aged adults appear to be the most affected, although children and the elderly can be susceptible too (2).
Not making enough DAO means histamine stays in our system for longer—and this is when symptoms start to appear.
When friends come to me who are struggling with headaches, insomnia, fatigue, anxiety, or feeling “blah,” the first thing I ask them is if they’re taking a magnesium supplement.
Magnesium participates in over 600 processes in the body. That means 600 processes can’t function properly without it. And because it’s super tough to get enough magnesium from food, so many people are silently suffering from symptoms of deficiency without even knowing it.
There’s a reason I recommend BiOptimizers Magnesium Breakthrough to my friends over other magnesium supplements. It contains seven different forms of magnesium and vitamin B6 and manganese to aid in absorption. After I started taking it, I could feel a huge difference in my sleep and energy levels.
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What Causes Low DAO Levels?
Genetics is the biggest risk factor for histamine intolerance. A mutation in the DAO gene is one of the main reasons people don’t make enough DAO (3).
But it’s not just genetics that put you at risk; there are other factors that also come into play. Gut dysbiosis, stress, infection, diet, and gluten intolerance are some of the most common.
Certain medications can increase histamine production and interfere with DAO activity, making individuals more susceptible to histamine intolerance symptoms.
Antidepressants (e.g., Prozac, Zoloft), antibiotics, and nonsteroidal anti-inflammatory drugs (e.g., ibuprofen and aspirin) are some examples. Even the overuse of antihistamine drugs (e.g., Benadryl and Zyrtec) can contribute to histamine intolerance.
Who Is Most Susceptible to Histamine Intolerance?
There are many underlying conditions that go hand in hand with histamine intolerance. More often than not, it’s actually a sign of a deeper issue.
Leaky gut, dysbiosis, food allergies, small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), Lyme disease, chronic use of certain medications, and a diet rich in foods that naturally contain histamine are potential root causes (3). Chronic stress and traumatic life events are other major risk factors.
High estrogen can also contribute to histamine production. This can affect both men and women, but women in particular notice an increase in symptoms around ovulation and menstruation.
The Low-Histamine Diet
There’s not much we can do to change our genes (yet!), but we can change the environment they’re exposed to. We can also work on healing the gut, where approximately 70 percent of the immune system resides.
By removing potential triggers, we can help calm inflammation to give the body a chance to heal, which is where a low-histamine diet comes in.
The purpose of a low-histamine diet is to slow the production of histamine by eliminating foods that trigger its release and buildup. We also remove foods that are naturally high in histamine, like fermented foods, alcohol, and smoked or cured meats.
After two weeks on this diet, if histamine intolerance is the cause, you should notice a positive change in your symptoms.
Now that we have an idea of what histamine intolerance is and the best approach for reducing your overall histamine load, Taylor is going to walk you through the low-histamine protocol she uses with her clients.
A Functional Nutritionist’s Guide to Reducing Your Net Load of Histamine
Hey all! Let’s talk a little bit more about who is a good candidate for a low-histamine diet and the best approach for following one correctly.
The low-histamine diet is not for everyone, and it isn’t going to be the cure for everyone’s symptoms.
With that being said, if you have unexplained symptoms from the list above and haven’t gotten answers from working with your doctor (or worse yet, left to think it’s all in your head!), you could benefit from trying a low-histamine diet.
Here’s what you need to know before getting started:
- The low-histamine diet is not meant to be a long-term solution. The goal is to stick to the diet for at least two weeks to see if you notice a positive change in symptoms. If you do, great! That means it’s working. If you don’t, give the diet a full month. If there still isn’t a change, your next move would be to consult a healthcare practitioner who can order the right testing and dig a little bit deeper for you.
- Eat plenty of nourishing foods. Unfortunately, many of the foods that are good for you also contain histamine, or its amino acid precursor histidine, which is another reason why this diet is not meant to be followed long-term. Fermented foods, fish, bone broth, avocados, and citrus fruits are some examples. It’s important to make sure you’re getting enough calories from low-histamine fats, protein, and plants.
- Certain foods can trigger symptoms that are not on the “avoid” list. And vice versa: there are foods on the “avoid” list that may not trigger symptoms. That’s the nature of histamine intolerance: it takes trial and error to determine what foods are the most problematic for you as an individual.
I know this sounds like a lot, but I’ve witnessed the power of a low-histamine diet, and it can be life-changing for some people. It’s not the answer for everyone, but it is a safe way to gain some insight into your own unique health situation.
1. Temporarily eliminate foods associated with histamine intolerance. Try avoiding the foods in the right-hand column for at least two weeks and see if you notice a positive change in your symptoms. If you don’t feel any relief, give your body a little more time and continue avoiding these foods for a full month.
An important note about food handling and storage:
The way you store and handle food (especially meats!) matters because this can also contribute to histamine levels. Store leftovers in the freezer instead of the refrigerator, and try not to let food sit out for a long time.
2. When it’s time, start reintroducing foods. After the elimination period, start adding foods back in one at a time. The key to the reintroduction phase is to get in touch with your body and how foods make you feel, which will take time, patience, and a lot of experimentation.
Your chance of reacting to a particular food also depends on how full your cup is at any given moment. For example, you might be able to consume higher histamine foods on days when your cup isn’t full. On other days, when your cup is full (if you’re stressed or dealing with a flare-up), it’s best to continue to avoid higher histamine foods.
You are the best judge of what’s going on in your body, and it’s up to you to identify any possible triggers.
If you react to a food, continue to avoid it. After you’re done reintroducing all of your foods, you can try again and see how you do. If you react again, it’s safe to assume that it’s best to avoid it long-term, and if it’s something you really love, enjoy it in small amounts on an occasional basis (preferably when your histamine cup is low).
Note: You can go through this process on your own, but working with a Functional Medicine doctor or nutritionist could be helpful for navigating the process.
3. Keep a journal and record everything during the reintroduction phase. You’ll want to write down your meals, the time you eat, the ingredients, and any symptoms that come up throughout the day. Having a paper trail will help you pinpoint what foods are potential triggers of your symptoms.
Supporting the immune system and gut microbiome during the elimination period is critical, but not all supplements are created equal. Some can actually stimulate additional histamine release and wind up causing more damage.
I like the brand Seeking Health and recommend it to all of my clients because the founder of the company, Dr. Ben Lynch, suffered from histamine intolerance himself and has done his due diligence to design his products specifically for people with histamine intolerance.
- Seeking Health HistaminX: This formula contains polyphenols that are super helpful for supporting the gut microbiome, like bromelain and quercetin. It also contains stinging nettle extract that supports a balanced immune response to allergens and helps lower inflammation.
- Seeking Health Histamine Block Plus: This provides additional supportive nutrients that people with histamine intolerance tend to be deficient in, like zinc, vitamin C, thiamin, vitamin B6, and DAO.
- ProBiota HistaminX Capsules: Probiotics are a go-to health supplement, but many bacteria strains actually raise histamine levels. It’s important to take a probiotic strain that doesn’t do this if you suffer from histamine intolerance symptoms. This supplement contains probiotic bacteria that don’t increase histamine and support a healthy immune and inflammatory response.
Disclaimer: There’s no guarantee that these supplements work for everyone. Each case is highly individualized. However, I’ve heard incredible reports from clients and success stories that these supplements have helped make their symptoms more manageable.
Because histamine intolerance is a newly identified condition, it can feel confusing and overwhelming at first since the research is still in its infancy.
Many of the food and supplement lists out there are based on people’s unique experiences. Here are some of the resources that have helped me navigate this world for my clients if you want to learn more:
- Is Histamine Intolerance The Cause Of Your Mysterious Symptoms?: an interview with Dr. Mark Hyman and Dr. Todd Lepine
- Dr. Ben Lynch videos
- Dr. Janice Joneja
Words of Encouragement
As you’re going through this process, try to be easy on yourself. It is not a straightforward, cut-and-dry process, and it takes a lot of experimentation to figure out your own unique triggers.
Be patient with yourself as you become more in tune with your body and aware of how certain foods or stressors fill up your histamine cup. If you or someone you know is struggling with histamine tolerance, send them this newsletter!
And please know that while it is not an easy process, making these changes to your diet has the potential to make a radical improvement in your symptoms and your health so you can get back to feeling like yourself and enjoying life!
With love and gratitude,
Dhru and Taylor