How to Deal With the Difficulties Associated With Histamine Intolerance

There is a significant difference between food allergy and food intolerance. In the case of an allergy, it is enough for a person to ingest only a small amount of the allergen and unpleasant symptoms will immediately appear, develop quickly and can be life-threatening. However, a true food allergy is relatively rare in adulthood. Most often it is a nut, fruit or vegetable allergy combined with a pollen allergy. The body's allergic reaction is triggered by the immune system, specifically the production of IgE antibodies. Allergies are therefore always diagnosed by an allergist or immunologist using a blood or skin test that detects IgE antibodies. “Symptoms depend on the size of dose of substance ingested and may be latent for a long time until they manifest, which can take up to several weeks, months or years. The diagnosis is confirmed by laboratory determination of the activity of the enzyme diamine oxidase (DAO)," says Dr. Kábrt. Common food intolerances also include lactose, gluten or histamine intolerance. All of them can cause many health problems that can complicate people's lives considerably.

Histamine in Food
‍While lactose or gluten intolerance is relatively well known to the public, histamine intolerance has so far escaped attention. Yet it is a widespread problem with potentially serious health consequences. "A substance called histamine is a natural part of living organisms – plants, animals and humans. It is also produced during natural fermentation, for example during storage, processing or maturation of food, and is often used in the food industry to enhance flavor," says the Chief Medical Officer. Histamine is found in high concentrations in, for example, aged and smoked cheeses, salami and other meat products, in seafood or tuna, in chocolate, sauerkraut, tomatoes and ketchup, in champagne or sparkling and red wine, and of course in various semi-finished products. "Normally, intake of these foods may not be a problem because the enzyme diamine oxidase (DAO) in the small intestine makes sure that histamine biodegrades and is then removed from the body. The problem arises when the DAO enzyme is deficient or has reduced activity," he points out. Histamine ingested through food is then metabolized much more slowly, accumulates in the body and enters the circulatory system through the intestinal mucosa and causes allergy-like symptoms. However, it is actually a manifestation of histamine intolerance aka HIT.  

Unpleasant Symptoms of HIT
‍Histamine affects many parts of the body, from the cardiovascular and nervous systems to the respiratory and digestive tracts to the skin and bone marrow. "It can manifest differently in each person, but typical symptoms include itching and redness of the skin, hives or skin rashes, bloating, abdominal pain and cramps, nausea, vomiting, diarrhea and other digestive problems, and in women it can aggravate menstrual pain," says Dr. Kábrt. Other symptoms include dizziness, headaches or migraines, swollen eyelids, stuffy nose or runny nose, sneezing, bronchial constriction, breathing difficulties or asthma. It can also cause muscle weakness, heart rhythm disturbances and tachycardia (increased heart rate), hypertension (increased blood pressure) or hypotension (decreased blood pressure). In extreme cases, an anaphylactic reaction can occur, which can even be life-threatening. If people experience any of these symptoms for a prolonged period of time, they should consult their doctor. If it is histamine intolerance, the symptoms are likely to get worse over time.

Temporary Or Permanent Intolerance
‍The cause of HIT may be due to genetic predisposition, increased dietary intake of histamine, reduced amount or activity of the DAO enzyme, or a combination of several causes. "Histamine intolerance can take a permanent form, which is usually caused by a genetic defect or a permanent deficiency of the enzyme. This problem afflicts approximately 1-3% of the population and continuously affects their quality of life," the chief medical officer says. In the case of temporary histamine intolerance, it is a temporary blockage or reduction in the activity of the DAO enzyme, which can be caused, for example, by eating certain foods, alcohol or certain drugs that inhibit, or suppress, the activity of the DAO enzyme. "Anyone can suffer from a temporary form of histamine intolerance and may experience milder symptoms such as a heavy feeling in the stomach, loss of appetite, dizziness or headaches, which can be triggered by even relatively small amounts of alcohol or drugs," he points out. A visit to a doctor's office is in order even at that point, as it can help prevent more serious complications from developing. Histamine belongs to the group of so-called biogenic amines, in addition to putrescine, cadaverine, tyramine, phenylethylamine, octopamine, dopamine or serotonin, which are also naturally occurring in various foods. If there are more biogenic amines in the diet that are also biodegraded by the DAO enzyme, histamine is broken down even more slowly in the body. Today, therefore, we are beginning to talk about biogenic amine intolerance rather than histamine intolerance alone.

Solving Histamine Problems
‍If people are unsure about the cause of their health problems that may be related to HIT, it is advisable to consult their GP about the next course of action. They can perform a so-called HIT test, which is based on observing the connection between their diet and the subsequent appearance of symptoms, or a test to determine the activity of the enzyme DAO in blood serum/plasma. Or they may recommend an allergist or immunologist who will perform an allergy test to detect IgE substances. "A possible solution to histamine intolerance is a low histamine diet that reduces the intake of biogenic amines and so-called histamine liberators that promote histamine release. These include citrus fruits, strawberries, kiwis, bananas, chocolate and shellfish. In addition to drugs, a deficiency of so-called cofactors, substances that are essential for the enzyme's function, such as vitamin C and B6, copper or zinc, can also cause a reduction in the activity of the DAO enzyme," the chief physician adds. To deal with some cases of temporary histamine intolerance, it is sufficient to introduce a histamine-reducing diet, where the intake of some foods should be limited and some foods avoided altogether. For example, pizza is a possible "histamine bomb" because it can contain many histamine-rich foods such as cheese, salami, smoked ham, tomatoes, yeast or ground meat. Combined with a glass of red wine, the intake of histamine by the food is then significantly increased, which can result in symptoms.

DAO enzyme replacement product
‍An option to prevent the development of unpleasant symptoms of HIT is to pay attention to the contents of food, read labels carefully and monitor the amount of preservatives. However, as part of a histamine diet, it is advisable to avoid nutritional deficiencies and not limit the intake of necessary nutrients. "Another option to address the problem is to replace the deficiency or low potency of the enzyme with the dietary supplement DAOsin, which contains the enzyme diamine oxidase (DAO), histamine then normally biodegrades and removed from the body," concludes Dr. Kábrt. In any case, if people are experiencing any of the symptoms described above, they should see a doctor, as this can prevent the situation from getting unpleasantly worse.