What is histamine and why is it so often overlooked?

Getting to know histamine

Histamine is a biogenic amine that can be found in almost every cell in the body. It’s produced by decarboxylation of the amino acid histidine and is present in mast cells. When released into the surrounding tissue, it can influence inflammation. It is also well recognized for its involvement in allergies, but most are unaware that it has other functions in the body, such as:

  • Regulating sleep,
  • Sexual function,
  • Wound healing.
  • It is also said to play a role in multiple sclerosis due to its capacity to stimulate T-cell differentiation.

When there is a buildup of histamine, the body struggles to break it down or metabolize it, which results in an imbalance that can generate symptoms including:

  • Asthma,
  • Headaches & Migraines,
  • Itchy skin,
  • Painful periods,
  • Tachycardia,
  • Flushing,
  • Rhinitis,
  • Diarrhoea, and
  • These symptoms are so similar to those of an allergic reaction that they are frequently misattributed to it and often underestimated or misconstrued.

However, unlike an allergy, symptoms do not always appear immediately because the body’s inability to remove histamine through normal pathways, specifically through the deactivation of specific enzymes, can occur gradually. Both endogenous and exogenous sources of histamine are capable of boosting histamine levels in the body due to the reduced activity of these enzymes and finding strategies to diminish these sources is one of the main techniques of treatment.

What are the main sources contributing to histamine build-up?

Diamine oxidase (DAO) is one of the key enzymes involved in the metabolization of histamine, and one’s diet plays a significant effect in histamine consumption. The list of histamine-rich foods is long and includes common foods such as cured meats, beans, pulses, hard cheeses, specific vegetables, and even certain fruits, making it difficult to stick to certain diets. This emphasizes the importance of supplementation to support DAO production and reduce the impact of associated inflammation.

Histamine levels can also rise when certain foods are consumed that have a contribution to a higher release of histamine in the body, such as soy sauce or oranges, which, while low in histamine, do contain putrescine, another biogenic amine. Biogenic amine is believed to have the ability to displace histamine from its mucosal mucine connection, increasing circulation histamine levels. Avocado, papaya, cocoa, walnuts, and strawberries are some more foods that are known to be histamine liberators.

Digestion is another source that contributes to histamine sensitivity making intestinal flora balance key.  Antibiotics and certain foods can disrupt bowel flora balance, resulting in an increase in bacteria that favor histamine production. Histidine carboxylase, an enzyme that converts the amino acid histidine to histamine, is produced by some bacteria, and once converted in the colon it is absorbed into the body contributing to symptoms.

Exercise can also have an effect on the release of histamine. For example, aerobic exercise is known to increase the release of histamine, and those who experience a sensitivity to histamine can experience associated symptoms such as migraines or itching.

Certain medications and the consumption of alcohol also have the ability to inhibit DAO causing increased histamine levels. Impairment of the enzymes can be due to commonly prescribed medications such as nonsteroidal anti-inflammatories while alcohol is known to give rise in the levels of circulating histamine as it decreases the amount of the enzyme diamine oxidase in the intestinal mucosa which can even occur in individuals who already don’t have a histamine sensitivity or genetic enzyme deficiency.

There are ways to manage a sensitivity to histamine which includes making dietary changes focused on fresh, minimally processed foods which contain fewer preservatives or fermented foods. Foods rich in Vitamin C, B6, and copper can also be beneficial as these may help increase DAO synthesis and support the degradation of histamine. Supplements that contain the DAO enzyme can play a key role in reducing symptoms as well as supporting the integrity of the bowel flora.

You can test if you have a genetic DAO enzyme deficiency with the GeneWell test (www.geneway.co.za)

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