What are the symptoms of histamine intolerance?
The symptoms of histamine intolerance are different from person to person. You may have one or more of these symptoms if you have high histamine levels:
- Diarrhea.
- Bloating.
- Nausea or vomiting.
- Headache.
- Runny or stuffy nose.
- Shortness of breath (dyspnea).
- Itching.
- Rash or hives.
- Flushing.
- Low blood pressure (hypotension).
- Irregular or fast heart rate (arrhythmia).
- Painful periods (menstruation).
- Swelling of your lips, tongue or throat.
What causes histamine intolerance?
Histamine intolerance symptoms happen when your body can’t break down histamine. Histamine is a chemical signal that opens up your blood vessels, constricts your airways and gastrointestinal (GI) tract, and creates mucus. Mast cells in your mucous membranes release histamine and other chemical signals to help fight infections and regulate your organs.
Your body uses enzymes, mostly diamine oxidase (DAO), to break down histamine. If you have low levels of DAO and you eat something or take medication that increases your level of histamine, the histamine signals can cause symptoms like diarrhea, headaches, runny nose and hives.
We’re not really sure what causes some people to have low levels of DAO or an inability to break down histamine as they should. Some factors that might contribute include:
- Genetics. Some people might inherit a difference in their DNA that keeps them from breaking down histamine like they should.
- Conditions that affect your gut. Inflammatory bowel disease (IBD), parasitic infections and other conditions that affect the natural bacteria of your gut can change how your body breaks things down.
- Kidney and liver diseases. Chronic kidney disease (CKD), viral hepatitis and liver cirrhosis can reduce DAO levels in your body.
- Medications. Some medications interfere with your body’s ability to break down histamine.
- Age. Histamine intolerance is more common in people over the age of 40.
What foods trigger histamine?
Some foods contain large amounts of histamine. These include foods that involve an aging or fermentation process like wine, beer and cheeses. Other foods can cause your mast cells to release histamine (histamine liberators). Both of these types of foods can cause excess amounts of histamine in your body.
Some examples include:
- Alcohol (wine, beer and champagne).
- Processed meat.
- Cheeses.
- Sauerkraut.
- Vegetables (tomatoes, eggplant and spinach).
- Tropical fruit (pineapple, bananas, papaya and citrus fruits).
- Fish (mackerel, tuna, sardines and herring) and shellfish.
- Strawberries.
- Nuts and peanuts.
- Licorice.
- Chocolate.
- Pork.
- Egg white.
- Additives (like colorants and preservatives).
- Certain medications (including some antibiotics, blood pressure medications, diuretics, local anesthetics and prescription painkillers).
What medications increase histamine levels?
Certain medications can increase the amount of histamine in your body. They do this by either causing your mast cells to release histamine or reducing the amount of DAO that’s breaking down histamine in your body. They include:
- Contrast agents used in medical imaging.
- Muscle relaxants.
- Opioids/narcotics.
- Analgesics.
- Anti-inflammatory medications.
- Local anesthetics.
- Blood pressure medications (antihypertensives).
- Antiarrhythmics.
- Diuretics.
- Antiemetics/gut motility medications.
- Antibiotics.
- Mucolytics.
- Bronchodilators.
- H2-receptor antagonists.
- Cytotoxic medications (chemotherapy).
- Antidepressants.
