Natural Treatment for Histamine Intolerance
I have never seen Quinten, a two-year-old with multiple problems. The parents called me from across the country because the grandmother was my patient. They had taken Quinten to several different doctors, but were unable to find out what was causing so many problems. They hated to see their little child suffer so much, and they knew something was wrong, but they weren’t getting any answers.
From the beginning, sleep was always an issue. The mom said she hasn’t slept a full night in two years because Quinten didn’t sleep very much, staying awake in spite of all their efforts, waking up frequently, and not able to get back to sleep and not taking naps during the day. Also, rashes would just appear all over, especially diaper rashes with every bowel movement. As a baby, Quinten was not quiet, being constantly awake and hyperactive – and keeping mom and dad from getting any rest at all. The doctors had no idea what could be going on, prescribing all sorts of treatments for the symptoms, including steroids and sedatives, but nothing changed. They decided they really needed help when their pediatrician told them not to worry when Hunter was having black stools, tested positive for blood, and was sent to a gastroenterologist for an endoscopy to look inside the stomach and find the source of bleeding.
As I listened to the story, I heard that little voice of Providence tell me that the problem was histamine. I had never heard of babies having problems with histamine, but as I thought about it, it made sense. Histamine is a neurotransmitter, a very small molecule made from Histidine, an amino acid. It is found everywhere!
Histamine is the most versatile neurotransmitter in nature. It is found in every type of organism from bacteria to humans. On top of the histamine we produce in our bodies, many plants use histamine so it’s in our food supply. Moreover, the effects on the body are protean – causing anything from a runny nose to schizophrenia. The following is a list of possible effects from too much of this chemical. (By the way, too little histamine has another list this long with different problems.)
Effects of High Levels of Histamine
- Sudden drops in blood pressure causing orthostatic hypotension, POTS, palpitations, anaphylaxis
- Allergy: Increased swelling, Runny nose, Sneezing, Watery eyes, Urticaria – allergic rash
- Pain – Low levels cause itching, High levels cause hypersensitivity to pain – fibromyalgia
- Insomnia – prevents sleep
- Stomach acid – ulcers, GERD, IBS
- Bowel regulation – diarrhea
- Inflammation – causes cytokine production – arthritis, any inflammatory condition
- Regulation of body temperature – “thyroid” imbalance
- Maintain hormone balance – Adrenal, steroid, and peptide hormones
- Regulate appetite – causes satiety and weight loss
- Asthma – direct effect on bronchoconstriction
- Urinary frequency – interstitial cystitis
- Decreased acetylcholine – low cognition, memory deficits, dementia, delirium
- Increased Norepinephrine and adrenaline – OCD, anxiety, hypertension, POTS, insulin resistance
- Decreased dopamine – hallucinations
- Increased serotonin – Clotting, nausea, IBS
Some may have only one symptom, while others will have multiple symptoms from too much histamine. The symptoms will vary in place and time in the same person. Rashes can show up anywhere, and go away, showing up somewhere else. Any of the symptoms can go away for any length of time, or another symptom may show up.
In Quinten’s case, the key component was bleeding ulcers – it is never “okay” for a two-year-old to have a bleeding ulcer. To me, that’s an emergency – not just to stop the bleeding, but to find out why.
It turns out, there are two enzymes that break down histamine in food and in the body:
- Diamine oxidase or DAO
- And histamine N-methyltransferase, or HNMT.
These rapidly break down histamine to prevent build-up. When the body releases histamine, it only lasts for seconds and is then broken-down. DAO is primarily in the intestines and blood. HNMT is primarily in the brain, kidneys, liver, and respiratory tract. Symptoms may vary depending on which enzyme is not functioning, and where the histamine is being made.
Factors that Increase Histamine in the Body
People who have a decrease in the function of one of these enzymes easily get excess histamine, producing any of the problems on the above list. As in Quinten’s case, some are born with a genetic abnormality in the enzyme which decreases its function. Others get decreased function for other reasons.
- Stress – Cortisol diminishes the DAO enzyme and increases histamine release from mast cells.
- Inflammation in the intestines – It’s hard to know if histamine causes intestinal problems, or if the intestinal issues cause high histamine. But, either way, inflammation causes the cells to produce less DAO enzyme. These include: IBS, IBD, Celiac, food sensitivities, SIBO, leaky gut, infections, yeast overgrowth or other inflammation of the gut.
- Overeating histamine – containing foods can overwhelm the DAO in the intestines.
- Medications – Many medications inhibit the action of DAO (muscle relaxants, narcotics, analgesics, local anaesthetics, antihypnotics, antihypertensives, antiarrhythmics, diuretics, antibiotics, antiemetics, bronchodilators, antiseptics, mucolytics, antihistamines, antidepressants) while others stimulate the release of histamine (painkillers, antibiotics, anti-hypotensives, anti-hypertensives, antitussives, diuretics, local anaesthetics, muscle relaxants, narcotics).
- Deficiency of copper prevents the proper function of DAO.
- Methylation deficiency – the HNMT enzyme requires methylation from SAMe.
Since doing this research for Quinten, I have found several people who have the same issue, with varying symptoms. My own grandson at just over one year of age wasn’t sleeping, and was getting diaper rashes so I told my daughter to try a low-histamine diet. He immediately responded by sleeping all night, taking naps, and stopped getting rashes. Several other of my older patients never had problems until a stressful event brought out one or more of the symptoms above.
What to do if you think you have a histamine problem? Blood and urine are available, but not always reliable. By far, the best test is to lower histamine. Besides avoiding all the things that cause it, above, here are several ways to do this.
Low Histamine Diet
There is no way to completely remove histamine from your diet, but you can avoid foods that contain high levels, and those which cause the body to release histamine. There are multiple lists that often contradict each other because each person is different. For example, eggs will be on the “AVOID” list for some, and on the “EAT” list for others. This is because the egg whites don’t contain histamine, but may cause the release of histamine for some people. The best way to do the diet is to lower the histamine intake, even avoiding foods that might release histamine, as much as possible.
Research has shown that being on a low histamine diet helps the enzymes to function better, so being very strict is essential. After the symptoms resolve, you can add things to your diet to see if you have a reaction. But, there is one caveat: the effects of histamine are additive. If you tolerate avocados, but then add some sauerkraut you may have a reaction. It isn’t because you don’t tolerate either one, but the two together overwhelmed your enzyme. It’s not like you are allergic to the foods, the reaction is only because it got to be too much. You need to be careful about putting certain foods together.
To add another wrinkle to the mix, and get you thoroughly confused, if you are allergic to pollen, and you’re having an allergic reaction, runny nose, sneezing, coughing, itching, and you add some food with histamine that you normally tolerate, you could react to it more. It’s all additive. That is why the lists of foods are so inconsistent. You will find a food diary to be essential.
I’m not going to reproduce a list here, as there are many to be found. The UK NHS has made a nice handout for their patients with this problem. It can be found here.
SUPPLEMENTS to Lower Histamine
DAO supplements should be taken with every meal, less than 15min before eating. This digestive enzyme is normally found in the intestines, and prevents histamine from causing inflammation in the intestines, as well as being absorbed and causing problems in the body. The amount to take is one capsule (10,000 units) with each meal.
Copper is essential for DAO function. Take 2mg per day for 90 days, then 4 mg once a week.
SAMe donates a methyl group to the HNMT enzyme, attaching it to histamine and deactivating it. If you don’t have SAMe, the enzyme doesn’t work. Take 400mg per day.
Quercetin prevents your mast cells (white blood cells, or immune cells) from releasing excess histamine into your body. Take about 1000 mg per day. If you are having a problem with acute allergies, asthma, or rashes, you can increase the dose, up to 2,000 mg three times per day, until the symptoms resolve, then go back to a lower dose that works. This nutrient is best taken with an enzyme, bromelain, to improve absorption.
MEDICATIONS to Lower Histamine
Cimetidine (Tagamet) is a medication for ulcers. If you have problems with excess stomach acid, this is a good blocker of histamine in the stomach. The best way to use it is to take 400mg for two weeks on, and then one week off. It does not lower the levels of histamine; it only blocks a histamine receptor found in the stomach that causes more acid to be produced. After you are on DAO and have a good low-histamine diet, you may not need this drug. I gave this to Quinten because of bleeding ulcers.
Diphenhydramine (Benadryl, Tylenol PM, and many others) is a medication for allergies that makes people drowsy because it blocks the histamine receptors in the brain. Since high histamine prevents sleep, this is a way to sleep at night. However, it does not lower the levels of histamine, and it has long-term effects of dementia. Again, for occasional, or short-term use, not for long-term use. Once you have a good diet you should not need this. There are other antihistamines, mostly allergy medicines or sedatives that do the same thing, and the same rules apply. The antihistamines that do not cross the blood-brain barrier don’t cause drowsiness but can help with immediate allergic reactions.
If you think you may have high levels of histamine, the best way to test is by your symptoms. I have found, as with Quinten, the response is immediate. This is not like a chronic inflammation that takes weeks to go away. Within a few days you will notice results – IF you lower your histamine enough. I had one patient who said she continued to have symptoms despite being on the diet, but she was drinking both coffee and tea – which are high in histamine. So, be careful. Look at everything. The supplements may be helpful, but the low-histamine diet is essential.