What is Histamine Intolerance?

by | Oct 2, 2017 | Gut Health, Lupus Blog | 0 comments

What is Histamine Intolerance?

Histamine Intolerance is much more common than you think in Autoimmune patients like Lupus.  Often the symptoms are not so obvious to the Doctors because of the overlap with Lupus symptoms.

What’s the cause of Histamine Intolerance?

In healthy individuals, histamine is broken down by two enzymes: DAO (diamine oxidase) and HNMT (Histamine N-methyltransferase).

DAO is produced in the intestine, so if the intestinal function is compromised as is the case with many Lupus patients due to Leaky gut there may be insufficient DAO  to metabolize histamine.

When build-up of histamine occurs, so do the symptoms. Decreased DAO  (enzyme) production may be why histamine intolerance is more common in persons with gut issues such as inflammatory bowel disease, IBS, Celiac, and SIBO.

It’s also important to note that DAO activity can also be inhibited by certain medications.

Lupus patients are on a ton of meds, have leaky gut, and likely have a DAO insufficiency to contribute to Lupus flares and Histamine intolerance.  So what came first, the leaky gut, lupus, or histamine intolerance?

Histamine intolerance is more widely accepted in Europe as a true medical condition and was recognized in 2012 by the German Society for Allergology and Clinical Immunology as a true disease with an unknown cause.

Lupus and Histamine Intolerance

Histamine intolerance appears to be more prevalent with those who have leaky gut coupled with inflammatory bowel disease, celiac disease, IBS etc.

In the US, histamine intolerance is not considered a disease so we have limited data on the incidence of histamine intolerance.

I can tell you that I’ve had this at the onset of my Lupus and have had patients heal their gut following the elimination diet and Alkaline Detox Protocol and were able to heal from the histamine intolerance, improving the DAO enzyme production and are doing great.

Symptoms of Histamine Intolerance

  • Headaches/migraines
  • Sleep Disturbance
  • Vertigo or dizziness
  • High Blood Pressure/ Low Blood Pressure
  • Severe Menstrual Cramping
  • Irregular periods
  • Anxiety and Difficulty Focusing
  • Nausea, vomiting
  • Abdominal cramps
  • Sinus congestion
  • Flushing/Hives
  • Fatigue
  • Too hot or too cold
  • Increased Heart Rate
  • Swelling and Water Retention

The symptoms of histamine intolerance are erratic and inconsistent so it can be confusing and frustrating.

What is Histamine

Histamine is a compound involved in many functions in our body; immune system, digestion, nervous system, cardiometabolic, and the endocrine system.

It is a chemical messenger which helps to spread messages from your body to the brain.  It is also a part of our stomach acid, which helps to break down the food in the stomach.

Antihistamines are usually prescribed for seasonal allergies such as Benadryl, Zyrtec, Claritin, etc.

Histamine’s main role is to cause an acute inflammatory reaction to notify your immune system of potential toxins.

It causes your blood vessels to swell by increasing white blood cells to find and attack the pathogen in your body.

This is the “innate” immune response that I talk about here.

Because histamine is in the bloodstream, it can affect your gut, lungs, skin, brain, and really the whole body potentially causing symptoms all over the body, making it difficult to diagnose.

Notice the similarities in the way Lupus affects our body?

What Causes Histamine Intolerance?

  • Allergies (IgE reactions not IgG)
  • Leaky Gut
  • GI bleeding
  • SIBO (Small Intestinal Bacterial Overgrowth)
  • Diamine Oxidase (DAO) deficiency
  • Histamine-rich foods

Avoid High Histamine Foods

This topic is controversial because histamine content of food depends on many variables:

  • food storage
  • ripeness or maturity of fruits and veggies
  • cooking and processing

It’s important to note that certain foods may not be high in histamine, yet are high in compounds known as histamine activators, which can trigger similar symptoms by increasing histamine levels.

The list below contains commonly accepted high histamine foods/histamine activators, but this list is by no means complete.  Available lists vary and consistent data is hard to find on histamine content of foods. What does seem to be agreed upon is that fermented and aged foods do tend to be some of the biggest offendors.

  • • Alcohol: Champagne, red wine, beer, white wine,
    • Fermented or smoked Meats/Fish: Sardine, mackerel, herring, tuna, salami
    • Pickled or canned foods: Sauerkraut, pickles, relishes, soy sauce
    • Fermented milk products: Yogurt, kefir, buttermilk
    • Aged cheeses: Parmesan, Gouda, Swiss, cheddar.
    • Fruit: Dried fruit, strawberries, citrus
    • Vegetables: Tomatoes and tomato products, spinach
    • Legumes: Chickpeas, soybeans, peanuts
    • Other: Cinnamon, chocolate
    • Grains: Wheat
    • Histamine Activators: Citrus, papaya, pineapple, nuts, strawberries, egg white, additives
    • DAO blockers: alcohol, black and green tea

What do you do if you suspect Histamine Intolerance?

Talk to your doctor to evaluate other possible conditions such as true allergies (IgE), Immune disorders or underlying digestive disorders.

Once these possibilities have been evaluated and addressed, an elimination diet should be  initiated to see if symptoms improve. A food diary is essential. Underlying issues must be corrected first to optimize improvement. Because the diet is restrictive, especially if added onto an already restricted eating plan, please consult a professional to ensure proper nutritional intake.

Keeping a food diary is essential to keep track of your symptoms.

Many patients who have Histamine Intolerance must be careful as the diet can be seerely restrictive, get under a care of a medical or nutritional professional to ensure safe improvement.

How histamine intolerance is diagnosed

There is no way to diagnose histamine intolerance.  In Functional Medicine, we consider the elimination diet as the gold standard.

There is no specific test to diagnose Histamine Intolerance.


Treatment for histamine intolerance

It isn’t just diet! Treat any underlying disorder first, as this may improve histamine tolerance, which is healing your leaky gut.

eWe usually recommend starting with the gut.  However, it’s an integrated approach that is most effective.


Elimination Diet is a treatment of choice.    The tolerance to histamine varies greatly from person to person and the amount of histamine tolerated must be revealed by trial and error.

While some can only tolerate very small amounts, others can be more liberal.


Mindful practice of yoga tends to be very helpful for Histamine Intolerance to calm anxiety and to bring healing from within.


It’s important to understand that sleep is everything!  This is when our bodies are busy healing and regenerating so if you’re not sleeping, it’s going to sabotage your body’s healing efforts.  We have natural Sleep Support supplements  available for you to help with this.

Aim for 7-8 hours a night!

Peer Support: Join our Lupus Rebel Facebook

Health crisis like Lupus and Histamine Intolerance can be a real challenge.  Support from family, community, and online support groups can be so helpful.

Relaxation: Take an Epsom salt baths, breathe, and meditate.

Supplements: I’ve found that this supplement for Histamine Control helps a ton 30 minutes before meals to decrease your symptoms.

We’ve got various Detox Program available for you from a simple PDF Lupus Gut Heal Guide to 5-week online Gut Healing Course,  to extensive 3 month Gut restoration program.

The key is to know that there are answers to your issues.  Talk soon.

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