Understanding Histamine Intolerance: An Evidence-Based Approach
Histamine intolerance, also referred to as enteral histaminosis or sensitivity to dietary histamine, is a disorder associated with an impaired ability to metabolize ingested histamine¹². Although interest in histamine intolerance has considerably grown in recent years, more scientific evidence is still required to help define, diagnose and clinically manage this condition².
What is Histamine Intolerance?
Histamine intolerance is a non-immune-mediated adverse reaction to food that arises from a reduced histamine degradation capacity in the intestine¹. A deficit of diamine oxidase (DAO), the primary enzyme responsible for scavenging histamine from food at the intestinal level, is recognized as the main etiologic factor that leads to histamine intolerance¹. This enzymatic deficit may have a genetic, pathological, or pharmacological origin, which causes the accumulation of histamine in plasma and the subsequent appearance of non-specific gastrointestinal and extraintestinal symptoms¹.
Symptoms of Histamine Intolerance
The symptoms of histamine intolerance can vary greatly among individuals. They often mimic those of an allergic reaction and can include:
– Skin reactions such as hives and itching
– Gastrointestinal symptoms such as nausea, vomiting and diarrhea
– Respiratory issues such as sneezing and difficulty breathing
– Cardiovascular symptoms such as palpitations and changes in blood pressure
– Neurological symptoms such as headaches and dizziness
Diagnosis of Histamine Intolerance
Currently, there is no consensual diagnostic algorithm for histamine intolerance¹. The diagnosis is often based on the patient’s history and the observation of symptom improvement when following a low-histamine diet. Some healthcare providers may also use a DAO enzyme activity test or a histamine provocation test to aid in diagnosis.
Treatment of Histamine Intolerance
The treatment management for histamine intolerance is limited to the strict avoidance of dietary histamine and DAO enzyme supplementation¹. Recent and ongoing trials are focused on the study of the efficacy of low-histamine diets and/or DAO supplementation in the preventive treatment of symptoms¹.
Conclusion
Histamine intolerance is a complex condition that requires further research for better understanding. If you suspect you have histamine intolerance, it’s important to seek medical advice before making any significant changes to your diet or lifestyle.
Remember, everyone’s body is unique and what works for one person may not work for another. It’s important to listen to your body and make dietary adjustments that suit your individual needs.
(1) Special Issue “Unfolding New Evidence on Histamine Intolerance” – MDPI. https://www.mdpi.com/journal/nutrients/special_issues/Unfolding_New_Evidence_on_Histamine_Intolerance.
(2) Histamine Intolerance: The Current State of the Art – MDPI. https://www.mdpi.com/2218-273X/10/8/1181.
(3) Histamine intolerance and dietary management: A complete review. https://www.elsevier.es/en-revista-allergologia-et-immunopathologia-105-articulo-histamine-intolerance-dietary-management-a-S0301054616300775.
(4) Biomolecules. https://doi.org/10.3390/biom10081181.