IF you’re regularly suffering from symptoms such as bloating, cramps, constipation and/or diarrhoea, you might assume it’s down to Irritable Bowel Syndrome (IBS).
A whopping 15% of Brits suffer with IBS, however, there’s a condition that’s relatively unheard of – histamine intolerance – that shares a lot of the same key symptoms.
That’s along with a multitude of other – often debilitating – symptoms, including skin issues, migraines and for women, irregular menstrual cycles.
According to the UK’S Histamine Intolerance Awareness campaign, the majority of people currently diagnosed with histamine intolerance are women in their 40s, with official figures as to the exact percentage of people suffering, still lacking.
Those who eat and drink high histamine foods, including alcohol, ready meals and aged cheeses (to name a few), could be more at risk.
You might have only come across the word ‘histamine’ upon taking antihistamine tablets, perhaps during hayfever season.
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And while histamine is associated with allergies, it also has a wealth of other vital functions in the body.
Confused?
“All humans need histamine; it is a naturally occurring chemical in the body,” explains Hussain Abdeh, Superintendent Pharmacist at Medicine Direct (medicinedirect.co.uk)
“It’s released into the bloodstream by your white blood cells when your immune system needs to defend the body against a potential threat, such as an allergen.
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“Histamine is mostly stored in immune system cells, although it can be found throughout the body.”
Hassan says histamine communicates with the brain and triggers the release of stomach acid to aid your digestion.
“Furthermore, it plays a part in lowering blood pressure by dilating the blood vessels.
“Histamine is also released after an injury as part of your immune response, such as a bee sting or a fall.”
He adds that taking an antihistamine does not mean you are killing the chemical off.
In fact, “you are merely preventing it from taking action against a potential trigger”.
Developing a histamine intolerance
When it comes to developing a histamine intolerance, Hassan explains that it tends to be a sign you have developed too much histamine.
“Having an excessive level of histamine in your body means you cannot break it down properly. This impacts other bodily functions.
“Histamine is produced naturally by the body, along with an enzyme called diamine oxidase (DAO).
“DAO breaks down the histamine that is contained in the food you eat.
“When you do not have enough DAO, your body cannot break down histamine properly, which can lead to histamine intolerance.”
He adds that sometimes histamine intolerance occurs due to bacterial overgrowth.
“When your food is not digested properly, bacteria can grow and cause excessive production of histamine.
“Because you have a higher level of histamine, it is too much for the DAO enzymes to handle, which means your body is left with too much histamine.”
The signs and symptoms
“When you suffer from histamine intolerance, it can often produce several of the key symptoms associated with IBS,” says Hussain.
“Symptoms shared between these two conditions include abdominal pain and/or cramping, digestive problems and nausea.
“Both problems can often cause the sufferer to feel bloated, too, which makes it easy to mistake histamine intolerance for IBS.
“Irritable bowel syndrome is a much more discussed and known condition, so it is often the go-to diagnosis.”
Some of the other common symptoms of histamine intolerance include headaches or migraines, and fatigue as well as a congested or runny nose.
“A woman’s menstrual cycle may be affected, which may manifest itself in cycle irregularities,” adds Hussain.
More serious cases of histamine intolerance can result in more severe symptoms including an irregular heartbeat and high blood pressure.
You may also experience swelling or abdominal cramps.
“Serious histamine intolerance can also impact your mental health, sometimes causing anxiety.
“Dizziness is a symptom in some people, too. Hives can often occur as a result of histamine intolerance, as can flushing of the skin.”
Hives can lead to extreme itching, which can often cause them to bleed.
“People who eat foods that are high in histamines, such as spinach, dried fruits, dairy products and fermented beverages like alcohol, may be at a higher risk of histamine intolerance.
“Some people also have a DAO deficiency, which makes an intolerance more likely.”
Dealing with histamine intolerance
Unfortunately, there is no treatment for histamine intolerance.
“Before you are diagnosed with it, your doctor will test to eliminate other problems and allergies that can trigger the same kind of symptoms,” reveals Hussain.
Diagnosis may require you to go on an elimination diet for up to one month.
“This involves altering your diet to cut out any foods that are known to either trigger histamine or contain high levels of histamine.
“You will then begin to slowly start reintroducing these foods to your diet to see if you begin to suffer from symptoms again.”
Unfortunately, some of our most loved foods contain histamine including alcohol (particularly red wine), smoked meats such as salami, ham and sausages, ready meals, matured and aged cheeses, chocolate and salty snacks including salted peanuts.
Other culprits include aubergine, rice vinegar, shellfish and pickled or canned foods.
Often, it’s aged or preserved foods that carry high histamine levels.
There’s also a range of other foods that can either release histamine or block the DAO enzyme.
These include most citrus fruits such as oranges and grapefruits, tomatoes and also legumes such as chickpeas and lentils.
Hussain adds that you may also need a blood test to see if you have a deficiency of DAO.
“Outside of making changes to your diet, your doctor may advise you to start taking antihistamines to inhibit the effects of histamine.
“You may also be advised to start taking DAO enzyme supplements, although, like any supplement, you should always talk to your doctor before you start taking them.
“Corticosteroids, which reduce inflammation, may also be recommended, although these should only be taken if prescribed and used exactly as your doctor tells you.”
Caring for your gut
Gut health can play a part in histamine intolerance.
In fact, health problems that damage the gut’s lining such as IBS, coeliac disease and Crohn’s disease can cause histamine intolerance.
Plus, Hussain explains that gastrointestinal disorders like inflammatory bowel disease can have an impact on your DAO enzyme levels, which may mean the enzyme is unable to break down a sufficient level of histamine, leading to histamine intolerance.
“DAO is a gastrointestinal enzyme, so when there is not enough of this enzyme to break down histamine, it is not absorbed properly within the gastrointestinal tract.
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“There is increasing research identifying a connection between histamine intolerance and conditions such as coeliac disease and eosinophilic gastroenteritis.
“However, this research is not yet entirely conclusive.”
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