Histamine intolerance is the intolerance towards “normal” levels of histamine in food caused by a decreased activity of the histamine-degrading enzymes diamine oxidase (DAO) or histamine N-methyltransferase (HNMT). In the gut the main enzyme is DAO while in other parts of the body like the skin and brain the enzyme HNMT degrades histamine.
Causes of histamine intolerance
Histamine intolerance is caused by an impaired enzyme activity.
- Enzyme production problems (inflammatory bowel diseases, food deficiences)
- Enzyme inhibitors (certain biogenic amines, certain medicines)
- Enzyme competitors (biogenic amines)
- Enzyme genetic defects
Mast Cell Activation
Mast cells are part of the body’s defence system to protect against infection and injury. Mast cells contain histamine, heparin, prostaglandins and other pro-inflammatory mediators. A well-know unwanted mast cell degranulation is via an allergic reaction to an allergen which raises IgE levels in the blood.
- Non-allergic mast cell degranulation is also possible which is then called Mast Cell Activation Syndrome. One example is Mastocytosis which leads to too many mast cells.
Symptoms of histamine
- Skin: itch (pruritis), skin redness/flushing, red spots, skin rash/eczema, hives (urticaria).
- Gastro-intestinal tract: stomach acid reflux, diarrhea, nausea, vomiting.
- Respiratory: runny nose (rhinitis), bronchocontriction –> asthma, chronic cough.
- Vascular: vasodilation –> low blood pressure (hypotension), dizziness, fainting, anaphylaxis, oedema
Cascade of symptoms of histamine intolerance & mast cell activation
Bronchocontriction makes you more sensitive to low oxygen levels and so you may develop symptoms of hypoxia when for example room ventilation is bad.
- Shortness of breath
- Chest pain
- Tension-type headache
- Muscle pain/cramp, Frozen shoulder
- Problems with speech, Stuttering
- Hearing problems
- Hair loss , Cold feet (the extremities of the body)
- Tired eyes
- Vision/Focus problems
- Macula degeneration?
- Confusion , Disorientation
- Brain white matter lesions –> Vascular dementia
- Sleep-apnea , Nose pain
- Coma, Death
The production of Levo-dopa from which dopamine is synthesized requires oxygen!! Hypoxia therefore may cause low dopamine levels.
- Cognition: problems with memory, attention/concentration, problem-solving
- Motor control (Parkinsonism): unsteady gait
- Prolactin secretion: low libido
- Chemoreceptor Trigger Zone: Nausea, Vomiting, Lack of appetite (anorexia)
- Mood: Depression
Recovery from hypoxia: high dopamine
- Hallucinations: noise, smell
Your body will respond to hypoxia by producing adrenaline which increases your heart- and breathing rate.
- Rapid heart beat
- Rapid breathing
- Insomnia –> Fatigue
- Panic attacks
- Vasoconstriction –> High blood pressure (hypertension)
- Parotid gland
- Mouth (sores)
- Nose (nasal congestion)
- Uterine muscle contraction
- Unexplained bruising / bleeding
- Check if you recognize the symptoms of histamine intolerance and/or mast cell activation. Yes, then go to the next step.
- Understand histamine intolerance and/or mast cell activation. Read, read, and read.
- Register in a diary what you eat, which medicines you take, other possible triggers and the symptoms you experience.
- Eliminate the suspicious food and other triggers.
- Re-introduce the food/trigger after a while, in order to find out, if this particular food/trigger does or does not provoke adverse reactions.
- When your family members have the same type of symptoms you could test for genetic defects in the enzymes.
- Hypoxia can be determined by monitoring with a finger-pulse oximeter.
Treatment of histamine intolerance & mast cell activation
- Prevent leaky gut
- Increase the activity of enzymes
- Decrease histamine input
- Prevent mast cell degranulation
- Avoid vasodilators
- Decrease aggressive prostaglandins
- Increase oxygen saturation
- Prevent the effect of histamine
- Maintz L., Novak N. (2007) Histamine and histamine intolerance, Am J Clin Nutr. 85(5): 1185-96
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