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Histamine intolerance: what is it?

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Histamine intolerance causes allergy-like symptoms when consuming high levels of histamine. Symptoms include hives, congestion, swelling, headache, diarrhea, and heartburn. A low histamine diet is the main treatment, avoiding processed and fermented foods, and alcohol. Vitamin C and B6 can help, and antihistamines can reduce symptoms.

People with histamine intolerance experience symptoms similar to an allergic reaction when they consume foods that contain high levels of histamine. The body naturally produces enzymes that help break down histamine, but those with a histamine intolerance have lower levels of these enzymes. Because the body can’t break down histamine properly and quickly if it doesn’t get enough of these enzymes, high levels of histamine can build up, leading to many different symptoms.

The most common side effects of histamine intolerance are hives, nasal congestion, facial swelling, headache, diarrhea and heartburn. Some people experience more serious symptoms, including increased heart rate, chest pain, asthma attacks or panic attacks. These symptoms can be indicative of many other conditions other than histamine intolerance, so the condition can be difficult to diagnose. Symptoms usually appear when histamine gradually builds up in the body, so doctors who suspect a patient has a histamine intolerance will usually put the patient on a low histamine diet for several weeks to see if the symptoms improve after ruling out more serious conditions.

A histamine-free diet is the main form of treatment for patients diagnosed with histamine intolerance. It is important for patients to inform their doctors of any medications they are currently taking, as some medications can adversely affect the function of enzymes that metabolize histamine. Vitamins C and B6 are also beneficial because they stimulate diamine oxidase, one of the main enzymes responsible for breaking down histamine. Over-the-counter and prescription antihistamines are helpful for patients with intolerance as they can help reduce symptoms and can prevent symptoms if the patient eats a histamine-rich food by mistake.

Processed and fermented foods are the largest group of histamine-rich foods and should be avoided completely by anyone with an intolerance. Fermented cheeses, soy sauce, and fermented vegetable products, such as sauerkraut, can trigger symptoms. Many meats, poultry and fish products are also high in histamine and chicken, shellfish, sausages and ham are the main culprits.

Spinach and tomatoes contain high levels of histamine, but most other fruits and vegetables are safe. Patients on strictly histamine-free diets should also avoid citrus fruits. These fruits don’t actually contain histamine, but they can cause the body to naturally release more histamine.

Red wine contains high levels of histamine and should be avoided by patients with histamine intolerance. Also, any type of alcohol can reduce the activity of diamine oxidase. Patients should avoid alcohol altogether if they still experience symptoms of intolerance after eliminating histamine-containing foods and red wine from their diet.

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