Low Histamine Diet
&
Histamine Intolerance
One-quarter of what you eat keeps you alive.
The other three-quarters keep your doctor alive.
Written by White Shark, 2009
What is Histamine?
Histamine is a natural chemical produced by the body and is also present in many foods. Histamine is released by the body during times of stress, allergy, infectious diseases etc. Histamine (2-[4-imidazolyl]ethylamine) was discovered in 1910 by Dale and Laidlaw, and it was identified as a mediator of anaphylactic reactions in 1932. Histamine is a potent mediator of numerous biologic reactions inside our body.
Who are the people who are hypersensitive to Histamine?
Many people are hypersensitive to histamine, especially people suffering from allergies, asthma, urticaria, eczema, seborrheic dermatitis, ulcerative colitis, Crohn's disease, pompholyx, irritable bowel syndrome, and anyone suffering from an acute infection. Elevated histamine concentrations and diminished DAO activities have been shown for various inflammatory and neoplastic diseases such as Crohn disease, ulcerative colitis, allergic enteropathy, food allergy, migraines, headaches, and colon cancer. Histamine-intolerant women often suffer from headache related to their menstrual cycle and from dysmenorrhea. These symptoms may be explained by the interplay of histamine and hormones. Histamine has been shown to stimulate, in a dosedependent manner, the synthesis of estradiol.
What is Histamine Intolerance?
Healthy people have an enzyme, diamine
oxidase (DAO), which breaks down any excess histamine that they absorb from
a histamine-containing food or any histamine stored inside our own cells, liberated
by histamine liberator foods.
When healthy people eat a food which contains histamine, or foods that liberate
histamines, it does not affect them thanks to a healthy level of diamine oxidase
in their body. However, some people have a low level of this enzyme. When they
eat too many histamine-rich foods they suffer ‘allergy-like’ symptoms such as
headaches, rashes, itching, eczema, hives, diarrhea, vomiting, abdominal pain,
flatulence, etc. This is called histamine intolerance. When you are
hypersensitive to histamines, it is called histamine intolerance.
Histamine intolerance results from a disequilibrium of accumulated histamine and
the capacity for histamine degradation.
Next diagram shows all the symptoms associated with histamines, and the pathways
how histamines affect different organs and different functions.
Histamine-related symptoms. Maintz, L. et al.
What dietarry factors have an important effect on the histamine levels in our body?
There are 4 major dietary factors that can affect histamine levels inside our body.
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consumption of foods known as high histamine foods, like vinegar.
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consumption of foods known as histamine liberators, like sugar, MSG, sulfites, nitrites.
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consumption of diamine oxidase blockers (DAO blockers), mainly alcohol.
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consumption of diamine oxidase competitors (DAO competitors), mainly alcohol.
What foods are known as High Histamine Foods?
Foods that are particularly high in histamine and other vasoactive amines include but are not limited to:
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Fermented drinks like champagne, wine, beer, cider and other fermented drinks and spirits. (alcohol is also DAO blocker)
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Vinegar and foods containing it such as dressings, pickles, mayonnaise, ketchup, mustard
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Prepared salads, salads with dressings, pickles
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Tinned and canned vegetables and other foods
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Sauerkraut and other pickled foods
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Marinated Tofu and soya sauce
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Parmesan cheese and all other fermented cheeses
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Sausages and all other processed meats (ham, salami, gammon, bacon, mortadella)
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Mushrooms and quorn
-
Coffee
-
Tinned, canned and smoked fish (tuna, salmon, herring, mackerel) and crustaceans.
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Dried fruit, seeds, nuts.
-
Yeast extract, yeast, foods made with yeast like bread
-
Chocolate, cocoa, coca-cola, and all industrial drinks. Water is the only safe drink.
What foods are known as Histamine
Liberators?
Foods that stimulate release of histamine
from mast cells are called histamine liberators. Even foods low on histamines
can be histamine liberators.
Examples of histamine liberator foods are:
-
Sugar, Chocolate, Corn syrup, dextrose, other sugars
-
Food additives like preservatives, MSG, glutamates, benzoates, sulphites, nitrites, several colorants (yellow E-102 and E-110, E-124, amarant E-123)
-
Artificial sweeteners like aspartame, sorbitol, xylitol
-
Coffee
-
Sweet and sour tropical fruits like bananas, avocado, papayas, kiwi, pineapple, mango, figs, dates
-
Citrus fruits like lemon, lime, oranges, grapefruits, mandarins, clementines, tangerines
-
Sweet common fruits like grapes, cherries,
-
Almost all berries like strawberries, raspberries, blackberries, blueberries, cranberries
-
Pea, lentil
-
Spices, most herbal spices including black pepper, sweet pepper
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Nightshades like tomatoes, paprika, peppers, potatoes, eggplant.
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Tree-nuts and peanuts, including walnuts, hazelnuts, pecans etc.
-
Shellfish including oysters, prawns, blue shells
-
Egg white
-
Pumpkin
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Spinach
Some food additives such as glutamates, benzoates, sulphites, nitrites, several
colorants (yellow E-102 and E-110, E-124, amarant E-123), can release endogenous
histamine.
According to the Department of Dermatology at the University of Bonn (Germany),
the intake of endogenous histamine-releasing foods or drugs causes the same
symptoms as rich-histamine food intake.
If you are suffering from any chronic health problem, odds
are your diet is an important factor.
Huge number of people suffering from different chronic health problems are
actually intolerant or hypersensitive to some of the foods they may be
consuming on the daily bases.
Low histamine diet can help many people
recover.
Alcohol is one of the most harmful products for people with DAO deficiency. It
contains histamine, cadaverine and other amines, it releases endogenous
histamine and has the property of blocking DAO, with the possibility of
interfering in the metabolism of its own histamine and of the one found in
ingested food. Ethanol intake causes DAO activity reduction, even in healthy
people without genetic DAO deficiency and not only in people predisposed to low
DAO levels.
Ethanol aggressively attacks DAO, so even with a normal level of DAO (activity higher than 80 HDU/ml) histamine saturation in blood occurs. This is perfectly reflected in the mechanism taking place in a hangover. Most people, even without having low DAO activity, present a typical picture of general discomfort that encompasses the set of symptoms, and these alcohol effects are due to the increased histamine in blood.
What foods are known as low histamine foods?
Histamine intolerant people thrive on food that has not been
processed very much. Raw food, raw vegetable, raw fruit, raw organic milk,
raw organic eggs, raw wild fish, raw soaked nurs, raw soaked seeds, raw
vegetable juices, extra virgine oils, etc.
Check the blood type lists and your own blood type, when choosing the food.
Commonly considered safe low histamine foods, for 99% of people are:
- Grains: natural whole grain rice, natural whole grain oats, whole grain millet, whole grain buckwheat, quinoa
- Unrefined and unprocessed sea salt, with no additives. Extremely important part of the low histamine diet, as it is a natural antihistamine! Read the label! Available online!
- Fresh, clean water. Another very important part of the low histamine diet, as it is a natural antihistamine!
- natural fresh unprocessed meat
- natural, wild, fresh unprocessed ocean fish like cod
- Root vegetables: carrots, red beet, onions. (some people react on onions! be careful with onions!)
- natural organic apples, natural organic plums
- adzuki beans, mungo beans (may not be well tolerated by all people, be careful with beans)
- sweet potatoes
- whole fresh sesame seeds (not for everyone)
- chia seeds
- fresh raw milk (milk is a common allergen, not safe for many kids)
- coconut. Most people can tolerate coconuts! But some kids react on coconuts
Though beans and raw milk possess antihistamine properties,
you can still be allergic to or react to them so please always proceed with
caution! Beans contain lectins, surface proteins, and people of blood type O
have particulary problem to tolerate beans. Soy is also a bean, and is also a
top allergen. Milk is a top allergen!
Can I Improve my Tolerance to Foods?
Yes, You can improve your food tolerance! To improve your
food tolerance, learn about
fecal microbiota transplant and learn about
liver flushing!
Harmful foods - foods you should always be avoiding?
Those foods are harmful for everyone !
EVERYDAY
TOXINS and Foods that kill
Avoid eating foods
that kill
AVOID Sugar
If I am hypersensitive to some food, does it mean I am also allergic to it?
To not tolerate some food or to be hypersensitive to some food does not automatically mean that you are allergic to that
food ! It only means you are hypersensitive.
An allergy is defined as a specific antibody response. An allergy is the
response of the body's immune system to normally harmless substances, such
as pollens, foods, and house dust mite. In IgE mediated allergies the
immune system produces exaggerated amounts of a distinct class of antibodies
known as IgE antibodies that are, specific for the particular offending
allergens.
There are 2 general types of allergy tests. Skin tests and blood tests.
There are three common types of skin tests: Skin prick test, Intradermal
test and Skin patch test.
During the skin prick test, skin is intentinally injured by a series of
scratches or needle pricks allowing the solution with allergn to enter the
skin. A drop of a solution containing a possible allergen is placed on
injured skin. If the skin develops a red, raised itchy area (called a
wheal), it usually means that the person is allergic to that allergen. This
is called a positive reaction to the allergy test.
During the Intradermal test, a small amount of the allergen solution is
injected into the skin. This test is usually performed when when a substance
does not cause a reaction in the skin prick test but is still suspected as
an allergen for that person. The intradermal test is more sensitive than the
skin prick test but is more often positive in people who in reality are not
allergic. (false-positive test results are common).
For a skin patch test, the patch with allergen solution is taped to the skin
for 24 to 72 hours. This test is used to detect a skin allergy called
contact dermatitis, common cause of eczema.
Allergy blood tests are designed to measure the level of substances in the
blood called antibodies. Blood tests are not as sensitive as skin tests but
are often used for people who are not able to have skin tests and for
babies.
What are the most common signs of food intolerance?
Signs of intolerance could be, but are not limited to:
- colic, flatulence, diarrhea, gas and bloating
- abdominal pain
- headache (immediately, or even many days after eating that food )
- itch, eczema, rash
- constipation
- excessive sweating'
- fever, freezing
- nervousness
- depression
- excessive anger
- fear
- head banging
- phobias
- sadness
- pain in different parts of body
- reaction on the skin
- reaction in the eyes, eye twitches
- muscle twitches, cramps, tremor
- mood swings
- hot flushes
- anxiety
- chronic fatigue
- chronic insomnia
- hair loss
- grey hair
- etc ...
Histamine and headache
Headache can be induced dose-dependently by histamine in
healthy persons as well as in patients with migraine (53, 61).
Histamine-induced headache is a vascular headache caused
mainly by nitrate monoxide (62). Histamine releases endothelial
nitrate monoxide upon stimulation of H1R, which is also expressed
in the large intracranial arteries (63). In migraine patients,
plasma histamine concentrations have been shown to be
elevated both during headache attacks and during symptom-free
periods. An increase in the number of brain mast cells is associated
with pathologic conditions such as migraine, cluster headache,
and multiple sclerosis (64). Many migraine patients have
histamine intolerance evidenced by reduced DAO activity, triggering
of headache by food rich in histamine (eg, long-ripened
cheese or wine), and the alleviation of headache (ie, disappearance
of symptoms) under a histamine-free diet (57, 65) and
therapy with antihistamines (66).
Histamine and gastrointestinum
Besides headache, gastrointestinal ailments including diffuse
stomach ache, colic, flatulence, and diarrhea are leading symptoms
of histamine intolerance. Elevated histamine concentrations
and diminished DAO activities have been shown for various
inflammatory and neoplastic diseases such as Crohn disease
(17), ulcerative colitis (67), allergic enteropathy (39), food allergy
(33, 68, 69), and colorectal neoplasmas (24). In the colonic
mucosa of patients with food allergy, a concomitant reduced
HNMT (70) and an impaired total histamine degradation capacity
(THDC) (69) have been found (33), so that the enzymes
cannot compensate each other. Therefore, an impaired histamine
metabolism has been suggested to play a role in the pathogenesis
of these diseases.
Histamine and airways
During or immediately after the ingestion of histamine-rich
food or alcohol, rhinorrea or nasal obstruction may occur in
patients with histamine intolerance; in extreme cases, asthma
attacks also may occur. Reduced HNMT activity has been shown
for patients with food allergy (70) and asthma bronchiale (71).
"Let thy food be thy medicine,
and thy medicine be thy food."
Hypocrites, the Father of Modern Medicine
Sources:
Histamine
and histamine intolerance by Laura Maintz and Natalija Novak
REFERENCES
1. Silla SantosMH. Biogenic amines: their importance in foods. Int J Food
Microbiol 1996;29:213–31.
2. Bieganski T, Kusche J, Feussner KD, Hesterberg R, Richter H, Lorenz W. Human
intestinal diamine oxidase: substrate specificity and comparative inhibitor
study. Agents Actions 1980;10:108 –10.
3. Bieganski T, Kusche J, Feussner KD, Hesterberg R, Richter H, Lorenz
W. The importance of human intestinal diamine oxidase in the oxidation
of histamine and/or putrescine. Arch Immunol Ther Exp (Warsz)
1980;28:901– 6.
4. Bieganski T, Kusche J, Lorenz W, Hesterberg R, Stahlknecht CD,
Feussner KD. Distribution and properties of human intestinal diamine
oxidase and its relevance for the histamine catabolism. Biochim Biophys
Acta 1983;756:196 –203.
5. Bieganski T. Biochemical, physiological and pathophysiological aspects
of intestinal diamine oxidase. Acta Physiol Pol 1983;34:139 –54.
6. Sattler J, Hafner D, Klotter HJ, Lorenz W, Wagner PK. Food-induced
histaminosis as an epidemiological problem: plasma histamine elevation
and haemodynamic alterations after oral histamine administration
and blockade of diamine oxidase (DAO). Agents Actions 1988;23:
361–5.
7. Wantke F, Gotz M, Jarisch R. The red wine provocation test: intolerance
to histamine as a model for food intolerance. Allergy Proc 1994;
15:27–32.
8. Wantke F, Hemmer W, Haglmuller T, Gotz M, Jarisch R. Histamine in
wine. Bronchoconstriction after a double-blind placebo-controlled red
wine provocation test. Int Arch Allergy Immunol 1996;110:397– 400.
9. Zimatkin SM, Anichtchik OV. Alcohol-histamine interactions. Alcohol
Alcohol 1999;34:141–7.
10. Sattler J, Lorenz W. Intestinal diamine oxidases and enteral-induced
histaminosis: studies on three prognostic variables in an epidemiological
model. J Neural Transm Suppl 1990;32:291–314.
11. Wantke F, Hemmer W, Focke M, Stackl W, Gotz M, Jarisch R. Are
adverse effects of sildenafil also caused by inhibition of diamine oxidase?
Urol Int 2001;67:59 – 61.
12. Sattler J, Hesterberg R, Schmidt U, Crombach M, Lorenz W. Inhibition
of intestinal diamine oxidase by detergents: a problem for drug formulations
with water insoluble agents applied by the intravenous route?
Agents Actions 1987;20:270 –3.
13. Jarisch R, ed. Histamin-Intoleranz. Histamin und Seekrankheit. (Histamine
intolerance. Histamine and motion sickness.) Stuttgart, Germany:
Georg Thieme Verlag KG, 2004 (in German).
14. Jarisch R, Wantke F. Wine and headache. Int Arch Allergy Immunol
1996;110:7–12.
15. Wohrl S, HemmerW, Focke M, Rappersberger K, Jarisch R. Histamine
intolerance-like symptoms in healthy volunteers after oral provocation
with liquid histamine. Allergy Asthma Proc 2004;25:305–11.
16. Pollock I, Murdoch RD, Lessof MH. Plasma histamine and clinical
tolerance to infused histamine in normal, atopic and urticarial subjects.
Agents Actions 1991;32:359 – 65.
17. Schmidt WU, Sattler J, Hesterberg R, et al. Human intestinal diamine
oxidase (DAO) activity in Crohn’s disease: a new marker for disease
assessment? Agents Actions 1990;30:267–70.
18. Missbichler A. Diagnostischer Nachweis der Aktivita¨t von Diaminooxidase
in Serum oder Plasma. (Diagnostic proof of the DAO activity
in serum and plasma.) In: Jarisch R, ed. Histamin-Intoleranz. Histamin
und Seekrankheit. (Histamine intolerance. Histamine and motion
sickness.) Stuttgart, Germany: Georg Thieme Verlag KG, 2004:8 –17
(in German).
19. Jansen SC, van DM, Bottema KC, Dubois AE. Intolerance to dietary
biogenic amines: a review. Ann Allergy Asthma Immunol 2003;91:
233– 40.
20. Dale HD, Laidlaw PD. The physiological action of -iminazolylethylamine.
J Physiol (Lond) 1910;41:318 – 44.
21. Steinhoff M, Griffiths C, Church M, Lugar TA. Histamine. In: Burns T,
Breathnach S, Cox N, Griffiths C, eds. Rook’s textbook of dermatology.
Oxford, United Kingdom: Blackwell Science, 2004:9.50 –2.
22. Vlieg-Boerstra BJ, van der HS, Oude Elberink JN, Kluin-Nelemans JC,
Dubois AE. Mastocytosis and adverse reactions to biogenic amines and
histamine-releasing foods: what is the evidence? Neth J Med 2005;63:
244 –9.
23. Ring J. Angewandte Allergologie. (Implemented allergology.)
Munich, Germany: Urban & Vogel, 2004 (in German).
24. Raithel M, Ulrich P, Hochberger J, Hahn EG. Measurement of gut
diamine oxidase activity. Diamine oxidase as a new biologic marker of
colorectal proliferation? Ann N Y Acad Sci 1998;859:262– 6.
25. Kusche J, Bieganski T, Hesterberg R, et al. The influence of carcinoma
HISTAMINE AND HISTAMINE INTOLERANCE 1193
by guest on April 3, 2015 ajcn.nutrition.org Downloaded from growth on diamine
oxidase activity in human gastrointestinal tract.
Agents Actions 1980;10:110 –3.
26. Kalchmair B, Klocker J, Perkmann R, et al. Alterations in plasma amine
oxidase activities in a compartment syndrome model. Inflamm Res
2003;52(suppl)1:S67– 8.
27. Schwelberger HG. Diamine oxidase (DAO) enzyme and gene. In: Falus A, ed.
Histamine: biology and medical aspects. Budapest, Hungary: SpringMed Publishing,
2004:43–52.
28. Schwelberger HG, Hittmair A, Kohlwein SD. Analysis of tissue and subcellular
localization of mammalian diamine oxidase by confocal laser scanning
fluorescence microscopy. Inflamm Res 1998;47(suppl):
S60 –1.
29. Schwelberger HG, Bodner E. Purification and characterization of diamine
oxidase from porcine kidney and intestine. Biochim Biophys Acta
1997;1340:152– 64.
30. Brown DD, Tomchick R, Axelrod J. The distribution and properties of
a histamine-methylating enzyme. J Biol Chem 1959;234:2948 –50.
31. Klocker J, Matzler SA, Huetz GN, Drasche A, Kolbitsch C, Schwelberger HG.
Expression of histamine degrading enzymes in porcine tissues. Inflamm Res
2005;54(suppl):S54 –7.
32. Kufner MA, Ulrich P, Raithel M, Schwelberger HG. Determination of
histamine degradation capacity in extremely small human colon samples.
Inflamm Res 2001;50(suppl):S96 –7.
33. Raithel M, Kufner M, Ulrich P, Hahn EG. The involvement of the
histamine degradation pathway by diamine oxidase in manifest gastrointestinal
allergies. Inflamm Res 1999;48(suppl):S75– 6.
34. Backhaus B, Raithel M, Hahn EG. Nicht-immunologisch induzierte
Histaminfreisetzung an vitalen menschlichen Darmschleimhautbiopsien durch
Stimulation mit Polyaminen. (Nonimmunologically induced histamine release of
biopsies of vital human intestinal mucosa after stimulation with polyamines.)
Allergo J 2005;14:41 (abstr) (in German).
35. Tsujikawa T, Uda K, Ihara T, Andoh A, Fujiyama Y, Bamba T.
Changes in serum diamine oxidase activity during chemotherapy in
patients with hematological malignancies. Cancer Lett
1999;147:195– 8.
36. Schwelberger HG. Histamine N-methyltransferase (HNMT) enzyme and gene. In:
Falus A, ed. Histamine: biology and medical aspects. Budapest, Hungary:
SpringMed Publishing, 2004:53–9.
37. Yamauchi K, Sekizawa K, Suzuki H, et al. Structure and function of
human histamine N-methyltransferase: critical enzyme in histamine
metabolism in airway. Am J Physiol 1994;267:L342–9.
38. Raithel M. Durchfa¨lle und weicher Stuhl. In: Jarisch R, ed.
HistaminIntoleranz. Histamin und Seekrankheit. (Histamine intolerance. Histamine
and motion sickness.) Stuttgart, Germany: Georg Thieme Verlag KG, 2004:77–110
(in German).
39. Raithel M, Matek M, Baenkler HW, Jorde W, Hahn EG. Mucosal histamine content
and histamine secretion in Crohn’s disease, ulcerative colitis and allergic
enteropathy. Int Arch Allergy Immunol 1995; 108:127–33.
40. Sattler J, Hesterberg R, Lorenz W, Schmidt U, Crombach M, Stahlknecht CD.
Inhibition of human and canine diamine oxidase by drugs used in an intensive
care unit: relevance for clinical side effects?
Agents Actions 1985;16:91– 4.
41. Ahrens F, Gabel G, Garz B, Aschenbach JR. Release and permeation of
histamine are affected by diamine oxidase in the pig large intestine. Inflamm
Res 2002;51(suppl):S83– 4.
42. Aschenbach JR, Oswald R, Ga¨bel G. Gastrointestinal epithelia as barriers to
luminal histamine of microbial origin. Z Gastroenterol 1998; 36:12–7.
43. Sattler J, Lorenz W, Kubo K, Schmal A, Sauer S, Luben L. Foodinduced
histaminosis under diamine oxidase (DAO) blockade in pigs: further evidence of
the key role of elevated plasma histamine levels as demonstrated by successful
prophylaxis with antihistamines. Agents Actions 1989;27:212– 4.
44. Petersen J, Raithel M, Schwelberger HG. Characterisation of functional
polymorphisms of the human diamine oxidase gene. Inflamm Res 2005;54(suppl):S58
–9.
45. Petersen J, Drasche A, Raithel M, Schwelberger HG. Analysis of genetic
polymorphisms of enzymes involved in histamine metabolism. Inflamm Res
2003;52(suppl):S69 –70.
46. Schwelberger HG, Drasche A, Petersen J, Raithel M. Genetic polymorphisms of
histamine degrading enzymes: from small-scale screening to high-throughput
routine testing. Inflamm Res 2003;52(suppl): S71–3.
47. Petersen J, Raithel M, S