Every few months I experience an “aha” moment. I moment that arises on a quest to understand more about the body and what drives disease. A moment that arises when a patient is no longer getting better and I refuse to give up. Besides the obvious fulfilment I get from seeing patient’s everyday, it is these moments of clarity that cause me to fall in love with naturopathic medicine, over and over again.
The most recent proverbial light-bulb went off during my research on histamine intolerance. If you have suffered from allergies, you are aware of histamine and its annoyingly debilitating effects,—itchy throat and eyes, sneezing, runny nose, hives—which are treated with anti-histamines. If you have suffered from heartburn, you may have taken histamine antagonists to prevent the release of stomach acid. But it doesn’t stop there!
If you suffer from intense menstrual cramps, you may have a histamine intolerance. Easy bruising? Skin flushing? Also caused by histamine intolerance. Are you anxious, depressed and/or have difficulties sleeping? Then you may also have a histamine intolerance.
As a naturopath, my role is to determine the mechanism or thread that ties all symptoms together and quite obviously histamine intolerance is a thread.
Histamine is derived from the amino acid, histidine and in addition to its release by mast cells from your immune system, it is also produced in certain foods and gut bacteria.
There are 4 types of histamine receptors found throughout the body, resulting in a variety of effects and symptoms. Within smooth muscle, histamine causes contraction, leading to pain. It increases stomach acid production, resulting in indigestion and diarrhea. The production of histamine occurs at the expense of other amino acid derivatives, such as serotonin, melatonin and dopamine, thus causing mental illness and insomnia. And by causing dilation and increased permeability of blood vessels, histamine leads to skin flushing, low blood pressure and bruises that appear out of nowhere.
The issue with histamine intolerance is that it develops insidiously, as a result of multiple exposures to allergies, histamine-containing foods and bacteria. Foods can either contain high amounts of histamine or histidine or they can cause the release of histamine in the body. Wine and champagne is the worst . So take the summer for example, aka outdoor wedding season…Pollen, check; champagne toast, check; wine with dinner, check! And your body starts filling with histamine. Now lets add the gut bacteria component to really tip the scales.
Our digestive system is inhabited by trillions of bacteria that help us fight infection, absorb nutrients, breakdown food AND breakdown or build-up histamine. But what happens when you have digestive problems? Bloating, gas, irregularity and stomach pain…all signs of an imbalance in your gut flora and many times, an overgrowth of histamine-producing bacteria! Instead of bacteria that helps, you have bacteria that hinders.
Lastly, an important enzyme that breaks down histamine, DAO, is produced in the gut. If your gut is not functioning well, this enzyme is not being produced adequately—its that simple. And many medications and foods prevent its production as well.
Wow, that sounds horrible and irreversible and inevitable. Can anything be done?
Since the development of histamine intolerance involves many factors, so does treatment.
First, is to eat a low-histamine diet. Avoiding smoked meats and aged cheeses, alcohol (which also hinders DAO production), shellfish, vinegars, certain nuts, and chocolate is key to limiting further histamine exposure. Supplements, including probiotics, are required to prevent histamine release from mast cells and promote its breakdown. Clinically, improvements are seen within 4 weeks, but complete healing can take longer as the gut is healed.
Histamine intolerance is the perfect example of the interconnectedness within our body. With most diseases it is a game of “chicken or the egg” in determining what happened first, but it is never difficult to see how things are linked or the theme that binds your symptoms together.