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Could histamine provide the answer?
When taking a client’s case history histamine is not always the most obvious avenue to take. It is natural for practitioners to explore other possible causes first, such as blood sugar control, adrenal balance, thyroid function and digestive health. However once all this has been dealt with and all or some symptoms remain it can be frustrating to know that something has been missed or overlooked. In such instances, and as long as symptoms fit, histamine intolerance may hold the answer and is something to keep in mind with the release of our new histamine test this year.
Many of you are probably familiar with the work by Carl Pfeiffer in the 70’s linking histamine to depression, hyperactivity and mental fogginess. In addition to this other symptoms of elevated histamine include low blood pressure, tachycardia, diarrhoea, vomiting, headaches, dizziness, nasal congestion, asthma and skin conditions like urticaria, flushing and pruritus. All of which are commonly seen in practice. Part of the reason that symptoms affect these areas is that histamine, (although present throughout the body) is particularly concentrated in the lungs, skin and colon.
Although these symptoms could easily be mistaken for an IgE reaction histamine intolerance is not IgE mediated. Symptoms are caused by excessive quantities of histamine in the body which can arise due to reduced function of the main enzyme which breaks it down - diamine oxidase (DAO). If this enzyme is deficient or inhibited histamine levels will rise.
Certain foods are high in histamine e.g. tuna, red wine and aged cheese whilst others, although low in histamine, encourage the release of it within the body e.g. banana, citrus fruit, tomatoes and chocolate. A low histamine diet can therefore be very restrictive and difficult to follow especially as it requires an individual to avoid healthy foods. Having a test available can help to give clients the chance to know that they will be restricting their diet with good reason.
It is also worth noting that some drugs can inhibit DAO. Some of the more well known ones include Amitriptyline, Acetylcysteine and Propafenon. Whilst it is of course not possible to take a person off their medication, supplementing with the enzyme might be something to consider if taking any of these drugs.
Pfeiffer C. (1975). Mental and Elemental Nutrients. New Canaan, CT: Keats Publishing.
Maintz L. & Novak N. (2007). Histamine and histamine intolerance. American Journal of Clinical Nutrition. 85:1185-96.
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