Histamine intolerance: digestive disorders, fibromyalgia, long covid and chronic lyme disease
Introduction
Histamine intolerance is a growing health problem worldwide, particularly in industrialized countries. Although this molecule is mainly known in the context of allergies, its role goes far beyond this field. Histamine is present in our bodies and in our food, playing essential roles in various physiological processes. However, when its metabolism is disrupted, it can lead to a series of debilitating symptoms that are not always well understood or diagnosed. This intolerance can mimic allergies or chronic diseases, making diagnosis complex.
In this article, we'll explore in depth what histamine is, the mechanisms underlying intolerance, its symptoms and methods for managing this condition. This condition, although still poorly understood in some medical spheres, appears to be linked to the growth of various food intolerances, exacerbated by modern lifestyles, stress and dietary changes.
What is histamine?
Histamine is a biogenic amine, synthesized from L-histidine, an essential amino acid. It plays a key role in our immune system, and is involved in inflammatory and allergic responses. Histamine is stored in certain cells, notably basophilic granulocytes and mast cells, which are types of white blood cells involved in immune defense. When an allergen or other trigger is detected, these cells release histamine, causing symptoms such as itching, redness and inflammation.
In addition to its role in allergies, histamine is also crucial to other bodily functions. It regulates gastric acidity, aiding digestion, and acts as a neuromediator in the brain, influencing processes such as wakefulness and alertness. Histamine can also come from exogenous sources, i.e. through the diet, particularly fermented or aged products such as certain cheeses, cold meats or smoked fish. Certain foods naturally rich in histamine, such as tomatoes and spinach, can also contribute to its excess in the body.
However, when the body fails to properly break down this histamine, it builds up and can cause intolerance, generating a wide range of symptoms, without an allergic reaction as such being involved.
Histamine intolerance: a pseudo-allergy
Unlike classical allergies, which involve a specific immune response with the production of antibodies, histamine intolerance involves an enzymatic problem. This phenomenon is sometimes referred to as a pseudo-allergy, because although the symptoms may resemble those of an allergy, the underlying mechanism is different. It is not a case of type I hypersensitivity (immediate allergies) or type III hypersensitivity (delayed hypersensitivity), but rather a defect in histamine degradation due to an enzyme deficiency.
The enzymes primarily responsible for histamine degradation are diamine oxidase (DAO) and histamine N-methyltransferase (HNMT). These enzymes are mainly found in the cells of the intestine. DAO plays a crucial role in the small intestine, preventing histamine from entering the bloodstream, while the two enzymes work together in the large intestine, where increased fermentation occurs. When these enzymes are deficient or dysfunctional, histamine is not properly degraded, leading to accumulation in the body.
Symptoms of histamine intolerance
Symptoms of histamine intolerance are varied and affect several body systems. These symptoms may mimic other pathologies, making diagnosis difficult.
Central nervous system: headaches, migraines, nausea, vomiting, hot flushes, dizziness, mental confusion (brain fog).
Digestive system: diarrhea, abdominal pain, gastric reflux, flatulence.
Cardiovascular system: palpitations, arrhythmia, variations in blood pressure.
Respiratory system: nasal congestion, sneezing, rhinitis, difficulty breathing (bronchoconstriction).
Skin: redness, itching, hives.
Reproductive system: uterine cramps, dysmenorrhea.
Immune system: chronic infections, Covid-long, Lyme disease.
Musculoskeletal system: Fibromyalgia
Because of their diversity, these symptoms are often confused with other medical conditions such as allergies, chronic digestive disorders, heart disease or hormonal imbalances. Recognizing the true cause of hyperhistaminesis is fundamental to its biological and functional management.
Causes of histamine intolerance
Histamine intolerance can have many causes. There are three main reasons:
Genetic polymorphism: Some people are born with a genetic predisposition to produce less DAO or to have a less functional DAO. These people are generally affected from childhood, with symptoms appearing after the introduction of diversified foods into their diet.
Damage to the intestinal lining: The intestinal cells that house the DAO and HNMT enzymes can be damaged by conditions such as celiac disease, irritable bowel syndrome (IBS), overpopulation of bacteria in the small intestine (SIBO), intestinal dysbiosis (dysbiosis of fermentation but especially putrefaction) or biliary problems. When the intestinal mucosa is inflamed or damaged, enzymes no longer function properly, resulting in poor histamine degradation. Chronic stress can also play a role, disrupting the integrity of this intestinal wall.
Enzyme cofactor deficiency: Enzymes need vitamins and trace elements to function properly. A lack of these cofactors, such as vitamins B6 and C, or minerals like zinc and copper, can compromise DAO activity.
Let's just look at the other causes in list format:
- Enzyme-reducing allopathic drugs.
- Methylation disorders reducing NHMT efficiency.
- Putrefaction dysbiosis saturates DAO and HNMT.
- Destruction of DAO by toxic SIBO bacteria.
- Disruption of histamine degradation by Candida albicans.
- Excessive consumption of DAO-inhibiting foods.
- Stress and cortisol impact histamine activity.
- Estrogenic predominance activates histamine release.
- Thyroid disorders favor histamine release.
- Autoimmune diseases triggering histamine release.
- Chronic viruses that activate mast cells and cause histaminosis, especially in Covid long
Foods concerned
Histamine-rich foods include seafood such as tuna, mackerel and shellfish. Aged meats and cured meats, such as salami and ham, are also rich in histamine due to the fermentation and maturation processes. Fermented dairy products (aged cheeses, yoghurt), as well as fermented foods such as sauerkraut, vinegar, wine and beer, also contain high concentrations of histamine. Vegetables such as tomatoes, spinach, eggplants and avocados are also rich in histamine, as are certain fruits such as strawberries, bananas and pears.
For those suffering from histamine intolerance, excessive consumption of these foods can cause symptoms such as headaches, rashes, digestive disorders or nasal congestion. A balanced diet moderate in histamine, accompanied by preventive measures, can be essential to improve well-being.
For a more in-depth list of histamine-rich foods, readers can consult the one provided in the book. Total avoidance followed by partial reintroduction of the foods concerned can help manage hyperhistaminesis, but this approach is not a panacea. Optimal management of this sensitivity requires identification of the underlying cause of excess histamine.
Micronutrients and active components that can help reduce histamine
DAO (Diamine Oxidase): This enzyme is essential for the breakdown of histamine in the digestive system. DAO supplements can be particularly useful for those with a natural deficiency of this enzyme.
Quercetin: This natural antioxidant, found in apples and onions, has anti-inflammatory effects and can inhibit histamine release. * Beware of those allergic to histamine: the firm has found that quercetin tends to worsen their symptoms.
Bromelain: An enzyme extracted from pineapple, it helps reduce inflammation and allergic reactions, and complements quercetin for a synergistic effect.
Vitamin C: Acts as a natural antihistamine, supports the immune system and helps break down histamine. Vitamin C can reduce the release of histamine in the body.
Vitamin B6: Essential for the production of the DAO enzyme, this vitamin plays an important role in histamine metabolism.
Zinc: This mineral is important for immune regulation and helps stabilize mast cells, notably the release of histamine.
Magnesium: Essential for cellular regulation, it calms inflammatory reactions and can help reduce excessive histamine production.
EGCG (Epigallocatechin gallate): Green tea's main antioxidant. Green tea is a valuable source of bioactive compounds with beneficial effects for people sensitive to histamine. Here are some of the compounds found in green tea that help reduce the effects of histamine:
L-Theanine: This amino acid, unique to green tea, is known for its calming and relaxing properties. It also helps stabilize mast cells, the cells responsible for releasing histamine in the body, triggering allergic and inflammatory reactions.
Skullcap (Scutellaria baicalensis): Used in Chinese medicine, it has antihistaminic effects and reduces allergy-related inflammation.
Lanceolate plantain (Plantago lanceolata): This plantain stabilizes mast cells and limits histamine release, often used to soothe respiratory allergies. *Caution: many people with hyperhistamines are allergic to this plant.
Nettle (Urtica dioica): A plant with natural antihistaminic properties. It helps reduce allergy symptoms such as itching and nasal congestion, and stabilizes histamine release.
Turmeric (Curcuma longa): Thanks to curcumin, it acts as an anti-inflammatory and mast cell stabilizer, helping to reduce histamine release in the body.
In-office and laboratory tests to help detect hyperhistaminesis
There are several detection methods for diagnosing histamine intolerance, both in the doctor's office and remotely. These techniques measure histamine levels and the efficiency of the enzymes responsible for its degradation. The main approaches include dark-field blood analysis, dry blood analysis and blood smears.
Dark-field blood analysis: This method is based on the observation of blood cells in real time using a dark-field microscope. Unlike conventional techniques, this method does not involve staining or fixing the cells, offering a dynamic view of their morphology and behavior. In particular, it enables the detection of abnormalities such as infections or blood disorders that could indicate histamine imbalance.
Blood smears:This classic method involves spreading a thin layer of blood on a microscope slide to examine the morphology of blood cells. This test can also be carried out at home under the supervision of an expert in nutritional and functional biology.
There are also specific laboratory tests for the direct measurement of histamine or the enzymes responsible for its degradation:
Plasma histamine assay: This test measures histamine levels in the blood. Elevated levels may indicate an abnormal accumulation of histamine. However, rapid fluctuations in histamine levels often require several samples for accurate measurement.
Diamine oxidase (DAO) assay: This test assesses the efficiency of the DAO enzyme in histamine degradation. Low DAO levels may be a key indicator of histamine intolerance.
Urinary histamine test: measures histamine levels in urine over a 24-hour period. Although less invasive than blood sampling, its results can be influenced by dietary factors.
Genetic tests: These tests can identify genetic mutations affecting the production or function of the DAO enzyme, indicating a predisposition to histamine intolerance.
The winning solution: the NSSR® method
N for Cleanse: We begin every treatment by cleansing the entire digestive tract, ensuring that the mouth is sanitized. A mouth full of bacteria will chew food and send bacteria (anaerobic and aerobic) further down the digestive tract. So there's no point in cleaning lower down, when cleaning higher up is a disaster! Substances specific to the NSSR® method are used to sanitize the digestive tract.
S for Seal: We need to seal the barriers that form the basis of our immune system: they precede innate and adaptive immunity. If the barriers are permeable, bacteria can roam freely in the body. And if they do, they can freely trigger immuno-inflammatory reactions. You know what I mean...
S for Care: The next step is to take care of the mucous membranes. Fucosyllactose poly-morphisms (FUT2) are present in 20% of the Caucasian population. The presence of mucins provides a good "Velcro" grip for the development of good bacteria, the fight against bad bacteria and the elimination of biofilms. With genetic polymorphism in Caucausians, 20% of the Caucasian population lacks the "good velcro" FUT2 for the attachment of good bacteria. Biofilms are simply biological films that hold bad bacteria under a cellulose matrix. Basically, it's a "hide-and-seek" game for bacteria! Bacteria come and go as they please. What's more, this layer of cellulose prevents the phyto-aromatherapy products from working properly. Hence the treatment "failures". As a result, it's no longer a question of failures or Herxheimer reactions, but rather of the presence of biofilms. Taking care of them is essential if the rest of the body is to function properly.
R for Repair: Repairing the intestinal immune system and controlling systemic inflammation is key to managing histamine issues. It is crucial to regulate the activation of inflammation involving NFkB, cyclooxygenases and lipo-oxygenases.
The four phases of the NSSR® method are highly effective in regulating the cause and consequences of hyperhistaminesis.
Conclusion
Management of histamine intolerance
To effectively treat histamine intolerance, it's essential to address the underlying causes, such as SIBO (Small Intestinal Bacterial Overgrowth), fermentation dysbiosis, putrefaction dysbiosis, chronic mononucleosis, long COVID or any other underlying co-infection such as lyme disease. If these infections are not properly treated, the immune system will continue to stimulate histamine production in an attempt to combat these conditions. This constant overload leads to symptoms similar, if not identical, to those of histamine intolerance.
Histamine, being constantly called upon to respond to the infection, fails to resolve the underlying problem, and the body then manifests symptoms such as brain fog, chronic fibromyalgia-like pain, headaches, brain fog and digestive disorders. These symptoms are frequently observed in consultation.
Management of histamine intolerance is based primarily on our NSSR® method, accompanied by a strict low-histamine diet to be followed for a period of 1 to 3 months. Although this diet is restrictive (as it requires the elimination of a wide variety of fermented, aged or histamine-rich foods), it does reduce the histamine load in the body. Once this initial phase is over, foods can be gradually reintroduced, while symptoms are monitored.
Alongside this diet, complementary approaches such as phytotherapy and micronutrition can be helpful. The use of herbs with natural antihistaminic properties, as well as supplementation with cofactors necessary for the proper functioning of the DAO enzyme, can help reduce symptoms. These treatments provide essential support in managing histamine levels, particularly when the underlying infections are effectively treated.
Histamine intolerance is a complex, often under-diagnosed condition that can seriously impair the quality of life of those affected. It illustrates how dietary and metabolic imbalances, as well as chronic infections, can give rise to varied and persistent symptoms that are difficult to identify. With a better understanding of the underlying pathophysiological mechanisms and appropriate natural approaches, it is possible to better manage this intolerance and improve patients' well-being.
For more information, see "Histamine intolerance - understanding symptoms, diagnosis and treatment", published by Editions du Dauphin.
(The coverture image shows an oesinophil: a white blood cell classic of allergic reactions)
