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Histamine Intolerance

Updated: Sep 28, 2022

The first time I diagnosed #histamine intolerance was probably about ten years ago and admittedly, it was a blatant case. She had been seen by several prior physicians who gave her a plethora of medications for a multitude of conditions: polycystic ovarian syndrome, type 2 diabetes, irritable bowel, hypertension, hypothyroidism, metabolic syndrome, anxiety, panic attacks, suicide ideation, hives, itchy tongue, and the list goes on and on. Most all of these resolved when we got to the underlying issue.


I wish I could remember how I figured out histamine was a primary underlying cause of her discomfort, because I had never even heard of histamine intolerance prior to this woman's case. We don't learn about these things in school; systems medicine is not part of our training. What I do remember, after the initial battery of tests including an ultrasound on her #thyroid which discovered a parathyroid tumor growing within her thyroid (which is likely to irritate the thyroid, causing inflammation and dysfunction but our system is so much more keen on medicating as opposed to identifying the cause), is we initiated a food, chemical and dye sensitivity test.


She immediately responded with tingly throat and tongue to most of the foods on her plan. Fairly quickly it was clear this was an IgE response and less so about her other immune mediators, and these don't show up on sensitivity tests because it's an entirely different pathway. Her system had been on fire for so long, between gross trauma, profound stress, a previously undiagnosed tumor, and what we would learn to be a genetic predisposition to having an intolerance to histamine.



Our gut health is largely the result of the bacteria in our gastrointestinal system and how that bacteria nourishes itself and even off-gases after a hearty meal. Our body provides enzymes and acids and such to help in this process, and these by-products from the bacteria in turn support our own health. For example, it is this outcome of these bacteria having eaten in our gastrointestinal cafeteria that offers us the precursors for our neurotransmitters. Histamine is one of these biogenic amines, as they are called. There are foods and ultimately bacteria which are more apt to create histamine than others, and some of us have a handicap of sorts that limits our ability to efficiently process any one of these by-products. Other times it is an unhealthy microbiota or bacterial colony in our gut which can create exceedingly unhealthy by-products and their subsequent consequences, dis-ease and discomfort.


When our gut is out of balance though, or our body is inhibited in someway, that causes a disturbed gastrointestinal environment, and a variety of symptoms can result, not just within the gut such as stomach upset, but also cardiovascular, respiratory and skin issues. When we see histamine responses specifically, very often this is the result of reduced activity of the enzyme, diamine oxidase (DAO). This sort of cascade can also result in what you may have heard called Mast Cell Activation Syndrome (MCAS) which is another interesting discussion for another post (members peek in your Detoxification & Wellness program for a plethora of details). Real quickly though, MCAS can be the underlying cause of hives, asthma, migraines, low blood pressure, GI disorders such as irritable bowel, IBD, eosinophilic esophagitis, painful menstrual cramps, depression, and certainly anxiety.


How Do I know if I have HIT?


Histamine Intolerance is diagnosed when clients have low serum DAO values, two or more gastrointestinal symptoms described for histamine intolerance (HIT), and a reduction of complaints due to a histamine-reduced diet. The remedy is oral supplementation of a commercially available DAO food supplement, which is prepared from the pig kidney. Truth be told, we are a cash-based practice so rather than endure all the many tests third party payers will reimburse (or at least acknowledge) and await the camet of symptoms, we strongly encourage our clients to identify their medical DNA profile (anonymously) and we can then quickly discover the underlying potentials in our epigenetics.


A child with asthma and eczema may not clearly fit the criteria established for HIT, but a quick peek at his genetics may reveal SNPs in his histamine receptors (HNMT and HRH1) and add to that additional SNPs in his IgE, IgG, and IgA activity and we know we have a reactive child. Exploring epigenetics a bit further then, even detoxing ability, we can identify ability in CYP1A2, COMT, GAD, MAOA, and MTHFR. Lots to uncover in an epigenetics exploration, which we offer our clients in a six week program when they become active clients in our wellness program.


What can I do if I think I have DAO deficiency?


Typically, people with #DAO deficiency will benefit from a supplement that activates the DAO enzyme. The client I mentioned previous was greatly improved by this supplement, and subsequently surgery to remove her parathyroid tumor. Even before surgery we resolved her hypertension, type 2 diabetes, irregular cycles, and some of her #anxiety, but following removal of her tumor, her mental health began to stabilize. The DAO enzyme became a mainstay in her routine for maintaining optimal wellness, as we as a complete lifestyle transformation, learning healthy boundaries, processing past grief, and all the work so many want to skip through for that quick fix. Movement is also key. So often we feel we are super busy and moving and we're even exhausted, but it is mental and emotional fatigue; we are not moving near enough to maintain optimal health. We can also include specific vitamins and minerals to promote the DAO enzyme and maximize our success (members read further in the Detoxification & Wellness program).


More importantly though is working with a functional and integrative clinician who will dig in with you and help you lay out a path towards healing. These sorts of scenarios are not as simple as addressing a sprained ankle or an ear infection, which even in themselves may need to be looked at more deeply. The DAO enzyme supplement alone is unlikely to offer complete resolution, because most people are so disembodied, there are a plethora of issues to address before we work to resolve and heal from these underlying, or root causes. We can't skip steps in our healing process.


Call our office. Schedule your initial history and then your physical exam, and you'll be considered an active Eden member without any additional fees. You'll then be privy to a number of benefits as long as you maintain regular wellness visits, but among these is an extensive Detoxification & Wellness program that dives deeper into all of these issues, and more. Health & Wellness really is our passion. We literally walk with you on this journey (meet with us at 1pm today at Eagle Creek for our Hike with the Doc event) and are overjoyed to share the science as it is revealed to us. Our bodies are truly miraculous, as is Mother Earth, and that relationship is symbiotic, but we have a lot of threats to our wellness which we can navigate together - as a team.


Schnedl, W. J., Schenk, M., Lackner, S., Enko, D., Mangge, H., & Forster, F. (2019). Diamine oxidase supplementation improves symptoms in patients with histamine intolerance. Food Science Biotechnol, 28(6), 1779-1784.

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