Do you have health issues when you consume foods such as alcohol, bananas, chocolate, milk, nuts, papayas, pineapples, or shellfish? Does consumption of these foods lead to headaches, high blood pressure or heart rate, anxiety, increased body temperature, dizziness, or swelling? If so, histamine intolerance might be an issue for you to consider.
Histamine is a chemical used by our digestive and nervous systems, but it’s best known as being a response to an allergic agent. It sounds the alarm for the rest of the immune system to respond to the perceived threat while dilating the blood vessels so that our white blood cells can do their thing. Once histamines have done their job, enzymes break it down so it doesn’t continue to affect us.
If we have issues with inflammation/infection, genetics, certain medications, gluten or high-histamine foods, the enzymes required to remove the histamine (DAO and HNMT) are not able do their job effectively. This may lead to symptoms throughout the body. In addition, high histamine levels may also contribute to gut issues by creating zonulin. This protein causes gaps between our intestinal cell walls which may cause leaky gut.
Histamine issues may also be related to a Mast Cell Activation response.
What causes high histamine levels?
Allergen that may cause an IgE response
- Bacterial overgrowth such as SIBO, mold, lyme, yeast, etc…
- Leaky gut
- Gut inflammation
- Fermented alcohol
- Consumption of high-histamine and fermented foods
- Enzyme deficiency
- Genetics and issues with methylation
Histamine related foods
We need to consider both histamine containing/releasing foods as well as foods that affect the actual removal of histamine. Dr. Amy Myers, MD, recommends that those with histamine issues avoid the following histamine containing foods:
- Fermented alcoholic beverages, especially wine, champagne, and beer
- Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc.
- Vinegar-containing foods: pickles, mayonnaise, olives
- Cured meats: bacon, salami, pepperoni, luncheon meats, hot dogs
- Soured foods: sour cream, sour milk, buttermilk, sourdough bread, etc.
- Dried fruit: apricots, prunes, dates, figs, raisins
- Most citrus fruits
- Aged cheeses, including goat cheeses
- Nuts: walnuts, cashews, peanuts
- Vegetables: avocados, eggplant, spinach, tomatoes
- Smoked fish and certain species of fish: mackerel, mahi-mahi, tuna, anchovies, sardines
In addition, she recommends removing foods that have been found to release histamine:
- Cow’s milk
- Wheat germ
- Many artificial preservatives and dyes
Finally, she recommends the removal of foods that may affect the function of the DAO enzyme responsible for the removal of histamine:
- Energy drinks
- Black tea
- Mate tea
- Green tea
How about Amines?
Just like histamines, there are additional amine containing foods that may negatively affect our health. These include:
- Tyramine (e.g., in cheese)
- Phenyl ethylamine (e.g., in chocolate)
- Agmatine, putrescine, cadaverine, spermidine (e.g., in decomposing fish)
- Tryptamine from tryptophan
According to the Clinical and Translational Allergy Journal, amines such as tyramine, putrescine, and cadaverine are also produced by bacteria during fermentation, storage, or decay of food.
As with histamine, enzymes are used to break down amines. In this case, the body requires an enzyme called MAO, which—as I have seen in my clinical practice—is prone to genetic SNPs or defects.
Where are amines found?
- All cured meats, especially pork products: ham, salami, pepperoni, wild boar, bacon, sausages, fresh pork
- Fresh or canned tuna, canned sardines, anchovies, mackerel, salmon, herring, processed fish products (fish pastes, smoked fish, dried fish, or pickled fish, fish sauce)
- Blue cheese, Parmesan, Brie, Camembert, Emmental, Gouda, Cheddar, and hard cheeses in general
- Oranges, bananas, tangerines, pineapple, grapes, strawberries
- Tomatoes, pickled cabbage, eggplant, spinach, broad beans, peanuts, tree nuts
- Fermented soy products, including miso and tempeh
- Green tea, champagne, coffee, cocoa, chocolate, wine, beer, fresh fruit juices, smoothies
In addition to food, amines can be found in over-the-counter cold medicines, decongestants, nasal drops or sprays, some pain relievers, anesthetics, and antidepressants.
The amine content of foods can vary based on its method of processing, age, ripeness, handling, storage, variety, cooking method, and other factors. According to the article “Are Consumers Aware of the Risks Related to Biogenic Amines in Food?”, amine formation is often prevented by chilling and freezing methods. When these methods aren’t possible, the use of “hydrostatic pressure, irradiation, controlled irradiation, controlled atmosphere packaging, or the use of food additives” are employed.
Issues with amines
Symptoms of amine sensitivity are similar to those of histamine sensitivity: headaches, rashes, eczema, vomiting, heart palpitations, fever, depression, diarrhea, etc. Amine issues are well known, and studies cite findings that diets low in amines have helped various conditions. For example, 58% of adult patients with irritable bowel syndrome (IBS) have found that amines were the cause of their symptoms, while 73% of patients have found that low-amine diets helped alleviate their migraine symptoms. Over 61% of folks found that amines and salicylates were responsible for their hives.
What to do?
An elimination trial is key. There are also labs that test for high histamine and enzyme levels but not for amines. In addition, you may elect to try supplements designed to help with high histamine and low enzyme levels. Vitamin A may also help minimize a histamine response.