Low Histamine Diet for MCAS and/or Histamine Intolerance: The Pros & Limitations

Low histamine diets may help with relief (as they introduce less histamine into the body) and they are discussed all the time as a “solution” – but they aren’t really a solution or a bandaid?

High histamine foods causing symptoms are usually the straw breaking the camel’s back; there are usually deeper, bigger issues as to WHY a person is struggling with Histamine in the first place

• Either making too much too frequently usually from a trigger and/or
• Not clearing or breaking down histamine fast enough often from a deficiency of some sort

When people think of the word “histamine,” over the counter anti-histamines medications (like Zyrtec and Benadryl) typically come to mind too which have a time and place (but are very reactionary and dare I say also a bandaid). I will say they may very much be needed in the moment, but long term it is best to look at root causes and do interventions specific to the underlying factors. Let’s dive deeper into this big histamine topic.

First: What Is Histamine?

Histamine is a chemical found naturally in our body, and it is an important component primarily for the immune system. Histamines are produced and stored in mast cells and released when there is a potential invader/exposures, which can lead to common symptoms such as itching, sneezing, headaches, asthma, rashes, hives, painful periods, anxiety, nausea, bloating, diarrhea among so many other symptoms. While unpleasant, this is your body’s natural defense mechanism to “something triggering it.”

Histamines in foods:

It’s not just made in our bodies; it is naturally present in certain foods that humans often eat. Some examples of high histamine containing foods: canned tuna, avocado, bananas, cheese, fermented foods to name a few. So when you eat high histamine foods, you are introducing more into your body – so it’s another cook in the kitchen – but I am not one to blame healthy foods as the root of our health problems.

What is Histamine intolerance (HIT)?

HIT is like it sounds: an intolerance causing adverse symptoms rather than a potentially life threatening IgE mediated allergy (like when people think of analyphaxis for those diagnosed with peanut or egg allergies). Contrary to popular belief, histamine intolerances are NOT an allergic reaction. Histamine intolerance is often difficult to pinpoint due to resemblance of common allergy symptoms. Many times people self diagnose that they have seasonal allergies (or a Doctor gives this label without actually allergy testing) and it could be HIT or MCAS.

HIT is essentially a mismatch between too much histamine in the body (produced and/or consumed) and the speed at which the body clears it (via DAO enzymes in the gut). If too much histamine is released and/or it is not broken down fast enough = a person often gets histamine overload symptoms.

We can’t not address MCAS when talking about histamine. Histamine intolerance and MCAS are not the same thing; both conditions involve histamine, but MCAS is a more complex disorder involving a broader immune system overreaction and can be triggered by a wider range of factors.

Diamine oxidase (DAO)

This is the specific enzyme the digestive tract makes to to break down histamines. If you’re deficient in the DAO enzyme, then your histamines are not being broken down properly.

There are various reasons for diminished DAO enzyme activity including

• Genetics
• Medications such as antidepressants (effexor, cymbalta), immune modulators (plaquenil, enbrel), antiarrthymics (metoprolol, cardizem) histamine blockers (pepcid, zantac)
• Alcohol intake
• Stress
• Intestinal bacterial overgrowth/gut dysbiosis to name a few.

Many symptoms of HIT and MCAS overlap and include:

• Anxiety and/or fast heart rate
• Brain fog
• Urinary tract pain that is not UTI
• Vaginal pain or discomfort
• Hives, itching
• Red color/flushing of skin
• Diarrhea, IBS, stomach pain, bloating
• Nausea, “car sick” or “motion sick”
• Migraines/headaches
• Wheezing
• Low blood pressure
• Shortness of breath
• Watery eyes
• Swelling of the tongue/mouth
• Unintentional weight gain
• Menstrual pain/PMS/infertility
• Bad case – anaphylaxis is possible

Histamines are not inherently a bad thing

Histamines are part of our immune system, which is a “good thing.” So the goal is not to rid the body of histamines, it’s just that having too much in the body and/or inability to clear histamines quickly enough can lead to symptoms.

So the next question should really be, then WHY is there too much in the body and/or why can the body not rid it? In a clinic setting, a “root cause approach” doesn’t typically happen, and patients get anti-histamines meds recommended, which isn’t bad as patients deserve treatment and relief; but there is often deeper issues at hand that haven’t been well looked into that could lead to a better proactive solution.

The “Histamine Bucket” Analogy

There is a great analogy to explain how histamines become too much: If a person’s “histamine bucket is filling up” with too many invaders/exposures and/or DAO enzymes are not doing their job to break down the histamine fast enough, then the bucket of histamine continues to fill up and eventually begins to overflow. The “bucket overflowing” is what can lead to symptoms from excess histamine.

What “fills up the histamine bucket?”

These below are often underlying culprits. The more of these that are present, the more that adds to up to increased histamine productions and/or decreased ability to clear histamines quick enough:

• Toxic indoor mold exposures – the most common thing I see in practice!
• Environmental allergens that have been diagnosed
• Poor sleep
• NSAIDs and other medications
• H. Pylori infection
• Gut dysbiosis (as seen in a GIMAP test; certain bacteria produce histamine)
• Estrogen dominance (higher levels of estradiol relative to progesterone especially in the luteal phase of the menstrual cycle around day 19-21)
• Under eating
• Chronic stress
• Heavy metal bioaccumlation (can be seen in urine testing)
• Alcohol consumption and/or excess amounts of histamine containing foods
• Lyme disease

How much Histamine is “too much?”

This is entirely dependent on each individual as each person has their own tolerance level to histamine. Each item on the list above is another “drop into the bucket” so the more of the above that applies to the patient, the more likely HIT can become a problem.

What Can I Do To Lower My Histamine Level?

Here are a few suggestions for what you can do to reduce symptoms if you have histamine intolerance:

1) Consult with your practitioner if you question if histamine overload is a problem for you. I highly recommend you explore and address the specific root cause(s) of your histamine imbalance. To me this is the best proactive strategy.

2) Talk to your doctor to see if you are a candidate for anti-histamines, which are over the counter. Taking these medicines is one reactive strategy but there some preventative strategies too that may help with decreasing or not even needing anti-histamine medication. Note, if you are always reaching for anti-histamines, this can eventually do more harm than good. Antihistamines block stomach acid production and can exacerbate intestinal bacterial overgrowth, and worsen heartburn – and now you got GI issues.

3) Minimize high histamine foods or foods that release histamines in the meantime but view this as a short term strategy as it isn’t “fixing anything

• Processed meat products—sausage, ham, salami, bacon
• Aged cheeses
• Fermented foods—sauerkraut, soy sauce, kombucha
• Alcohol—wine, ciders, beer and other fermented alcoholic drinks
• Dried fruit
• Certain veggies—eggplant, tomatoes, spinach
• Certain nuts & legumes—cashews, walnuts, peanuts
• Canned and smoked fish
• Wheat products
• Bananas
• Strawberries
• Avocados

4) Avoid DAO enzyme-blocking foods in the short term

• Alcohol, energy drinks, black and green tea

5) Increase histamine reducing nutrients and screen for deficiencies and correct them! I see so many people with diagnosable nutrient deficiencies per their bloodwork. Many of these are used to make progesterone, DAO, stomach acid – all things that balance with histamine

• Quercetin
• Omega 3 fatty acids
• Vitamin C
• Vitamin B6
• Zinc
• Copper
• Magnesium

6) Consider taking histamineX probiotic; note that other probiotic strains can worsen HIT, so talk with an integrative dietitian about your unique situation.

7) Get a GIMAP test and address gut dysbiosis (especially overgrown histamine producing bacteria in the gut) and H. Pylori if present

8) Stop drinking tap water and only drink reverse osmosis or distilled water. Yes there will be less minerals but you can get those from foods or supplements. It is more important to not drink arsenic, chromium hexavalent, radium, and all sorts of other legal and common health deterrents. I’ve literally seen people come off antihistamines by literally just not longer drinking tap water (which is legalized slow poisoning in my opinion).

9) And the most important thing – CHECK YOUR HOUSE FOR CLINICALLY SIGNIFICANT LEVELS OF TOXIC INDOOR MOLD.

• Do this by ordering a ERMI at home dust kit (get kit # 1). It is the only medically acknowledged way to check your house and the data correlates to labs. Don’t waste your time with the petri dishes – they don’t mean much and don’t give us an numerical data.
• If you ERMI score is above a 5, you need to hire a certified mold inspector to find the where and why, and then remediate.
• Mold is the number one thing I see hold people back in terms of MCAS and HIT and just constantly needing medicines to treat the symptoms.
• Take my Healing from Mold Online Program if you want a start to finish process on what to do if you think or know mold is impacting your health.

Need help piecing all that together into one easy general protocol to get started? Click here for access to my histamine protocol with discounted pricing and free shipping.

Need individual consultation? Schedule a consult package today!

References:

https://pubmed.ncbi.nlm.nih.gov/34209583

https://pubmed.ncbi.nlm.nih.gov/33921522

https://pubmed.ncbi.nlm.nih.gov/32643952

https://pubmed.ncbi.nlm.nih.gov/29181545

https://pubmed.ncbi.nlm.nih.gov/34833463

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