Do you ever feel like you are more “allergic” to the world than you once were in your golden days?
Have you ever noticed repeated bouts of unexplained hives, itchy/watery nose and eyes, headaches and skin flushing? Perhaps you noticed this reaction after a specific meal, environmental exposure or certain time of the month.
Unfortunately, I know how it feels.
If this sounds familiar, you may be battling histamine intolerance and I want to share with you why this all may be happening.
In today’s article, we will be reviewing the basics of histamine intolerance, high histamine foods, and how to initiate a histamine intolerance diet in order to alleviate symptoms.
What is Histamine Intolerance?
Alright, so let’s start from the beginning. What the heck are histamines, you ask? Great question. Histamines are chemical messages that provoke an allergenic response in our body. The most common symptoms include but are not limited to s sneezing, itching, runny eyes or nose and often times a rash or hives on the skin. This type of reaction is common after ingestion of a food allergen. (However, keep in mind that food allergies are different than food sensitivities and food intolerances)
While a histamine response can be extremely annoying and if severe enough, can negatively impact training, histamines actually do serve a purpose in the body. Histamines are responsible for the following tasks in our body:
- Standard component of the human immune response
- Blood pressure regulation
- Hormone regulation
- Creation of stomach acid
- Production of neurotransmitters
When our body is in a state of great health, it is easily able to regulate and control our histamine response. In other words, when our immune system is functioning properly, our histamine levels are kept in balance and the histamine that runs through our circulatory system can be found at low levels.
Histamine N-Methyl Transferase (HNMT), the enzyme that is concentrated in our major organs, is mainly responsible for the intracellular breakdown of histamine. When our body does not have enough HNMT, symptoms or a diagnosis of asthma is often the end result.
Diamine Oxidase (DAO) is the other critical enzyme in the world of histamine regulation. While HNMT is in charge of intracellular regulation of histamine, DAO is responsible for extracellular regulation of histamine. DAO is found mainly in the cells of our intestines as well as our kidneys. Experts have come to find that when a deficiency in DAO is present, symptoms such as persistent gastrointestinal issues/IBS and food allergies/sensitivities can be observed.
Why is Excess Histamine Production so Common in Athletes?
The busy, intense lifestyle of the typical athlete can more easily trigger a histamine response. While we like to think that athletes are one of the healthiest populations on the planet, in many cases, the exact opposite is true.
It’s important to understand that in addition to normal histamine production, the following can increase the amount of histamine that an athlete’s body
- Physical stress (injury, surgery, bug bites, intense training without proper recovery- enough said)
- Ongoing emotional stress (nothing like balancing work, school or a social life with training demands!)
- Poor quality diet (Competing on the road or overseas, eating in a college or work cafeteria every day etc.)
- Hormone imbalance (Common when diet does not support training demands, during menstruation etc.)
- Bacterial imbalance in our intestines (NSAIDS, antibiotics, birth control, food poisoning, junk food, etc.)
- Allergic reactions to the environment (animals, pollen, mold exposure, etc.) and seasonal weather changes (pressure, temperature, elevation etc.)
- Genetics
- Poor sleep
Make sense? Now that we have that covered, I want you to think of the histamine regulation system in the body as one big “bucket.” The bucket has the ability to be filled and then emptied. If the bucket is filled too quickly (think injury, bug bites, poor diet, major stress all at once!), thus surpassing the body’s ability to empty the build-up( i.e. DAO, HNMT), the athlete will start to experience symptoms.
While no two athletes are alike, the overflow of the histamine “bucket” often disguises itself in the form of joint pain or joint swelling, headaches/ migraines, asthma, persistent cough, flushing of the skin, heartburn, anxiety, tachycardia, peripheral neuropathy, insomnia, gas, bloating, constipation, diarrhea, low blood pressure, runny nose and eyes, hives, and itching. An athlete may experience all of these symptoms and sometimes just one or two.
Fun fact: The reason why a classic sign of histamine intolerance can be poor sleep quality is because of your body’s natural histamine production increases between 2:00-4:00 am.
What Foods Contribute to Histamine Intolerance?
Sadly, there are a number of foods that can contribute to histamine intolerance. The worst part? Many of these foods are fresh, whole foods that are touted by dietitians across the country! Examples include avocado, banana, fermented foods, walnuts, cashews, peanuts, soybeans, chickpeas, shellfish, and chocolate.
Specifically, there are two categories of high histamine foods: Aged/fermented and histamine liberators.
The most offensive foods are those that fall into the category of aged and or fermented. The best examples include alcohol, pickles, cheese, aged meats, sauerkraut, kimchi, vinegars, and kombucha.
Histamine liberators on the other hand, are foods that stimulate histamine release in the small intestine. In other words, the issue is not that these foods contain histamine, but instead stimulate production. The most prominent examples include nuts, fish, ripe avocados, ripe bananas, spinach, citrus and tomatoes.
If there is anything I can tell you after working for years with this population, it is that no two individuals are alike when it comes to foods that provoke a histamine related reaction. Therefore, in my experience, the histamine intolerance protocol works best when we remove all potential offenders at once then slowly reintroduce one at a time. This is the most effective way to be certain as to what that particular individual can and cannot tolerate.
I know what some of you are thinking right now…
“I would rather die than live a life without guacamole.”
“Peanut butter is synonymous with oxygen in my world.”
“ My weekend is just not complete without at least once glass of alcohol!”
OK, relax. I need you to understand two key points before you panic.
1) High histamine foods are usually NOT the main culprit, but instead, we consider them to be the “last pour” into the “bucket” that puts one’s immune system over the edge. An overload of stress, environmental triggers, hormonal imbalance, injury etc. is the root cause of why the body suddenly cannot make enough DAO to breakdown excess histamine. An abundance of histamines floating through the blood stream is a sure sign that our “bucket” is full. This is typically when symptoms can be observed.
2) Everyone’s tolerance level is different. For example, sauerkraut is a high histamine food, but one might be able to tolerate 1-2 TBSP with zero negative side effects. In fact, that individual may not even experience the slightest reaction until they have 2 TBSP of sauerkraut along with a hunk of cheese, glass of wine, and ¼ cup pickles within a 24 hour period. Again, we’re going back to that “bucket” concept.
How do I Know if I Need to be on a Histamine Intolerance Diet?
As you can probably guess, the last thing I ever want to do is place someone on a histamine intolerance diet when that may not even be the reason for their chronic health issues.
If you are not sure where to begin and better yet, if your healthcare provider is not sure where to begin, these are the steps I recommend that you take:
1) Has your healthcare provider recently performed extensive or even routine lab work on your and “everything was perfectly normal” yet you are still experiencing aggravating symptoms? ? If the answer is yes, this might be a clue that excess histamine is an issue for you.
2) Think back to the first time that you began experiencing symptoms. Were you under a significant amount of stress. If yes, add this clue to your case.
3) Now that you are aware of most common foods known to trigger a histamine reaction, do you feel worse when you eat a collective amount of these foods in a short period of time? What about excess alcohol intake? Can you tolerate distilled liquor but not fermented beverages such as beer, wine and cider?
4) Lastly, work with your healthcare provider to ensure that you are not suffering from an undiagnosed autoimmune condition, as this can be the underlying cause of your symptoms. (Think fibromyalgia, lupus, Celiac Disease etc.)
How do I Initiate a Histamine Intolerance Diet?
If you or your healthcare provider suspects that you are suffering from a histamine intolerance, it is best to begin an elimination diet.
Step 1: Eliminate all high histamine and histamine reaction provoking foods for at least 4 weeks. ( FYI- 6 weeks is the ultimate goal as many individuals do not experience true relief until this point. 10 days is the very shortest time frame for elimination. Anything shorter and you typically will not see any results.) Here is a great site if you are looking for a more comprehensive list.
Step 2: Hopefully at this point you are feeling better. Now it is time to reintroduce one new food every 3-4 days. Unfortunately, delayed hypersensitivity reactions are quite common. This means you could ingest a food one day but not experience any adverse reaction(s) until 3-4 days later.
Step 3: Be sure to take notes throughout this process. Document meals and days where you felt great as well as days where you experience a poor reaction. This will help you put the pieces together as there may be some foods you tolerate just fine, and others that send your immune system into overdrive after just a few bites.
Pro Tip #1: If you happen to react poorly on day 1 of introduction of a particular food, you may want to remove that food and reintroduce again in a few weeks, possibly even a few months.
Pro Tip #2: Although not considered to be high histamine, wheat, caffeine and dairy are items that are famous for placing stress on the human immune system. I have had many athletes in the past not experience full relief from a low histamine diet until they removed these potential triggers items at the same time. These foods can eventually be reintroduced after 4-6 weeks as well.
Pro Tip #3: Do not fret if you find that you are unable to tolerate a large grouping of your favorite foods. Sometimes it is just a matter of getting your body back in balance ( AKA pour out some of the contents in the “bucket” ) in order to allow the immune system to relax enough not to “attack” certain offending foods.
Are There any Foods That can Reduce the Histamine Response in the Body?
Yes! Excellent question my friend.
There are a handful of foods and spices known to have an antihistamine effect.
Anti-inflammatory spices such as turmeric, ginger and garlic have proven themselves worthy of lessening the histamine burden. In other words, these spices are mast cell stabilizers. Use these rich spices as often and as generously as you can.
Quercetin, a powerful flavonoid from the group of polyphenols is also known for its antihistamine effects. Foods rich in quercetin include apples, grapes, broccoli, onions, and blueberries.
Many athletes swear by swinging nettle tea, and with good reason as it contains naturally occurring antihistamine properties. If you feel compelled to sip on a cup or two of this tea during the day, there is no shame in that game.
What are the Best Supplements to Help Reduce my Histamine Intolerance?
Now remember, supplementation, even if great quality, will never take the place of a low histamine diet. However, if a low histamine diet is combined with quality supplementation, you may witness a little miracle.
Think of supplements as mini training wheels. We want to train your body to ride strong on it’s own before we set it free of supportive supplementation.
Here is the antihistamine supplement protocol I pieced together over the years for my clients and athletes. The approach works well for most, just be sure to start low in terms of dosage and increase gradually.
HistDAO (DAO enzyme) with each meal (Xymogen)
Digestive Enzymes (one serving 5-10 minutes before each meal.) (Pure Encapsulations Ultra Digestzymes)
500mg Quercetin twice/day. (Jarrow Formulas)
100mg B6 twice/day (Douglas Laboratories)
Daily probiotic that contains the strain known as bifidus infantis (Align is a great example).
1,000 mg Vitamin C twice/ day between meals. If tolerated, work your way up to 3,000 mg twice/day. (Integrative Therapeutics or Metabolic Maintenance, whatever we can find on Amazon)
Bonus round: For true all-star status, add 1 tablet of Integrative Therapeutics Theracumin (turmeric) and Allicin (garlic) before bed each night (Designs for Health)
(While Amazon is a convenient place to purchase your supplements, all FWDfuel readers will receive 20% off professional grade supplements and free shipping over $49 for life from Wellevate.)
I’m Still not Sure if I Have a Histamine Issue. Is There Testing I can Have Done?
As mentioned, eliminating histamine-provoking foods for 4-6 weeks (or at the very least, 10 days), is the gold standard when it comes to testing. Not to mention, this approach is usually a more cost effective option for most people.
However, if you are working with a healthcare practitioner, particularly one that is trained in Functional & Integrative Medicine, he or she may be able to order serum histamine, zonulin (a protein that keeps together the tight junctions between cells of the wall in your digestive tract) and DAO if you are looking for a bit more concrete evidence for your case.
In summary, histamine intolerance can be a frustrating immune response, especially when you are working your tail off to reach a certain level of fitness. The great news though, is that you can lighten the histamine load and improve symptoms with the strict removal of high histamine foods in conjunction with professional grade supplementation. All it takes is a little strategy and perseverance.
Have you ever suffered from a histamine overload? What foods seemed to tip your histamine “bucket” over the edge? Did you find any particular supplements to be helpful? Please share your comments below!
References
- https://www.ncbi.nlm.nih.gov/pubmed/17490952
- https://www.ncbi.nlm.nih.gov/pubmed/30022117
- https://www.ncbi.nlm.nih.gov/pubmed/16675339
- https://www.ncbi.nlm.nih.gov/pubmed/29475774
- https://www.ncbi.nlm.nih.gov/pubmed/29606813
- https://www.ncbi.nlm.nih.gov/pubmed/28624934
- https://www.ncbi.nlm.nih.gov/pubmed/27590961
- https://www.ncbi.nlm.nih.gov/pubmed/26242570
