Histamine is a substance which has important functions in the body. It has a vital role in the immune system, it helps transmit messages in the brain and nerves, it triggers the release of stomach acid, and it is important in the contraction of some muscles.
What affects levels of histamine in our bodies?
Histamine can be thought of like water in a bucket. Certain things add more water (histamine) into our buckets – such as foods, stress, chronic inflammation, hormonal changes (such as those which occur during the menopause), some medications. Some people also are genetically prone to either producing more water (histamine) or having smaller buckets because they have lower levels of the enzyme diamineoxidase (DAO) which removes histamine from the body. There are many things which can affect our histamine levels, and our ability to get rid of histamine from the body.
What is Histamine Intolerance (HIT)?
HIT occurs when people develop symptoms as a result of higher levels of histamine in their bodies. This can occur at any time, but may happen during menopause directly because of fluctuating and reducing levels of hormones contributing to higher levels of histamine, and indirectly because of the effect the menopause has on things like the gut microbiome, stress levels, sleep and so on. Symptoms of HIT include abdominal pain, diarrhoea or constipation, bloating, irritable bowel syndrome, nausea, joint pains, anxiety, sleep disturbances, hot flushes or cold chills, runny eyes/nose, sneezing, rashes, fatigue, headaches, dizzy spells, itchiness, indigestion or acid reflux.
How is HIT diagnosed?
There is no test for HIT. It is possible to test the levels of DAO, and for things which may contribute to its function such as vitamins C and B6, and zinc, but a normal level of DAO does not rule out HIT – remember your bucket may be a normal size (normal levels of DAO) but you may still have too much water in it (for example by producing too much histamine and/or consuming food high in histamine).
How can a dietitian help?
Implementing a dietary restriction of histamine is a crucial step in both diagnosing and managing this condition. The low histamine diet involves a short-term elimination phase, followed by a systematic reintroduction of foods to identify individual tolerance levels to histamine. Seeking dietetic support is crucial to effectively identify triggers while maintaining optimal nutrition. Here are a few ways in which a dietitian can assist:
1. Identification of trigger foods
2. Customized nutrition plans
3. Symptom tracking
4. Supplement recommendation
5. Behavioural and lifestyle counselling
The objective is to keep the diet as diverse as possible, minimising food restrictions while managing symptoms. Given that each individual’s tolerance to histamine is unique, the approach to reducing dietary sources of histamine needs to be personalised.
How does HIT affect the menopause?
As well as the hormonal changes of the menopause sometimes triggering HIT, HIT can make menopausal symptoms worse. Additionally, some people find that they can be quite intolerant of HRT when they have HIT, meaning they need to have a completely individualised approach to their HRT regime. At Menopause Care, HIT appointments are longer than usual so that we can provide a completely holistic approach to supporting people with HIT, including tailored advice with HRT. Appointments with our dietitian are also available to ensure people with HIT have expert nutritional advice with this complex condition.
Histamine intolerance symptoms include
Abdominal pain, aches and pains, acid reflux, anxiety, brain fog, constipation, depression, diarrhoea, dizziness, eczema, fatigue, food sensitivities, general feeling of unwell, headache, indigestion, intolerance to medicines, intolerance to strong smells, intolerance to temperature changes, light-headedness, low blood pressure, migraine, nasal and sinus congestion, palpitations, panic attacks, rashes, shortness of breath, urinary symptoms, wheezing.
