Updated: Oct 9, 2018
Do you suffer from 'seasonal allergies' that get worse after eating cheese, wine, sauerkraut, beer, vinegar, shellfish or dairy? And do you have other gut related issues on top of your hay-fever symptoms?
Many people think that seasonal allergies and non-anaphylactic allergic responses are a normal part of life. As Spring hits Melbourne, many have been complaining of their ‘hay-fever’ symptoms and reaching for anti-histamine solutions. The itchy eyes, throat and skin, post nasal drip, and constant sneezing, headaches, wheezing and irritation are unpleasant, and can severely interfere with daily life. Many believe that seasonal allergies can’t be helped, and the only solution is to get the best strength anti-histamine drug, and avoid environmental triggers like pollen.
But what if your allergies are nothing to do with the pollen in the air, and everything to do with the food you are eating, and the health of your gut? That’s right, histamine intolerance, disorders of the Mast Cells that produce histamines, dysbiosis (bacterial imbalance), intestinal permeability or Small Intestine Bacterial Overgrowth (SIBO) in your gut, could be the cause of your allergies.
Allergies are not normal. Allergies are not a matter of luck, or a certain time of year. Allergies are directly related to a faulty immune response. When allergy strikes we should be asking what has caused it, rather than simply trying to quell our reaction with paramedical anti-histamines. An allergic reaction doesn’t occur due to a deficiency of anti-histamines! It’s an immune response, and is designed to help us heal inflammation.
Histamine is the main chemical responsible for ‘hayfever’ type allergic reactions. It’s a naturally occurring part of our immune system, and central nervous system. In the gut histamine is part of stomach acid, regulates our immune response, it dilates blood vessels so white blood cells can recirculate to attack sites of inflammation, and it also acts as a neurotransmitter in the brain. A healthy system should break down histamine in the gut, with an enzyme called Diamine Oxidase (DAO.)
Symptoms of Histamine Intolerance
Inflammation, swelling and pain
fatigue, mood related symptoms like depression and anxiety
Hives, rashes, itchy skin
nausea, vomiting, cramps,
sinus congestion, post nasal drip
asthma, wheezing, difficulty breathing and holding breath
Histamine levels in the body can build up if we cannot break it down, are eating a high histamine diet, or are suffer from the gut disorders mentioned above. The two best strategies for initial allergy management are to reduce high histamine foods, and to heal the gut.
Reducing Dietary Histamine
So many common foods are high in histamine, and many people with allergies would benefit from reducing, if not eliminating some of these foods. Avoiding histamine rich foods isn’t a lifelong sentence, and many people find great success, and are able to reintroduce these foods after a period of avoiding them, and healing their gut. A general rule of thumb to help remember which foods are high in histamine relates to tehir age, or rate of decay, so fermneted foods, leftovers, alcohol, cured meats which have a longer processing time tend to have higher histamine.
Alcohol is a sinister culprit, because it contains high histamine, triggers the release of more histamine AND blocks the DAO enzyme (the substance that breaks down histamine.)
High Histamine Foods
Fermented foods like sauerkraut, kombucha, alcohol (especially wine and beer)
Cured meats like salami, bacon or left over meats (that have been able to ferment in the fridge)
Citris fruits and dried fruits
Aged cheeses and most dairy products,
Vinegar, olives, pickled foods
Seafood, especially shell fish
Avocados, eggplant, potatoes, spinach
Bone broth cooked for long periods (shorter cooked brews are better tolerated)
Histamine Releasing foods
Nuts (esp cashew)
Fruit: Strawberries, bananas, tomatoes, pineapple
Low Histamine foods
Freshly cooked meat and eggs
Gluten free grains
Fresh fruit & veg (unless listed above)
Coconut, rice, nut milks,
Olive and coconut oil
So what if cutting out dietary Histamine doesn’t reduce symptoms?
The next strategy is to aggressively heal the gut. There is a large correlation between bacterial Dysbiosis in the large intestine, and small intestinal bacterial overgrowth (SIBO), and histamine disorders. Histamine disorders exist on a spectrum, and can range from a mild intolerance, to full blown Mast Cell Activation Syndrome (MCAS).
Bacteria release histamine, and thus an overgrowth of pathogenic bacteria or an insufficiency of beneficial bacteria in the large bowel, or bacteria overgrowth in the small intestine like SIBO, (where it’s not supposed to be!) can be a major problem. SIBO is especially important to investigate, given that bacteria in the small intestine damage the gastrointestinal lining where the DOA enzyme (and other enzymes) are made, thus increasing histamine levels in the body. As enzymes are not produced efficiently, food is not broken down adequately, leading to carbohydrate malabsorbtion, and subsequent fermentation, creating the perfect breeding ground to encourage more SIBO!
Intestinal permeability (leaky gut), gluten intolerance, and inflammatory bowel disorders can also damage the gut lining where the DAO enzyme is produced, creating further problems. An inflamed gut, can lead to multiple food allergies, and auto-immune diseases, so it’s important to assess if you have allergies.
If you have removed high histamine foods and are still suffering, reach out to a functional medicine practitioner for help in assessing you digestive function and whether MCAS might by a problem for you. MCAS can be triggered by multiple causes, but commonly occurs with Chronic Inflammatory Response Syndrome (CIRS) which is an illness that routinely occurs with Lime disease or Mold Illness.
Slide from Mast Cell Activation Disorder Webinar by Dr Gupta and Dr Jill Carnahan
Having suffered from both CIRS and MCAS myself, I know it can be an overwhelming diagnosis, and unfortunately not many doctors are savvy with how to diagnose, test and treat, particuarly in Australia.
And if it still doesn’t work – Keep hunting for the root cause
Investigate whether you might have Mast Cell Activation Disorder (MCAD). MCAD is a complex, multi system, multi symptom disorder whereby the immune system becomes hyperactive, releasing the contents of masts cells. Mast cells are white blood cells that release mediating substances like histamine, (and 200 others!) which systemically effect the entire body. Classic symptoms of MCAD involve chronic inflammatory reactions, allergies, fatigue, sensitivity, depression, IBS and many more. Read more about MCAD here from the legendary Chris Kresser
Aside from reducing dietary histamine intake and healing the gut, there are many natural ways to calm the histamine response in your body. Although anti-histamine pharmaceuticals will quickly quell symptoms, they unfortunately deplete the DAO enzyme over time. Antidepressants, Non-steroidal anti inflammatory drugs (NSAID) also deplete DAO.
Vitamin C, MSM (Methylsulfonylmethane), and L-glutamine are supplements you can seek to help calm your mast cells and reduce histamine. Herbs like stinging nettle, peppermint, holy basil, turmeric, thyme, quercetin (probably the most commonly used), bromelain, and ginger have been shown to be helpful in mediating histamine response. As you can see below, I have used the whole kit and kaboodle (holy basil,and quercetin are in my supplement box!) I have also diffused ginger, thyme and peppermint essential oils.
Healing the gut is important in calming inflammation of any kind, and particularly with histamine intolerance. Prebiotics and probiotics can often cause reactions in people with MCAS or histamine intolerance, as the point of probiotic & prebiotic interventions is to grow beneficial bacteria! It’s important to tread carefully, and seek expert help for more well tolerated products. Lactobacillis Casei is a common strain of bacteria found in probiotics that is particularly aggravating for those with histamine issues. Lactobacillus Plantarum is a strain of bacteria that has shown to be helpful with histamine issues, and it’s certainly helped me! I have been using this formula for a few months with great results