Symptoms
The following pseudoallergic symptoms occur after ingestion of histamine-rich foods. The same person may not be affected by all of the symptoms.
- Diarrhea, stomach pain, colic, flatulence.
- Headaches and migraines, “histamine headache“.
- Dizziness
- Stuffy nose, runny nose, also known as gustatory rhinorrhea (runny nose when eating).
- Sneezing
- Headache
- Asthma, asthma attack
- Low blood pressure, rapid pulse, cardiac arrhythmia.
- Hives, itching, skin redness (flush), feeling of warmth.
- Oedeme
- For women: Menstrual cramps
The clinical picture has been studied and made known mainly in Central Europe. Many foods rich in histamine are also poorly tolerated by people with map tongue. Some authors estimate that up to one percent of the population is affected. In many countries, that would be over 80,000 people. However, the figure is disputed.
Trigger
Consumption of histamine-rich foods such as wine, cheese, sausage table. Histamine-rich foods are primarily ripened, fermented, microbially produced, and spoiled foods (see also under Fermented Foods). Histamine is usually formed by microorganisms (bacteria, fungi) only during ripening. Alcohol promotes the release of histamine and at the same time inhibits its breakdown. A number of drugs also promote the release of histamine or inhibit its breakdown. These include, for example, the opioids (morphine) and acetylcysteine.
Causes
Histamine does not usually cause reactions when administered perorally in healthy individuals because it is inactivated in the intestine by metabolizing enzymes and is not bioavailable. Diamine oxidase in particular acts as a protective metabolic barrier by oxidizing histamine. In histamine intolerance, this barrier function is disturbed, histamine is available in the organism and leads to the pseudoallergic reactions. Histamine in high doses or when administered intravenously can cause symptoms even in non-sensitive individuals. Certain intoxications with digesting fish (especially mackerel and tuna) are attributed to the high histamine concentrations. Possible underlying causes include inflammatory bowel disease and fungal infections with Candida, which can damage the gastrointestinal environment.
Diagnosis
With the doctor or health care professional. Proper diagnosis is not easy because the clinical picture is not well known, can be confused with allergy, and symptoms such as headache or gastrointestinal discomfort are nonspecific. According to the literature, the diagnosis is based on the clinic and a provocation test. Other food allergies, e.g. lactose intolerance, other allergies and diseases that cause similar symptoms. Histamine intolerance is a nonallergic reaction (not IgE-mediated).
Nonpharmacologic treatment
For prevention, histamine-rich foods should be avoided by following a low-histamine diet. Table Also, medications that release histamine or inhibit its breakdown should not be taken if possible.
Drug treatment
Antihistamines:
- Antihistamines, such as cetirizine, loratadine, or diphenhydramine, reverse the effects of histamine in the body, eliminating symptoms. See under antihistamines.
Mast cell stabilizers:
- Cromoglicic acid and nedocromil inhibit the release of histamine from mast cells, see under mast cell stabilizers.
Enzymes:
- Diamine oxidase can be supplied in the form of a drug when needed. In many countries, daosin is commercially available as a nutritional supplement for food intolerance due to histamine intolerance. The capsules are taken before meals.
Vitamins and minerals:
- Vitamin B6, copper and vitamin C are important cofactors of diamine oxidase, which breaks down histamine and can be supplemented.
Glucocorticoids:
- And other anti-allergic drugs such as epinephrine or beta2-sympathomimetics in a severe allergic reaction (anaphylaxis).
If a severe reaction is expected:
- Carry an emergency allergy kit.
