This is the 4th iteration of the long overdue. “I’m eating healthy and feeling like lousy. Why!?”
I’m doing everything right!
You’re eating healthy and feeling like lousy. What’s up with this! You start your day with your bone broth protein shake. You’re having canned wild caught sardines or salmon and a massive salad for lunch. And dinner is even better! A slow cooked chuck roast, with some yams, and a ton of vegetables. Sounds like a solid plan to me. Heck, you’ve even stopped your late-night eating with the Netflix binge, you’re exercising, getting sunlight, destressing. Nature cure in action. What gives?
Maybe you’re suffering from histamine intoxication.
What is Histamine?
Histamine is a signaling molecule that supports the activity of your homeland security, regulates gut activity, supports reproductive function, and works as a neurotransmitter in your central nervous system.
Many of you may be familiar with histamine and allergies. You sniff up some pollen, mites, animal dander, and you’re on a quick trip to annoying runny nose, congestion, and sneezing. Or you ingest or are topically exposed to something your immune system doesn’t like and you develop hives.
We have more immediate and then delayed immunological reactions. Histamine is an integral part of our immediate response. What it does is increase capillary permeability. So, you have your swat team racing down roads trying to get to where the 911 call was made. They arrive and need to get into the crime scene. But the building with the hostages is locked up. And so, the building needs to be breached. Explosives are used, so the swat team can get inside and save the day.
Okay, it’s not that messy, but histamine essentially allows the immune system to permeate potentially infected areas.
What is histamine intoxication?
Histamine intoxication was first recognized as scromboid fish poisoning. Meaning a pathological histamine load from eating decayed fish. Now remember, histamine impacts much more than allergies. So, symptoms are variable and not very specific. Symptoms include:
Nausea
Vomiting
Diarrhea
Sweating
Abdominal Cramps
Tingling
Itching
Burning
Flushing
Hives
Swelling
Low blood pressure
Headache
Palpitations
The symptoms tend to resolve on their own and occur within a few hours of eating an offending food, lasting up to 48 hours. We’ll talk about potential offenders in a second.
How is it diagnosed?
We don’t have a really good way of diagnosing histamine intoxication. The most important factor is relating foods potentially high in histamine to onset of symptoms. Other ideas have been proposed, such a food analysis for histamine, which isn’t very practical. Analyzing the content of what is vomited, no thanks. Other ideas include looking at urinary or whole blood histamine. A lot of methylation wizards do this. The idea that you need methyl groups to put histamine in your toilet.
The best we seem to have at this point in time is dietary analysis, the associated symptoms above and seeing if over the counter agents like Zyrtec are helpful. Which should make sense. If you have tons of histamine floating around, blocking the receptors should provide symptomatic relief.
Sources of histamine
The most dense sources of histamine are aged fish. What happens is there are bacteria in the fish that convert the amino acid histidine into histamine. For whatever reasons, fish seems to harbor the bacteria Klebsiella pneumoniae and Morganella morganii, which are superstars at doing this. The fish that harbor the most are tuna, skipjack, mackerel, bonito, mahi-mahi, sardines, yellowtail anchovies and herring.
It’s interesting that in Naturopathic Medicine, a supplement we use in addressing hypertension is bonito fish concentrate. One of the symptoms of histamine intoxication is low blood pressure. Maybe it’s the histamine. Going to have to rethink about using that one in some folks!
The most dense sources are going to be canned varieties of the fish. Once the fish dies, it begins decaying and the two bugs mentioned above will grow in number rapidly, converting more histidine into histamine. Fish you’re buying kept cold in the meat case at the supermarket is likely to be lower in histamine.
Other potential food sources include broths, jerky, cheeses, canned meats, fermented foods like yogurt, sauerkraut, and natto. There is mention of certain fruits and vegetables being culprits for histamine intoxication. The idea is that these other foods cause one member of your homeland security called the mast cell to release histamine. But the concept of “histamine releasing foods,” outside of anaphylaxis and hives hasn’t been well characterized.
Essentially, think of anything protein dense and whether it is prepared in an environment that would allow histamine producing bacteria to flourish.
What’s the science says
As usual it’s mixed. Some studies have found no relationship between ingestion of histamine dense foods and signs of histamine intoxication. Others have. What it has to do with is differences between individuals. Some people are really good at detoxifying histamine whereas others are impacted by the smallest amounts. Factors that impact histamine detoxification include nutritional status, use of certain medications, exposure to environmental toxicants and chronic infection.
What should you do?
As per ush, my suggestion is you work with someone so you aren’t inappropriately removing foods from your diet and putting yourself in a bigger hole. The best dietary approach is one that includes variety. Less variety means you’re more likely to poke holes in your micronutrient status, which opens up the door for all sorts of other issues.
You can test your tolerance by eating a few cans of sardines in one sitting. Do it over the weekend, so if you feel unpleasant you can recover at home. Watch for onset of the symptoms above a few hours after chowing down.
If you suspect histamine intolerance and are eating a lot of canned fish or meat, it makes sense to replace those sources with fresh fish and meat.
Avoid slow cooking your protein dense foods. Doing so increases the likelihood that histamine producing microbes will flourish, resulting in higher levels of histamines in your food.
Take a break from bone broth and fermented foods – sauerkraut, beet kvaas, yogurt, natto, etc. Opt for fresh vegetables instead.
Deeper investigation
You may be deficient in certain micronutrients. The most important being copper. If you don’t get relief from the basic steps one consideration is discussing copper deficiency with your doctor. Other potential deficiencies include Vitamin C and B Vitamins.
Another consideration is gut dysbiosis. Meaning the environment in your intestinal tract is such that you are more susceptible to the effects of both histidine and histamine dense foods. The solution for this would be antimicrobial treatment, which is something I do not recommend doing on your own.
Hormone imbalance can contribute to poor histamine tolerance. We need these signaling molecules to be produced, do their thing and then get out. Sounds like the maintenance guy or something. An example of this is estrogen. Ladies need the right amount and detoxification pathways that can clear that estrogen. Estrogen dominance is a condition where excess estrogen is produced, it’s out of balance with progesterone, it can’t be cleared from the body sufficiently or all three. The processes that move estrogen out of the body include a methylation step. So does histamine. If you’re estrogen dominant, estrogen and histamine have to compete for the same enzymes that are required in order to put them in the toilet. In this case, it would be more about clearing your estrogens as opposed to slathering on hormone creams or using other means of replacement.
Stress contributes because a mechanism similar to hormone imbalance. Your nervous system releases signaling molecules called catecholamines. Norepinepherine, primarily. It also needs to be detoxified and competes with histamine on its way out. If you don’t have a mindfulness technique, get one. I usually recommend the phone app “calm.” But there are many ways to practice mindfulness.
There are many aggressive approaches you can read about on the internet that are, frankly, ridiculous. These histamine elimination protocols, where you’re down to eating nothing but chicken and rice. Sure, that’ll work. But I’m reminded of that family guy episode where the Griffins’ home is infested with fleas, and a swat team arrives to take out the fleas with firearms.
Start with the basic approaches above, and if that doesn’t help, consider deeper investigation.
Further Reading
Shils, Maurice Edward, and Moshe Shike, eds. Modern nutrition in health and disease. Lippincott Williams & Wilkins, 2006