DISCOVERING THE SECRET CONNECTION BETWEEN HISTAMINE INTOLERANCE AND PMS

HOW IS HISTAMINE INTOLERANCE CONNECTED WITH PMS

Histamine and Inflammation can be used synonymously. Histamine causes inflammation and inflammation in return positively impacts its release leading to the vicious cycle of damage and radical formation. Histamine is not Bad; it is a vital molecule for a plethora of bodily functions.

Why body needs histamine?

Histamine is a crucial molecule that serves many functions in the body. Being a Neuro- mediator it controls thermogenesis, Appetite, and cognitive and behavioral functions in the body.

Physiologically-

- It stimulates gastric juices.

- Plays a role in inflammation and vasodilatation.

- Promote cytokine production.

- Enhance smooth muscle contraction

- Work as a neuro-hormone.

Histamine receptors are distributed all over the body through which it acts on the target cells. They are namely-H1, H2, H3 and H4 receptors which are spread among the gastrointestinal, respiratory, circulatory, and nervous systems.

One thing which is interesting to know is you may have experienced allergic reactions around your ovulation or a few days before your periods. This occurs because of the correlation between estrogen and histamine. Fluctuating levels of estrogen hormone in women can impact the levels of histamine in the body.

The HISTAMINE induced Symptoms may look like this-

- You may feel nauseous, bloated, or constipated

- Stomach fullness, pain, or flatulence

- Skin flushes, urticaria, itching, swelling

- Headache, dizziness, Nasal congestion.

You may experience some of these with variable severity, duration, and onset.

Some women may experience adverse symptoms, others have mild to moderate ones. It is something that we call HISTAMINE INTOLERANCE.

A person cannot degrade normal levels of histamine in the body which is otherwise degraded by healthy individuals due to the sensitivity to dietary histamine. As a result, histamine gets accumulated in the blood and produces inflammation.

Enteral histaminosis

The histamine is manufactured and stored mainly in the Mast cells in the body. It is released within a short period and produces its action. After that, it is degraded in the gut. Diamine oxidase (DAO) is responsible for this role. It acts upon histamine and converts it into an inactive form that can easily be excreted by the body or recycled.

However, Any pathology or alteration in the gut environment can greatly hamper this process resulting in more histamine in the blood. Additionally, ingesting histamine-rich foods further add to the list.

DAO DEFICIENCY

Some researchers point to the fact that some individuals are not able to produce sufficient amounts of DAO enzyme due to genetics, food habits, drugs, or underlying disorders.

GENETICS

Asian and African populations are found to be DAO deficient.

DISEASES/ DISORDERS hampering DAO activity

DAO enzyme can be sufficient in the body still the body cannot flush out that extra histamine due to disturbed gut health. Gut Health is really important as it not only flushes out toxins but influences the digestion process in the body. These factors can alter the gut microbiota which further aggravates the problem.

Dysbiosis in the intestines can further lead to more and more production of histamine. There are certain strains of bacteria, which under pathological conditions can produce histamine and promote inflammation. At the same time, it affects estrogen clearance which disrupts the hormonal cycle of the body.

Inflammatory bowel diseases, functional gastrointestinal disorders like Celiac disease, carbohydrate malabsorption, non-celiac gluten sensitivity, gastro-enteritis, and short bowel syndrome affect the mucosal integrity of the intestines, henceforth, promoting inflammation and histamine release in the body.

It has been observed that people suffering from Migraine attacks have DAO deficiency in the body.

Histaminic Foods

Many foods produce histamine in the body or we can say they act as an exogenous source of histamine.

Fish is the most common source of histamine intoxication. A Meta-analysis carried out in 2018 of different scientific reports on histamine intoxication between the interval (1959- 2013) observed Fish as a causative agent in 98% of cases with cheese as the second culprit.

However, histamine intoxication and histamine intolerance are two different things. We call histamine toxicity when abnormal levels of histamine, >500mg/ kg are found which on ingestion causes moderate to severe allergic reactions in the body.

Histamine intolerance is the sensitivity of individuals to even normal levels of histamine in the body due to diminished histamine degradation or enzyme deficiency. This is what we call Food intolerance similar to Lactose intolerance or gluten sensitivity among masses.

How it manifests itself

We can find varied forms of symptoms and signs when dealing with histamine intolerance. This is not just a bunch of symptoms but involves many systems of the body at the same time. You may experience hot flushes or itching and at the same time headache, dyspnea, stomach pain, or tachycardia.

Clinical Symptoms

Gastrointestinal

- Nausea

- Vomiting

- Postprandial fullness

- Abdominal pain

- Bloating

- Flatulence

- Diarrhea

- Constipation.

Circulatory

- Increased Heart Beat

- Low blood pressure

- Collapse.

Dermal

- Itching

- Flushes

- Urticaria

- Eczema

- Swelling.

Respiratory

- Rhinitis

- Rhinorrhea

- Sneezing

- Breathlessness

- Stuffy nose.

Nervous

- Headache

- Dizziness

- Insomnia

The most common ones are gastro intestinal followed by circulatory symptoms. These are expressed by different H receptors present all over the body.

You can rule out other food allergies by performing a Skin Prick test or Plasma tryptase.

Other Tests include a Histamine provocation test and colon biopsy to diagnose the problem.

Currently, no tests are available that can confirm HIT in a patient.

DIETOTHERAPY

Treatment through diet or dietary changes plays an important role in Histamine intolerance. Certain foods are high in histamine that can act as a source of histamine, increasing its levels in the body. The patient who is already DAO deficient finds it difficult to cope with their symptoms with the help of only drugs.

Anti-histamine medicines have little to no role in HIT. They can only block the symptoms but can’t help with the actual cause. To deal with this issue, Dieto-therapy comes into play. Incorporating foods with low histamine index can help with the aggravating episodes of HIT.

Planning proper dietary habits greatly help with food intolerances, same with HIT.

High histamine Foods

- Oily fish

- Fermented Meat

- Tomatoes

- Spinach

- Vinegar

- Seafood

- Cheese

- Yeast products

- Alcohol

Moderate histamine foods

- Shellfish

- Eggs

- Soy & its products

- Eggplant

- Avocado

- Banana

- Pineapple

- Kiwi

- Plum

- Chocolate

- Nuts (figs, raisins, prunes).

Low histamine foods

- Soyabean

- Chickpeas

- Lentils

- Milk

- Mushroom

- Chilli powder

- Cinnamon

- Cloves

DAO blocking Foods

- Tea

- Alcohol

- Energy drinks.

DAO PROMOTING FOODS

These foods promote adequate secretions of DAO enzymes in the body.

- Vitamin B6

- Vitamin C

- Quercetin (onion, grapes, berries, cherries, broccoli, and citrus fruits).

- Magnesium.

Drugs affecting DAO production, levels, and Secretion

- Expectorants & mucolytics

- NSAIDS

- Bronchodilators- theophylline

- Antibiotics- cefuroxime, doxycycline, neomycin, and metamizole)

- Antidepressants

- Diuretics- furosemide

- Opioids- Morphine, codeine.

- Local & General anesthetics.

- Barbiturates.

Interesting Facts

- Boiling in water reduces the biogenic amine content in vegetables by transferring them from food to water. Biogenic amines are compounds that are made of amines. Histamine is one such biogenic amine compound derived from histidine.

- Grilling increases histamine content in seafood and meat.

- Dysbiosis that is altered microbiota of intestines decreases DAO activity significantly.

- The fresher the food, the lower chances of histamine or biogenic amine formation.