Histamine intolerance is really common in SIBO sufferers.

Histamine is a chemical released by our body’s immune system in response to an injury, infection or foreign substance in the body. Histamine kicks off an inflammatory response that helps increase blood flow and white blood cells to infected or injured areas of the body. When your immune system is functioning optimally, histamine can be helpful.

But, histamine becomes a problem child when your immune system becomes dysregulated. A good example of this immune dysregulation is allergies.

The immune system starts to overreact to benign substances like they are foreign invaders such as dogs, cats, pollen, certain foods and the other common allergens. Your immune system turns into an overprotective parent and tries to protect you from substances that you don’t need to be protected from. Just like over protective parents, allergies are annoying!

When the immune system stimulates your MAST cells to release histamine in response to an allergen, you can experience a runny/stuffy nose, itchiness, rashes, sneezing and difficulty breathing. Popular allergy meds are anti-histamines that help decrease the amount of histamine being released by your cells to reduce allergy symptoms.

Since 80% of your immune system resides in the gut, it is not surprising that an inflamed and imbalanced gut can lead to an increase release of histamine. Gut imbalances can lead to histamine intolerance.

In this blog, I want to highlight why you may struggle with histamine and SIBO and what you can do about it.

Why SIBO can lead to high histamine levels in the gut?

  • Inflammation and intestinal permeability in the gut can cause an overactive immune response and an increased release of histamine
  • Bacteria can produce histamine. You could have an overgrowth of bacteria that produces histamine leading to higher histamine levels.
  • Diamine Oxidase (DAO) is an enzyme that breaks down histamine. It is produced in the small intestines. Inflammation and damage can hinder the production of DAO enzymes. With an inability to break down histamine, your histamine levels will rise.
  • MAST cell activation disorder occurs when the mast cells unstable and release histamine chronically. There is a strong connection between MAST cell activation and SIBO.

Two other factors why your histamine levels could be elevated:

You can also have a genetic predisposition to higher histamine levels. A recent study found that variants in DAO genes strongly influence expression and activity of the DAO enzyme. Meaning that some individuals may be genetically prone to producing less DAO, which could be a risk factor for higher histamine levels.

The good news is that your genes are not your destiny. The researchers found that genetic variance alone was not significantly associated with histamine intolerance. They hypothesize that histamine intolerance usually results from a blend of genetic and environmental factors.

Having gut imbalances and these genes could create a perfect storm that leads to histamine intolerance.

For women, estrogen promotes histamine release from mast cells and a down-regulation of DAO production. If you struggle with estrogen dominance (which is common with gut imbalances), this hormone could be driving an elevation in histamine. If estrogen is a culprit, you will typically notice more histamine reactions around ovulation (mid-cycle) or right before menstruation.

Histamine in Foods

If you have underlying issues that are raising histamine levels in the body, consuming foods that are high in histamines can aggravate symptoms. This reaction to high histamine foods is usually referred to as histamine intolerance.

Foods that contain histamines or increase the release of histamines can cause problems for those with histamine problems. Typical symptoms of histamine intolerance are:

  • headaches/migraines
  • sinus congestion, sneezing or runny nose
  • itchiness on skin or in throat
  • rashes, flushing or hives
  • diarrhea
  • nausea
  • GI cramping
  • tissue swelling

There are tons of foods that contain histamine. The most common culprits for histamine reactions are fermented foods (kombucha, wine, beer, yogurt, kim chi, sauerkraut, vinegars etc), cured meats, aged cheeses and dried fruits. If you have high histamine levels, these can add more fuel to the fire.

There are also long lists on the internet of foods to avoid when you have histamine issues. In most cases, complete dietary restriction of histamine foods is unnecessary. Even if you are intolerant to some histamines, usually you will have a threshold level of histamine foods that you can tolerate.

Understanding what your threshold level of tolerance is will be a better way to invest your time and energy than trying to remove all histamine foods. Plus, to really control histamines, you need to address the root cause factors that are driving the levels up.

Tips to Address Histamine Intolerance

Treat your SIBO

As I described above, SIBO can drive inflammation in the gut and increase histamine levels. If untreated, SIBO can keep histamine levels chronically elevated.

Clearing the SIBO can help qualm the histamine storm. It is also important that you address root causes of your SIBO so that it doesn’t return.

Balance the Gut

After you clear the SIBO, restoring balance in the gut is key. Usually people with SIBO have large intestine imbalances that can drive inflammation, intestinal permeability and poor immune function. All of which can drive high histamine release.

Using properly timed probiotic and prebiotic strategies can help with histamine intolerance. It is key that you are choosing strains that are histamine free or histamine degrading to prevent aggravation of symptoms.

Reduce inflammation in the gut

Reducing over activation of the immune system can help reduce histamine intolerance. Endotoxin in the gut can often lead to chronic immune activation and inflammation in the gut.

Endotoxin binders can help reduce inflammation in the gut by binding to toxins before our immune system reacts to them. Binders allow the immune system to calm down and re-calibrate. Reduced immune activation will reduce histamine release.

I prefer using IgG supplements like MegaIgG2000 or SBI protect to bind to endotoxins for reducing inflammation in the gut.

Stress Management is key

Stress activates the HPA axis and raises cortisol levels. This stress response will also cause mast cells to release histamine. Therefore, staying out of fight or flight can help stabilize mast cells and keep histamine levels in check.

I like meditation and diaphragmic breathing techniques to help increase your body’s resilience to stress. Getting adequate sleep and sunshine is also important.

DAO enzymes can help reduce histamines in the gut

Diamine oxidase is the enzyme that breaks down histamine. You can supplement with DAO enzymes to help increase the breakdown of histamine from foods you are eating.

DAO enzymes can help you reduce the symptoms of histamine intolerance. These enzymes can also increase your ability to tolerate more histamine containing foods. For woman with histamine issues due to estrogen spikes, DAO enzymes can be taken around ovulation and before your period to help blunt symptoms.

It is important to mention that these enzymes are for symptom management while you address the underlying issues causing the histamine issues. These shouldn’t be taken long term.

Increase intake or supplement with nutrients that stabilize mast cells

Selenium and vitamin C have been shown to stabilize mast cells to reduce histamine release. Spices like ginger and tumeric are also good mast cell stabilizers.

Supplementing with quercetin can also be helpful. I like Quicksilver Scientific’s Hist-Aid blend of nutrients to support lower histamine levels, which includes vitamin C and quercetin.

Reduce heavy hitters, but try not to get too restrictive

As mentioned above, avoiding the big histamine foods can be helpful if you have histamine related issues, but trying to avoid them all can be stressful and unnecessary. Histamine intolerance is a spectrum and most people can tolerate some histamine foods. It’s all about finding what histamine foods trigger you and the threshold level of histamine that you can tolerate.

Your histamine issues are rooted in immune dysfunction not a diet problem. Focusing more of your energy on fixing the immune dysfunction will result in less histamine reactions.

Bottom Line

High histamine levels are common with SIBO. High histamine foods are not usually the problem, but they can aggravate symptoms. For long term relief from histamine issues, you need to treat and repair the gut vs trying to avoid all histamine containing foods.

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