HISTAMINE INTOLERANCE: Symptoms, Root Causes in the Gut Microbiome, and Treatment

Welcome Friends I'm Dr Raj srinambujra pad and today's video is all about histamine intolerance now I'm sure most of you are already familiar with lactose intolerance which is where a person avoids dairy products like cheese and gluten intolerance which is when a person reacts to the protein gluten that's present in traditional wheat bread but a lot of people are not familiar with histamine intolerance which is what inspired me to make this video in histamine intolerance unfortunately a person can feel like they react to everything awareness of histamine intolerance has grown in the last couple years but it's still very possible that your doctor has not even heard of this condition sadly in histamine intolerance a person will react to a lot of foods that are typically considered healthy like fermented drinks like kombucha or fermented foods like sauerkraut which are loaded in probiotics they'll even react to avocados which are known to be a healthy source of good monounsaturated fats so what are histamines histamines are compounds made by our immune system specifically mast cells and basophils which are types of white blood cells these cells are armed and ready for battle at all times because they're packed with granules when they get triggered they release these granules which are full of inflammatory mediators one of which is histamine so normally histamine is actually an important part of your immune system but too much histamine can cause symptoms in histamine intolerance the body can't process histamines properly there's a combination of increased production and decreased breakdown of histamines which causes it to accumulate High histamine can cause a wide range of symptoms and that's because there's four different types of histamine receptors and they're located in organs throughout our body in our brain histamine acts as a neurotransmitter and it influences our sleep wake cycle too much histamine can cause insomnia anxiety headaches dizziness and tinnitus which is ringing in the ear in our stomach histamine triggers the release of gastric acid too much histamine can cause acid reflux or heartburn in our nose histamines can cause sneezing nasal and sinus congestion on our skin histamines can cause itching as well as rashes like hives or eczema histamines cause blood vessels to swell so it can cause flushing or swelling anywhere in your body in the lungs histamines cause constriction of the Airways which can cause wheezing or difficulty breathing in the heart histamines can cause palpitations rapid heart rate and even high blood pressure once again histamines can act as a brain neurotransmitter that's why too much histamine can trigger anxiety and insomnia and they're also a big trigger for migraine headaches antihistamines are histamine 1 receptor blockers and that's why they often cause drowsiness as a side effect in the stomach histamine triggers the production of gastric acid which is why too much histamine can cause acid reflux or heartburn acid suppressive medications like famotidine or Pepcid work by blocking the histamine 2 receptors on the stomach once again histamines can cause a wide range of symptoms ranging from nasal congestion to skin rashes you might be thinking histamine symptoms sound a lot like allergies well yes it does it turns out that the symptoms of histamine intolerance and allergies are actually very similar but the mechanism is different and therefore the treatment is different in allergies your body is reacting to a specific food or environmental item for example when a person with a peanut allergy eats a peanut this causes their immune cells to produce ige antibodies that are specific to the peanut proteins these ige antibodies then bind to the Mast Cell along with fragments of the peanut allergen and this triggers a mast cell to release its granules this process is called degranulation and remember these granules are loaded in histamine anaphylaxis is a life-threatening allergic response where a person has an extremely high ige mediated response toward a specific food or environmental allergen in this example a person with a severe peanut allergy accidentally consumes a peanut this causes the mast cells to go crazy and explode and release large amounts of histamines and other inflammatory mediators this can trigger Airway constriction that can be life-threatening this is why it's so important that patients with anaphylaxis always carry an EpiPen because of the similarity and the symptoms it's helpful to rule out allergies before diagnosing histamine intolerance you can do this through a blood test that checks the ige antibodies that are specific to common food and environmental allergens the most common food allergies include wheat dairy products from cow's milk soy eggs peanuts fish tree nuts and shellfish now let's get into the mechanism of histamine intolerance histamine is broken down by two important enzymes the first is called Dao which stands for diamine oxidase and it's found in the lining of your intestines the second enzyme is called h m t which stands for histamine and methyl transferase and it's found inside the cells of many organs throughout your body in histamine intolerance their significant reduction in the Dow enzyme and this is caused by inflammation and disruption in the gut microbiome this is what causes the histamines to accumulate now let's talk about the production of histamines histamine is made from the essential amino acid histidine by an enzyme called histidine decarboxylase this enzyme is made by the bacteria that are present in food as well as the bacteria in our gut microbiome people with histamine intolerance have increased production of histamines by bad bacteria in their gut microbiome which I'm going to get into more detail later because of the microbes that are present in food aged in fermented foods have higher levels of histamines this includes foods like sauerkraut aged cheeses aged vinegars soy sauce and even bone broth once again it's the bacteria in these foods that are producing the histamine another category of food high in histamines is fish especially canned or smoked fish like tuna or sardines in fact there's a type of food poisoning called stromboid poisoning which is caused by fish that has not been stored properly and has an excessively high level of histamine scrambled poisoning can cause symptoms like nausea vomiting diarrhea abdominal pain headaches dizziness and rashes but the good news is it's usually self-limited within 24 hours and is treatable with antihistamines histamines are also the reason why some people get a mahimahi flesh interestingly fish are not only high in histamines they also have Inhibitors of the Dow enzyme just remember the fresher the fish the less histamine it'll have next we have foods that cause increased histamine release by your immune cells this includes citrus fruits like oranges and lemons as well as strawberries although these foods do not contain High histamines they cause your mast cells to release more histamines now let's talk about alcohol most alcohol are high in histamines because they're made through a fermentation process alcohol also reduces the activity of the Dow enzyme in the lining of your intestines finally alcohol and histamines compete for the same enzyme called aldehyde dehydrogenase which is involved in the breakdown of histamines as you can see there are multiple reasons why a person with histamine intolerance would not tolerate any alcohol the bad news is that there are some produce items that are unsuspectingly high in histamines this includes spinach eggplant avocados and tomatoes now let's review the three mechanisms in how foods can cause symptoms in histamine intolerance first some foods are naturally high in histamine like fermented foods like soy sauce second some foods inhibit the Dow enzyme like alcohol finally some foods cause your body to release more histamines from the immune cells like citrus fruits next it's also important to be clear that there are three sources of histamines there's food your immune cells and finally your gut microbiome coming up we're going to do a deep dive on why a disrupted gut microbiome can be a big root cause of histamine intolerance most people with histamine intolerance acquire this problem at some point in their lives so what causes them to become histamine intolerant one of the big root causes of histamine intolerance is disruption of the gut microbiome if there's an overgrowth of bad bacteria in the microbiome these bacteria can end up eating the Dow enzyme and increasing production of histamines interestingly the number one most common symptoms seen in histamine intolerance is bloating that's because small intestine bacterial overgrowth also known as sibo is a common root cause of histamine intolerance so what is sibo normally your small intestine does not have a lot of bacteria and the primary role of the small intestine is to absorb nutrients from your food most of the bacteria are located in the large intestine or colon but if the bacteria from the large intestine back up into the small intestine these bacteria are now in the wrong place and they can cause a lot of bloating and discomfort the good news is sibo is a treatable condition and I have a whole video dedicated to sibo which I'll link below sibo causes histamine intolerance by damaging the enzymes that are located on the lining of our small intestine these tiny finger-like projections are microvilli on a cell in the lining of our small intestine at the edge of these cells is something called the glycocalyx this is a protective glycoprotein layer with enzymes that normally help with food digestion unfortunately in sibo the bacteria end up eating the glycocalyx and they also end up eating up the Dow enzyme which is stored in the cells lining the microvilli this is why sibo can be a big root cause of histamine intolerance next we have dysbiosis dysbiosis means there's an overgrowth of a bad bacteria and it doesn't necessarily have to be in the small intestine so it could be in the colon research shows that certain species of morganella hafnia Proteus anaerobacter anaerococcus citrobacter pseudomonas and lactobacillus ceremony can produce higher levels of histamine from your gut that's because these bacteria produce higher levels of that enzyme histidine decarboxylase so they convert the amino acid histidine into histamine once again this is why a disrupted gut microbiome can be a big root cause of histamine intolerance you could also have dysbiosis with a fungal overgrowth like candida to learn more about candida as well as small intestine fungal overgrowth I have a whole video dedicated to this topic which I'll link below another root cause of histamine intolerance is leaky gut also known as abnormal intestinal permeability normally the lining of your intestines is only a single layer thick and the cells are bound together by tight junctions these are the cells that carry the Dow enzyme and they normally break down histamines before they enter your bloodstream in leaky gut there's disruption in the tight junctions between the cells so histamine can go straight from your food into your bloodstream on top of that food particles and bacteria can enter your bloodstream triggering immune dysregulation which can cause autoimmune disease and it causes your mast cells to release more histamines to learn more about leaky gut please check out my video and I'll share the link below next inflammatory bowel disease which consists of Crohn's Disease and ulcerative colitis is also associated with histamine intolerance these are autoimmune diseases affecting the intestines and they are strongly linked to dysbiosis and inflammation which can impact the Dow enzyme as well as the production of histamines by the microbiome histamine intolerance is also associated with irritable bowel syndrome or IBS what's fascinating is research shows that the histamine levels correlate with the severity of the abdominal pain IBS is just a label for the symptoms but it turns out that sibo is a big root cause of up to 70 percent of IBS remember sibo bacteria can eat up the Dow enzyme on the lining of the intestines next we have gluten sensitivity about eight percent of the U.S population is Gluten Sensitive meaning they feel better when they avoid gluten from their diet research shows that non-celiac gluten sensitivity is associated with a dow deficiency and hence can be associated with histamine intolerance as well before we move on I want to emphasize that a big root cause of histamine intolerance is a damaged gut microbiome that's because the bad bacteria can reduce the activity of the Dow enzyme and increase production of histamines there are also genetic causes of Dow deficiency in fact over 50 Snips which are genetic mutations in the down Gene have been identified now let's Circle back to the symptoms of histamine intolerance people with histamine intolerance often get symptoms right after eating foods that are high in histamines if you're noticing that certain foods give you a runny nose or make you anxious these could be symptoms of histamine intolerance so how do we make the diagnosis of histamine intolerance the first step is to rule out allergies you can do this through a blood test that measures the ige antibody level specific to all the food and environmental allergens unfortunately at this time there's no accurate blood test stool test or urine test to diagnose histamine intolerance intestinal biopsies to measure the Dow enzyme activity which can be done during an endoscopy or colonoscopy is still in research phases the gold standard of diagnosis is a low histamine diet if you follow this diet for two weeks and your symptoms improve then we can make the diagnosis of histamine intolerance let's review the foods that you have to avoid on a low histamine diet first we have aged and fermented foods like sauerkraut soy sauce aged vinegars cheese alcohol as well as processed or cured meats you also want to avoid canned or smoked fish produce items high in histamines include spinach tomatoes eggplant avocados bananas pineapple as well as mushrooms histamines are also found in legumes like soybeans lentils and peanuts you also want to avoid strawberries as well as citrus fruits like oranges because these fruits can increase your release of histamines finally coffee black tea as well as chocolate could also be a problem for many people with histamine intolerance interestingly apple cider vinegar seems to be tolerated in histamine intolerance even though other aged vinegars are not tolerated being on a restricted low histamine diet is hard and some people get overwhelmed not knowing what to eat the good news is the low histamine diet is just to make the diagnosis of histamine intolerance and to manage your symptoms but ultimately it's not the treatment for the condition ultimately the treatment is to address the root cause which is often a damaged gut microbiome let's go over a couple more tips for the low histamine diet because histamine is made by the microbes that are present in food as it ages you want to eat fresh or frozen only this is why you want to avoid leftovers that have been kept in the refrigerator if you're meal prepping the best thing to do is to freeze your food as far as cooking methods you'll want to avoid slow cookers as well as frying or grilling because these methods could increase the histamines in the foods the good news is that boiling or pressure cooking seem to be fine and do not increase histamine levels another helpful tip is if you have a flare-up of your histamine symptoms you can often feel better quickly by doing a short period of fasting where you just drink water this gives your digestive tract a break and allows your body to focus on clearing out the histamines if you feel so much better on a low histamine diet this confirms the diagnosis of histamine intolerance the next step is to address the root cause and heal your gut the good news is we can run some tests to figure out exactly what's going on in your gut microbiome if you're having a lot of bloating we can diagnose sibo with a sibo breath test there's also a stool microbiome test that can tell us if you have inflammation leaky gut dysbiosis candida overgrowth parasites or an infection with H pylori the good news is we can use Herbal antimicrobials to clean up the microbiome this includes berberine which comes from the root of the berberine plant oregano oil which comes from the Mediterranean herb and alicidin which has the antimicrobial compounds from garlic these herbal antimicrobials have anti-inflammatory benefits and they work for a wide variety of gut issues including sibo CFO which is a small intestine fungal overgrowth dysbiosis as well as candida overgrowth to heal leaky gut we use the amino acid powder called L-glutamine which is food for the cells lining your intestines which are called enterocytes we can also use a supplement called IGG guard which is dairy-free immunoglobulins derived from bovine serum to help rapidly heal inflammation in the gut in leaky gut it's also important that you clean up your diet this means cutting out refined sugar gluten dairy alcohol and vegetable oils it's also important to avoid non-steroidal anti-inflammatory drugs like ibuprofen which can often worsen leaky gut and to manage your stress to help promote gut healing now what about the use of antihistamines well that's a great question let's dive into it the great news is we carry a natural antihistamine called histamine support which is natural ingredients like quercetin vitamin C stinging nettle broblin and NAC these ingredients help to stabilize mast cells and reduce histamine release it's best taken at a dose of two capsules twice a day if needed over-the-counter antihistamines can also be used short term this includes histamine one blockers like Loratadine which is Claritin or cetirizine which is Zyrtec histamine 2 blockers like famotidine which is Pepcid reduces the production of stomach acid so it can be used to treat heartburn or acid reflux it's best to avoid using these medications long term because otherwise when you stop them you may get a rebound increase in histamine production digestive enzymes can also make a big difference in histamine intolerance our digestive enzyme Pro helps to Target the breakdown of proteins fats and carbohydrates this can help to prevent bloating as well as to reduce inflammation in the gut we also carry vegetarian digestive enzymes you can also supplement with the Dow enzyme it's typically made from porcine kidneys and I'm excited to announce that I'll be carrying it soon in my supplement store what's fascinating is there's a natural food source of the Dow enzyme and it comes from sprouted legumes keep in mind that not everyone can digest legumes but if you can then sprouting peas or legumes especially in the darkness is a great way to get a natural food source of the Dow enzyme it's also helpful to give your body some of the cofactors for the Dow enzyme this includes vitamin C B6 which is found in our methyl B complex magnesium as well as zinc and copper which are found in our multivitamin next we have vitamin D which is very important for immune regulation so you'll want to supplement with vitamin D3 with K2 either in capsule or liquid drop form to get your blood level optimized to a goal of 60 to 80. now you may be wondering about probiotics great question let's go over it research shows that there are higher levels of a good bacteria called bifidobacterium in normal people compared to those suffering from histamine intolerance there's also a good probiotic yeast called saccharomyces boulardi or S boulardi which has been shown to improve the activity of the Dow enzyme our probiotic 20 billion as well as our probiotic 100 billion has bifidobacterium as well as multiple good strains of lactobacillus to help with dysbiosis in the gut you can also try espularity just by itself and our probiotic 20 billion also contains escularity as well there's a lot of literature showing that escularity can help with IBS symptoms and it also helps to prevent the growth of other bad yeast like candida in the microbiome the good news is as your gut gets healthier the cells lining your intestine will produce more Dow enzyme which will lead to better histamine tolerance this is when you can gradually start reintroducing histamine-containing foods and hopefully now you'll be able to tolerate them much better you also want to avoid down blockers which include many common medications Believe It or Not ibuprofen and other common non-steroidal anti-inflammatory drugs as well as common antibiotics like Augmentin can block the Dow enzyme in the description below I'm going to link a review article that has a table listing the many other medications that can also block the Dow enzyme now let's talk about histamines in women for you men out there please stick around you may find this information interesting high levels of histamines can actually cause bad menstrual cramps unfortunately this is an additional symptom that women with histamine intolerance can experience if this is the case taking an antihistamine at the start of the period can help reduce the cramps this is a graph showing the hormones in the menstrual cycle what's fascinating is histamine levels correlate with estrogen levels estrogen is more dominant in the first half of the month called a follicular phase so this is when women experience more histamine symptoms close to ovulation there's a peak in both the estrogen levels as well as the histamine levels and this can trigger migraines in some women in the second half of the menstrual cycle called the lunial phase we see a rise in progesterone which correlates with a rise in the Dow enzyme so women with histamine intolerance will typically have less symptoms in the lunal phase of their cycle unfortunately because progesterone levels drop right before the menstrual period this can cause a rise in the histamines which can cause the bad menstrual cramps what's really amazing is that histamine intolerance improves during pregnancy this is because pregnancy is a high progesterone state but also because the Dow enzyme is actually made by the placenta in fact dowel levels can be up to 500 times higher during pregnancy another cool fact that I wanted to point out here is this pregnant lady is holding an apple and apples are a great source of quercetin which is a natural antihistamine histamine levels also vary along with our circadian rhythm which is our sleep wake cycle typically histamine levels are higher during the evening and night time so you may notice that certain foods affect you more when you have them for dinner as opposed to breakfast now I want to introduce you to two other conditions that are similar to histamine intolerance but a bit more severe the first condition is called Mast Cell Activation Syndrome it has symptoms very similar to histamine intolerance but often more severe episodic and not always connected to food it's thought to be caused by a hyper-reactive immune system that's been triggered by an infection or toxin exposure possible root causes include many of the gut conditions we talked about such as sibo or dysbiosis but it can have other triggers as well such as Lyme disease and viral infections like Epstein-Barr virus cytomegalovirus herpes viruses varicella even long covet it can also be triggered by exposure to heavy metals and molds what's fascinating is research even shows that exposure to EMF which is electromagnetic fields can activate mast cells in sensitive individuals to diagnose Mast Cell Activation Syndrome you want to measure the blood levels of an enzyme called tryptase which is often elevated during a flare the treatment for Mast Cell Activation Syndrome is similar to the treatment for histamine intolerance in that you want to address the root cause which often involves healing the gut or addressing any chronic infections next there's a condition called systemic mastrocytosis this is a more serious hematologic condition where mast cells start multiplying and can infiltrate your bone marrow it can also cause enlargement of your spleen lymph nodes and liver in systemic mastocytosis the blood level of tryptase is elevated all the time regardless of symptoms this is a condition that needs to be treated by a hematologist which is a blood specialist now returning to histamine intolerance I want to emphasize the good news histamine intolerance is a treatable condition and healing the gut is the key to restoring your Dow enzyme now I want to introduce you to one of my patients named Tony when Tony first came to see me he was having a lot of symptoms including food intolerances anxiety insomnia rashes headaches and sinus pressure interestingly all these symptoms began in October of 2021 when he also noticed a shift in his gut health that's when he started having constipation occasional episodes of diarrhea as well as bloating when I tested his gut I found that he had both sibo and leaky gut over the next couple months we worked on treating his sibo and healing his leaky gut Tony was extremely committed to his health and did a wonderful job in following all the protocols the amazing news is as his gut healed all his other symptoms went away so Tony had a classic case of histamine intolerance that was causing this wide range of symptoms and it was all due to a damaged gut that was affecting his Dow enzyme many of the supplements like histamine support as well as the cofactors for the Dow enzyme improved his symptoms but ultimately it was healing his gut that improved his quality of life dramatically the best part is he was able to go back to eating all his favorite foods like spinach salad pizza coffee and even an occasional alcoholic beverage thank you Tony for inspiring me to make this video and for allowing me to share your story so here are the key points histamine intolerance can cause a wide range of symptoms histamine is found in many foods but especially aged and fermented foods having lower levels of the Dow enzyme due to a damaged gut is a big root cause of histamine intolerance the gold standard of diagnosing histamine intolerance is if your symptoms improve on a low histamine diet but ultimately the treatment is to heal your gut so that you can restore your Dow enzyme and reintroduce Foods thanks so much for watching this video If you enjoyed it please give it a thumbs up and subscribe to my Channel please leave all your questions and comments below I look forward to hearing from you thank you again and have a wonderful day [Music]

Channel: Rajsree Nambudripad, MD

Views: 650,242

Keywords: histamine intolerance, gut health, functional medicine, high histamine foods, histamine intolerance foods, histamine foods, histamine intolerance diet, how to heal histamine intolerance, food intolerance vs allergy, gut microbiome, DAO Enzyme, leaky gut, SIBO, food allergy, food intolerance bloating, food intolerance treatment, gut health supplements, gut health foods

Id: _jQL4qoJDG0

Length: 30min 25sec (1825 seconds)

Published: Sun Dec 18 2022