Is SIBO causing your histamine intolerance symptoms?

Do you experience symptoms such as:

  • itchy eyes, skin, ears, nose,
  • hives, flushing,
  • vertigo or dizziness,
  • heart palpitations; low or high blood pressure,
  • sleep disturbances, anxiety or panic attacks,
  • runny nose – congestion,
  • headaches, migraines? (3)

These symptoms can be frustrating, especially when you do not know what causes them. Maybe you even had allergy tests, but they all came back negative.

Now that is the time to think about histamine intolerance.

The topic of histamine intolerance remains close to my heart because I had been suffering from this condition for several years until I could identify the cause of my weird symptoms, so I know how bad it can be!

sibo and histamine intolerance symptoms

What is histamine?

It is a chemical made by your body that has quite a few roles. Most importantly, it helps the body to get rid of allergens. It is part of the inflammatory response. Histamine allows the white blood cells to fight against pathogens, viruses, allergies. It is also involved in digestion. This component can also be found naturally in many foods. (1)

What is histamine intolerance?

We usually can break down histamine by two enzymes: DAO (Diamine Oxidase) and HNMT (Histamine N-methyltransferase). The problem occurs when these enzymes don't work correctly. DAO enzyme is made in the intestines, and when there is inflammation (which can be caused by many things such as Leaky gut, and SIBO), breaking down histamine will not happen properly. Excess histamine will lead to various symptoms. (2)(3)

Is it always histamine intolerance?

The short answer is no. It is always crucial to talk to your healthcare practitioner to rule out allergies, digestive disorders, or even mast cell disorders.

It is important to note that histamine intolerance is a consequence, not an actual cause in itself. It is associated with different digestive conditions such as IBS (Irritable Bowel Syndrome), SIBO (Small Intestinal Bacterial Overgrowth), IBD (Inflammatory Bowel Disease), Celiac disease, etc. (4)(5)

How to diagnose histamine intolerance?

Some doctors like measuring the DAO enzyme activity in the blood and using a stool test to check histamine levels. Low DAO enzyme levels and high levels of histamine may point to the direction of histamine intolerance, but the results are not always correlated with the symptoms. (3)(6)

The most accurate strategy is to use a low histamine diet as an elimination diet by removing high histamine-containing foods and see if symptoms start improving on the diet. (7)

What about foods in terms of histamine intolerance?

Since it is considered an intolerance, symptoms might not appear right after consuming a triggering food, as in an allergic reaction. Everyone has a certain "threshold," and you may start experiencing various symptoms if that is reached.

It is often recommended to follow a low(er) histamine diet to reduce the symptoms and help you identify some of your triggers.

There are different food categories that you may need to avoid:

Histamine-rich foods such as fermented foods (sauerkraut), aged, cured, processed meats (bacon, salami), cheese, dairy products, vinegar, and certain vegetables: eggplant, spinach, avocado, ripened fruits.

Histamine liberating foods: alcohol, bananas, citrus, tomatoes, legumes, walnuts, wheat germ, chocolate, etc.

Foods that block the DAO-enzyme production, such as alcohol, green and black tea, energy drinks.

You can try to include more whole foods in your diet: fresh (possibly grass-fed) meat and freshly caught fish, rice, quinoa, nut or rice milk, fresh vegetables, leafy greens, healthy oils, pasture-raised eggs, or quail eggs. (8)

sibo and histamine intolerance connection

How is SIBO and Histamine intolerance connected?

  • Small intestinal bacterial overgrowth (SIBO) can cause histamine intolerance symptoms.SIBO is an overgrowth of normal or even bad bacteria in the small intestines, where there should only be a low amount of bacteria present compared to the large intestine.  The body has its defense mechanisms (like gut motility, adequate stomach acid levels, intact ileocecal valve, etc.) to prevent overgrowth. (9)
  • Certain species of bacteria (such as L. casei and L. bulgaricus) in your small intestine may produce histamine. (10)
  • The DAO enzyme, which is responsible for reducing histamines in your intestines, tries to break down the excess histamine from external sources: food, drink, and internal sources such as bacteria.
  • SIBO and other digestive dysfunctions can cause damage to the intestinal wall and brush border enzymes.
  • If the DAO enzyme function is compromised, then it won't be able to keep your histamine levels in check.
  • Excess histamine level contributes to digestive dysfunctions, leaky gut, and food intolerances by causing inflammation.
  • Histamine gets absorbed through your intestines into your blood and increases the circulation of histamine throughout the whole body, reaching many organs: the brain, gut, heart, lungs, skin, and many others.
  • A high level of histamine in these organs leads to symptoms (as mentioned at the beginning). (11)(12)

Besides SIBO, other factors can block the process, such as environmental toxins, infections, stress, medications, hormonal imbalances, thyroid dysfunction, yeast overgrowth, etc.

How to overcome Histamine intolerance and SIBO?

To overcome histamine intolerance, you first need to focus on gut healing. Getting rid of SIBO or infections can help you say goodbye to histamine issues.

  • Removing the triggering foods from your diet that may feed SIBO and inhibit DAO-enzyme production for a few weeks can help ease the symptoms. This can mean an anti-inflammatory diet combined with a low-histamine diet.
  • The necessary cofactors (vitamin B6, vitamin C, Magnesium, copper) can support DAO-enzyme production and DAO-enzyme supplements to reduce symptoms. (13)(14)(15)(16)

  • Certain herb extracts, such as Quercetin, can act as a natural antihistamine and have anti-inflammatory, immunomodulating, and antioxidant properties. (17)(18)

  • Using probiotics can support the gut healing process by resolving SIBO and reducing symptoms and inflammation. (19)(20) Some practitioners claim that probiotics should be chosen wisely to avoid histamine-producing strains.
  • Apply lifestyle changes like fixing your circadian rhythm, working on stress management, and practicing mindful eating habits.
  • Address the root cause of your SIBO and focus on prevention and supporting your body's natural defense mechanisms.

 The Bottom Line

When your body cannot effectively break down histamine, you may experience all sorts of (digestive, neurological, cardiovascular, allergy, etc.) symptoms. In many cases, it takes a while to identify if histamine intolerance indeed contributes to the symptoms. One of the best ways to find out is to follow a low histamine diet and check how your body reacts.

It is crucial to note that histamine intolerance is likely caused by certain digestive dysfunctions, dysbiosis, infections, or inflammation, and it is highly associated with SIBO.

There are natural remedies and lifestyle changes that can support the healing process. Focusing on finding the underlying causes and reducing symptoms with the right food plans can provide significant improvements.

 

This post is only for informational purposes and is not meant to diagnose, treat, or cure any disease. I recommend consulting with your healthcare practitioner always before trying any treatment or dietary changes.

References
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  1. Jutel, M., Blaser, K., & Akdis, C. A. (2006). The role of histamine in regulation of immune responses. Chemical immunology and allergy, 91, 174–187. https://doi.org/10.1159/000090280

  2. Comas-Basté, O., Sánchez-Pérez, S., Veciana-Nogués, M. T., Latorre-Moratalla, M., & Vidal-Carou, M. (2020). Histamine Intolerance: The Current State of the Art. Biomolecules, 10(8), 1181. https://doi.org/10.3390/biom10081181

  3. Maintz, L., & Novak, N. (2007). Histamine and histamine intolerance. The American journal of clinical nutrition, 85(5), 1185–1196. https://doi.org/10.1093/ajcn/85.5.1185

  4. Schnedl, W. J., & Enko, D. (2020). Considering histamine in functional gastrointestinal disorders. Critical reviews in food science and nutrition, 1–8. Advance online publication. https://doi.org/10.1080/10408398.2020.1791049

  5. Schnedl, W. J., Mangge, H., Schenk, M., & Enko, D. (2021). Non-responsive celiac disease may coincide with additional food intolerance/malabsorption, including histamine intolerance. Medical hypotheses, 146, 110404. https://doi.org/10.1016/j.mehy.2020.110404

  6. Mušič, E., Korošec, P., Šilar, M., Adamič, K., Košnik, M., & Rijavec, M. (2013). Serum diamine oxidase activity as a diagnostic test for histamine intolerance. Wiener klinische Wochenschrift, 125(9-10), 239–243. https://doi.org/10.1007/s00508-013-0354-y

  7. Sánchez-Pérez, S., Comas-Basté, O., Veciana-Nogués, M. T., Latorre-Moratalla, M. L., & Vidal-Carou, M. C. (2021). Low-Histamine Diets: Is the Exclusion of Foods Justified by Their Histamine Content?. Nutrients, 13(5), 1395. https://doi.org/10.3390/nu13051395

  8. Reese I. (2018). Nutrition therapy for adverse reactions to histamine in food and beverages. Allergologie select, 2(1), 56–61. https://doi.org/10.5414/ALX386

  9. Schnedl, W. J., & Enko, D. (2021). Histamine Intolerance Originates in the Gut. Nutrients, 13(4), 1262. https://doi.org/10.3390/nu13041262

  10. Turner, H. (2017). SIBO and Rheumatology: Does Bacterial Overgrowth Impact Autoimmunity? National University of Health Sciences. Retrieved from https://www.naturalhealthresearch.org/wp-content/uploads/2017/04/SIBO-Rheumatology-Turner.pdf

  11. Wood J. D. (2006). Histamine, mast cells, and the enteric nervous system in the irritable bowel syndrome, enteritis, and food allergies. Gut, 55(4), 445–447. https://doi.org/10.1136/gut.2005.079046

  12. Lynch, D. B. (n.d.). Does SIBO Affect Histamine Intolerance and DAO? Retrieved from drbenlynch.com: https://www.drbenlynch.com/sibo-histamine/

  13. Martner-Hewes, P. M., Hunt, I. F., Murphy, N. J., Swendseid, M. E., & Settlage, R. H. (1986). Vitamin B-6 nutriture and plasma diamine oxidase activity in pregnant Hispanic teenagers. The American journal of clinical nutrition, 44(6), 907–913. https://doi.org/10.1093/ajcn/44.6.907

  14. Hagel, A. F., Layritz, C. M., Hagel, W. H., Hagel, H. J., Hagel, E., Dauth, W., Kressel, J., Regnet, T., Rosenberg, A., Neurath, M. F., Molderings, G. J., & Raithel, M. (2013). Intravenous infusion of ascorbic acid decreases serum histamine concentrations in patients with allergic and non-allergic diseases. Naunyn-Schmiedeberg's archives of pharmacology, 386(9), 789–793. https://doi.org/10.1007/s00210-013-0880-1

  15. Bois P. (1966). Role du magnesium dans le metabolisme de l'histamine [Role of magnesium in histamine metabolism]. L'union medicale du Canada, 95(3), 313–314.

  16. Schuschke D. A. (1997). Dietary copper in the physiology of the microcirculation. The Journal of nutrition, 127(12), 2274–2281. https://doi.org/10.1093/jn/127.12.2274

  17. Mlcek, J., Jurikova, T., Skrovankova, S., & Sochor, J. (2016). Quercetin and Its Anti-Allergic Immune Response. Molecules (Basel, Switzerland), 21(5), 623. https://doi.org/10.3390/molecules21050623

  18. Weng, Z., Zhang, B., Asadi, S., Sismanopoulos, N., Butcher, A., Fu, X., Katsarou-Katsari, A., Antoniou, C., & Theoharides, T. C. (2012). Quercetin is more effective than cromolyn in blocking human mast cell cytokine release and inhibits contact dermatitis and photosensitivity in humans. PloS one, 7(3), e33805. https://doi.org/10.1371/journal.pone.0033805

  19. Zhong, C., Qu, C., Wang, B., Liang, S., & Zeng, B. (2017). Probiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current Evidence. Journal of clinical gastroenterology, 51(4), 300–311. https://doi.org/10.1097/MCG.0000000000000814

  20. Leventogiannis, K., Gkolfakis, P., Spithakis, G., Tsatali, A., Pistiki, A., Sioulas, A., Giamarellos-Bourboulis, E. J., & Triantafyllou, K. (2019). Effect of a Preparation of Four Probiotics on Symptoms of Patients with Irritable Bowel Syndrome: Association with Intestinal Bacterial Overgrowth. Probiotics and antimicrobial proteins, 11(2), 627–634. https://doi.org/10.1007/s12602-018-9401-3

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