Histamine intolerance (med: food-induced histaminosis, enteral-induced histaminosis) describes an intolerance to foods with high histamine levels and/or the inability of the human body to break down (metabolise) the ingested histamine sufficiently.

Prevalence of histamine intolerance

Around 3% of the population is affected by histamine intolerance. According to Jarisch (Jarisch, 2004) approximately 80% of sufferers are women and most of them are around age 40. A possible cause for this lies in the decline of oestrogen levels as menopause sets in.

The diamine oxidase (DAO) enzyme

Histidine (a natural amino acid) in foods is metabolised by bacteria into histamine. The histamine will then be further metabolised in the human body with the help of the enzyme diamine oxidase (to be found in the small intestine, liver, kidneys and blood) or histamine N-methyltransferase (HMT, HNMT, to be found in the liver). The DAO supposedly uses the Vitamin B6 as a cofactor. In the case of histamine intolerance the activity of either one - mostly the DAO - or both of these enzymes is reduced. This reduces the body's ability to break down the histamine that has either been ingested or produced by the body itself. When a person eats foods that are rich in histamine or release histamine from storage (mast) cells in the body then this will result in a "pseudoallergic" reaction. Since histamine intolerance tends to appear as a consequence of other food intolerances and food allergies, it should be pointed out that the ingestion of foods that are otherwise not tolerated, e.g. lactose by those suffering from lactose intolerance, will also cause a massive release of histamine.

A healthy person continuously produces DAO that is released into the intestinal lumen. When the person eats foods that are rich in histamine, then that histamine can already be "neutralised" in the intestine. This, of course, only works up to a certain level. If too much histamine is ingested (for example, from foods that have gone bad (often bad fish)), then even a healthy person will experience the typical symptoms of "histamine toxicity". If not enough DAO is produced, then a person can already experience symptoms after eating foods with relatively low histamine levels. This is called histaminosis or histamine intolerance.

Sources:
Jarisch, R.,2004: Ärztemagazin 08/2004, Histamin-Intoleranz
Jarisch, R. "Histaminunverträglichkeit", Thieme Verlag TB 2. Auflage
Schmutz Helmut (Autor); Abbot, G.; Lieners C.; Mayer, I.; et.al; "Nahrungsmittelunverträglichkeit (Histamin Intoleranz)", Sachbuch, Wien 2006
Sattler, J; Hafner, D; Klotter, HJ; et.al; "Food-induced histaminosis under diamine oxidase (DAO) blockade in pigs: Further evidence of the key role of elevated plasma histamine levels as demonstrated by successful prophylaxis with antihistamines"; Agents and Actions; Volume 27, Numbers 1-2 / April 1989
Maintz, L.; Noval, N.: "Histamine and histamine intolerance", American Journal of Clinical Nutrition 2007 (85)1185-1196

Last Updated on Friday, 05 April 2013 07:47