Dermatographic uticaria (itchy skin or hives like above) can be a sign.
Rosecea in the face in midlife can be a sign.
These patients will usually have inflammation in the gut, IBS, SIBO, food intolerance etc which can result in leaky gut and changing the microbiome.
It can result in shortness of breath so they get swelling and inflammation in the lining of their lungs.
Histamine in the body also affects us circadian rhythm so often patients become insomniacs.
Brain fog and fatigue is common because when your immune system is on red alert like that the whole time it’s exhausting.
Sneezing upon eating something can trigger the mast cells to produce a histamine reaction.
Women with persistent interstitial cystitis may have histamine intolerance.
Swelling in the body may be histamine intolerance.
Many patients have normal histamine metabolism but it’s just there’s just too much histamine to cope with due to dysbiosis in the gut producing more histamine or a genetic predisposition to low DAO which is the enzyme that breaks histamine down. Some 3% of the population at least will have poor histamine metabolism in which case it’s double whammy for them so they’ve got too much histamine production and very poor destruction but so they’re going to have more inflammation so having a low histamine diet for everybody is helpful.
But a low Histamine diet is difficult to do. Everything from tomatoes to cheese to meat and fish contain histamine. anything slightly aged..Fresh fish for example starts to breakdown and produce histamine the moment it’s been caught. Its only fish that is frozen at sea the minute it’s caught will have be safe for someone with intensive histamine reactivity. Or literally frozen or sold on the day of slaughter! Kefir or yoghurt, kombucha, kimchi, or any of the fermented foods all high in histamine. You would need to know your butcher really well to get really fresh and lovely and tender meat. Its different levels for different people. Sometimes this is why we see very healthy individuals getting sicker.
How to treat it? The medication cetirizine and loratadine prescribed three times a day but at least twice a day can be helpful. You can buy over the counter. In some patients they are game changes and in some patients they make no difference at all. No major research is done yet and the full picture of these genetic mutations in susceptible individuals is also not yet available. Also a supplement called Quercitin.
If you have fluid and stop Histamine containing foods the fluid should fall out of you. If you stop Histamine containing foods and no real improvement in symptoms then the patient should be investigated for Mast Cell Activation Syndrome (MCAS). Over 50 mutations have been identified in genes which can lead to MCAS and so people will have different degrees of those mutations, this will determine how severe their MASC dysfunction. Im going to do a post on this. Functional medicine doctors and practitioners should be familiar with this but regular Medical Doctors or Dermatology may not be. Its a new fascinating area of research. See podcast on Liz Earl with Dr Tina Speers
MCAS
3% of the population have poor histamine metabolism BUT about 17% of the population have dysfunctional mast cells which overreact and trigger too easily and to things, things that they should just be ignoring. Our mast cells are part of our immune system, a very important part, there sort of like bouncers in a nightclub, they are the first cells the meet infection. There just inside the gut wall, the lungs, in the mouth and nasal passages and under our skin so they’re poised ready of to defend the body basically.
Over 50 mutations have been identified in genes which can lead to MASC and so people will have different degrees of those mutations, this will determine how severe their MASC dysfunction. MASC release histamine and over thousand different potent and powerful chemicals cytokines and chemokines into the system. (This is very helpful if you’ve got an infection but not great if you haven’t) and they could they cause unnecessary inflammation when there’s a very small stimulus like smelling someones perfume, that they should just really be ignoring into the body.
Also in some patients clotting occurred in the body and from post mortems that have been done they’ve had both bleeding and clotting present which fits with the MCAS picture.We don’t have all the answers but might be worth trying treating acute Covid patients with the treatment for MCAS as soon as they catch it so to catch the ones who are in the 17% bracket.
In the UK a doctor has been researching this and treated over 100 patients with long covid. So far Only 2 out of 100 had no previous history of histamine reaction. Some had a few allergies childhood history of eczema, bad reaction to insect bites maybe big bit of rosacea as they get older.Or could be patients with severe IBS or even mild IBS with chronic headaches and undiagnosed hives. She treated them for MCAS and their symptoms improved massively. If you’ve got MCs overproducing histamine all the time your body has to get rid of it. If you are then eating a lot of high histamine foods that can cause issues because you’re just overload a system, that’s already overloaded.
To get on my cancellation list for histamine consultation email moc.liamg@3102yhprummanoif
