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HIGH HISTAMINE – LOW

HEALTH

Histamine Intolerance and

children with autism

Some children with autism can present

with “allergic-like” symptoms, when
there is no obvious elevation in serum
level of IgE or chronic urticaria, as
expected during a typical histamine
reaction. There appears to be non-
allergic mast cell activation, most likely
in response to environmental and stress
triggers, which in turn contributes to
inflammation.

In some children with autism, histamine

intolerance may be contributing
significantly to symptoms generally
associated with ASD.

What is Histamine?

Histamine is a biogenic amine and small

quantities are present in almost all
foods, which usually cause no problem.
There is always a certain amount of
histamine in circulation in plasma (the
fluid part of the blood) and the level
changes throughout the day. It’s
generally high in the daytime and low
during sleep and extremely low during
deep sleep.

Histamine acts as a modulator of several

neurotransmitters in the brain and plays
a key role in keeping the body awake
and alert. If you have a child, who really
struggles to fall asleep, then suspect
high histamine levels as a potential
contributory factor. Another key job that
histamine carries out is to stimulate the
secretion of acid in the stomach.
Adequate stomach acid is fundamental
to digestion and the absorption of
vitamins and minerals.

Histamine also protects the body

against pathogens such as insect bites,
toxic chemicals, nettle stings and the
like. In such scenarios the body releases
a large amount of histamine to go to the
site, causing blood vessels to widen so
that white blood cells can move quickly
to the area of assault to help repair and
protect it. As part of the histamine
reaction, and in order to get the
pathogen out, the tissue surrounding
the affected area secrete fluids (a runny
nose for instance).

If there is a lot of histamine in the gut

then stools may regularly contain
mucous, which is part and parcel of the
histamine reaction. Table 1 shows the
key signs of histamine intolerance.

How is Histamine
manufactured?

Histamine is manufactured and stored

in a number of cells in the body,
particularly mast cells that exist
throughout body tissues, especially
mucous tissue. Mast cells can also get
activated during times of stress and
CRH (Corticotropin-Releasing Hormone)
is released causing mast cells to liberate
histamine.

In theory cortisol contributes to lowering

histamine levels, but in those cases
where adrenals have been working hard
for an extended period of time, as is the
case with many people with an autism
diagnosis, cortisol levels tend to be low
and so CRH stays high, contributing to
releasing inflammatory cytokines such
as IL6 and IL8. Of significance in clinical
practice is the fact that histamine can
be activated as a result of infections,
whether bacterial, viral or parasitic and
as a result of toxic load.

When a large amount of histamine is

released, the body tries to balance it via
a negative feedback loop and produces
adrenaline to lower histamine levels – so
in cases of chronic infections there can
be chronically high levels of adrenaline
interfering with mood, sleep, and
intellectual development. It’s important
to note that infections and chronic stress
can contribute to high histamine levels
despite a diet low in histamine.

High doses of histamine are toxic to all

people and the tolerance level varies
between individuals based on genetics,
disease, gut damage and disturbed gut
microbiome, and use of certain
medication. In some cases, high
histamine levels are the result of the
inability of the body to break histamine
down adequately.

How is histamine broken

down?

In the CNS (Central Nervous System)

histamine is broken down by HMT
(Histamine Methyltransferase) enzyme.
This means that impaired methylation
can contribute to high histamine levels.
In some cases, methylated B vitamins
and supplements such as DMG and
TMG can help reduce histamine levels.

In the digestive tract, histamine is

broken down by DAO (Diamine Oxidase)
enzyme, which tends to be low in those
with allergies or auto-immune
conditions. A number of studies have
shown that DAO is dramatically
increased by the consumption of oleic
acid found in olive oil.

Interestingly during pregnancy DAO

production in the placenta can go up by
500 to 1000 times, in order to create a
metabolic barrier to prevent the
exposure of excessive histamine to the
foetus. If during pregnancy, migraines
and allergies seem to disappear or
diminish, then consider low DAO as a
contributing factor to the high
histamine levels both in the mother and
the baby. In cases where DAO levels
remain low during pregnancy
complications such as premature birth,
hyperemesis gravidarum, characterised
by severe nausea and vomiting or
gestational diabetes can occur. DAO
tends to occur mainly in the lining of the
intestine, as well as placenta kidneys
and the thymus gland.

HMT is more prolific and occurs in the

stomach, lung, spleen, kidney, thymus
and particularly the brain.

So how do we normalize
histamine levels?

Remove problem foods

Large quantities of histamine result

from microbial activity during the
rotting of food and during the
manufacture of cured, smoked and
fermented foods such as cheese, cured
meats, vinegar, alcoholic drinks,
sauerkraut, soya sauce etc. Microbial
enzymes convert histidine to histamine.

Leftover food can have significant levels

of histamine and the levels will vary
depending on how fast this microbial
metabolism takes place. It’s important
to note that histamine levels can be
excessively high well before the food is
spoilt.

Some foods have naturally high levels of

histamine. Table 2 has an outline of the
key foods to look out for. Some cosmetic
and toiletries also contain histamine-
releasing substances as such
cinnamaldehyde, Balsam of Peru,
benzoates of any type, and sulfites and
dyes. One of the clearest signs of
histamine intolerance is a bad reaction
to having fermented foods such as
sauerkraut.

Foods and supplements, which may

help with managing histamine levels

Consumption of foods high in quercetin,

a bioflavonoid found in ginger, garlic
and onions, elderberries, bee pollen, and
fennel leaves, can help lower histamine
levels.

Quercetin stabilizes the cell membrane

of mast cells and prevents them from
spilling their load of histamine into the
surrounding tissue. DAO needs copper
to function, so keeping normal copper
levels is essential – be mindful of
excessive zinc supplementation.

There are also supplements such as

DAOsin containing DAO to help break
down histamine from food but will not
increase levels of DAO in the gut.
Carnosine is a naturally occurring
dipeptide and has been shown to
protect mast cells from degranulation
and histamine release. Supporting the
adrenals is also important given the
feedback loop discussed earlier where
adrenaline is released to negate the
histamine in the system.

Other supplements that may lower

histamine levels are those containing
mangosteen which is both an anti-
inflammatory and a histamine inhibitor.
Black seed oil and nettle tincture can
both help reduce histamine levels as can
frequent dosing of vitamin C.

When considering probiotics it’s

important to ensure that supplements
contain the right strains. There are
certain probiotic strains which have
been shown to reduce histamine levels
such as Lactobacillus rhamnosus,
Bifidobacterium infantis,
Bifidobacterium longum, Lactobacillus
plantarum, and possibly
Lactobacillus reuteri . There are some
strains which have been shown to
promote the production of histamine
and should be avoided. These include;
Lactobacillus casei and Lactobacillus
bulgaricus .

Histamine can be a
problem for children with
autism

Histamine issues can come from a

number of sources and can be a
problem for a subset of children with
autism, regardless of whether or not a
diet is low in histamine foods and drinks.
It is important to ensure that underlying
infections and pathogens are addressed
and that all measures are taken to help
manage symptoms to reduce histamine
and control the inflammatory cascade
that it can promote.

Featured in the Autumn 2017 edition of

the Autism Eye Magazine Written by
Stella Chadwick.

TABLE 1

SIGNS OF HISTAMINE INTOLERANCE

Headaches/migraines

Difficulty falling asleep, easy arousal

Hypertension

Vertigo or dizziness

Arrhythmia, or accelerated heart rate

Difficulty regulating body temperature

Anxiety

Nausea, vomiting

Abdominal cramps

Flushing

Nasal congestion, sneezing, difficulty

breathing

Abnormal menstrual cycle

Hives

Fatigue

Tissue swelling

Bad reaction after eating fermented food like

sauerkraut

Physical reaction like hives or emotional

reaction like anxiety and hyperactivity if

consuming citrus foods

TABLE 2

FOODS NATURALLY HIGH IN HISTAMINE

Meat, poultry, fish egg. Fish and shellfish,

whether fresh, frozen, smoked or canned.

Processed smoked and fermented meats,

such as ham and bacon and sausages.

Leftover food protein based food. Only use

egg sparingly.

Milk and milk products. Cheese of any

kind, yoghurt, buttermilk, kefir

Fruits. Orange grapefruit, lemon, lime,

cherries, grapes, strawberries, apricots,

avocado, raspberries, pineapple, cranberries,

prunes, loganberries, dates, raisins, currants

Vegetables. Tomatoes, soy and soy

products, spinach, red beans, aubergine,

olives in vinegar or brine, pumpkin, pickles,

relishes, and other foods containing vinegar

Food additives. Artificial food colours,

preservatives, especially benzoates and

sulphites

Seasonings. Cinnamon, cloves, vinegar,

chilli powder, anise, curry powder, nutmeg

Miscellaneous. Fermented soy products

such as soy sauce, miso, fermented foods

such as sauerkraut, tea (regular or green),

chocolate, cocoa, and cola drinks, alcoholic

beverages of all types

Toiletries and cosmetics containing

cinnamaldehyde, Balsam of Peru, benzoates

of any type, sulphites and dyes

Medication. Some antidepressants, asthma

medication, anti-hypertensive drugs

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Tel: +44 (0) 20 7043 5165

Email: [email protected]

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