Fermented foods are typically high in histamine due to the presence of histamine-producing bacteria. You may want to steer clear of fermented foods such as sauerkraut, yogurt, and kimchi if you have histamine intolerance.
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Histamine intolerance is a popular topic of discussion in the health community. Awareness of this issue seems to be increasing, and more and more people are self-identifying as “histamine intolerant.” I used to suffer from a pretty severe histamine intolerance. I have used multiple strategies to address my intolerance, and have ultimately decreased it significantly. One of the most important methods I used to reverse my histamine intolerance was the liberal consumption of histamine-degrading probiotics, the subject of this article.
What is Histamine Intolerance?
Histamine intolerance is defined as “intolerance towards ‘normal’ levels of histamine in food caused by a decreased activity of the histamine-degrading enzymes diamine oxidase (DAO) or histamine N-methyltransferase (HNMT). In the gut the main enzyme is DAO while in other parts of the body like the skin and brain the enzyme HNMT degrades histamine.”1 Symptoms occur upon ingestion of high-histamine foods, and also in response to triggers such as high heat, extreme cold, harsh sunlight, and inhalation of irritants such as perfumes or car exhaust. Symptoms include skin flushing, rashes, urticaria, acid reflux, diarrhea, nausea, rhinitis, bronchoconstriction (asthma), low blood pressure, dizziness, fainting, anaphylaxis, and edema.
While my goal here isn’t to cover all the causes of histamine intolerance, I will mention a few for the sake of convenience. According to Mariska de Wild-Scholten, author of Understanding Histamine Intolerance and Mast Cell Activation, histamine intolerance can be caused by enzyme production problems (resulting from inflammatory bowel disease or nutrient deficiencies), enzyme inhibitors (heavy metals, certain medications), enzyme competitors (biogenic amines, similar in structure to histamine), and enzyme genetic defects (issues with DAO or HNMT). I would like to add another important point to this. Infections that trigger excessive mast cell activity may also lead to increased levels of histamine, since histamine is one of the primary substances released from mast cells. I think enzymatic problems definitely play a role in histamine intolerance, but I think the contribution of infections, including bacterial, viral, and parasitic infections, to histamine intolerance is underappreciated and needs to be given more attention.
Probiotics that Help with Histamine Intolerance
One of the primary strategies I have used for healing my histamine intolerance has been to consume plenty of probiotics. However, through much research and self-experimentation, I found that the specific type of probiotic I consume is key in reducing my histamine levels; this is because certain species of probiotics actually produce histamine whereas other species of probiotics actually break down histamine. The vast majority of probiotic supplements out there contain a mixture of histamine-producing and histamine-degrading species, which can make it difficult for histamine-sensitive people to find a probiotic that they can tolerate. Ideally, what we histamine-sensitive people want is to find a probiotic that contains only histamine-degrading species, so that we can use it therapeutically to break down histamine in our bodies. Using an exclusively histamine-degrading probiotic may be very beneficial, at least until the histamine intolerance is under control and balance has been restored to the gut microbiome, at which point a full-spectrum probiotic could be reintroduced.
I have personally tried all of the histamine-producing probiotics listed below, and know that they increase my own histamine levels. As I got my histamine intolerance under control and my microbiome more balanced, I have been able to reintroduce these gradually. I would be wary though if you are still in the throes of a major histamine intolerance, so definitely read the labels of probiotics before purchasing!These are some of the histamine-producing probiotic species to watch out for if you are purchasing a probiotic supplement.2-5
Now, let’s talk about the histamine-degrading probiotics. As a side-note, below, I use the term “biogenic amines” several times and wanted to explain beforehand what this term means. Biogenic amines refers to a family of biochemical substances with nitrogen groups. The five biogenic amine neurotransmitters include histamine, serotonin, dopamine, norepinephrine, and epinephrine. However, biogenic amines can also occur in foods, which is the subject of this post. Histamine (wine, fermented foods), tyramine (cheese), phenyethylamine (chocolate), putrescine, cadaverine, spermidine (decomposing fish), and tryptamine. For someone with histamine intolerance, other biogenic amines in foods may pose additional problems. The good news is that the probiotics listed below that degrade histamine also act similarly on these other biogenic amines, helping to break them down!
Here is a summary of the probiotic species that degrade histamine and other biogenic amines, and that can be found in the form of supplements. I have personally used all of these probiotics, for varying lengths of time, and they have been crucial in my recovery process. The exact supplements I used are listed after this section:
Lactobacillus rhamnosus: Stabilizes mast cells, preventing release of inflammatory mediators such as histamine.5
Bifidobacterium longum: This probiotic breaks down histamine. It also upregulates genes that create tight junction molecules, which are the molecules that hold the cells of our intestinal lining together, preventing the development of “leaky gut.”6 Leaky gut may exacerbate histamine intolerance, so fixing the gut itself may help address the root cause of histamine intolerance.
Bifidobacterium lactis and Bifidobacterium bifidum: Both of these help break down biogenic amines such as histamine and tyramine.7
Lactobacillus plantarum: Interestingly, this particular species of lactobacilli helps break down biogenic amines such as histamine, rather than producing them, as many other lactobacilli do.8
The Probiotic Brands I Recommend for Histamine Intolerance
Klaire Labs Ther-Biotic Factor 1 is an encapsulated probiotic containing only Lactobacillus rhamnosus, a key histamine-lowering probiotic strain. You can purchase it here: Klaire Labs – Ther-Biotic Factor 1.
Culturelle is another probiotic containing Lactobacillus rhamnosus. You can buy it here: Culturelle Daily Probiotic
For Bifidobacteria, I recommend Seeking Health’s ProBiota Bifido. This is a very high-quality probiotic that I personally use on a daily basis. You can get it here: ProBiota Bifido
Finally, for Lactobacillus plantarum, I recommend Jarrow Formula’s Ideal Bowel Support, available here.
If you are suffering from histamine tolerance, histamine-lowering probiotics may help immensely in restoring normal probiotic balance in your digestive tract, relieving the symptoms of histamine intolerance.
De Wild-Scholten, M. (2014). Histamine intolerance. Retrieved from http://www.histamine-intolerance.info/.
Thomas, C.M., Hong, T., van Pijkeren, J.P. Hemarajata, P., Trinh, D.V., Hu, W., Britton, R.A., Kalkum, M., Versalovic, J. (2012). Histamine derived from probiotic lactobacillus reuteri suppresses TNF via modulation of PKA and ERK signaling. PLOS One [online], Retrieved from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0031951.
Fernández, M., Linares, D.M., Alvarez, M.A. (2004). Sequencing of the tyrosine decarboxylase cluster of Lactococcus lactis IPLA 655 and the development of a PCR method for detecting tyrosine decarboxylating lactic acid bacteria. Journal of Food Protection, 67(11), 2521-2529. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15553636.
Priyadarshani, W.M.D. & Rakshit, S.K. (2011). Screening selected strains of probiotic lactic acid bacteria for their ability to produce biogenic amines (histamine and tyramine). Food Science and Technology, 46(10): 2062-2069. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2621.2011.02717.x/abstract.
Linares, D.M., del Río, B., Ladero, V., Martínez, N., Fernández, M., Martín, M.C., and Álvarez, M.A. (2012). Factors influencing biogenic amines accumulation in dairy products. Frontiers in Microbiology, 3, 180. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390585/.
Forsythe, P., Wang, B., Khambati, I., and Kunze, W. A. (2012). Systemic effects of ingested lactobacillus rhamnosus: Inhibition of mast cell membrane potassium (IKCa) current and degranulation. PLoS One, 7(7), e41234. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398942/.
Takeda, Y., Nakase, H., Namba, K., et al. (2009). Upregulation of T-bet and tight junction molecules by Bifidobacterium longum improves colonic inflammation of ulcerative colitis. Inflammatory Bowel Disease, 15(11): 1617-1618. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19161180.
Mokhtar, S., Mostafa, G., Taha, R., Eldeep, G.S.S. (2012). Effect of different starter cultures on the biogenic amines production as a critical control point in fresh fermented sausages. European Food Research and Technology 235(3): 527-535. Retrieved from http://link.springer.com/article/10.1007%2Fs00217-012-1777-9.
Capozzi, V., Russo, P., Ladero, V., Fernández, M., Fiocco, D., Alvarez, M.A., Grieco, F., and Spano, G. (2012). Biogenic amines degradation by lactobacillus plantarum: Toward a potential application in wine. Frontiers in Microbiology, 3:122. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3316997/.