Histamine sensitivity

Has histamine intolerance finally gone mainstream?

Last week, the Daily Mail published an article by Victoria Aitken outlining her experiences and symptoms after consuming wine, tomatoes, strong cheeses, vinegars, Marmite, anchovies and fermented foods — rashes / hives / urticaria and migraines and headaches being the end result.

Histamine is a component of foods — rather than an ingredient, per se — and histamine sensitivity is not an allergy, but as it can mimic an allergy, it’s often perceived to be one. Histamine is released in the body during a food allergic reaction, but if you consume it directly, you’ll experience similar symptoms, albeit never life-threatening. It is caused by an inability to metabolise and break down this excess histamine, often due to a deficiency of an enzyme called diamine oxidase (DAO), for which supplements are available.

Earlier this year, Dr Janice Joneja — probably the leading international expert on the condition — wrote The Beginner’s Guide to Histamine Intolerance, which I reviewed here. What interested me about the book was learning that diagnosis is not straightforward, and is essentially one of exclusion. There is no real test for it — which may have something to do with the fact that a few (certainly not all) doctors, dietitians and immunologists still view the condition with a little scepticism and suspicion.

Thankfully, histamine intolerance research is continuing apace, and just a few weeks ago a paper was published in The Journal of Pharmaceutical and Biomedical Analysis suggesting a new approach to the diagnosis of the condition, by determining levels of histamine and a related compound, methylhistamine, in urine — which would be less invasive than a blood test to investigate the activity of DAO.

Further, a paper published just yesterday in the journal Allergy was also interesting: although it was small, a quarter of participants with suspected histamine intolerance had elevated histamine levels during the day, possibly due to reduced DAO levels, while the remaining three-quarters had normal histamine and DAO but increased prevalence of other food intolerances. Clearly, accurate diagnostic protocols are urgently needed.

This is clearly a fast moving field, now. When I wrote my first book in 2003, Living with Food Intolerance, I only dedicated a single page to the ‘amines’, with only a paragraph to histamine itself (which I didn’t even index, much to my shame). That book is in urgent need of an update, and I expect I’ll be needing to dedicate a whole chapter to it when I eventually get around to it!

Meanwhile, in a final piece of histamine news, healthcare professional readers may be interested to know that Dr Joneja is bringing out Histamine Intolerance: a Comprehensive Guide for Healthcare Professionals, on the 27th November. I imagine it is much needed …

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