Endometriosis & histamine intolerance

Many women with Endometriosis are unknowingly suffering from a ‘histamine intolerance’ that can be making their symptoms worse. Could this be you? Read on to find out more.

What is histamine?

Histamine is a biological compound (an “amine”) that you produce as part of your normal, local immune response. When your immune system is triggered, mast cells release histamine which travels thru the blood stream to try and expel an allergen. Most people have heard of histamine in context of an allergy response (where many take an ‘anti-histamine’ to solve the problem).

 What is a histamine intolerance?

A lot of practitioners use the term ‘histamine intolerance’, but it isn’t really an accurate description of what is happening when someone has an issue with histamine. You don’t become ‘intolerant’ to the histamine itself, but rather to too much histamine in your system (due to too much coming in and not enough going out – more on that below). A better name for it would be “histamine excess”. You can easily test serum histamine levels in a simple blood test to se where you’re at, but more often than not testing is unnecessary as symptoms are often obvious.

Symptoms of excess histamine are very common in women with Endometriosis

If you have Endometriosis, how many of these excess-histamine symptoms sound familiar to you?

  • Pain 
  • Fatigue
  • Migraines/ reoccurring headaches (especially pre-period)
  • Heavy, painful periods
  • Teeth clenching/ grinding
  • Depression and/or anxiety
  • Arrhythmias
  • Nasal congestion
  • Aching joints
  • Stomach upsets
  • Fluid retention
  • Eczema 

Tip – if you get any of these symptoms around ovulation or pre-period, it is a good indication you are suffering from excess histamine.

The link between Endometriosis, oestrogen and histamine 

One of the main drivers of Endometriosis is excess oestrogen that results from a woman’s inability to detoxify it efficiently. Oestrogen can fuel the Endometriosis itself, but also stimulates mast cells to release histamine and down-regulates the DAO enzyme that is designed to break histamine down. Histamine then stimulates the ovaries to make more oestrogen, then the newly produced oestrogen stimulates mast cells to release more histamine and down regulate DAO a little more. Thus the vicious circle continues, and your symptoms of histamine excess slowly get worse and worse.

Foods can contribute to histamine excess

Some foods are rich in histamine or good at liberating histamine in the body. Many of these foods are considered ‘healthy’, but may really affect you if you are sensitive to them (like women with Endo). 

Some of these foods include:

  • Fermented foods – vinegars, coconut aminos, anything pickled, kefir, miso, sauerkraut, kombucha, soy sauce/tamari, bone broth, kim chi etc. 
  • Vegetables – baby spinach, mushrooms and eggplant
  • Fruits – dried fruits, avocado, banana, grapes and melon.
  • Nuts – peanuts, coconut, anything smoked/roasted
  • Meats – anything smoked/processed
  • Dairy – all excepting butter; avoid aged cheeses in particular 
  • Yeasts – in breads, alcohol, etc
  • Other – anything canned, chocolate
  • Alcohol – wine and beer, but especially red wine & champagne.
  • Spices – chili, cayenne pepper, paprika, sumac, curry powder

NB: Histamine levels in foods will also always increase:

  • With browning & grilling foods (like meats)
  • In leftovers (like the ones you leave in the fridge)
  • By over-cooking foods
  • In overly ripe, soft fruits.

Reducing/ eliminating your intake of high histamine foods can offer you fast symptom relief if you are sensitive to them. The only real way to find out if you’re being affected by these foods is to take a long break and see if you feel better.

Other ways you can lower your histamine levels for symptom relief

The cool thing about naturopathic medicine is there a number of ways you can approach a single issue – and that includes histamine excess. Some ways in which you can improve your histamine levels outside of dietary modifications include:

Working on your gut

The gut and its microbiome play an important role in breaking histamines down, thus optimising your gut function is imperative to keeping histamine levels in check. It is also important that you are checked for underlying GI infections, dysbiosis and SIBO that can all contribute to histamine excess.

Improving your liver detoxification pathways, especially for excess oestrogen

Improving your ability to efficiently detox oestrogen is a quick way to help minimise your endogenous histamine levels. The best way to do this is to:

  • Optimise your bowel function (make sure you are pooping daily)
  • Optimise your methylation status, working with a practitioner like me to tailor your B vitamins & other cofactors.
  • Use natural medicines like iodide and calcium-d-glucorate which both support oestrogen clearance.  
  • By maintaining healthy insulin levels and body weight. 
  • By getting off and detoxing from the oral contraceptive pill

NB: Some practitioners recommend using B6 for histamine intolerance as it an essential cofactor for DAO that helps break down histamine in the gut. However, I rarely recommend B6 for histamine intolerance to my clients with oestrogen or histamine issues, as it can potentially make symptoms worse (as B6 is used by the body to convert the amino acid histidine to histamine). 

Optimising the function of DAO that breaks down histamine

There are many ways you can improve yuour DAO status to reduce your histamine levels. Some of these include:

  • Optimising DAO cofactors which include zinc, copper, vitamin C and magnesium. 
  • Increasing your long chain fatty acid intake, with foods like olive oil. 
  • Optimising your progesterone levels. Progesterone helps to balance oestrogen, is anti-inflammatory, will lighten period pain and heavy periods and increase your mood and sleep quality. It also upregulates DAO (that breaks down histamine) and helps to stabilise mast cells. If you are interested in taking some bio-identical progesterone, consider talking to your doctor about Prometrium 100mg – which will help minimise both your Endo and histamine excess symptoms.

NB: Be careful if you are using Vitex (Chaste Tree) to naturally stimulate your progesterone levels, as it may increase symptoms of Endo by up-regulating oestrogen production in some.

Avoiding environmental triggers that can trigger a histamine response

Certain environment triggers exist that increase histamine and its related intolerance symptoms. These triggers include: 

  • Mould and mycotoxins often found in water-damaged buildings
  • Environmental xenooestrogens, mostly found in commercial foods (due to pesticides) and plastics (NB: the ocean is one of richest sources of microplastics on the planet at the moment, making seafood avoidance a good idea too)
  • EMFs and dirty electricity sources
  • Dust
  • Pollens