In this week’s episode of IWG Radio, Dr. Nicole Rivera and Clinical Nutritionist, Brooke, discuss the difference between a histamine intolerance and allergies. Have you been suffering from congestion, runny nose, itchy skin, or other allergy-like symptoms? You may be having a reaction to certain foods that are high in histamine. Learn more in Histamine Intolerance vs. Allergies and start feeling relief today!
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Brooke:
Welcome back to another episode of IWG radio. My name is Brooke and I am the clinical nutritionist at Integrative Wellness Group. I'm here with Dr. Nichole our functional medicine physician. Today we wanted to bring you some information on high histamine versus food allergies. I know some of you are probably thinking, "What the heck is histamine?" You might not know much about it or what it does. You may have heard of it in terms of a seasonal allergy or maybe with even a regard to a food allergy. We wanted to clear up some of the information for you today and help out anybody who maybe experiencing some of these symptoms. I'd like to welcome Dr. Nicole and I would like to have her introduce, just a little bit of information about what we do here at Integrative Wellness Group.

Dr. Nicole:
Hey there everyone! Dr. Nicole here. Like Brooke said, I am the functional medicine physician here. Brooke and I work side by side helping people with various different symptoms that they maybe experiencing over the course of time. Functional medicine, we really strive to decipher the different symptoms that you may be experiencing by doing very specific lab testing and then figuring out the root cause of those symptoms. Then being able to set you up on a holistic program in order to resolve those symptoms and get you feeling better than you ever have.

Brooke:
Let's talk about histamine today and what it is and what really the key functions within the body.

Dr. Nicole:
[00:02:00]
Histamine is something that we may have heard of in reference to antihistamine so something like a Bendryl and there's a lot of other different types of antihistamines out there . Typically we're grabbing for something like that in the event that maybe we ate the wrong thing, we started to experience some swelling or hives or itchiness. Then we might even be grabbing for something like that in the event that we're having really bad seasonal allergies.

Overall with histamine, there's quite a few different things that it does in the body and not always does it necessarily creating that type of response. Histamine is in charge of our muscle contraction. It's also one of the primary neurotransmitters in the body so it plays a very big role on the nervous system. It also plays a role on the brain which is also part of the nervous system. One of the primary things that it does is it defends us from bacteria and viruses and that is one of the reasons you might experience that "histamine response" aka the swelling, aka the rash as well as nasal congestion, itchy skin. All of those can be in part because histamine goes up because you were exposed to something like bad bacteria or virus as well. It's not always just solely a histamine response that might be coming from food.

Brooke:
[00:04:00]
I'm glad that you mentioned that it's something that's naturally occurring and that it's something that we need in the body because I think this is a reoccurring theme with anything that we really talk about. Certain things that are in the body naturally are good when they're at moderate levels. When they start to become raised, if they're triggered by something in the environment, if they're triggered by something that we eat and they start to raise, that's when we start to get those symptoms. I know you mentioned the itchy skin, and the swelling, and the hives, are there any other things ... I know something like nausea could even be a side effect so just mentioning all those and making sure we're covering the ground so that everybody knows a little bit more about that.

Dr. Nicole:
You definitely can have gastrointestinal manifestations. You could have indigestion. You can have even abdominal pain. That's not the most common but indigestion I would say is a little bit more common. You can definitely have nasal congestion. You can even have chest pain. You can have anxiety. Your blood pressure can drop. Also, you can even have something a little bit more severe than just hives and itching, which I know some people are like, "No, that's severe." I've had plenty of people come through my doors that have had hive breakouts and I know they're not a fun experience. Even it can be something that contributes to eczema which is usually more long standing than hives. Hives usually will come and go based off of the elevations and histamine and then when they drop it will go back to normal. It has been known to play a very big role in eczema as well.

Brooke:
With regard to actual true food allergies, can you explain a little bit more about the difference between those two things?

Dr. Nicole:
I think this is really, really important because I've had a lot of people come through my doors that talk about different food allergies that they have and they talk about certain histamine foods that they consume and that they feel maybe an itchiness at the back of their throat, or they feel their mouth goes a little bit numb, or they get tingling in their tongue, or they get a runny nose. They're pretty much describing this as an immediate onset. With histamine, or a histamine response, that's actually not what happens.

[00:06:00]
Typically if you're having that immediate onset response, that is a food allergy. What it's classified as a IGE food allergy and that type of food allergy is an immediate onset allergy. You eat something and you're going to have an immediate response. Some of those immediate onset allergies can be really severe. If you ever heard of somebody who ate the peanut and their throat closed up and they had to be rushed to the hospital, that is also another category of an immediate onset. A histamine response actually takes quite a few hours to show any symptoms.

I heard an example and I felt like it made a lot of sense. It's almost like you're filling the bucket with water and you fill it over the course of time and then by the time that it fills all the way to the top and it starts to spill over, that's when you start to feel the symptoms. The food goes into your system and it slowly raises those histamine levels and once it gets past the threshold, that's when you're going to have a response. Again, it could go back to some of those symptoms we mentioned before. It's not typical that you will have immediate onset symptoms from histamine foods.

Brooke:
How would somebody know that they would have a problem with histamine versus a food allergy? What type of testing or analysis would you recommend if someone were to come in with those symptoms?

Dr. Nicole:
There's definitely a couple of different ways that you can go to just evaluate your histamine levels on their own. If you ever had blood work done and your [basa 00:07:25] fills were elevated on your blood work, don't get me wrong, basa fills are indicators for various different things. It could even be an indicator for parasites at high enough levels. Obviously you have to do backup testing to solidify that, but basa fills being elevated on your blood sometimes can be in correlation with high histamine levels.

[00:08:00]
Another test that actually measure histamine directly is if you do a urine based neurotransmitter panel and that will give you your histamine levels amongst your other neurotransmitters. You can also see if you have elevated histamine levels on that type of panel. One of the most accurate and effective in treatment is looking at genetics. There is an amazing company called 23andme that you can order a genetic test it's rather inexpensive. Through that type of testing, you're going to get a lot of information about your genetic mutations. If you have any type of genetic predisposition in what you call the DAO pathway, then that can contribute to your DAO enzymes not working as well. Those are the primary enzymes that help you to break down histamine.

If you don't have proper functioning DAO enzymes, then the histamine builds up and your body doesn't have the ability to break it down. That is definitely something that you would want to have information about if you do feel like you're suffering from histamine types of responses or if you've noticed that you've had high histamine levels on a previous neurotransmitter panel. The DAO enzyme plays a very big role in your histamine tolerance essentially.

Brooke:
If somebody has a genetic mutation, their DAO pathway and their enzymes aren't working properly, is that going to affect different areas of the body as well?

Dr. Nicole:
[00:10:00]
Overall, it's primarily going to effect their histamine breakdown but for any of you that may be listening and feel like you do or know that you do have a histamine issue. If you're a woman and had a child and if you noticed during your pregnancy that you actually had no issues with any histamine foods and you had no issues with hives, and you had no issues with any types of rashes or typical symptoms you would have when you were not pregnant, that's because the placenta actually releases tons of DAO during your pregnancy. You'll see most of your allergies or high histamine symptoms resolved completely while you're pregnant.

Brooke:
Is there any connection with the DAO or histamine itself with hormones?

Dr. Nicole:
Definitely. I know that through my own clinical practice, I have a lot of women that mention, "I notice my hives and I notice my itchy skin more so around my ovulation time and my cycle" and estrogen is something that will amp up the levels of histamine. You might notice I might not have hives all the time, but I do notice that I have them more within the week to 2 weeks before my cycle.

Brooke:
Are there any other external factors that might affect histamine levels?

Dr. Nicole:
There are some medications that can definitely raise histamine levels as well so you might notice some of the symptoms that we mentioned if you take something like an nsaid which is your traditional Motrin, Advil, different types of OTC pain medication. You might notice it if you take a diuretic, an antibiotic, and even some types of antidepressants. Some of those medications have been known to raise histamine levels as well, so if you take it and you start to break out in hives, you're not necessarily having an allergy to the medication, you might be just having a raised histamine level as well.

Brooke:
That seems to make sense too because something like an antidepressant is going to change levels with your brain chemicals and the hormones in your brains. If histamine is something that is affecting those as well, it seems to make sense that some of those things might overlap like that.

[00:12:00]
You also mentioned earlier that there is some type of response having to do with exposure to a bacteria or a virus and how is that affecting our immune system and the histamine as well?

Dr. Nicole:
The histamine definitely plays a role in helping us combat and defend ourselves against bacteria and viruses. One of the most abundant areas in our bodies for bacteria and virus is definitely going to be in our gastrointestinal system. There actually has been known types of bacteria that subside within the gastrointestinal tract that can convert histadine into histamine. Then that conversation can create an overabundance of histamine within the gut which can create inflammation int hat specific part of the body. In the even that somebody has a damaged gastrointestinal system and things from the gut are passing into the blood, which is what we call leaky gut, which we have done in previous podcast on, that can also now allow this histamine to travel into the blood and create an overabundance of the histamine in the blood, which then creates the whole cascade of the hives, the possible chest pain, indigestion, itchy skin, lowering the blood pressure. You can definitely have some gastrointestinal symptoms if it resides just in the gut or it can manifest back into those other symptoms that we mentioned if it does get into the bloodstream.

Brooke:
We talked about a lot of different areas of the body that can be affected by histamine or raised histamine levels, but I want to talk about the foods that we're putting in our body. That's something we can definitely have a little more control over. Let's elaborate a little bit more on that.

Dr. Nicole:
[00:14:00]
There's a whole array of different foods that are classified as high histamine foods. Typically if you're experiencing any of these symptoms that we're talking about today, then you may be avoiding these foods altogether. One of the things that I've recently read up on, I found to be very, very interesting, it has to do with fish and it has to do with the whole process from catching the fish to how it's preserved before it is actually eaten.

What I mean by that is the longer a fish will go after being caught and then killed essentially, the longer a dead fish will go without being gutted will increase the histamine levels. It will actually double the histamine every 20 minutes that it is not alive but not gutted. I found that to be really, really interesting because we don't really have the most control over our food industry. Half the time when we go to a grocery store, we don't know our fish is coming from. I found that was really, really interesting in the fact that if you're not catching the fish and gutting it immediately, then there is a possibility that there is an astronomical amount of histamine within that fish.

[00:16:00]
You also have to think about shellfish because you might eat shellfish and I hear this a lot. A lot of people say, "I have an allergy to shellfish." Shellfish they're not gutted. They're typically just not gutted. That's the style of the fish. If you're eating something like shellfish, you may not necessarily be having a food allergy, you may be having a histamine problem. Those types of fish, again, are not gutted normally. Keeping that in mind, if you do classify yourself as a someone who has a histamine problem or a histamine intolerance, then you might want to consider trying fish but trying fish that was maybe freshly caught as well as gutted by whoever caught it. If you have friends that are fishermen, go hang out with them. That's definitely an important part of the puzzle.

I mentioned before how there's different microorganisms in the gut that can convert histadine into histamine. This same exact concept carries over for fermented foods. What I mean by that is most fermented foods go through microbial fermentation. This is everything from alcohol to pickled vegetables to processed meats, cheese, and even some forms of milk and other dairy. These different types of foods going through a microbial fermentation, might also have an overabundance of histamine because of that conversation of the histadine, histamine. These are also foods you want to be really cautious with if you do feel like you're having some of these histamine symptoms.

There's also some other foods that are a little bit less assuming. Different things like citrus fruits, strawberries, as well as raspberries, tomatoes, some tree fruits like apricot, cherries, plums. There's definitely quite an array of different types of foods that are known to be high in histamine. It gets a little bit tricky when you're dealing with these symptoms and then you go on this low histamine diet to avoid all of these histamine rich foods. Sometimes you're going to see improvement and sometimes you won't.

[00:18:00]
This really comes back to the conversation about that DAO enzyme. If you have very low functioning DAO pathways genetically, then you don't really have sufficient amounts of enzymes in order to break down the histamine within the body. Like we talked about before, you're not just getting histamine from food, your body is naturally making histamine. If you're making histamine and your body can't break down the excess because those DAO enzymes don't work, then that is also going to be problematic. It's definitely important to know if those pathways work properly so that you can best support your body and then supplement with the right types of enzymes in order to decrease the overabundance of histamine in the body.

Brooke:
If somebody presents to you with some of these symptoms and some of our listeners might be, what would be your first steps as to finding out what's going on and then moving forward into really what you would do to support them?

Dr. Nicole:
First and foremost, you want to rule out any type of gastrointestinal issues. What I mean by that is checking to see if there is any of those microbes in the gut. If it's bacteria or if it's a yeast organism or even parasites that could be creating more of that abundance of histamine within the body. That's first and foremost is ruling in or out any type of gut dysbiosis. Then you also want to look at the difference between is this truly food allergies or is this histamine issues?

A food allergy panel can be very, very useful with determining if there is anything they're truly having a food allergy to. Also measuring their histamine levels through that neurotransmitter panel which is urine based. Then doing some genetic testing as well in order to check to see where their DAO enzymes are at. If they do show up that they don't have high histamine levels on the neurotransmitter panel, then I probably wouldn't necessarily go forward with the genetic testing because at that point we have ruled out that histamine is not their problem. It's really just a matter of having more clarity on the gut and then having more clarity on histamine through that neurotransmitter panel then going from there.

[00:20:00]
Brooke:
I think that's great too because the testing really speaks for itself in saying what exactly is going on and it really allows us to get to that root cause of what's going on and less guesswork and getting you better, sooner with less trial and error.

Dr. Nicole:
I always tell people you don't know, you don't know. You get a lot of clarity from doing the testing and you really just know exactly what your body needs. You can support it more effectively and do things a lot faster as well. That's important for people that have been suffering for a long time.

Brooke:
As a special bonus for you, we did want to offer you a free 15 minute strategy call with me and I think it would be really great with us to sit down and talk about what's going on with you. Is this something that might be related to histamine? Is it possibly a food allergy? Is it possibly something else that you're experiencing?

Dr. Nicole:
We're also going to attach a comprehensive list of all of the high histamine foods so you have that as a resource and you can use that for some trial and error if you do feel like you related to this podcast. The best thing going forward is to really schedule your call with Brooke so that you can really learn more about what might be going on with you and get that clarity so that you're not necessarily having a limited diet without necessarily even having a histamine issue. We thank you so much for listening and until next time.