Imagine your kitchen sink. Believe it or not, it’s a great way to understand Histamine Intolerance.  

Think about your sink working normally. You run the water from the faucet. Water goes down the drain. Great! 

Now imagine what happens when the drain is clogged. If you run water, it doesn’t drain out of the basin. It builds up. 

And if the water continues to run, it keeps building up. And eventually, if the drain can’t remove water as fast as it’s coming in, the water will overflow. Then water spills out of the basin and onto your floor. Not great. 

So, how is that like Histamine Intolerance? 

Think of histamine as the water flowing into the sink. Think of the sink as your body. And think of how the body breaks down histamine as the drain.  

If your body isn’t “draining” the histamine as fast as the histamine is coming in, it builds up. And it can build up to the point that it causes problems. 

And that’s Histamine Intolerance. Histamine Intolerance is when your body can’t keep up with your histamine load. 

Keep reading to learn: 

• Symptoms of Histamine Intolerance 
• What is histamine? 
• Where does histamine come from? 
• Ways the body breaks down histamine  
• Testing for Histamine Intolerance  
• My top tips for managing histamine levels  
• Why Mast Cell Activation Syndrome and Histamine Intolerance feed into each other  
• How Mold Toxicity, gut issues, and other conditions are contributing to your Histamine Intolerance  

So, let’s get started! What are your first clues that you might be dealing with Histamine Intolerance?  

Symptoms of Histamine Intolerance   

It’s important you know that this blog post is for informational and educational purposes. It’s not meant to treat any health condition or to be prescriptive for anyone. Always be sure to work with your healthcare practitioner.  

Do you notice certain symptoms more when you eat certain foods?  

Do you have Mast Cell Activation Syndrome? 

If you answered yes to either of these, Histamine Intolerance may be worth looking into more. 

How many of the following symptoms do you have? 

Some common symptoms of Histamine Intolerance include:  

 Skin related symptoms like: 

• Itching 
• Hives / Urticaria 
• Eczema 
• Flushing 
• Rashes 

Gastrointestinal (GI/ Gut) related symptoms like: 

• Abdominal pain 
• Acid Reflux / Heartburn  
• Bloating 
• Diarrhea 
• Gas  

Respiratory related symptoms like:  

• Asthma 
• Congestion  
• Postnasal drip  
• Runny nose 
• Sneezing 

Cardiovascular (heart) related symptoms like: 

• Heart palpitations  
• Low blood pressure  

Brain and Nervous System related symptoms like: 

• Anxiety  
• Fatigue  
• Headaches / migraines  
• Brain fog 
• Sleep problems  

This is just a short list of some of the more common symptoms.  

These symptoms can also be related to other conditions, though. 

So, you always want to be sure to talk with your provider to rule out serious issues that may need immediate medical attention. 

But if you do suspect you have Histamine Intolerance, knowing more about what histamine is and where histamine comes from will help you understand this intolerance better. 

Let’s take a look at that next. 

What is Histamine?  

Histamine is a type of chemical called an amine.  

Your body makes different types of amines. Amines play roles in many of the body’s important processes.  

Histamine in particular plays an important part in: 

• immune response 
• the sleep/wake cycle 
• and even digestion  

For example, histamine can create inflammation. Inflammation is very important in wound healing. 

Histamine also plays a part in the sleep-wake cycle. Do you have insomnia? Or do you wake up frequently between 2 and 4 am?  

It may be related to histamine. 

Histamine signals neurons in the brain that encourage wakefulness. Histamine also inhibits the neurons that promote sleep.  

Even the digestive process needs histamine. Histamine signals to the brain that it’s time to release stomach acid. Stomach acid helps break down the food you eat. 

So, you can see that histamine is important. 

But if you have too much histamine, or more accurately, more histamine in your body than it can keep up with, you can end up with Histamine Intolerance. 

When this happens, you’ll start to experience some of those symptoms you just read about. It’s like the body’s way of saying it can’t handle any more. 

So where does histamine come from? Keep reading to learn more. 

Where Does Histamine Come From?  

Histamine can come from eating high histamine foods. 

Your body also makes histamine. 

Let’s start by looking at how you may be adding to your histamine load by eating foods with a high histamine content. 

High Histamine Foods  

Many types of foods can be high histamine.  

Aged or fermented foods are histamine-rich foods. These foods can include:  

• pickles  
• sauerkraut  
• wine  
• beer 
• whiskey and bourbon  
• aged cheeses  
• processed meats like salami 

Other foods can be high histamine, too.  

Even some foods you might think of as “healthy” may be high histamine.  

Certain fresh vegetables like eggplant, green beans, and spinach are high histamine.  

Fruits like papaya, pineapple, and bananas are also high histamine.  

Even shellfish have high levels of histamine. 

AND there are still other foods that are technically low histamine but can be histamine-releasing!  

Some examples are citrus fruits, strawberries, and walnuts.  

All of these kinds of foods can add to your histamine load. 

But here’s something I really want you to know.  

Remember, Histamine Intolerance is when your body can’t break down histamine as fast as it’s coming in.  

Think back to the sink analogy for a second. 

If your sink basin is empty, you can add a little bit of water to the sink without it overflowing. 

That little bit of water won’t cause major problems even if the drain is clogged. 

What does that really mean for you if you have Histamine Intolerance? 

Well, depending on your level of intolerance, it might mean that you can eat 1 strawberry. Strawberries are high histamine. But if you eat 1 strawberry, your “sink” might not overflow. 

If you eat 10 strawberries, though, your “sink” might overflow and cause problems. 

Or, if you had 1 strawberry, 1 pickle, and several sips of wine, it might all add up on you. 

You may do better with a lower histamine wine, when you want a glass for a special occasion.

Everyone is different in what they can tolerate and how much they can tolerate. 

Related Article: High and Low Histamine Foods List

You’ll read some of my top tips for managing histamine a little further down. 

But next, let’s look at how you make histamine in your body. 

Histamine Production in the Body  

To understand this process, let’s back up a step and look at cells. 

Cells communicate to the rest of the body through something called receptors.  

Receptors respond to everything, both inside your body and outside in your environment. 

There are many kinds of receptors in your body.  

When it comes to histamine, you have 4 histamine receptors: 

• H1 
• H2 
• H3 
• H4 

Here’s a brief overview of a few roles these 4 types have. 

Histamine Receptors 

H1 receptors are found throughout the body.

This is the histamine receptor that H1 blockers like Claritin, Allegra, and Zyrtec work on.  

They are associated with allergic reactions, inflammation, and immune response. 

H2 receptors are found in high numbers in the GI tract.

This is what H2 blockers like Pepcid (famotidine) and Tagamet (cimetidine) work on. 

H3 receptors are found in the brain. 

They are important in sleep/wake cycles, alertness, and how much energy you have. They modulate the release of histamine and other neurotransmitters. 

H4 receptors are found in numerous places in the body, like the spleen, brain, intestines, and lungs.

They play a part in the release of histamine and other neurotransmitters. 

But where does that histamine come from?  

How Does Your Body Make Histamine? 

You read earlier that you can add to your histamine load by eating high histamine foods.  

But your body makes histamine, too. That’s where the histamine receptors come in to play. Those receptors are a part of cell signaling.  

Receptors respond to everything inside your body and outside your body. Part of this response is to release mediators. 

Histamine is one of many different types of mediators.  

Histamine can come from these types of white blood cells: 

• Mast cells 
• Basophils 
• Eosinophils 

Related Article: Mast Cell Foundations: Mediators and Receptors

With Mast Cell Activation Syndrome, your cells can become overly reactive. And they keep releasing histamine. 

When this happens, your cells have gone haywire. They aren’t responding normally.  

That means you can end up with higher histamine loads than your histamine degrading enzymes can keep up with. 

This is why people who have Mast Cell Activation Syndrome often also have Histamine Intolerance.  

It is possible to have Mast Cell Activation Syndrome but not Histamine Intolerance, though. 

Remember Histamine Intolerance is when your body isn’t breaking down histamine fast enough and it builds up in your system. 

So, if your body produces a lot of histamine because of MCAS but it can keep up, you might not get Histamine Intolerance. 

Read more about the similarities and differences of these two conditions in my post: Histamine Intolerance vs. MCAS. 

But why wouldn’t your body break down histamine fast enough? That’s the next question. 

We’ll talk about that next.  

Histamine-degrading Enzymes 

Your body has tens of thousands of different kinds of enzymes. They all have important functions. 

For example, you have very specific enzymes in your body that break down histamine.  

These 2 major enzymes break down histamine:  

• DAO (diamine oxidase) – made in the small intestine 
• HNMT (Histamine N-Methyltransferase) – made during methylation process 

But, there are many other enzymes that break down histamine as well. These enzymes break down histamine, too: 

• ALDH (aldehyde dehydrogenase) 
• MAO (monoamine oxidase) 
• UGT1A4 (UDP-glucuronosyltransferase 1-4) 
• ACAT (acetyl-CoA acetyltransferase)  
• NAT (N-acetyltransferase) 
• CYP1A2 (Cytochrome P450 Family 1 Subfamily A Member 2) 

If your body isn’t making enough of these histamine-degrading enzymes to keep up with your histamine load, you can end up with Histamine Intolerance. 

There are quite a few detox pathways and processes that produce these different enzymes. These include:  

• Glucuronidation 
• Acetylation 
• Methylation 

We’re focusing in this post on DAO and HNMT, so you’ll read more about the methylation process in just a bit. 

Up next, you’ll read what affects the production of the 2 major histamine-degrading enzymes (DAO and HNMT) next. 

What Affects the Production of DAO and HNMT? 

It’s important you know that this blog post is for informational and educational purposes. It’s not meant to treat any health condition or to be prescriptive for anyone. Always be sure to work with your healthcare practitioner. 

I often mention how interconnected the body and all its systems are.  

That’s why in the MC360™ method, our practitioners work from a root causes approach. 

What is the big underlying factor that leads to all the health problems you are experiencing? 

Let’s take a look at some of the common root causes of Histamine Intolerance next. 

Genetics and Histamine Intolerance 

For some people, the root cause of Histamine Intolerance is a genetic predisposition. 

Your genes code the production of DAO and HNMT. Genetic variants can result in how much or how little of these enzymes your body will make. 

For DAO, you look at variants in the AOC1/ABP1 gene. 

For HNMT, you look for variants in the histamine N-methyltransferase gene (the HNMT gene). 

Working with someone who understands genetics can help you interpret test results to understand this better. 

You can’t really do anything to change your genetic makeup. But you can still support your body’s production of DAO and HNMT and your genetic expression. 

For nearly all genes, genetic expression is more important than genetic makeup. That’s good news!  

You’ll read about some ideas on how to do this coming up.  

But first look at some of the other root causes of Histamine Intolerance. Let’s start with a big one…Mold. 

Mold Toxicity and Histamine Intolerance 

Mold Toxicity is the #1 root cause I see in my practice.    

Mold Toxicity can lead to so many problems… including Mast Cell Activation Syndrome and Histamine Intolerance. 

Related Article: How To Detox Your Body From Mold 

You can read more about how mold can lead to MCAS or HIT in the article above. 

But in a nutshell, mycotoxins (toxins from mold) can: 

• Disrupt your immune system 
• Cause nervous system dysregulation 
• Create GI (gut) issues 
• Interfere with your detox pathways 
• Negatively impact genetic expression 

If you think of root causes like a skyscraper, genetics may be ground your skyscraper is built on. But the foundation level of the skyscraper is often Mold Toxicity.  

And once you’ve got that foundation of Mold Toxicity, you can unfortunately add on to that with more and more levels.  

Mold Toxicity can lead to other potential root causes of Histamine Intolerance like:  

• Nutrient deficiency  
• Gut inflammation 
• Methylation issues 

Keep reading to learn why these are important root causes to consider. It will also help you better understand how to manage Histamine Intolerance. 

Let’s start with nutrient deficiency. 

Nutrient Deficiency 

Those 2 main histamine-degrading enzymes, DAO and HNMT, need a lot of different nutrients.  

Some nutrients are needed to produce these enzymes.  

But these enzymes also need nutrients to activate. These nutrients are called cofactors. 

Here are some of the nutrients your DAO needs: 

• Magnesium 
• Zinc 
• B6
• Copper 
• Vitamin C  

HNMT needs methylation to work properly. Here are some of the nutrients your methylation cycle needs: 

• Magnesium 
• Folate 
• B12 
• Zinc 
• Potassium 

If you are sensitive, be very cautious with methylfolate and methylcobalamin (folate and B12).  

Taking these too soon or at too high a dose can backfire. 

In the MC360™ method, we recommend only starting these further down the road or while working 1:1 with a practitioner. 

If you don’t have enough of any of those nutrients, you may not be producing enough DAO or HNMT. 

Supplements may be helpful in getting some of these important nutrients into your body. 

You may also consider supplementing DAO.  

I created a special formula that takes into consideration the sensitive population. This formula has been generally well-tolerated since it doesn’t have a lot of fillers and other potential mast cell triggers. 

And it’s got just a tiny sprinkle of B6 to activate the DAO. Otherwise, in people who are low in B6, DAO supplementation without B6 may not work for them. As you just saw, B6 is an important cofactor for DAO. 

In addition to nutrient deficiency, gut inflammation can interfere with your DAO production.  

Gut Inflammation and Histamine Intolerance 

DAO is made in the small intestine. But, if there is inflammation in the small intestine, it can greatly reduce your ability to make DAO. 

Studies have shown that inflammatory bowel diseases like IBS or Crohn’s can affect the production of DAO.  

Conditions like SIBO (small intestinal bacterial overgrowth) and SIFO (small intestinal fungal overgrowth) can also cause disruption to the gut causing an inflammatory response. 

And research has shown that when the gut lining is damaged through any of these conditions, histamine production can increase as well. 

So, your body is making more histamine, but it isn’t making enough DAO to break it down. 

What’s even worse is that histamine has also been shown to contribute to reactions with the gut lining.  

This, unfortunately, can be a self-feeding cycle. 

You may want to consider different ways to support your gut. Of course, if you have a condition like SIBO or SIFO, addressing those can help reduce gut inflammation. 

You can consider gut supports like digestive enzymes and histamine-lowering probiotics to help keep your gut in good shape. 

Related Article: Enzymes, Short-Chain Fatty Acids (SCFA’s) and Gut Health in SIBO, Mast Cell Activation Syndrome and Histamine Intolerance 

Another root cause of Histamine Intolerance may be methylation issues. Keep reading to learn more. 

Methylation Issues and Histamine Intolerance 

Histamine N-methyltransferase (HNMT) is the other major histamine-degrading enzyme your body makes. It breaks down histamine made by cells like mast cells.   

Did you know that when there is more histamine in your gut than DAO can break down, it leaks out of the gut and into your bloodstream?  

HNMT works to break down histamine overflowing from your gut as well.  

HNMT needs the cofactor SAMe (S-Adenosyl-L-Methionine) to work. 

Methylation is a process that produces SAMe (S-Adenosyl-L-Methionine).   

So, if your methylation process isn’t working as it should, your body might not be producing enough SAMe to activate HNMT.   

Mold Toxicity negatively affects the methylation process and other detox processes as well. 

I don’t usually recommend supplementing with SAMe for the sensitive population, though. It can reduce your body’s own production of SAMe. 

In the MC360^™ method, we work on fixing the root causes affecting methylation. And then methylation supports have to be added at the right time. 

But if you are ready for methylation supports, here are some ideas.  

Methylation Support for Histamine Intolerance  

Methylation is quite complex. 

I talk about it more in the MC360™ Precision Mold Master Class. 

But some very basic starter supports you might consider are cofactor supplements. 

Again, cofactors are nutrients that make HNMT (and DAO) work. 

Like with DAO production, you need a lot of different nutrients to support methylation. 

Of course, always work with your provider before starting anything new. Especially if you have a lot of sensitivities. 

And if you do want to try a new supplement, I suggest starting with “drops or sprinkles” and then slowly build up as tolerated. 

Zinc picolinate is one of the cofactors needed for methylation. This is a gentler supplement, so you may be able to start with this even if you have some sensitivities. 

If you aren’t super sensitive and can take combo products, you might also consider Homocysteine Factors. This is a blend of nutrients that can help support methylation. 

One last important note about methylation. 

Most people I work with aren’t able to support methylation right away. Especially if they are dealing with mycotoxins.  

So be very careful before you start working with methylation. And again, talk with your provider who knows your health history and risk factors. 

You’ve just read a few ways you can help support yourself if you have Histamine Intolerance.  

Keep reading to learn more about managing Histamine Intolerance. 

My Top Tips on Managing Histamine Intolerance 

It’s important you know that this blog post is for informational and educational purposes. It’s not meant to treat any health condition or to be prescriptive for anyone. Always be sure to work with your healthcare practitioner.  

You’ve already read about how supplementing can help with the production of DAO and HNMT. 

And you’ve read that supporting good gut health can be helpful, too. 

Here are a few more ideas you can talk with your provider about if you think you have Histamine Intolerance. 

The Low Histamine Diet for Histamine Intolerance 

Before you change your diet on your own, please make sure you’re working with a healthcare practitioner who can help you with this. Never limit foods unnecessarily, and always have a licensed medical provider who is supervising your case. 

If you have Histamine Intolerance, you might want to consider a low histamine diet.  

A 2019 study found that a low histamine diet helped improve symptoms in the majority of the test subjects. The diet increased their DAO levels. 

One idea as to why this happened is because DAO wasn’t getting used up breaking down high histamine foods. 

If all you’re dealing with is Histamine Intolerance, you’ll likely see a big difference in how you feel in just a few weeks. 

Tips for Doing a Low Histamine Diet 

One of the biggest mental hurdles you can overcome is to think in terms of replacing foods rather than removing foods. 

This shows you that you still have a lot of choices.  

But more importantly, you want to maintain as much nutritional variety as possible. 

This is why working with someone who understands your unique nutritional needs can be very helpful. 

When I modify recipes, I look at the high histamine ingredient and think about what might be a similar low histamine ingredient. 

I do this in all my low histamine recipes.

For example, spinach is high histamine. So, I think in really simple terms. What’s another leafy green vegetable that’s low histamine? 
 
I’ve found arugula to be a great substitute for spinach.  

I’ve put together a food list for you to help you figure out some better choices to eat if you have Histamine Intolerance. 

The list could be a great resource for you to print out or refer to when you are meal planning: Low Histamine Food List

Here are a couple of posts with ideas already put together:

• 10 Low Histamine Breakfast or Brunch Ideas
• 14 Healthy Low Histamine Meal Ideas

And these two posts may also be helpful as you’re getting started and figuring out what to eat:  

• Identifying High Histamine Foods  
• What to Eat on a Low Histamine Diet 

You want to be careful about some of the high histamine food lists you see online. Some of them list any food that caused the writer a reaction, even if that reaction may not have been histamine related. 

If supplements and diet aren’t helping as much as you want, you may be dealing with Histamine Intolerance PLUS something else. Like Mold Toxicity or Mast Cell Activation Syndrome. 

So, next, take a look at some other steps to consider for helping to manage Histamine Intolerance. 

Nervous System Supports and Histamine Intolerance 

Supporting your nervous system is one of the first steps you can take to significantly calm your mast cells. 

If your mast cells aren’t in a state of overreaction, they won’t be releasing as much histamine.  

That can help lower your overall histamine load. 

Nervous system work has been a game-changer for both me and my clients. It’s at least 50% of the healing process for people who are struggling. 

Nervous system support is step #1 in the MC360™ process. 

If you have a sensitive system, addressing the nervous system can help you tolerate the supports you need to get better. 

Stress and trauma can also activate mast cells and put your nervous system in a sympathetic state (flight, fight, freeze.) 

Working with your nervous system to get into the parasympathetic state (rest, heal, digest) can also help calm your mast cells and their responses.  

And as you can see in the description rest, heal, digest, being in the parasympathetic state can also help with digestion.

That can help with gut inflammation, which is one of the root causes of Histamine Intolerance you read about earlier. 

You can learn more about supporting your nervous system with the Mast Cell Nervous System Reboot here:  

Supporting Your Mast Cells  

Because mast cells release histamine, supporting your mast cells with supplements may also help with Histamine Intolerance. 

This is step #2 in the Mast Cell 360 process.  

I share my favorites in the Top 8 Mast Cell Supporting Supplements Master Class. 

This class also includes natural antihistamines. 

One of my favorites is perilla seed extract. 

Perimine is one to consider. 

In my Top 8 Mast Cell Supporting Supplements Master Class, I cover not only my top favorite supplements, but I also give you tips on how to onboard each one.  

Address Root Causes  

Getting to the big underlying factors of what’s causing your health issues is the next step. 

You read about some of the root causes for Histamine Intolerance earlier. 

Mast Cell Activation Syndrome and Mold Toxicity tend to be the big underlying causes that lead to the other underlying causes like vitamin deficiency. 

In the Mast Cell 360 practice, mold is the biggest root factor we see. 

So, addressing mold will also help with coinfections. 

See, when mold messes up your immune system, you may have trouble fighting off infections like SIBO, SIFO, and even Lyme.

When you get these infections under control, your mast cells won’t be releasing as much histamine in response. That’s going to help with Histamine Intolerance, too. 

Mold messes up your nervous system, too! That’s another reason you may need nervous system supports if you have Mold Toxicity. 

To learn more about all of these ways to help manage Histamine Intolerance and more, check out my MC360^TM Precision Mold Master Class.

H1 and H2 Blockers and Histamine Intolerance 

Earlier, you read a little about histamine receptors H1, H2, H3, and H4. 

Here’s how H1 and H2 blockers may help with Histamine Intolerance. Basically, these blockers interrupt the normal response that would happen when histamine receptors are triggered.  

Remember that H1 receptors are found throughout your entire body. And they are associated with allergic reactions, inflammation, and immune response. 

So, when you take an H1 blocker like Claritin or Allegra, some of those responses will be dampened. That can help with your overall mast cell and histamine-related symptoms.  

H2 blockers work similarly in that they also block histamine receptors. H2 blockers like Pepcid are marketed for acid control. 

Remember that H2 receptors play a part in helping to reduce over-production of stomach acid.

So, blocking this response means your body won’t produce as much stomach acid. 

That can help with symptoms of reflux and GERD. But, your prescriber may also recommend them to help with calming mast cell related food sensitivities. 

These H2 blockers are known to help mast cells in general as well to be less triggered in the GI tract. 

Something you should know about H2 receptors is that they don’t work directly on stomach acid. They are only temporarily blocking the signal to produce stomach acid. They don’t cause long term issues like PPIs (proton pump inhibitors) do.  

PPIs shut down stomach acid production irreversibly by blocking certain enzymes found in the stomach.  

But for temporary relief of mast cell and histamine-related symptoms related to the H2 receptors, your medical provider may consider H2 blockers like famotidine (Pepcid) or cimetidine (Tagamet). 

You might be thinking you have Histamine Intolerance. But you might be wondering how do you know for sure? 

Here’s a little bit on testing. 

Testing for Histamine Intolerance 

Right now, there is no consensus on official diagnostic criteria for Histamine Intolerance. 

But you can get some clues through diet and testing. 

If you do try the low histamine diet and see improvement in your symptoms, that’s a good indicator you are dealing with Histamine Intolerance. 

When testing, the most studied diagnostic approach is analyzing histamine levels in the blood or urine against plasma DAO levels.  

These tests measure the amount of histamine that degrades over designated timeframe.  

But some studies have shown that these measurements can’t be considered conclusive. 

And it has been proposed that activity of DAO can vary even over the course of just one day. 

Skin prick testing can offer some clues, but the results may not reflect histamine problems in the small intestine.

And it is challenging to tell the difference between HIT and other allergic reactions. 

Urine testing is being studied but at this time, this approach is still being validated. 

There are other tests that are very invasive. Some involve biopsy of the colon or small intestine.  

So, for these reasons, many people choose to pay attention to their symptoms and see if there is any improvement first with a low histamine diet, supporting mast cells, and histamine degrading enzymes. 

Just remember, recovering your health is not an overnight fix. And it sometimes takes some detective work. 

I encourage you to enjoy all of your small wins. Any step in the right direction is one step closer to where you want to be. 

As you pay attention to improvements, you’ll be amazed at how far you’ve come! 

What are some of your winning moments in addressing Histamine Intolerance? 

Learn More About Histamine Intolerance  

• Travel Tips and Tricks for Those With Histamine Intolerance 
• Safe Skincare for Those With Histamine Intolerance 
• Managing Histamine, Salicylate, and FODMAP Intolerance with Histamine Intolerance 
• The Best Antihistamine for Histamine Intolerance and Mast Cell Activation Syndrome

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