Histamine Intolerance, GAPS and Low Carb

Histamine is a neurotransmitter which is involved in our local immune response. Here is a quote from an excellent post by That Paleo Guy on Histamine Intolerance:

Histamine is a chemical which occurs naturally in certain foods. This is also one of the chemicals that is released in the body as part of an allergic reaction, causing the typical ‘itching, sneezing, wheezing, swelling’ allergy symptoms. We all have an enzyme (Diamine oxidase [DAO]) which breaks down any histamine that we absorb from a histamine-containing food, so when we eat a food which contains histamine it does not affect us. However some people have a low level of this enzyme, and when they eat too many histamine-rich foods, they may suffer ‘allergy-like’ symptoms such as headaches, rashes, itching, diarrhoea and vomiting or abdominal pain. This is called histamine intolerance. Some studies have also suggested links between histamine intolerance and urticaria, asthma, eczema and anxiety and panic attacks.”

The above is only a very partial list of symptoms which may be related to the cascade of reactions caused by histamine intolerance.

Here are some additional common ones:

  • autonomic dysregulation: tachycardia, palpitations, light headedness,
  • low blood pressure and fainting
  • constipation and bloating
  • muscle pain, cramps
  • joint pain, athritis
  • hearing problems, tinnitus
  • attention and memory problems
  • depression, mind racing
  • insomnia, fatigue
  • unexplained bruising and bleeding
  • restless leg syndrome
  • flushing and rosacea

My dietary approach is to limit my carbohydrate intake because when I eat too many carbs my weight climbs and I feel tired and depressed. I also adhere to the GAPS Protocol in an effort to heal longstanding digestive symptoms. In recent months the main stay of my diet consisted of long cooked GAPS soups and stews. I would make a large pot of soup and eat the left overs for several days for lunch and dinner. In addition I ate fermented vegetables, cheese, avocado, sausages, bacon, dark chocolate, all low carb and GAPS compliant. Over time I began to feel more and more anxious. I experienced chronic ringing in my ears, my sleep quality became increasingly poor and I started to feel fatigued and depressed, while at the same time keyed up and constipated.

Fortunately for me, Monica, one of my readers, and the thoughtful and courageous author of the blog, Beyond Meds, sent me an e-mail. She wrote that she thought I might be interested to learn that her autonomic dysregulation, low blood pressure, light headedness, palpitations and physical stamina were all so very much improved since adopting a low histamine diet. She had been also a follower of a Paleo/GAPS style diet, featuring long simmered bone broths and fermented foods, all of which are very high in histamine. The coin dropped, and I began to wonder, could it be that I also was histamine intolerant?

All the foods I had been eating were very high in histamine. The main stay of my diet was left overs. When protein ages, like left over chicken soup in the fridge, it develops increasingly high levels of histamine. There are many lists of high histamine foods on the internet, some of which conflict, and it can be confusing.

Here is list of problematic foods and beverages from the UK’s Histamine Intolerance Awareness site. Some foods contain high levels of histamine, others cause histamine contained in our own cells to be released, some block the enzyme that breaks down histamine resulting in elevated levels.

High histamine level foods:

  • Alcohol
  • Pickled or canned foods – sauerkrauts
  • Matured cheeses
  • Smoked meat products – salami, ham, sausages….
  • Shellfish
  • Beans and pulses – chickpeas, soy beans, peanuts
  • Nuts – walnuts, cashew nuts
  • Chocolates and other cocoa based products
  • Most citric fruits
  • Wheat based products
  • Vinegar
  • Ready meals
  • Salty snacks, sweets with preservatives and artificial colourings

Histamine liberators:

  • Most citric fruits – kiwi, lemon, lime, pineapple, plums…
  • Cocoa and chocolate
  • Nuts
  • Papaya
  • Beans and pulses
  • Tomatoes
  • Wheat germ
  • Additives – benzoate, sulphites, nitrites, glutamate, food dyes

Diamine Oxidase (DAO) blockers:

  • Alcohol
  • Black tea
  • Energy drinks
  • Green tea
  • Mate tea

Debatable:

  • Yoghurt – depends on the bacteria culture used
  • Egg white – it is a histamine liberator only when in its raw state

Other:

  • Yeast – even though it does not contain histamine as such, yeast serves as a catalyst for histamine generation during manufacture. There is no yeast in the end product

I stopped eating left overs. I cooked smaller pots of food and froze the left overs in individual containers. I stopped eating cheeses, bacon and avocado. I began eating more salads. Most foods contain histamine, so you cannot have a histamine free diet like you can have a gluten free diet. But it is the relative quantity of histamine in relationship with your own capacity to handle it that translates into symptoms. I clearly was overwhelming my capacity to metabolize the histamine quantity that I was ingesting.

Within days of instituting the dietary changes, I slept better than I have in years; very deeply and I dreamt. This is unusual for me. I have had insomnia since I was a child, probably due to life long undiagnosed histamine intolerance. A sense of calm and peace replaced the chronic anxiety I was experiencing, my spirits lifted and I felt much less tired and more alert. Given the strength and immediacy of my response to lowering the histamine content of my diet, I believe that histamine intolerance should be considered in every case of anxiety disorder, depression, sleep and attentional disorders, especially if a person is aware of food sensitivity issues. My father could not tolerate eggs, shellfish, strawberries, and alcohol, all which either contain high levels of histamine or liberate histamine. There may be genetic vulnerabilities.

Low carb diets can be very high in histamines. If a person is eating low carb, and not feeling well, maybe it has to do with too much avocado, aged cheeses or salami, or bacon and eggs.

The GAPS diet is naturally high in histamines. It can be modified, with care taken to avoid left overs, bone broths and fermented foods. These important foods may be added back in very very incrementally as the body heals. Perhaps one shred of sauerkraut or a spoonful of broth, and titrating up as tolerated. Meanwhile probiotics can be used, as long as they do not contain histamine producing species of microflora. It remains a priority to heal the gut, as for most people, it is likely the damage to the enterocytes which comprise the mucosa of the gut wall, which has resulted in a lack of capacity to produce the enzyme DAO that metabolizes histamine. Thus the underlying cause of histamine intolerance is ultimately in most cases likely to be gut dysbiosis, and there must still be an ongoing effort to heal and rebalance the microflora.

In an effort to support my metabolism of histamine, I have begun to take supplemental Vitamin C 2000 mg a day, Magnesium Glycinate 400 mg a day and one capsule of Holy Basil, an Ayurvedic herb thought to modulate histamine levels. I have very quickly begun to feel much better.

According to the ancient healing science of Ayurveda, left overs are not to be consumed. Only freshly prepared food is considered healthful. In the yogic tradition, left over food has lost its prana, its vital life force. An article in Yoga Journal entitled “Lifeless Leftovers” had this to say:

“The body’s inability to metabolize foods that are not fresh results in the formation of ama, or toxic undigested material,” adds Shubhra Krishan, author of Essential Ayurveda and What it Can Do for You (New World Library, 2003). This substance clogs up the vital channels of the body, disrupting digestion and ultimately giving rise to everything from fatigue to disease. Since food begins losing prana the moment it’s disconnected from its life source, it is important to create meals using only the freshest ingredients and to take care not to overcook them. Try not to cook meals ahead of time; if possible, make a few separate trips during the week to buy fresh produce. And instead of buying frozen, canned, or processed foods, reach for those that are still closest to their original state, such as fruits, nuts, and freshly cut greens.”

It also seems clear that everyone will have their unique personal response to different foods, and each individual’s response may vary over time, and thus there is a need to keep a food diary and track symptoms in order to figure out what to avoid and what makes you feel good. Initially it makes sense to eliminate many high histamine foods until the body heals, but eventually many things may be added back in. This is something worthwhile to figure out, so that one is not unnecessarily restricting food choices.

Here is a link to a post about keeping a food journal that contains a download for a well designed food diary template.

There is so much to explore about this topic, that I plan to write about it in many future posts. Histamine impacts our well being or lack there of in many fascinating ways. I believe it is a very under recognized and probably fairly common condition that causes a great deal of suffering. Here is a link to one of the best and most thorough posts about histamine intolerance by Dr. Janice Joneja from Food Matters.

About Judy Tsafrir

I am a board certified, Harvard trained and affiliated, adult and child psychiatrist and psychoanalyst, and certified GAPS practitioner.

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Disclaimer

This article is for informational purposes only, and is educational in nature. Statements made here have not been evaluated by the FDA. This article is not intended to diagnose, treat, cure or prevent any disease. Please discuss with your own, qualified health care provider before adding in supplements or making any changes in your diet.

  • http://www.nourishholisticnutrition.com Anne

    This is quite interesting and I’m so glad you took the time to post about the histamine connection to impeding GUT recovery. After reading this I can see that this is something most practitioners may miss. Once again, this points to the importance of discovering what works best for the individual and your own health issues. GAPS/Paleo/SCD are all a good place to start but then the diet needs to be modified according to how one responds – as you so rightly point out. Certainly eating leftovers is problematic for most who tend to easily grow yeast. Curious why avocado’s are on your list of high histamine foods?

  • http://www.nourishholisticnutrition.com Anne

    I also wondered if you had added L-Glutamine to help heal leaky GUT? I find this is very helpful with those I work with. Fresh ginger root tea is another helpful tonic.