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Natural Awakenings Greater Boston - Rhode Island

Allergies and Histamine Intolerance

May 28, 2021 09:31AM ● By Gary Kracoff
Diet and Therapeutics to Support a Healthy Response

Allergies are an abnormal immune system response to a typically harmless substance. Someone without allergies would have no reaction to the substance, but when a person that is allergic encounters the trigger (allergen), the body reacts by releasing chemicals which cause allergy symptoms. During this response, the allergen binds to antibodies on cells in the body, including mast cells and basophils. These cells release chemicals like histamine and leukotrienes, resulting in allergy symptoms.

The first time a B-cell is exposed to an allergen, no allergic reaction will occur, but plasma cells will initiate an overproduction of IgE antibodies. The IgE molecules attach themselves to mast cells or basophils. This is called sensitization. When the allergen enters the body for the second time, the IgE antibodies react by binding the allergen. The IgE-primed mast cells and basophils will then release granules containing histamine and other allergic mediators. This will cause an allergic reaction.


Histamine is part of our bodies’ natural response to insults or invaders. It prompts blood vessels to swell and fluid to leak from capillaries, causing swelling. It is an inflammatory bio-chemical, is mainly stored in mast cells and basophils, and it is a main contributor to allergic disease.

Elevations in plasma or tissue histamine levels have been noted during anaphylaxis and allergic responses of the skin, nose and airways. The effect of histamine is tied to the type of receptor where it attaches. Although histamine is only one of many mediators of allergic disease, it plays a primary role in allergic rhinitis, urticaria, anaphylaxis, and to a lesser degree, asthma.

Genetic Variants

Certain individuals are genetically prone to low levels of the DAO and HNMT enzymes which are responsible for degrading histamine to control excess. Genetic testing can reveal variants in the genes that make these enzymes and may be impacting histamine levels. Pathways can be supported nutritionally to improve function.

Allergy versus Histamine Intolerance

Histamine intolerance is not the same as an allergic response. Histamine intolerance takes time to appear and is not evident immediately after histamine-rich foods and beverages. Allergies, on the other hand, usually develop within minutes of exposure. With histamine intolerance, the total level of histamine in the body gradually rises and overwhelms the enzymes capacity to break it down over time.

Allergies are the result of histamine release. Symptoms of allergy and histamine intolerance are very similar. When an allergy triggers the immune system, histamines often produce inflammatory responses such as puffy eyes, an itchy rash, or a sneezing fit. When this occurs, people often reach for an antihistamine medication like Benadryl.

Symptoms of histamine intolerance include difficulty falling asleep at night, hypertension, chronic headaches or migraines, an accelerated heart rate, dizziness or vertigo, general anxiety, bloating and swollen body tissue, inexplicable nausea and vomiting, chronic nasal congestion, an abnormal menstrual cycle, facial flushing, especially after drinking wine, fatigue and exhaustion for no reason. Allergy tests that measure IgE reactions to specific foods will be negative in histamine intolerance.


After the allergy threat is eradicated, natural enzymes called diamine oxidase (DAO) and HNMT will typically break down the histamine, so it doesn’t build up in the system. These enzymes can become less effective and histamine levels rise.

Histamine Intolerance and the Gut

The gut is often involved in high histamine. There is a vicious cycle (see graphic above) that involves intestinal permeability, histamine release, inflammation, impaired digestion, dysbiosis, high histamine, zonulin and further intestinal permeability.

Inflammation in the gut activates mast cells and histamine production. This decreases DAO enzyme and reduces the amount of histamine breakdown. DAO surrounds microvilli in the gut. When there is poor mucosal integrity (leaky gut), low DAO levels are found.

Support the gut with a non-inflammatory diet, digestive enzymes, probiotics to establish a healthy microbiome, addressing relevant genetic variants and taking in enough fiber and water to support elimination. An antioxidant like pyrroloquinoline quinone (PQQ) can help remove inflammation from toxins circulating in the blood stream due to gut permeability.


Allergies are best addressed by avoiding the allergen and using a natural antihistamine and anti-inflammatory product. In cases of histamine intolerance, it is critical to lower the histamine level, so it is also important to avoid allergens, avoid high histamine foods and foods that release histamine, support genetic variants that interfere with histamine breakdown and support gut health, the liver and stressed adrenals (as cortisol output is important in controlling histamine levels).

These natural remedies are helpful in cases of high histamine and allergy:

Boswellia inhibits inflammation, histamine and 4-series leukotrienes which make it helpful for asthma, allergies, sinusitis, emphysema as well as histamine intolerance.

Stinging Nettle works similarly to allopathic antihistamines by attaching to the histamine receptor and preventing the inflammatory response.

Quercetin and L-Theanine block histamine release from mast cells. Quercetin also helps the gut to heal. Bromelain reduces edema and inflammation associated with allergic rhinitis.

Luteolin acts as a natural antihistamine by preventing mast cell

Histamine degrading probiotics (Bifidobacterium longum, Bifidobacterium infantis, Lactobacillus rhamnosus, Lactobacillus salivarius, Lactobacillus plantarum) balanced with beneficial bacteria that produce histamine (Lactobacillus reuteri, Lactobacillus helveticus, Lactobacillus casei, Lactobacillus bulgaricus) is the ideal probiotic. A balanced, broad-spectrum product is much better than one that is mega-dosing a few varieties of bacteria.

DAO and DAO cofactors help to breakdown excess histamine: Vitamin B6,
Vitamin C and Copper are cofactors.

Support SAMe (needed for histamine breakdown by HNMT), do not supplement SAMe, rather spare it by supplementing Creatine and Phosphatidyl Choline.

N-Acetyl-L-Cysteine is needed to make the master antioxidant, glutathione and protect against oxidative stress. Licorice soothes the gut and reduces gastrointestinal inflammation.

Vitamin C is a natural antihistamine. According to a 2018 study on Vitamin C, oxidative stress plays a key role in allergic disease. Vitamin C is a powerful antioxidant and anti-inflammatory which makes it very useful in the treatment of allergies.

Helpful hints:

• Support genetic SNPs; these involve the breakdown of excess histamine and methylation.  Histamine requires methylation to be metabolized.  Persons with high histamine are under-methylators.

• Support the gut, an unhealthy gut is often the root cause of low DAO production.

• Avoid high histamine foods, and DAO enzyme blocking foods. Foods high in histamine include aged and fermented foods like sauerkraut, soy sauce, wine, vinegar, beans and aged meats.  Beverages that inhibit DAO include alcohol, black, green and mate tea.

Dr. Gary Kracoff is a naturopathic doctor and registered pharmacist at the Johnson Compounding and Wellness Center, located at 577 Main St., Waltham. For more information, call 781-893-3870 ext. 2 or visit

Interesting Facts About Histamines

• Histamine attached to H1 receptors play important roles in motion sickness. Antihistamines are effective preventatives.

• Vitamin C has been shown to be an effective remedy for seasickness.

• Homeopathic remedies can be used to desensitize individuals from allergens. There are homeopathic formulations specifically for the pollens in New England.

• Histamine has been shown to enhance the production of estradiol, making women feel more “hormonal”; conversely, higher levels of estrogen can potentiate the action of histamine, exacerbating allergy symptoms including premenstrual headaches and migraines.