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Updated: May 2, 2023

Histamine intolerance affects millions of people every year, and many are unaware of its symptoms or that they may be presented with it. The connective tissues in your body produce histamine to help organs, muscles, and nerves receive and deliver messages to your brain and immune system. For example, histamine signalling will trigger your brain tissues to release pent-up stomach acids to process the foods you eat. It also helps the immune system response by drawing attention to damaged tissue that requires repair.

Histamine Intolerance

Histamine intolerance comes from an overproduction of the histamine molecule from mast cells and basophils. Most patients with histamine intolerance symptoms present with hyperinflated histamine levels and/or no way to metabolize it, leading to symptoms such as sinus issues, intestinal permeation, chronic headaches, anxiety, fatigue, hives, nausea, and digestive problems.

It's important to clarify that histamine intolerances are very different than mastocytosis and mast cell activation syndrome. In these disorders, patients either genetically produce too many mast cells, or the mast cells are hyper-reactive to triggers and release too much daily histamine. These disorders are managed differently and you should always first speak to your doctor or naturopath for a proper diagnosis.

While histamine presents widely throughout the body and serves many functions, the abundance of histamine production and uptake inside the digestive system has led researchers to investigate the root causes of excess histamine and the potential for probiotic treatment in stabilizing it. Probiotics for histamine intolerance offer significant opportunities to reduce histamine production and treat histamine intolerance.

What is a Histamine?

Histamine release occurs naturally inside your body as one of the five major biogenic amines. These five neurotransmitters, dopamine, norepinephrine, epinephrine, serotonin, and histamine, regulate brain functions and endocrine responses.

Your cells produce histamine to send signals from your body to your brain as a part of complex biochemical reactions, particularly in digestion and gut motility. They also produce histamine to stimulate the immune response, activating your white blood cells to defend you from allergens or other threats.

What Causes Histamine Intolerance?

Your body produces histamine for its own use, and when your body can’t produce enough enzymes to break down all the histamine in your system, your histamine levels rise, creating an imbalance. This causes every mast cell in your body to produce the enzyme to break it down, known as diamine oxidase or “DAO”. DAO is responsible for breaking down the histamine compound in your food, and a lack of it creates a histamine-derived imbalance or build-up.

Symptoms of elevated histamine include:
  • itchy, flushed skin

  • diarrhea & abdominal pain

  • nausea

  • headaches

  • congestion, running/itchy nose & eyes

  • dizziness

  • heart palpitations/anxiety

You may not be aware of it, but you have relatively high amounts of naturally occurring histamine in your diet every day.

Foods high in histamine include:
  • Fermented foods and beverages like Sauerkraut and wine

  • Processed meats

  • Aged cheeses

  • Eggplants and spinach

  • Avocados

  • And dried fruits

Some foods, including alcohol, energy drinks, black tea, and green tea, block DAO, preventing it from breaking down histamine. While other factors, including genetics and medications, may lower DAO production, diet factors significantly decreased DAO activity.

It's important to recognize that a histamine-rich diet enhances the production of gut bacteria in healthy individuals, and is not an unhealthy way to eat. In fact, histamine-rich foods are usually the highest in naturally occurring probiotics. However, when your system falls out of balance, multiple sources of histamine build up and trigger histamine intolerance.

The problem arises when dietary intake and bacterial histamine production combine at such staggering levels that human mast cells can't manufacture enough DAO to process the overflow. Disorders like SIBO, or small intestinal bacterial overgrowth, can also exacerbate histamine intolerance because they not only generate their own histamine release but damage the area of the gut lining that creates a large supply of the body’s DAO enzyme. Therefore, people with small intestinal bacterial overgrowth or SIBO are at a much higher risk of presenting with histamine intolerant symptoms.

Antihistamine Probiotics vs. Histamine Intolerance

Because histamine production is deeply connected to gut bacteria levels, researchers have been looking into histamine-reducing probiotics as a treatment.

Treatment of histamine intolerance focuses on ways to limit histamine intake and remove excess histamine from your system. Diet plays an important role in limiting histamine sources, but research has uncovered more about the interplay of gut bacteria in health. Using probiotics for histamine intolerance treatment demonstrates improved outcomes for people suffering from histamine intolerance.

So much of your gut health depends on your gut biome. These microscopic bacteria coexist in your digestive tract and help your body break down and process foods. Some strains of beneficial gut bacteria, known collectively as probiotics, display histamine-increasing properties, while others offer histamine-lowering effects.

The role of probiotic bacteria in curbing histamine overproduction is a rapidly advancing area of mast cell research, and you can find numerous studies connecting probiotic strains to lowering histamine presentations (or increasing it, for that matter). For example, because histamine is a biogenic amine, physicians have been looking to other naturally occurring biogenic amines, such as lactic acid (and lactic acid-producing bacteria) in its role in histamine intolerances. It may come as a surprise, but any of the common ‘good for you’ probiotics from the lactobacillus family are being investigated as possible aggravators due to their high lactic acid production in food. However, the impacts on histamine depend on the strain, so this does not apply to all strains of a specific species or genus. Alternatively, low-histamine probiotics activate anti-inflammatory agents in the mast cells, help stabilize mast cells, and down-regulating the sensitivity of histamine receptors. Many of these flora are found in the Bifidobacterium genus. Some histamine-lowering strains include: ​​

  • Lactobacillus plantarum

  • Bifidobacterium longum - helps improve gut barrier and assist in histamine degradation

  • Bifidobacterium infantis

  • Lactobacillus rhamnosus

  • And physicians have been looking into the probiotic lactobacillus reuteri, which they derive from histamine itself

Moreover, some histamine-increasing probiotics include:

  • Lactobacillus casei

  • Lactobacillus Bulgaricus

  • Streptococcus thermophilus

  • Lactobacillus delbrueckii

  • Lactobacillus helveticus

More so, some probiotics are classified as histamine neutral, or helpful at lower doses, such as lactobacillus acidophilus when taken under 1 billion CFU per day. Histamine-lowering probiotics muffle histamine signals and compounds like the probiotic b. longum display clinical benefits in lab tests against allergies. However, people are different, and we all have unique levels of gut flora in our stomachs and intestines, so probiotic supplements don't have a uniform effect on all demographics. An anti-inflammatory diet regimen that avoids histamine-rich foods lays the basis for reducing histamine levels. Incorporating probiotics that assist in histamine prevention or removal can present meaningful improvement and symptom reduction in patients suffering from histamine intolerance.

In all cases, you should work with your doctor to confirm your diagnosis and develop personalized treatments for histamine intolerance. Many factors in your health composition and diet limitations affect treatment and results.

For example, consuming the aforementioned DAO-blocking foods, such as alcohol, can create confounding impacts when using probiotics to manage histamine symptoms.

Learn More About Histamine Intolerance Treatment

Research indicates that readjusting your gut flora with low-histamine probiotics can reduce inflammation, alleviate symptoms, and reduce the effects of seasonal allergies. Treatments that include a low-histamine diet combined with histamine intolerance probiotics work together to improve gut health in people diagnosed with histamine intolerance.

Most patients with histamine intolerance tend to have an overabundance or bacterial deficiency in their gut flora. The key to resolving symptoms is to eradicate the aggravates (both food and flora) and restore a healthy bacterial balance to the ecosystem. Furthermore, as described above, taking the wrong probiotic supplement can worsen your condition, as they promote histamine production. If you want to learn more about probiotics or the management of histamine intolerance symptoms, contact our Toronto Naturopath, Dr. Courtney Holmberg ND by calling (647) 351-7282 today.

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Nov 06, 2023
Rated 5 out of 5 stars.

Great piece! Extremely helpful in guiding as to which probiotics will make sense to buy. Thank you!


Matthew Guy
Matthew Guy
Oct 15, 2023
Rated 5 out of 5 stars.

After taking a probiotics tablet for 2 days my face and neck is bright red and itchy and I think this article has explained why, I had the same when I tried bone broth as well, so will give it miss for a day or two and see if it goes away.

Thank you for such a great explanation


Sep 30, 2023
Rated 5 out of 5 stars.

Thank you for breaking this down and explaining it so simply. I‘m using the lists you’ve provided to check before buying probiotics.


Sep 09, 2023
Rated 5 out of 5 stars.

This is very helpful! I re-check this list before I buy any probiotic


Jul 23, 2023
Rated 5 out of 5 stars.

Such a good article. Thankyou so much. Kind regards Louise UK.

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