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Finding The Cause of Your Histamine Intolerance or MCAS
Finding the Root Cause of Histamine Intolerance and MCAS is not as simple as one many think. Histamine intolerance has many causes and many things including certain medications can aggravate the condition. With more and more awareness of MCAS/Histamine intolerance, doctors and patients are starting to see that it is not as rare as what was once thought. Histamine intolerance occurs when there is a buildup of histamine in the body. While many foods contain high histamine levels, there are many other causes for this “build-up” of histamine that you need to know about. In today’s article, we will review some of these root causes as well as some of the strategies for improving the function of an enzyme called DAO.
Let’s Talk About Root Cause(s) of Histamine Intolerance and MCAS

What is Histamine Intolerance

Histamine is a neurotransmitter that regulates a variety of physiological functions including sleep-wake cycles, appetite, memory and the stress response. It is also a key player in the immune system, central nervous system, as well as your digestive tract.
Problems with Histamine are implicated in multiple neuropsychiatric disorders; for example, histamine imbalances have been reported in Anxiety, Depression, Alzheimer’s disease (*), and narcolepsy (*)
Histamine causes a sudden and rapid inflammatory response, setting off an alarm within the immune system that invaders are present.  As a result, white blood cells are called upon to swiftly identify and eliminate the foreign bodies.  It is the quick flood and build-up of histamine that can cause symptoms such as headache, itchiness, flushed face, and overall feeling inflamed and uncomfortable.
Histamine works through your bloodstream so high levels that aren’t broken down can potentially harm not only your gut but your lungs, brain, skin, and cardiovascular system. It is for this reason that symptoms can vary from person to person.

Breaking Down Histamine With DAO

In a healthy person, histamine is broken down by two enzymes: DAO and HNMTHistamine intolerance symptoms may occur when one of these enzymes isn’t working correctly. DAO is made in the intestines and Histamine N-methyltransferase (HNMT) is an enzyme expressed in the central nervous system.(*)

Diamine oxidase (DAO) supplements can help replenish the diamine oxidase enzyme in your gut.  These supplements help break down foods that contain high levels of histamine. Research shows that ingredients in these supplements  can provide natrural relief from headaches, digestive issues, and skin reactions.

If you have poor gut health you are more prone to histamine intolerance.

The many Root Causes of Histamine Intolerance and MCAS

Histamine Intolerance Symptoms

If you have too much histamine in your gut and it’s released from your cells, you can end up with too much histamine collecting in your blood. This causes symptoms including:

  • Migraines
  • Bloating
  • Feeling sick
  • Gas
  • Stomach pain
  • Throwing up
  • Constipation
  • Fullness
  • Muscle aches
  • Pain
  • Stuffy nose
  • Asthma
  • Hives
  • Dizziness
  • Psoriasis

Take the Histamine Intolerance/MCAS quiz here 

Gut Problems and Histamine Intolerance MCAS

Treating Histamine Intolerance

What do you do if you have histamine intolerance besides implementing a low histamine diet?  The Key to naturally addressing High histamine is to address

1- WHY you are creating excess histamine.

2- Why Your body Cant break down histamine

So we already talked about bone broth and kombucha being potential dietary problems but there are others you should be aware of – food like sauerkraut, kefir, wine, beer, smoked meats, aged cheeses, pickles, eggs, citrus fruits and vinegar- any of these foods can drive up your histamine levels. Does any of this sound familiar?

Now these are just some of the foods, there are also additives, colors, binders and fillers as well, you can check out this article for a more in depth list of foods containing histamines-I have also put together a free downloadable Histamine intolerance guide.

The Many Causes of Histamine Intolerance and MCAS

What Causes Histamine Intolerance

You naturally produce histamine along with the enzyme diamine oxidase (DAO). DAO is responsible for breaking down histamine that you take in from foods.

If you develop a DAO deficiency and are unable to break down histamine, you could develop an intolerance. Here is my Histamine Support Pack that can provide some intial relief to the symptoms of histamine intolerance.

When we about the cause of histamine intolerance and MCAS, keep in mind that there is no one singular cause or reason. There are many things filling up your histamine bucket. These things filling your histamine bucket may include.

  1. Genetic SNP in the DAO or HNMT enzyme- this is where the enzyme doesn’t work the way it should- you have a mutation in the gene
  2. Gluten intolerance or Celiac Disease- due to the damage it causes to intesinal mucosa.
  3. Mold biotoxins
  4. Gut Dysbiosis, Small Intestinal Bacterial Overgrowth or SIBO- Here are some of the Best Ways To Address Histamine Intolerance/MCAS when you have SIBO
  5. DAO-blocking foods
  6. Reheating foods that increase amount of Histamine
  7. Foods that are High in Histamine
  8. Inflammation- Maybe you have Crohn’s, Ulcerative colitis, and inflammatory bowel disease.
  9. LPS bacteria- LPS bacteria can also cause a Leaky gut.  Heres a video on my YouTube Channel
  10. Medications: these may be from medications like Anti-inflammatories such (ibuprofen, aspirin),
    1. Anti-depressants (Cymbalta, Effexor, Prozac, Zoloft)
    2. Anti-histamines (Allegra, Zyrtec, Benadryl) H1 blockers
    3. Immune suppressants such (Humira, Enbrel, Plaquenil)- these are mediations people who have Rheumatoid arthritis, or inflammatory bowel disease (UC or often are taking)
    4. Histamine (H2) blockers (Tagamet, Pepcid, Zantac)- Many of these medications will either release excess histamine or will block the enzyme that breaks down histamine. Either way- you end up with excess histamine.
  11. Food Additives that contain High Levels of Histamine
  12. Nutritional status- Several vitamins and minerals serve as enzymatic cofactors. These vitamins activate the DAO and HNMT enzyme. If the enzyme fail to be activated, we cant break down histamine and it accumulates. Learn more about Natural Ways to Incrase DAO enzyme Activity here
  13. Hormones-The complexity of histamine intolerance extends to the interaction between histamine receptors and hormones like, estrogen,  progesterone, testosterone and DHEA. Estrogen can also influence endogenous histamine levels by down regulating DAO activity. This ultimately leads to high histamine levels in the body.Learn more about the connection between histamine and hormones here.

Vitamins and Minerals Required for DAO and HNMT Enzyme Activity

So we have talked about the foods that cause excess histamine, we have talked about some of the conditions that causes excess histamine, we talked medications that liberate excess histamine or interfere with the enzyme that breaks down histamine. We know need to understand the importance of certain vitamins and how they “turn on” these histamine degrading enzymes.

Because a low histamine diet is so restrictive, its not something one can do for month on end. The Key to naturally addressing High histamine levels is to address two very important components

1- Histamine Production histamine- You can learn more about cause of histamine here

2- Histamine Degradation (Breakdown) You can learn more about Histamine Breakdown here

As a reminder, HNMT is the key enzyme that breaks down histamine in the Nerve system and DAO is the primary enzyme that breaks down ingested histamine as well as histamine originating from allergies. As you can see in this illustration-

The Many Causes of Histamine intolerance and MCAS

The DAO enzyme is dependent on Iron, B12, B6, Copper and vitamin C . Remember in order for DAO to break down Histamine we need these vitamin cofactors.

Histidine and Histidine Decarboxylase

Histidine is an amino acid. People use histidine as medicine. Some people take histidine for health problems related to metabolic syndrome, rheumatoid arthritis, allergic diseases, diarrhea caused by cholera infection, ulcers, and anemia caused by kidney failure or kidney dialysis. But if you take a look at the above image you will also notice that histidine is broken down into histamine.

The enzyme that converts histidine into histamine is called Histidine decarboxylase. This enzyme is the key member of the histamine synthesis pathway.(*) What this means is that Histamine cannot be generated by any other known enzyme. Magnesium and B6 are important enzyme activators needed for conversion of histidine to histamine. B6 is also needed to activate DAO enzyme. When vitamin B6 deficiency exists, DAO cannot be produced effectively, as B6 plays an important role in the process of DAO formation(*)

Some Final Reminders About Finding The Cause of Your Histamine Intolerance or MCAS

So as I bring this video to a close, there are few closing points I want to summarize.

#1- There are many reasons you or a loved in is suffering with Histamine intolerance or MCAS- while we talked about many aspects of histamine intolerance today, please understand that if at any time you are dealing with a GI problem, you may need to do a bit more than go on a low histamine diet. You may need to dig a bit deeper into why. Your “Why” may be rooted in one or many of the problems you see below.

  1. You may have gluten sensitivity/Celiac
  2. You may have a gut infection
  3. You may have a leaky gut
  4. Might have a yeast overgrowth
  5. You might be sensitive to oxalates
  6. You may have bile acid malabsorption
  7. You may have food allergies IgE immune reaction
  8. You may a delayed food sensitivity (IgA and IgG immune reaction)
  9. You may have hormone imbalances
  10. You May dealing with Mold Biotoxins
  11. You may have SIBO or SIFO

#2 Identify the Causes of histamine intolerance– Low histamine diets are only one piece of a much bigger picture. Work with A Certified Functional Medicine Practitioner who has experience on this condition. Working with a less experienced provider can be a costly mistatke.

#3 support the DAO and HNMT enzymes by taking the minerals, vitamins and cofactors that will help ensure the enzyme works correctly and finally at a minimum, take a supplement that contains Quercetin, NAC, and stinging nettle stabilize the mast cells.

#4- Naturally treating Histamine intolerance needs a multipronged approach

I hope you enjoyed today’s video (If watching on my Youtube channel) or todays blog if you are reading it on my website.  – I hope you learned a few things, if you did be sure to subscribe to our YouTube channel. Comment below and share this video with someone you care about.  I will be doing another video where I will talk about some of the additional strategies for addressing histamine intolerances.


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