HISTAMINE INTOLERANCE

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The importance of Methylcobalamin

Histamine and Heartburn

Many people with histamine intolerance regularly take medications to control heartburn.

Histamine acts to increase hydrochloric acid secretion by cells in the stomach lining. An overload of histamine can cause the production of excess stomach acid, which is why one of the treatments for heartburn is the H2 antagonist Rani-tidine (TM)*.

Panto-prazole* is another drug for heartburn patients that decreases the amount of acid produced in the stomach. The problem is, long-term treatment with panto-prazole* may also decrease the body’s ability to absorb vitamin B-12, resulting in a deficiency of this vitamin.

Vitamin B12 Deficiency

Vitamin B12 (cobalamin) is an essential vitamin, required for DNA synthesis (and ultimately cell division) and for maintaining nerve myelin integrity.

Symptoms of a vitamin B-12 deficiency may develop slowly and include pale skin, weakness, tired feeling, shortness of breath, and a fast heart rate. Vitamin B12 deficiency can potentially cause severe and irreversible damage, especially to the brain and nervous system. When levels of B12 are only slightly lower than normal, they can lead to a range of symptoms including fatigue, depression and memory loss.

Foods richest in Vitamin B12 may cause problems

Foods richest in Vitamin B12 include shellfish, liver, fish, crustaceans, fortified soy products, fortified cereals, red meat, milk, cheese and eggs. Most of these foods are also high in histamine, and are best avoided by people with histamine intolerance. Fortified cereals are processed foods with B12 (not methyl B12) added to them by the manufacturer.

Problems with Vitamin B12 absorption

Furthermore, not everyone is able to absorb Vitamin B12, even if they eat foods that contain it. The human physiology of vitamin B12 is complex, and therefore may go awry, leading to B12 deficiency.

Health conditions that may lead to poor B12 absorption include:
Atrophic gastritis (thinning of the stomach lining)
Pernicious anemia
Surgery that removed part of the stomach or small intestine, including weight loss surgery
Conditions affecting the small intestine, such as Crohn’s disease, celiac disease, bacterial growth, or a parasite
Heavy drinking
Immune system disorders, such as Graves’ disease or lupus
Long-term use of acid-reducing drugs, e.g. Panto-prazole*
A strictly vegan diet
A vegetarian diet that does not include enough eggs or dairy products to meet vitamin B12 needs
Advanced age

Cyanocobalamin is synthesized using cyanide

One way to combat Vitamin B12 deficiency is to take supplements. However, most Vitamin B12 supplements are in the form of cyanocobalamin rather than methylcobalamin.
Cyanocobalamin is artificially synthesized in laboratories. One of the main ingredients is potassium cyanide – yes, you read it right – cyanide, the well-known poison. Cyanocobalamin is the form used in most pharmaceutical preparations because adding cyanide stabilizes the molecule.
When we ingest cyanocobalamin, we are being exposed to small amounts of cyanide.

Methylcobalamin is more easily absorbed

Furthermore, cyanocobalamin is harder for our bodies to metabolize than methylcobalamin. Many people with histamine intolerance are, without being aware of it, ‘undermethylators’. Undermethylation, or ‘histadelia’, is an inherited condition characterized by elevated blood levels of histamine.
If our bodies cannot properly methylate vitamin B12, they cannot adequately absorb it. Methylcobalamin is already methylated, and thus more easily assimilated into the body.

If you are histamine intolerant – or even if you’re not – the optimum way to make sure you’re not Vitamin B12 deficient is to take methylcobalamin. It is available from pharmacies as pleasantly-flavored pills or drops, to be dissolved slowly under the tongue.

*Note: Our web host, WordPress, appears to block certain brand names and drug names such as Rani-tidine(TM) and panto-prazole, unless they are hyphenated.

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Histamine poisoning is not uncommon

Fatal histamine poisoning

Earlier in 2014 two people met a tragic death after eating fish. The culprit was found to be scombroid poisoning.
Scombroid poisoning is a now-outdated term for histamine fish poisoning. It is also sometimes known as pseudoallergic fish poisoning, histamine overdose, or mahi-mahi flush.
Histamine is colorless, odorless and tasteless. Scombroid fish histamine poisoning is hard to detect without scientific equipment, and can be fatal.
‘The term scombroid was used because the first fish species implicated in this poisoning were from the suborder Scombridae, which includes mackerel, tuna, marlin, swordfish, albacore, bonito, skipjack, and almost 100 other species (Scombridae is derived from the Greek word scombros, which means mackerel or tunny). The term histamine fish poisoning is now considered more appropriate because many cases are from nonscombroid fish. Examples include mahi-mahi (dolphin fish), amberjack, herring, sardine, anchovy, and bluefish.’

Source: Medscape

Histamine poisoning is not uncommon

Doctor warns scombroid poisoning involved in Bali death of Noelene and Yvana Bischoff is not rare

Connor O’Brien
Albert & Logan News
February 10, 2014

Yvana Bischoff, 14, and Noelene Bischoff who died in Bali after suspected food poisoning. Source: News Limited

A BRISBANE doctor who treated his wife for the same type of food poisoning which killed a Queensland mother and daughter in Bali says the illness is more common than most people think.

Noelene and her 14-year-old daughter Yvana Bischoff died while holidaying in Bali in January.

The subsequent autopsy indicated that they died from a combination of scombroid poisoning from food that was suspected to be tainted and existing medical conditions.

Experienced Daisy Hill general practitioner Nick Stephens cautioned that scombroid poisoning is actually not that rare, after treating his wife for it last year.

“It’s the most common form of fish poisoning in the world,” Dr Stephens said.

“But on the other hand, the complication of death (resulting from scombroid poisoning) is rare.”

Having been in the industry for 35 years, Dr Stephens was stunned when his wife Lorraine turned up at his clinic on Melbourne Cup day last year with systems of scombroid poisoning.

Mrs Stephens had been out for lunch at a South Bank restaurant when she and three friends had a major reaction about ten minutes after eating mahi mahi fish – the same variety the Bischoff’s had consumed shortly before their deaths.

Dr Stephens, 64, said when his wife arrived at his work she was bright red, having palpitations and struggling to breathe.

“I’ve never seen a patient ever look so red with a headache and the palpitations. So, obviously, with a severe dosage it can kill,” he said.

Dr Stephens said an analysis of the symptoms left him in no doubt that his wife had suffered from scombroid poisoning, even though it can be difficult to confirm.

“You cannot run a blood test or doing anything else to confirm it,” he said.

“They’ve had exactly the same problem with these people overseas, they can’t confirm it but they can’t find anything else.”

Since the attack, she has suffered from pancreatitis, which her husband believes may be a rare complication from scombroid poisoning.

Source: the Courier Mail

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Extra supplements for Histamine Intolerance sufferers

Histamine Intolerance Supplements

supplementsIf your histamine intolerance symptoms are extremely severe, then in addition to adhering to the Strictly Low Histamine Diet you may wish to take some additional supplements. Here are some suggestions.

* Low-acid Vitamin C  1000 mg twice daily.
Note: Standard Vitamin C supplements work well too, but but if you are taking high doses you may experience a burning or irritating sensation in the urinary tract. People with certain conditions such as interstitial cystitis, prostatitis and stomach ulcers often have a hard time tolerating high-acid vitamin C supplements.

* Vitamin B6 100 mg once daily.
Note: never exceed the recommended dose.

Your body needs Vitamin C and vitamin B6 to manufacture the DAO enzyme, which helps break down histamine in the body. Copper is also necessary for DAO production, but too much copper can be toxic. If your diet includes  variety of fresh, unprocessed foods it will already provide you with sufficient copper and you won’t need copper supplements.

* Digestive enzymes, one capsule before each meal. Choose a broad spectrum formula, including digestive enzymes to break down both protein (such as pepsin) and carbohydrates (such as amylase). Those who are histamine intolerant need help digesting protein, so that it does not linger in the gut fermenting and producing bacteria and histamine.

* Vira Stop is an enzyme formula dedicated to breaking down protein.  The recommended dose is 2 capsules daily. Begin gradually, by taking half a capsule per day and build up to 2 capsules over a few weeks. You should take this supplement on an empty stomach – i.e. either one hour before you eat or two hours afterwards. Never swallow probiotics and Vira Stop at the same time because they can interfere with each other.

* Probiotics. There are two species that actually cause histamine to be released in the body and those are Lactobacillus casei and Lactobacillus bulgaricus. Avoid them. Two very important types for people with histamine intolerance are Bifido infantis and Bifido longum. Take any probiotic supplement that contains both of these.

* Zinc inhibits the release of histamine from mast cells. Take 50mg of zinc per day, with a meal containing starch. This helps your body to absorb the zinc.

Remember that what you leave out of your diet to control histamine levels is probably even more important than what you take in via supplements.
Taking every recommended supplement will have little effect if you are still eating histamine-rich or histamine-triggering foods.  Consult the book for the complete diet.

Health and medical information disclaimer:

The information provided on this website is intended only to aid you in making informed decisions about your health. It is not intended to be a substitute for advice and treatment prescribed by a registered dietitian, nutritionist or doctor. The content of this website may not be used as a basis or means for any form of self-diagnosis. If you suspect that you have a medical problem, we urge you to seek the help of a medical practitioner.

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Why most low histamine food lists are so confusing.

Low histamine food listsLow Histamine Food Lists

The Internet offers many ‘low histamine’ food lists. Reading them all can be confusing, because they often contradict each other. Low histamine food lists are not as simple as, say, gluten-free or lactose-free food lists, because gluten and lactose are either found in a food or they are not. Their existence is independent of storage conditions and freshness.

Histamine levels, by contrast, fluctuate. A food might be low in histamine to begin with, yet high in histamine as it ages. Histamine levels in food also vary depending on the storage methods (e.g. freezing halts histamine development).

Furthermore, some of these published lists include foods that may not have high histamine levels, but which contain compounds that provoke histamine release. Others do not.

Many low histamine food lists do not take into account foods that may be DAO blockers. Moreover, they may not include mention of oxalate (oxalic acid), an irritant that can trigger histamine release, thereby causing the same symptoms as histamine. Oxalates can also contribute to the distress and debility of chronic fatigue syndrome and myalgic encephalomyelitis, because they damage and destroy mitochondria. High levels of oxalate in the intestines also hinder beneficial bacteria from colonizing the gut.
Nor do many food histamine lists consider foods that release other biogenic amines, those which may contribute to HIT and which certain foods may release in some individuals, despite the fact that the foods themselves may not contain any biogenic amines.

To add to the confusion, some individuals have published  lists of foods which are tailored to their own unique body chemistry. That is, they themselves might be able to tolerate the foods on their list, but most other people cannot. One “low histamine” recipe-writer, for example, recommends using lentils, cocoa, berries and thyme, despite the fact that SIGHI (Swiss Interest Group Histamine Intolerance) describes lentils as “incompatible.”  Histamine expert Dr Janice Joneja says, “Berries tend to be high in benzoates. Benzoates release histamine.” And, “There are certain herbs which release histamine. Thyme, for example, releases histamine.” Cocoa contains compounds that are known histamine liberators.

Another person who blogs about mast cells has published “low histamine” recipes that include ingredients such as mushrooms, split peas, squash and quorn, all of which are described as “to be avoided” in numerous authoritative low histamine food lists from around the world.

Even the most authoritative lists, compiled by medical researchers, can have disparities. There is disagreement about a wide range of fruits, vegetables and spices including cherries, grapes, cranberries, blackberries, peaches, apricots, nectarines, pears, black-currants and red-currants, blueberries, kiwi-fruit, pineapple, plums, papaya, mushrooms, broad beans, pumpkin, anise, cinnamon, nutmeg and cloves.
Legumes and pulses are also debatable. Some lists include non-soy legumes such as dried beans and peas and lentils. All lists ban soy and red beans.
Again, some lists ban all nuts, while others forbid only walnuts, pecans and cashews.

This is why “Is Food Making You Sick? The Strictly Low Histamine Diet” recommends only those foods which have been agreed upon by every genuine, science-backed and meticulously researched source. The low histamine food list in this book is strictly low histamine, as are the recipes.

 

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Should Histamine Intolerance sufferers go gluten free?

Don’t panic about gluten!

Some people believe that if you suffer from histamine intolerance you should go gluten free.

These days, there is a fashion for avoiding gluten-containing foods because ‘gluten free’ is perceived as ‘healthier’. Gluten-containing foods include wheat, barley, rye, triticale, kamut and spelt.

Gluten is a natural plant protein that helps bread rise and gives bread, cakes, pastry, pasta, noodles, and similar foods their elasticity and texture.

The truth is, gluten is only a problem for people who are non-celiac gluten sensitive (NCGS), or who have celiac disease – that is, approximately 1% of the population. (Note: NCGS is a condition that is distinct from celiac disease.)

Foods that happen to contain gluten may also be a problem for people who are sensitive to those particular foods. For example, you may not be celiac or NCGS, but you might have been diagnosed as being sensitive to wheat, for reasons other than its gluten content. People with histamine intolerance should avoid wheat germ, in any case.

If you have celiac disease or NCGS then it is vital to avoid gluten because it can cause intestinal permeability, which is also known as ‘leaky gut’. This can in turn lead to DAO insufficiency and thus to histamine intolerance. Gluten intolerance is also linked with autoimmune  diseases.

However if you are, like the vast majority of the population, perfectly capable of digesting gluten without any problems, gluten-containing foods are actually good for you. They are highly nutritious – packed with vitamins, minerals and beneficial fiber.

“Studies show that whole grain foods, as part of a healthy diet, may help lower risk of heart disease, type-2 diabetes, and some forms of cancer. A 2005 report from the American Dietetic Association warned that gluten free products tend to be low in a wide range of important nutrients, including B vitamins, calcium, iron, zinc, magnesium, and fiber. There’s also little point in eliminating just some gluten. For people who are sensitive, even trace amounts can cause damage to the small intestines. So an almost gluten-free diet isn’t going to help if you have a problem.” [Source: WebMD]

In a normal, healthy person gluten will not cause a leaky gut. And the odds are, you are one of the 99% who can digest gluten.

If you think you really might be celiac or have NCGS, ask your doctor for a test. The Celiac Disease Foundation states that there are several blood tests available that screen for celiac disease antibodies. “If test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.”

Even if your celiac test comes up negative, you could try avoiding all gluten for at least 30 days to see if that makes your health improve. If you do feel better, this might indicate that you have NCGS.

If you really are gluten intolerant you’d have to cut out all gluten, down to the tiniest particle. An ‘almost-gluten-free’ diet will not help at all.

Simply avoiding gluten because you think it’s ‘bad’ for you means cutting a lot of nutritious foods from your diet. You can, of course, do so if you wish, but-

  • it’s more than likely there will be no benefit in it
  • you’d have to cut out a wide range of foods, because if you check the ingredients on labels, there are traces of gluten in most pre-prepared foods
  • commercially available gluten free foods often contain higher amounts of saturated fats, refined sugars and other undesirable ingredients
  • prepared gluten free foods are usually more expensive

The book “Is Food Making You Sick?” contains a large number of gluten free, low histamine recipes. Is Food Making You Sick?

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Boosting your DAO

boosting your daoAntihistamines

If you find that taking certain antihistamines significantly improves your health, then it’s likely you suffer from HIT (Histamine Intolerance). Some common antihistamine trade names include:

Zyrtec = cetirizine, an antihistamine that works by blocking histamine (H-1) receptors.
Zantac – ranitidine, an antihistamine that works by blocking histamine (H-2) receptors.

Both of these – like any medications – can have unwanted side effects. However, these are generally outweighed by their benefits, at least in the short term. Taking them is a good way to hit your symptoms hard and really get them to settle down. If you wish to follow up the potential side-effects of Zyrtec and Zantac, click on these links: Zantac   Zyrtec

That said, taking Zantac and Zyrtec is not a long-term solution. It’s like putting a bandage over an infected wound – it looks okay from the outside but the problem remains. Besides, over time the body can develop resistance to the meds. Then they gradually lose their efficacy and you go back to ‘square one’.

About Boosting Your DAO

We suggest that HIT sufferers:

  • Make sure none of your other medications (if any) are DAO (diamine oxidase) blockers, which might have brought on your symptoms in the first place. If possible – and under medical supervision – try to wean off them.
  • Stick to the Strictly Low Histamine Diet and its associated dietary supplements. A low histamine diet with safe, natural supplements has no unwanted side effects and for many people it has provided that ‘miraculous’ relief they have been seeking. It doesn’t take months and months to get a result – only a few weeks.
  • Another essential is dietary fiber. Consuming abundant fiber has been proven, in numerous studies, to decrease inflammation in the body (and the reverse is true of a high fat diet). It can actually improve the binding ability of the histamine H-1 receptor.
  • Stress can be a powerful trigger for Histamine Intolerance too, so it’s important for people with HIT to treat themselves kindly and allow themselves time to relax. For anyone with HIT who is reading this post, we recommend visiting the Helpguide website and looking at their excellent Stress Management Guide.
  • Protect and heal your intestinal mucosa. The body produces DAO in the small intestine, the upper part of the large intestine, and the kidneys. To help protect and heal the mucosal lining of your intestines, include the spice turmeric and brassica vegetables (e.g. cabbage, cauliflower, broccoli, Brussels sprouts, )in your diet. Prebiotics and probiotics, too, play an essential role in the healing of the gut.
  • Protect and heal your kidneys. Your kidneys may be perfectly healthy, but there are still things you can do to make sure they stay that way – and to boost their DAO producing capabilities. The Kidney Foundation of Canada recommends that people with kidney disease should ‘control your salt intake and avoid foods with a high sodium content. These include processed foods like “deli” meats, canned foods, convenience and “fast” foods, salty snacks and salty seasonings.’ They also say, ‘Phosphorus is a mineral which normally keeps your bones strong and healthy. However, too much phosphorus may cause itchy skin or painful joints. When the kidneys start to fail, your blood phosphate level will rise. Therefore, you may need to limit certain foods which contain even a moderate amount of phosphorus. These include milk, cheese and other milk products, and protein foods such as meat, fish and poultry.’