Histamine Intolerance, Inflammation and RLS (PART 5): TREATMENT

ImageI have thoroughly scoured the web to see if there is a supplement or herb on the market that can naturally and effectively increase the level of DAO (you’ll read below that this is the enzyme the keeps the histamine levels in check). There are a few products on the market, but the reviews are POOR. I don’t recommend that you purchase them. My belief is that you’ll find more success in using natural antihistamines along with a low histamine diet.

However, there have been several scientific studies that show how copper increases the activity of the DAO enzyme. There is a direct relationship between the two.

“Copper supplementation of adult men: effects on blood copper enzyme activities and indicators of cardiovascular disease risk.” Jones AA, DiSilvestro RA, Coleman M, Wagner TL. Department of Human Nutrition and Food Management, Ohio State University, Columbus 43210-1295

“Although copper had no significant effects on any parameter for the entire study group, it did significantly increase two enzyme activities (SOD and DAO), as well as lipoprotein oxidation lag times, in 10 subjects in the lower half of a median split for precopper values. Thus, copper supplementation appeared to influence some types of measurements in subjects beginning with less than median values.”

There are a lot of options available to you (many of them are listed below). There are tests available, diets, books, websites and blogs that can guide you and help you to lessen your histamine level. By lessening your histamines, your inflammation will lessen, which in turn will lower the intensity of your Restless Legs. It will also help you to sleep better. What more could you ask for.

Because you have Restless Legs, you’ll have to keep in mind that sugary histamine inhibitors like chocolate are not an option for you. It’s important to keep the main Restless Legs triggers in mind (sugar, msg, alcohol, caffeine, gluten etc.) when you’re developing your low histamine diet.

It’s a bit of a challenge, but it’s not hopeless. I’ve done it, as have many others. All I can tell you that it’s worth every sacrifice and effort that you’ll need to make.

PART 5 of this series on Histamine Intolerance, Inflammation and RLS will feature a MASSIVE list of natural antihistamines for you to choose from.

from Healthy Pixels
Copper is required to form the DAO enzyme and copper deficiency associates with low DAO enzyme activity in animals. More research is necessary to confirm that copper supplementation increases DAO activity. Foods high in copper include fresh basil, cocoa powder, cashews, soybeans (mature), herbal tea, sesame seeds, sunflower seeds, garbanzo beans and lentils.

from Dr. Janice Vickerstaff Joneja, Ph.D., R.D. on Swanson Health Products
Diamine oxidase (DAO) is an essential enzyme in the body that breaks down histamine. The body then takes the break-down products (called imidazole compounds) and excretes them through the kidneys into the urine. When the body’s level of histamine exceeds its requirements, DAO breaks down the excess so that histamine is kept within the “normal” level. A normal level of histamine is required for its vital control of some brain and digestive tract functions, and immune defenses. If a person has a slightly lower level of DAO, or has eaten too many foods with high levels of histamine that exceed their enzyme’s capacity to break down the excess quickly enough, signs of histamine excess result. Each person has his or her own “limit of tolerance,” which is determined by his or her DAO’s ability to keep histamine at a tolerable level.

Once a person feels comfortable, he or she might try one histamine-rich food, while continuing to take DAO. If they do not develop the familiar signs of histamine excess, they should be able to eat the occasional histamine-rich food while continuing to take a DAO supplement. This should allow them to be less rigid in their dietary choices and to eat some of the high-histamine foods they especially enjoy on occasions. It’s important to recognize, however, that while DAO can help maintain a healthy histamine tolerance, a person can still exceed his or her limit.

Finding a balance really depends on your body’s ability to handle histamine. People who have very low levels of natural DAO will need to restrict their histamine-rich foods as well as taking a regular DAO supplement. If you experience only the occasional “histamine reaction” after indulging in too many histamine-containing foods you should be able to simply take a natural supplement when you plan to consume high-histamine foods and beverages such as wine and cheese at a party, or a large pepperoni pizza with double cheese and tomato sauce.

It is possible for anyone to exceed his or her DAO’s capacity to break down their excess histamine. For example, people who have quite normal levels of DAO may break out in hives after eating a large basket of strawberries. I have a client who breaks out in hives due to histamine excess when she eats ripe cherries from the tree in her garden; however, she can eat unripe cherries without difficulty because the unripe fruit has not yet produced a high level of histamine. Many people seem to develop a stuffy nose after consuming alcohol, especially if they consume a high-histamine food at the same time. Beer and pizza is a common combination that often results in headache, not so much from too much alcohol (although of course that will happen on occasion!) but from the excess histamine. If a person regularly experiences these signs after eating high-histamine foods it would be a good idea for them to try taking DAO prior to eating, and to find out if this helps. But again, I do want to caution that it is important to visit a health professional if your experience seems like it may be due to an allergy. We certainly do not want to encourage people to self-diagnose something that could truly be a medical condition. But in those instances where allergy is ruled out, histamine excess could be in play and in my experience, DAO has proven to be very helpful for many people.

Imageby Jamie Scott on That Paleo Guy
The main treatment is adherence to a low histamine diet. This is quite a separate entity to a histamine-free diet which would be practically impossible to adhere to, nor is it required for the patient to enjoy relieve from the typical symptoms of histamine intolerance. The key is to identify low histamine-containing and inducing foods and to bulk up the diet with these foods. I advise people to run a three day rolling average with their histamine loads. This allows a degree of freedom to perhaps consume some higher histamine foods, e.g. bacon, but still stay on top of histamine levels overall.

Once awareness is created around which foods are highest in histamine, constructing a low histamine ‘paleo’ diet is actually relatively easy to do. It is also important to recognise that a degree of additional tolerance is gained by removing the major inflammatory agents from the diet (grains, sugars & vegetable oils) – something that should already be taking place within the context of a paleo diet and which may explain either the full or partial relief people experience when they begin eating such a diet.

Where high histamine foods are unavoidable (e.g. you want to drain a bottle of red one night), then prophylactic dosing with antihistamines may buy you a bit of extra breathing space. However, in the general run of things, the taking of antihistamines appears to not add any additional benefit over the adherence to a low histamine diet. If an individual has been following a low nutrient diet for some time, then perhaps additional vitamin B6, copper and vitamin C may be of benefit. Diet should be assessed to ensure it is providing these nutrients in adequate amounts moving forward.

It is useful to assess all medications that are being used, including the oral contraceptive. It is quite on the cards that many of the medications that might be in play and which may interfere with histamine metabolism, are being used to treat individual symptoms of histamine intolerance, e.g. blood pressure medications, anti-depressants, and (ironically) histamine antagonists.

from Purehealth Clinic
Histamine intolerance (HIT) is defined as an intolerance to histamine. The cause can be a lack of the DAO enzyme needed to break down histamine, or be a discrepancy between DAO and histamine. In other words, you could have a high or normal level of blood histamine but not enough DAO to break it down. There is a test to measure the levels of DAO enzyme you have in your system to see if the lack of enzyme is your problem.

from Allergy UK
It should be noted that allergy tests measuring IgE levels, such as skin prick testing and specific IgE blood tests for these foods will be negative. This is because reactions to histamine are not caused by an IgE food allergy – the cause is histamine intolerance.

Diagnosis of histamine intolerance is usually made by a person trialling a low-histamine diet for a couple of weeks, and seeing if their symptoms improve. Blood tests that claim to be helpful in measuring levels of histamine or the level of the enzyme that normally breaks histamine down are not reliable.

Food exclusion should always be followed by a period of reintroduction in order to confirm a diagnosis. If this is not done the diet can easily become over restricted and unmanageable.  At worst it can become nutritionally deficient.

Imagefrom Healthy Pixels
If any type of food allergy is suspected, consult with an allergist and start carefully taking notes about diet and symptoms. ChartMySelf.com can help you keep online records of your health. Blood tests for both immediate and delayed food allergies are available to doctors from Great Plains Laboratory, US Biotek and many others. Depending on the type of allergy exposure and related damage, a body may require days, weeks, or even months to fully recover.

Histamine on the horizon
We can now begin to imagine how to change our diet, avoid certain drugs, and adjust our lifestyles to better regulate our histamine levels. By first identifying our allergens through food or skin tests, we can reduce exposure and dramatically empty our “histamine bucket” and lower inflammation. Even if we have no allergies to avoid, we can improve our ability to breakdown non-allergic histamine with C and B vitamins. Ideally we can better prepare our bodies to handle histamine “spikes” as needed for fighting disease, increasing motivation, or simply tolerating delicious leftovers.

We desperately need a way to identify and “scan” histamine content in our food and supplements prior to purchase and consumption. Packages can differ widely based on their microscopic bacteria content – even within expiration dates. Austrian scientists have made suggestions for tolerable levels for certain foods including sausage, fish and cheese, but we need global standards for all foods and awareness of the risks surrounding fish, fermented foods, canned meats, alcohol, prepackaged meals and other high-risk products.

Similarly, daily tracking of our own histamine metabolism would help guide our diet and lifestyle. Recognizing the triggers can help us map our journey to good health and beyond!

Imagefrom Judy Tsafrir, M.D. of Boston Holistic Psychiatrist
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.

Imagefrom The Failsafe Diet
FAILSAFE stands for Free of Additives, Low in Salicylates, Amines and Flavour Enhancers. It was originally designed to treat ADHD children, but has proven useful for a wide range of symptoms.

FAILSAFE is Sue Dengate‘s term for the low-chemical exclusion diet formulated by allergists at the Royal Prince Alfred Hospital in Australia. It is designed to treat sensitivities to specific natural and man-made flavouring, colouring and preservative chemicals found in foods.

Sensitivities to food chemicals are pharmacological and dose-related (like the side effects of drugs), rather than immune-mediated like allergies. Different people have dramatically different tolerance levels to salicylates, amines, glutamates, sulphites, food colourings and other additives, and sensitivity symptoms (intolerances), occur when a person’s tolerance levels are exceeded.

The symptoms caused by food chemicals appear to be allergy-like which can make determining their true cause very confusing. Despite food chemical intolerance being more common than true allergy, a lack of knowledge about this syndrome means that the symptoms are rarely understood properly by the layperson or the medical practitioner. There are specific metabolic reasons for these symptoms.

The failsafe diet excludes strong tasting and smelling foods and environmental chemicals, in particular:

About fifty additives including colours (like tartrazine, sunset yellow), flavours, preservatives and antioxidants (sulphites, nitrates, benzoates, sorbates, parabens).
Salicylates (aspirin) and polyphenols (natural flavours, colours and preservatives) found in a wide range of fruits and vegetables as well as in man-made NSAIDs and COX II inhibitors.
Neurotransmitters: free glutamates (MSG) and amines (histamine, serotonin, dopamine, phenylethylamine, tyramine and others) in aged proteins and fermented foods like cheese, game and hung meat.
Environmental chemicals and strong smells like perfumes, most commercial cosmetics, scented and coloured toiletries and especially mint and menthol products.
Some pharmaceutical drugs, including aspirin, all NSAIDS including ibuprofen, and the methyl-salicylates found in decongestants and anti-inflammatory creams.

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