‘Histamine intolerance or allergy? Practical ways to identify and address these conditions’ sponsored by OptiBac Probiotics

To download a PDF of the presentation, click here.

Please check back soon to see the answers to any questions that were posted during the webinar. 

Do you have evidence the probiotics are absorbed in the body?
Probiotics are not absorbed in the gastrointestinal tract. Our probiotic supplements survive the stomach and reach the gut alive, where they thrive and restore the natural balance of good to bad bacteria. The efficacy of our probiotics are demonstrated in the human clinical trials that have yielded clinically significant, measurable results that suggest our probiotic strains are positively influencing the health of the test subjects.

Whilst in vitro trials appear to demonstrate that certain probiotics are stomach acid resistant, the real ‘proof of the pudding’ are the human clinical trials which show notable effects on gut health, or cholesterol levels, or vaginal health. This is the ultimate confirmation that our probiotic strains survive stomach acid and colonise in the intestines or vagina and offer health benefits.

I am on a low histamine diet and still experiencing symptoms (swelling of lips) of histamine intolerance. Is it worth trying to supplement DAO? My understanding was DAO works for ingested histamine and if on a low histamine diet, is it recommended?
It’s important to remember that histamine intolerance is not solely a food intolerance. In addition to food, there are many other causes of symptoms such as medication, stress and especially poor gut health so any one of these could still be causing your symptoms. Your understanding is correct in that DAO works to break down ingested histamine whereas histamine N-methyltransferase (HNMT) degrades intracellular histamine. So taking DAO will help to break down ingested histamine and if your DAO levels are low then this could result in some relief. I’m assuming you’ve tried a strict low-histamine diet for at least 4 weeks and are still experiencing symptoms and so you could also try to boost DAO levels naturally using omega 3, calcium, zinc, iron, etc (I mentioned quite a few during the presentation). However, if the levels of histamine produced internally are high, a DAO supplement will likely not affect this intracellular histamine. I would recommend addressing the gut through the use of supplements including probiotics as the benefits of maintaining gut homeostasis may be experienced throughout the body.

I have a client who I suspect has histamine intolerance and she suffers from heartburn. Is this common?
Yes, this is a common symptom.

What about a test for a food intolerance rather than an allergy – if this is negative would it also suggest a histamine intolerance
The purpose and necessity of the allergy test is to rule out any possible allergies. This is important as allergies can be quite severe and/or life-threatening. So I’d personally recommend testing for an allergy and if this is negative, consider histamine intolerance as a possible condition.

Is a rash a common symptom of histamine intolerance?
Yes, this is a common symptom.

How long should I do a probiotic protocol for?
It depends on the condition you are trying to address, the individual and the probiotic strain. Some probiotic supplements can be taken on a daily basis to support gut health and others may not need to be taken long-term. My advice would be to join one of our free online training sessions where we go through the different strains you can use for different conditions and for how long.

I would love a list of all the studies that have been referred to during the talk but not referenced on the slides please:
The reference list is on the last three slides of the presentation. If you download the PDF version you will have access to them. Probiotic studies can also be found on our ‘Probiotics database’ website.

Is this a treatment that you take seasonally or long-term?
If you were referring to my personal hay fever treatment support using the ‘For every day MAX’ supplement combined with vitamin C, this specific combination is something I do only during the hay fever season. However, ensuring gut health through the use of nutrition, herbs and probiotics is something I practise long-term and intend to do for a lifetime!

Could Histamine have an impact on CRP levels?
“CRP and IL-6 levels are not simple surrogate markers for histamine or tryptase release by mast cells or basophils in acute allergic reactions” (Lin et al 2001). This quote is taken from a study which suggests that during this particular trial, histamine levels were negatively correlated with CRP levels. So the presence of high CRP levels does not simply mean that histamine is implicated. I believe more studies may be required to investigate exactly how histamine correlates with CRP levels.

Is there a test to check histamine levels in general and what is the level of histamine normally circulating?
Yes. ‘Lab tests online UK’ is a lab that tests histamine levels. From reviewing different research papers and labs which test histamine levels, the optimal histamine range seems to be between 25 to 65 ng/mL.

What dosage of pos bacteria do you recommend?
If you’re referring to the dosage of probiotic bacteria, then we recommend different dosages of our probiotic supplements depending on the condition you are trying to address and its severity. I recommend joining in on one of our free online training sessions to find out more.

Which specific strain of probiotics do you recommend for a Coeliac who had gluten by accident?
I would recommend Saccharomyces boulardii to benefit from potent anti-inflammatory effects and its ability to tighten tight junctions, which will reduce gut permeability. I would also strongly recommend it in combination with our ‘For every day MAX’ supplement which contains probiotic strains that will help to coat the gut wall lining, fortifying the gut’s natural defences.
Do the probiotics increase the client’s production of Secretory IgA within the gut wall?
Certain probiotic strains, such as Saccharomyces boulardii, are able to promote the secretion of secretory IgA. You can find out more about this on our ‘Probiotics database’.

How long can you safely take sach. B?
Saccharomyces boulardii is safe to take on a long-term basis.

Can you please share which strains of L. Casei and L.Bulgaricus are histamine-producing?
Based on the small amount of research available, it is thought that some of the bacteria used to ferment yoghurt and fermented foods could potentially exacerbate histamine production and typically these are strains of Lactobacillus casei and Lactobacillus bulgaricus. It’s important to remember that strains within a species of bacteria may react in a different way, and so not all strains within these species will have this effect. Research does suggest that L. casei (TISTR 389) and L. bulgaricus (TISTR 895) are potential histamine producers (Deepika and Rakshit 2011). There could be more strains in these species which also produce histamine but more research is needed to be definitive.

Is the affiliate scheme open to people in Ireland too?
Yes.

Is the technical training available to do online?
Yes. We offer a 1-hour online training session via Zoom.

Have you come across people who are histamine intolerant craving lots of fermented food, vinegar taste foods at all?
Craving for a particular food may be a sign of a food intolerance and individuals may often crave the foods they are intolerant too. As both fermented foods and vinegar are high in histamine, there is a possibility that an individual with histamine intolerance could experience such cravings. I personally have not come across this yet.

Could you please advise where can we do a DAO level test?
‘Cambridge CNS Lab’, ‘Biolab’, ‘Cerascreen’ and ‘Lab Tests Online UK’. ‘Lab Tests Online UK’ also tests histamine levels.

Could you again repeat what are the other states we need to rule out in diagnostic testing for histamine intolerance and what are these discriminative tests?
– Test for an allergy (to rule out any possible allergies)
– Test for DAO levels
– Keep a food diary to track reactions to certain foods
– Elimination diet (put client on low-histamine diet for 2-4 weeks & see if symptoms subside)
– Rule out other possible causes of symptoms ie Coeliac disease, mastocytosis, mast cell activation syndrome or cancer.

As none of these approaches can definitively diagnose histamine intolerance, your client should test positive for 2 or more tests for histamine intolerance to be diagnosed. For example, your client may test negative to an allergy and experience a relief in symptoms from a low-histamine diet. This may be an indicator that they are suffering from histamine intolerance.

For how long would you recommend to take the two probiotic strains for hay fever?
I would recommend taking these strains all year round as Lactobacillus acidophilus NCFM® & Bifidobacterium lactis Bl-04 are suitable for everyday use and will help to coat the gut wall lining and fortify the gut’s natural defence. As a secondary recommendation, I would recommend it to be taken at least 3 months prior to the hay fever season and during.

What are good natural ways to boost DAO levels?
Some natural DAO boosters are omega 3, calcium, zinc, iron & vitamin B12, magnesium and phosphorous.

Is there anything you would recommend for Rosacea (flushing) who responds well to antihistamines, so feel it’s histamine intolerance,thanks
I would recommend a low-histamine diet, DAO boosting foods and some natural antihistamines (vitamin C/B6, quercetin), seeing as the individual responds well to antihistamines. I would also recommend our ‘For every day EXTRA Strength’ supplement which has some anecdotal evidence behind it for Rosacea.

If someone has been diagnosed with IgE allergies (pollen and dust) could they possibly be histamine intolerant too, driving further symptoms?
Yes. Allergies such as pollen may act as histamine liberators which means that they help to release histamine from other foods, which could definitely increase or further drive symptoms.

In the very large Swedish birth study, the pre-term deliveries had the lowest allergy occurrence – why would this be please?
This stood out to me also. The researchers suggested that this negative association between very preterm birth and food allergy could be associated with the neonatal care initiated in very pre-term children, which includes the early introduction of foods orally (Mitselou et al 2018). As I mentioned during the presentation, research is showing that the introduction of highly allergenic foods during the early stages of development may actually decrease the risk of food allergy.

I have a client with polycythemia Vera and I’m interested to know more about the link with histamine.
A classic symptom of this polycythaemia vera is pruritus and doctors may often prescribe antihistamines in such cases. This indicates that histamine levels may rise as a result of this condition and if your client has this symptom then you may consider natural antihistamines to support. Also, research has found serum DAO activity reduced during anticancer drug treatment, so this may be something to consider if your client is on such treatment, as DAO is responsible for metabolising ingested histamine (Miyoshi et al 2015). I would advise the client to discuss further with their GP to decide a course of action.
Would you recommend charcoal as a way to reduce histamine levels?
Activated charcoal is actually one of my favourite health remedies. I’ve had much success using it in practice when it comes to food poisoning, insect bites, indigestion and much more! However, research is still in its early stages when it comes to charcoals effectiveness for food allergies, let alone histamine intolerance which is a much less understood and diagnosed condition. So would I recommend it? Well, I’d say there’s no harm in trying it alongside other well researched approaches to reducing histamine levels.

References:
Lin, Robert Y. et al. (2001), Interleukin 6 and C-reactive protein levels in patients with acute allergic reactions: an emergency department-based study. Annals of Allergy, Asthma & Immunology , Volume 87, Issue 5 , 412 – 416

Deepika Priyadarshani, W. M. and Rakshit, S. K. (2011), Screening selected strains of probiotic lactic acid bacteria for their ability to produce biogenic amines (histamine and tyramine). International Journal of Food Science & Technology, 46: 2062-2069

Niki Mitselou et al. Cesarean delivery, preterm birth, and risk of food allergy: Nationwide Swedish cohort study of more than 1 million children, Journal of Allergy and Clinical Immunology (2018)

Miyoshi, J et al. Serum diamine oxidase activity as a predictor of gastrointestinal toxicity and malnutrition due to anticancer drugs. J Gastroenterol Hepatol. 2015 Nov;30(11):1582-90.

Probiotics database – https://www.optibacprobiotics.co.uk/professionals/probiotics-database