What is histaminosis and what symptoms does it produce?

Histaminosis is the accumulation of a substance called histamine. Histamine is produced naturally in the body and is released by our immune system. It is present in certain cells called mast cells in the skin and respiratory system, acting as a neurotransmitter. 

It plays an essential role in various body functions, such as in allergic reactions, the production and secretion of gastric juices, the dilation of blood vessels, and the sleep and appetite cycle, among others.

The accumulation of histamine in the blood can arise due to sensitivity to foods with high levels of histamine or that stimulate the release of it, leading to a series of symptoms that the patient may present such as migraines, fatigue, insomnia, conjunctivitis, skin rashes, digestive problems, nausea, palpitations, etc. However, there are cases where, regardless of whether the consumed foods are high or low in histamine, there is a deficiency of the enzyme Diamine Oxidase (DAO), which prevents histamine from being adequately degraded. We do not refer to histamine intolerance as a traditional allergy since it is not mediated by immunoglobulins. It is estimated that histaminosis affects between 1 and 6% of the global population.

What genes are involved in histamine metabolism?

There are laboratory tests that analyze the enzymatic activity of the enzymes responsible for metabolizing histamine. In this sense, our DNA has much to say on this matter, as certain genetic variations have been associated with a deficit in the production and/or activity of the enzymes that metabolize histamine. These enzymes are as follows:

• DAO (Diamine Oxidase): It is responsible for degrading histamine in the intestine.

• HNMT (Histamine N-Methyltransferase): it is associated with the inactivation of histamine in certain immune cells of the tissues. 

For this reason, the genetic test of N·GENE analyzes the following genes:

1. Gene AOC1: which encodes the DAO enzyme.

2. Gene HNMT: which encodes the HNMT enzyme.

In total, 5 genetic variants in these genes are analyzed. Depending on how many risk alleles are present, there will be a greater or lesser predisposition to suffer from histamine intolerance. This information gives you an idea of the management capacity that person has regarding histamine. However, it is a predisposition. By themselves, these genetic variations are not sufficient to determine the onset or development of this intolerance, as genetic factors interact with environmental ones jointly. For this reason, other aspects must be taken into account when addressing a case in consultation, such as assessing the person's diet to evaluate its histamine content. Especially in individuals with a genetic predisposition to histaminosis. 

Which foods are high in histamine?

• Vegetables such as potatoes, beans, tomatoes, soy, avocados, peppers, spinach, or eggplant.

• Wheat and derivatives (bread, pizza, pasta, batter-fried foods, etc.)

• Spices such as cinnamon or vinegar.

• Citrus fruits.

• Strawberries, kiwi, and pineapple.

• Nuts.

• Cow's milk and derivatives (milk, cheese, yogurt, cream, butter, flan, etc.)

• Alcoholic and fermented drinks like wine and beer.

• Pork or blue fish: Its content increases with the degradation of these.

However, not only foods rich in histamine can increase our endogenous levels, but age, high estrogen levels, excessive alcohol consumption, allergies, or, as is very common, our ability to eliminate histamine from our body also play a role. 

Which foods should be recommended to a patient with histamine intolerance?

• Fruits: apple, mango, melon, grapes, watermelon, figs, berries.

• Milk and derivatives that are not from cows or soy.

• White fish: hake, cod, monkfish, sole, octopus, squid, cuttlefish, trout, sea bream, turbot, seabass.

• Quinoa, millet, and buckwheat.

• Vegetables: lettuce, arugula, lamb's lettuce, cabbage, cauliflower, broccoli, garlic, onion, cucumber, carrot, artichokes, leek, asparagus, beets, turnips, celery, and beans.

• Beef, rabbit, chicken, turkey, or lamb.

• Honey or stevia (if necessary).

• Egg yolk 

Supplementation with DAO

In cases of histaminosis, studies show that although supplementation of this enzyme does not completely eliminate the symptoms, it does provide an improvement in quality of life. For example, in the case of migraine, reducing pain and even eliminating the use of analgesics. In the case of urticaria, decreasing the use of antihistamines.

All studies have concluded that the greatest benefit is obtained from supplementation accompanied by a low-histamine diet.

How can N·GENE help us in nutritional consultation?

The information that N·GENE provides us, based on different genetic predispositions, helps guide the patient in the consultation, and therefore provides them with much more personalized guidelines and/or treatment.

It allows us to:

• Know the patient 

• Validate or reinforce your clinical suspicions.

• Fully personalize the nutritional strategy.

• Create greater adherence, allowing for better results.

• Loyalty among patients, as no other health professional has that information or knows that patient like you do.

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