When It’s Not Allergy – Solutions for Histamine Intolerance


According to a new study in JAMA Network Open, 1 in 5 Americans believe they have a food allergy, while only 1 in 20 actually do. Many of those who test negative for a true allergy may be suffering from a dietary intolerance. This population deserves support.

The most easily recognized dietary intolerance is to lactose. But perhaps the most troublesome, and the least recognized, is histamine intolerance. The symptoms seen in allergic reactions, such as a runny or stuffy nose, sneezing, watery eyes, itching, headaches, hives and digestion issues, are also seen in histamine intolerance.

Histamine is released by the immune system when fighting foreign invaders in the body such as bacteria, viruses and allergens. It is also required in digestion and in brain functions. What many people don’t realize is that histamine is also widely present in our diet.

Histamine intolerance happens when someone can’t break down histamine quickly or efficiently enough to prevent a reaction. In the digestive tract, histamine is broken down by the enzyme diamine oxidase (DAO), and it’s all a matter of balance.

Think of your body’s level of histamine as a bucket filling up with water. Everything is fine while the water is below the bucket’s edge; however as soon as the bucket overflows, reactions occur. Every person has a different sized bucket (depending on the level of DAO/DAO activity); the point at which the bucket overflows and reactions appear is called a person’s limit of tolerance. This limit varies between individuals.

For those who are histamine intolerant, common foods can present a real challenge. Our diet contains many ingredients that have high levels of histamine, which may occur naturally or are produced as a result of manufacturing and processing methods. In addition, food additives have the ability to release histamine inside the body and add to the body’s histamine level. Histamine occurs naturally in many foods that are good for you, such as, tomatoes, avocados, eggplant; fermented foods such as sauerkraut and kimchi; and foods in which microorganisms are used in the manufacturing process such as cheese, yogurt and sausages (e.g.: pepperoni and salami). Wines, beers and certain liquors also contain histamine and may trigger a reaction as well.

There are several ways you can help your customers address histamine intolerance, from dietary recommendations to supplements and raw food solutions.

Evaluate the Cause

A number of conditions and variables can promote excess histamine or cause low levels of DAO or DAO activity, thus stimulating a dietary histamine intolerance. These include genetics, allergies, acute and chronic inflammation, hormonal changes, mast cell activation disorders, and prescription medications. Understanding the influences can help you develop an appropriate plan.

Recommend a Histamine Restricted Diet

Whatever the source of excess histamine, reducing the amount entering the body will help to reduce the total, which can help manage reactions. Dietary restriction is by far the most effective measure, but also difficult to maintain for histamine intolerance, as the restricted foods are vast and impact nearly every part of the diet.

Offer a DAO Supplement

DAO, or diamine oxidase, is the major enzyme that breaks down excess histamine. When the body is not producing enough of it, histamine may rise to a level where reactions occur. It is similar to the more familiar lactase deficiency that causes lactose intolerance. Just as taking the lactase enzyme to aid in the digestion of lactose (the sugar found in milk), the DAO enzyme can be taken to neutralize histamine.

The original DAO supplement is available at retail as Umbrellux DAO. Like a lactase supplement, it works within 20 minutes to supplement your natural DAO levels and help defend against histamine reactions. It’s non-systemic, active only in the small intestine, and does not interfere with nutrient absorption. A DAO supplement is advisable even for those following a restricted diet. Because histamine can be found in so many foods and beverages, you never know when you’re going to inadvertently fill the bucket.

An Underserved Market

The fact is that many people today are concerned about dietary ingredients and their reactions. So much so that we see the numbers in the headline. But what happens when the diagnosis is “no allergy”—where do people turn? I’ve spent much of my career investigating and helping to define food intolerance and differentiate it from classical allergy. Based on the new report, it would appear that intolerance has, in fact, been grossly underrecognized.

Food intolerance is an underserved market with many people looking for solutions. You can find more information on my website, www.allergynutrition.com, where my books are also available. By educating yourself and your customers, and by offering options such as Umbrellux DAO, you’ll help raise awareness and provide hope to those suffering from “not an allergy.”


Note: The views and opinions expressed here are those of the author(s) and contributor(s) and do not necessarily reflect those of the publisher and editors of WholeFoods Magazine.

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Janice M. Joneja, Ph.D.
Janice Joneja, Ph.D., is a researcher, educator, author and clinical counselor with more than 30 years of experience in the area of biochemical and immunological reactions involved in food allergies and sensitivities. She holds a Ph.D. in medical microbiology and immunology, was a registered dietician in British Columbia for 27 years and a member of the Academy of Nutrition and Dietetics in the United States. For 13 years she was head of the Allergy Nutrition Clinic at the Vancouver Hospital and Health Science Centre. Joneja has authored 10 books and dietetic practice manuals on immunology and food allergies, and her work has been published in peer-reviewed scientific and medical journals as well as in popular magazines. She is a respected lecturer at universities, colleges and hospitals internationally and is called upon regularly as an expert in her field from the media. Joneja is president of Vickerstaff Health Services Inc., a practice that provides resources for people suffering from all aspects of adverse reactions to food, and for the professionals and caregivers who support them.


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