If you struggle with histamine intolerance or unexplained digestive symptoms, fixing your gut environment is integral to your healing. Groundbreaking research on the gut microbiome has led to advances in our understanding of why people develop histamine intolerance, and likewise, how to treat it.
Individuals with histamine intolerance show consistent markers of gut microbiome dysfunction.
Studies have consistently demonstrated that histamine-intolerant patients have:
- Elevated levels of stool zonulin - suggesting leaky gut and metabolites entering the bloodstream
- Increased levels of Proteobacteria - suggesting a high oxygen environment and Dysbiosis
- Significantly reduced alpha-diversity - a key marker of gut microbiome diversity
- Histamine-producing bacteria like Klebseilla Aerogenes and Morganella morganii
Diet strongly affects bacterial histamine production.
Bacteria such as Klebsiella aerogenes has been shown to produce histamine, as well as to contribute to abdominal pain in patients with IBS. For years, the low FODMAP diet has been recommended to people with IBS to reduce their symptoms, but the mechanism was not entirely clear. Now we know: in IBS patient with high baseline histamine levels, a low FODMAP diet led to an 8x reduction in urinary histamine – and a significant decrease in Klebsiella aerogenes abundance. Similarly, in mouse models, only those with high-histamine microbiota and fed a high-FODMAP diet developed gut hypersensitivity. This strongly supports the idea that diet affects bacterial histamine production, and that histamine plays a key role in IBS symptoms.
Targeted Strategies to Reduce Bacterial Histamine
I favour a multi-faceted approach to tackling histamine intolerance. Many clients who adopt solely a low-histamine diet will struggle to then reintroduce foods without major symptoms. I will work with you to improve your gut environment, and resultantly the gut microbiome, to help you to tolerate a more diverse diet. Long term goals I work with clients to achieve include:
- Supporting gut acidity. Encouraging a lower colonic pH (more acidic).
- Reduce gut oxygen. K. aerogenes and other histamine-producing proteobacteria thrive in higher oxygen environments in the gut. Certain fibre, prebiotics and PPAR-gamma activators help to support anaerobic gut balance.
- Increase gut motility. This is key for histamine intolerance to reduce the accumulation and absorption of histamine and other biogenic amines in the gut.
- Natural H4 blockers can reduce mast cell accumulation in the gut.
Individualised Nutrition
Histamine intolerance often comes hand in hand with further sensitivities, such as salicylate intolerance. I recognise the complexities with multiple sensitivities and can clients in implementing the following diets, tailored to individual needs:
- Low Oxalate Diet
- Low Salicylate Diet
- Low Fermentable Fibre Diet
These dietary approaches are often case-specific and typically serve as short-term solutions to help symptoms while we address the underlying issues.
Beyond Nutrition
Other key foundations I work with clients on is correcting your light environment, circadian biology and metabolic function.
