Diet and Therapeutics to Support a Healthy Response
Allergies are
an abnormal immune system response to a typically harmless substance. Someone
without allergies would have no reaction to the substance, but when a person
that is allergic encounters the trigger (allergen), the body reacts by
releasing chemicals which cause allergy symptoms. During this response, the
allergen binds to antibodies on cells in the body, including mast cells and
basophils. These cells release chemicals like histamine and leukotrienes,
resulting in allergy symptoms.
The first time a B-cell is exposed to an
allergen, no allergic reaction will occur, but plasma cells will initiate an
overproduction of IgE antibodies. The IgE molecules attach themselves to mast
cells or basophils. This is called sensitization. When the allergen enters the
body for the second time, the IgE antibodies react by binding the allergen. The
IgE-primed mast cells and basophils will then release granules containing histamine
and other allergic mediators. This will cause an allergic reaction.
Histamine
Histamine is
part of our bodies’ natural response to insults or invaders. It prompts blood vessels to swell and
fluid to leak from capillaries, causing swelling. It is an inflammatory
bio-chemical, is mainly stored in mast cells and basophils, and it is a main
contributor to allergic disease.
Elevations
in plasma or tissue histamine levels have been noted during anaphylaxis and
allergic responses of the skin, nose and airways. The effect of histamine is
tied to the type of receptor where it attaches. Although histamine is only one
of many mediators of allergic disease, it plays a primary role in allergic
rhinitis, urticaria, anaphylaxis, and to a lesser degree, asthma.
Genetic
Variants
Certain
individuals are genetically prone to low levels of the DAO and HNMT enzymes
which are responsible for degrading histamine to control excess. Genetic
testing can reveal variants in the genes that make these enzymes and may be
impacting histamine levels. Pathways can be supported nutritionally to improve
function.
Allergy
versus Histamine Intolerance
Histamine intolerance is not the same as an allergic response. Histamine
intolerance takes time to appear and is not evident immediately after
histamine-rich foods and beverages. Allergies, on the other hand, usually
develop within minutes of exposure. With histamine intolerance, the total level
of histamine in the body gradually rises and overwhelms the enzymes capacity to
break it down over time.
Allergies are the result of histamine
release. Symptoms of allergy and histamine intolerance are very similar. When
an allergy triggers the immune system, histamines often produce inflammatory
responses such as puffy eyes, an itchy rash, or a sneezing fit. When this
occurs, people often reach for an antihistamine medication like Benadryl.
Symptoms of histamine
intolerance include difficulty falling asleep at night, hypertension, chronic
headaches or migraines, an accelerated heart rate, dizziness or vertigo,
general anxiety, bloating and swollen body tissue, inexplicable nausea and
vomiting, chronic nasal congestion, an abnormal menstrual cycle, facial
flushing, especially after drinking wine, fatigue and exhaustion for no reason.
Allergy tests that measure IgE reactions to specific foods will be negative in
histamine intolerance.
DAO
After the
allergy threat is eradicated, natural enzymes called diamine oxidase (DAO) and
HNMT will typically break down the histamine, so it doesn’t build up in the
system. These enzymes can become less effective and histamine levels rise.
Histamine
Intolerance and the Gut
The gut is
often involved in high histamine. There is a vicious cycle (see graphic above)
that involves intestinal permeability, histamine release, inflammation,
impaired digestion, dysbiosis, high histamine, zonulin and further intestinal
permeability.
Inflammation in the gut activates mast
cells and histamine production. This decreases DAO enzyme and reduces the
amount of histamine breakdown. DAO surrounds microvilli in the gut. When there
is poor mucosal integrity (leaky gut), low DAO levels are found.
Support the gut with a non-inflammatory
diet, digestive enzymes, probiotics to establish a healthy microbiome,
addressing relevant genetic variants and taking in enough fiber and water to
support elimination. An antioxidant like pyrroloquinoline quinone (PQQ) can
help remove inflammation from toxins circulating in the blood stream due to gut
permeability.
Therapeutics
Allergies are
best addressed by avoiding the allergen and using a natural antihistamine and
anti-inflammatory product. In cases of histamine intolerance, it is critical to
lower the histamine level, so it is also important to avoid allergens, avoid
high histamine foods and foods that release histamine, support genetic variants
that interfere with histamine breakdown and support gut health, the liver and
stressed adrenals (as cortisol output is important in controlling histamine
levels).
These natural
remedies are helpful in cases of high histamine and allergy:
Boswellia inhibits inflammation,
histamine and 4-series leukotrienes which make it helpful for asthma,
allergies, sinusitis, emphysema as well as histamine intolerance.
Stinging Nettle works similarly to
allopathic antihistamines by attaching to the histamine receptor and preventing
the inflammatory response.
Quercetin and L-Theanine block
histamine release from mast cells. Quercetin also helps the gut to heal.
Bromelain reduces edema and inflammation associated with allergic rhinitis.
Luteolin acts as a natural antihistamine
by preventing mast cell
degranulation.
Histamine degrading probiotics
(Bifidobacterium longum, Bifidobacterium infantis, Lactobacillus rhamnosus,
Lactobacillus salivarius, Lactobacillus plantarum) balanced with beneficial
bacteria that produce histamine (Lactobacillus reuteri, Lactobacillus
helveticus, Lactobacillus casei, Lactobacillus bulgaricus) is the ideal
probiotic. A balanced, broad-spectrum product is much better than one that is
mega-dosing a few varieties of bacteria.
DAO and DAO cofactors help to
breakdown excess histamine: Vitamin B6,
Vitamin C and Copper are cofactors.
Support SAMe (needed for histamine
breakdown by HNMT), do not supplement SAMe, rather spare it by supplementing Creatine
and Phosphatidyl Choline.
N-Acetyl-L-Cysteine is needed to make
the master antioxidant, glutathione and protect against oxidative stress.
Licorice soothes the gut and reduces gastrointestinal inflammation.
Vitamin C is a
natural antihistamine. According to a 2018 study on Vitamin C, oxidative stress
plays a key role in allergic disease. Vitamin C is a powerful antioxidant and
anti-inflammatory which makes it very useful in the treatment of allergies.
Helpful
hints:
• Support
genetic SNPs; these involve the breakdown of excess histamine and
methylation. Histamine requires
methylation to be metabolized. Persons
with high histamine are under-methylators.
• Support the
gut, an unhealthy gut is often the root cause of low DAO production.
• Avoid high
histamine foods, and DAO enzyme blocking foods. Foods high in histamine include
aged and fermented foods like sauerkraut, soy sauce, wine, vinegar, beans and
aged meats. Beverages that inhibit DAO
include alcohol, black, green and mate tea.
Dr. Gary Kracoff is a naturopathic doctor and registered
pharmacist at the Johnson Compounding and Wellness Center, located at 577 Main
St., Waltham. For more information, call 781-893-3870 ext. 2 or visit NaturalCompounder.com.
Interesting Facts About
Histamines
• Histamine attached to H1 receptors play
important roles in motion sickness. Antihistamines are effective preventatives.
• Vitamin C has been shown to be an
effective remedy for seasickness.
• Homeopathic
remedies can be used to desensitize individuals from allergens. There are
homeopathic formulations specifically for the pollens in New England.
• Histamine
has been shown to enhance the production of estradiol, making women feel more
“hormonal”; conversely, higher levels of estrogen can potentiate the action of
histamine, exacerbating allergy symptoms including premenstrual headaches and
migraines.
