Foods, ingredients, or molecule intolerances appear to be on the rise and whilst some such as gluten or histamine are well known, others, such as salicylates, are more misunderstood. This article will delve into this lesser-known phenomenon exploring: 

• What are salicylates and what is salicylate intolerance? 
• Which symptoms are linked to salicylate intolerance? 
• What does the science say causes this condition? 
• How is salicylate intolerance diagnosed? 
• Suggestions on how to manage a suspected salicylate intolerance.

 
What are salicylates and what is a salicylate intolerance?  
 
Salicylates are natural chemicals found in many plants who use them to defend themselves against pests, bacteria, and environmental stressors. Salicylates are anti-inflammatory and as such have also been synthetically reproduced in laboratories for uses in medications, including aspirin and non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen. 
 
Salicylic acid has excellent anti-fungal and anti-bacterial properties, leading to its common use as an ingredient in processed foods, condiments, cosmetics, and beauty products. 
 
In terms of food, salicylates are found in many plant foods to a higher or lesser extent. Some of the foods that are common triggers are: 

• Berries (especially strawberries), grapes, oranges, and apples
• Tomatoes, peppers, and broccoli 
• Cinnamon, curry powder and chili powder
• Almonds and peanuts
• Tea, coffee, and some fruit juices

 
Salicylate intolerance is where a person’s system has difficulty metabolising and tolerating salicylates, leading to a range of symptoms.  The phenomenon was initially observed in medically diagnosed patients with either aspirin-exacerbated respiratory disease (AERD) or NSAIDs-exacerbated respiratory disease (NERD) (1,2).   In the cases of both AERD and NERD, high doses of chemical salicylates can trigger asthma, rhinosinusitis and urticaria.  
 
Clinical case studies have observed that for some, simply eating a diet high in salicylates can contribute to a variety of symptoms, although this can vary from person to person and may also depend on the quantity of salicylates eaten or exposed to over a short period of time. 
 
Which symptoms are linked to salicylate intolerance? 
 
Whilst respiratory and skin symptoms are the most recognised symptoms of salicylate intolerance, there are others including: 

• Digestive issues: stomach pain, bloating, wind, diarrhoea
• Headaches
• Behavioural changes including irritability, restlessness or difficulty concentrating.
• Joint pain and swelling, similar to arthritis symptoms. 
• Fatigue. Both chronic fatigue and low energy levels are often described.
• Anaphylaxis. Whilst extremely rare, severe allergic reaction has been reported. 

 
What does the science say causes this condition? 
As with so many conditions, the exact cause of salicylate intolerance is not well understood, however there are some areas which are being explored: 

• Inability to metabolise or detoxify salicylates properly. 
• Genetic SNPs. Some studies have identified modifications on genes (SNPs) including on CYP2C9, NAT2 and UGT1A6 which might indicate a susceptibility to salicylate intolerance. (3,4)
• Overexposure from food, medical or topical sources can lead to symptoms.
• Underlying health conditions. It is thought that some health conditions including irritable bowel syndrome (IBS), intestinal permeability (leaky gut) or Inflammatory Bowel Disease (IBD) may increase the risk of salicylate intolerance, however it may also be the salicylate intolerance which triggers the health conditions. Further studies are needed to explore this. (5,6)

 
How is salicylate intolerance medically diagnosed? 
Diagnosis of salicylate intolerance is tricky, mainly because of the number of overlapping symptoms with other conditions.  A medical or nutrition practitioner will undertake: 

• A review of your symptoms and medical history. Could your symptoms be linked to other conditions e.g., IBS, food allergies, auto-immune conditions?
• A dietary analysis. Keeping a food and symptom diary can help identify common food triggers. A nutrition professional can use that information to evaluate whether salicylates may be a cause.  
• Challenge testing. If your medical practitioner suspects AERD or NERD then challenge testing may be undertaken within a hospital setting. 

 
For many, a salicylate intolerance is linked to other conditions or genetics and is not, itself, the root cause.  Sufferers tend to go heavily down the elimination root, which whilst does initially provide relief, is not a sustainable or healthy long-term solution. Working with a practitioner to discover the main trigger of the sensitivity is key. 
 
Suggestions for managing a suspected salicylate intolerance.

1. Review your diet by using a food and symptom diary. (you can download one FREE below). Note, that if you are reacting to everything then you need to work with a professional to find the route cause rather than starting to eliminate foods as the foods aren’t the actual issue.
2. Complete this quiz to see whether salicylates rather than histamines might be a trigger for you. 
3. Consider adopting a low salicylate diet. If you plan on changing your diet, you should consult with a healthcare or nutrition practitioner.  A low salicylate diet shouldn’t be followed for more than 3 weeks as it could lead to nutrient deficiencies. 
4. Pay attention to the ingredients of the foods you eat. Check the food labels. Many processed foods, condiments and sauces contain salicylates. 
5. What gene SNPs may you have that could contribute to a salicylate intolerance? How efficient are your detoxification pathways?  
6. Many over the counter medications are based on salicylic acid, so check with your pharmacist.
7. Skin and personal care products often contain salicylates. Try to choose those that are salicylate free. If in any doubt, contact the manufacturer. 
8. Lifestyle and emotions can influence how well a person can tolerate things. Get regular exercise and manage stress and relaxation. 

 
If on medication, please speak to your GP/consultant before making any changes to your diet. 

 
Sign up for my news to receive the published articles straight to your inbox. 
 
Read more by clicking below to see my previously published articles: 
 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• Autumnal Allergies – Yes, it is a thing
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now?
  
  

Who Am I? 
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 
 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
References: 

1. Skypala IJ, Williams M, Reeves L, Meyer R, Venter C. Sensitivity to food additives, vaso-active amines and salicylates: A review of the evidence. Clin Transl Allergy. 2015;5(1):1–11. 
2. Kęszycka PK, Lange E, Gajewska D. Effectiveness of personalized low salicylate diet in the management of salicylates hypersensitive patients: Interventional study. Nutrients. 2021;13(3):1–14. 
3. Park SM, Park JS, Park HS, Park CS. Unraveling the genetic basis of aspirin hypersensitivity in asthma beyond arachidonate pathways. Allergy, Asthma Immunol Res. 2013;5(5):258–76. 
4. Palikhe NS, Kim SH, Nam YH, Ye YM, Park HS. Polymorphisms of Aspirin-Metabolizing enzymes CYP2C9, NAT2 and UGT1A6 in Aspirin-Intolerant urticaria. Allergy, Asthma Immunol Res. 2011;3(4):273–6. 
5. Raithel M, Baenkler HW, Naegel A, Buchwald F, Schultis HW, Backhaus B, et al. Significance of salicylate intolerance in diseases of the lower gastrointestinal tract. J Physiol Pharmacol [Internet]. 2005;56 Suppl 5:89–102. Available from: http://europepmc.org/abstract/MED/1624719
6. Tuck CJ, Malakar S, Barrett JS, Muir JG, Gibson PR. Naturally-occurring dietary salicylates in the genesis of functional gastrointestinal symptoms in patients with irritable bowel syndrome: Pilot study. JGH Open. 2021;5(8):871–8. 

 ​

The trees begin to lose their leaves, and you sigh a great sigh of relief thinking that the hay fever and seasonal allergies season is finally over. Then you realise that you are still getting symptoms – itchy eyes, runny nose, a dermatitis flare. It is very possible and even probable that you are suffering from Autumnal allergies. 
 
TV adverts and magazine articles would have you think that hay fever and seasonal allergies only happen in the spring and summer, but that isn’t the case.  Autumn brings its own set of allergens ready to trigger a runny nose, atopic dermatitis, and itchy eyes. If it isn’t plant pollen, what are the autumnal triggers that can cause so many issues? 
 
Weed pollen, mould spores and house mites are the most common triggers for Autumnal allergies, read on to find out more details and to get my 5 tips to lessen the autumnal allergy symptoms.
 
Weed Pollen 
 
Not all pollen producing plants flower in spring.  A whole category of weeds flower in the autumn and produce the highly allergenic weed pollen. These plants usually flower from late August until the first frost (usually around the end of November but growing later with climate change). This category of plants includes common weeds found in the UK such as nettles and sorrel but also varieties that are much newer to the UK and Europe such as the American Ragweed. Not only is ragweed a recent invader, but it also produces one of the highest amounts of pollen, causing uncomfortable hay fever and dermatitis symptoms in many sufferers.  
 
Mould Spores
 
Mould is around us all the time, but at this time of year levels peak with the falling leaves gently composting on the ground releasing large amounts of allergenic spores.  These are the main types of mould which have been highlighted as being triggers for allergy symptoms: 
 
Cladosporium Herbarum – this is a black mould that you can sometimes be found on bathroom walls or in a fridge, but it is also found on rotting vegetation. This is the considered the most allergenic of the moulds as it is easily airborne and so can spread quickly. 
 
 
Penicillium Notatum – found in decomposing leaves and soil. This mould is also the type you find on food that is going off eg. bread and fruit. 
 
Alternaraia Alternata – mainly found in rotting wood and therefore, forests, but can also be present on food and textiles. 
 
Dust Mites
Many sufferers of asthma, eczema or hay fever also have a dust mite allergy and whilst dust mites exist all year, reactions tend to peak in autumn as the weather becomes damp but remains relatively warm and we retreat inside and close our doors and windows, but we haven’t yet put our heating on. 
 
5 Tips to Lesson the Autumnal Allergy Symptoms

• Avoid stomping through fallen leaves as the movement will shake up any pollen or mould spores.
• Mould spores like the damp, so ensure your home is well ventilated and consider furnishings that can be easily wiped or washed.
• Check your property for any signs of damp or mould and consider purchasing some dehumidifiers for some of the less well-ventilated areas of your home and/or the bedrooms
• Avoid drying your washing on radiators as this drastically increases the amount of humidity in the air. 
• Remember to clean your fridge regularly as mould often builds in the more hard-to-reach shelves

 
If you were interested in this article, you may be interested in these other blogs I’ve previously published: 
 
Sign up for my news to receive the published articles straight to your inbox. 
 
Read more by clicking below to see my previously published articles: 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now? 
  
  

Who Am I? 
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
 

Blood sugars and continuous blood sugar monitors are all the rage and for good reason. Maintaining a stable blood sugar level isn’t just vital for metabolic health and weight, but also plays a key role in maintaining healthy skin and a normal functioning gut. 
 
This article will explore the connections between stable blood sugars and both skin and gut health and will provide practical tips to achieve and maintain this important balance: 

• The role of stable blood sugars
• Blood sugars and skin health
• Blood sugars and gut health
• My top tips for keeping your blood sugars stable.

 
The role of stable blood sugars
 
Before we go into the detail of blood sugar and skin and gut health, here’s a quick overview of how important blood sugars are, so that we put it all in context. 
 
Simplistically, blood sugar is our main source of energy, and we get it primarily from eating carbohydrates which our digestive system then breaks down to glucose. This then enters our blood stream and provides energy to cells.  Stable blood sugars are vital for lots of reasons, but here are the most cited ones: 

• Energy regulation – stable blood sugars provide a consistent energy supply preventing energy crashes and fatigue.
• Weight management – stable blood sugars are associated with better weight management. Blood sugar levels spiking quickly up before crashing down, can trigger overeating, especially carbohydrate rich foods, which can lead to weight gain.
• Diabetes prevention – blood glucose levels that remain stubbornly high can lead to insulin resistance, pre-diabetes, and Type 2 Diabetes. If your blood sugar levels crash too low, then you can be at risk for hypoglycaemia which can lead to headaches and energy crashes amongst other more serious effects. 
• Cognitive function – blood sugar levels can affect brain function and concentration. If you want to perform well, you should aim for stable blood sugar levels. 

Blood sugars and skin health
There are several ways that blood sugars can have an impact on skin health including: 

• Acne and inflammation.  There has been extensive research into the role of nutrition, including high-glycaemic (sugar) diets  and acne. (1)
• Acne is also linked to insulin response. Foods with high glycaemic values (those that make blood glucose levels rise and fall more quickly) are linked to higher insulin levels. (1,2) and higher insulin levels are linked to increased sebum production.
• Premature aging. Elevated blood sugar levels can have a damaging effect on collagen and elastin, both essential for skin firmness, therefore resulting in wrinkles.
• Glycation happens when the sugar in your blood stream attaches to a protein and produces Advanced Glycation End products (AGEs). These harmful free radicals accumulate and then damage further proteins such as collagen, which can then result in stiff, less resilient skin. 
• Eczema, psoriasis, and rosacea. High blood sugar levels have been associated with increased inflammation within the body, which can trigger these common skin conditions. 
• Itchiness. For many eczema sufferers the unbearable itch is one of the worst possible symptoms. Fluctuating blood sugar levels, specifically rapid spikes and crashes, have been observed to trigger increased itchiness. (3). 
• Skin barrier function (e.g., leaky skin). Eczema is closely related with a poor skin barrier which allows moisture to escape and irritants and bacteria to enter the skin more easily. (4)
• Bacterial infections.  Those suffering from eczema/dermatitis are more at risk to skin infections as their impaired skin barrier, which can be affected by blood glucose levels, allow bacteria through more easily. 

 
Blood sugars and gut health
 
Blood sugars and gut health aren’t usually associated by most people; however, high blood sugar levels can influence: 

• Your microbiome, or your own personal population of gut bacteria, which play a crucial role in not only your digestive health, but also your overall health and wellbeing.
• Digestive disorders. Those that are associated with unstable blood sugar levels include irritable bowel syndrome (IBS) and intestinal hyperpermeability (Leaky Gut). High glucose levels can also damage the intestinal lining, leading to inflammation and increasing gut permeability (5).
• Systemic inflammation (when your body has an exaggerated immune response to something). Systemic inflammation can damage the gut lining and lead to digestive discomfort and disorders. (6–7). 

 
My top tips for keeping your blood sugars stable. 
 

1. Balance your meals. Protein or fibre slows carbohydrate digestion so consider starting your meal with either of these, rather than first tucking into the pasta or bread. 
2. If you like a sweet treat, consider adding it to the end of a meal instead of having it on its own as a snack. If you do need snacks then try to have some protein first e.g., a handful of nuts and seeds.
3. Avoid ultra-processed foods and drinks. These contain more than the average amount of sugar. Just have a look at the labels!  The simpler ingredients you eat, the less chance you have of eating lots of hidden sugars. 
4. Stress can raise your blood sugar levels, so think about stress-lowering techniques. Can you go for a walk in nature at lunchtime? Can you listen to a meditation in your car before you go into work? Can you do a Yoga Nidra session that you find on YouTube before you go to sleep? 
5. Drink plenty of water. Even if hydration doesn’t lower your blood sugar levels it still helps support your skin and gut health. Try to drink regularly throughout the day rather than gulping down big quantities every so often. 
6. Consider getting a continuous glucose monitor (CGM) for a month. I don’t think everyone should have these for ever, but having one for a month can be really eye opening. What foods make YOU have a sugar spike? You may be surprised. I work with Veri who can supply you with a Freestyle Libre monitor and accompanying app. Clients who work with me can use this tool and have me access their data so that I can help interpret which is the best way of eating for that individual. If you want to find out more get in touch
7. Get a good night’s sleep. How well you sleep can affect your blood sugar levels the next day. I found that out whilst I was using a CGM and found that my normal breakfast had a much worse score the morning after a disturbed night. 

 
I run a 5 day ‘A Week to Reduce Your Sugar Cravings’ Challenge – it’s absolutely free and you can sign up here.
 
Sign up for my news to receive the published articles straight to your inbox. 
 
Read more by clicking below to see my previously published articles: 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now? 
  
  

Who Am I? 
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 
 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
References: 

1. Meixiong J, Ricco C, Vasavda C, Ho BK. Diet and acne: A systematic review. JAAD Int [Internet]. 2022;7:95–112. Available from: https://doi.org/10.1016/j.jdin.2022.02.012
2. Briganti S, Flori E, Mastrofrancesco A, Ottaviani M. Acne as an altered dermato-endocrine response problem. Exp Dermatol [Internet]. 2020 Sep 1;29(9):833–9. Available from: https://doi.org/10.1111/exd.14168
3.  Xu X, Zhang H, Li L, Yang R, Li G, Liu S, et al. Study of the Involvement of the P2Y12 Receptor in Chronic Itching in Type 2 Diabetes Mellitus. Mol Neurobiol [Internet]. 2022;59(3):1604–18. Available from: https://doi.org/10.1007/s12035-021-02676-4
4. Lee Y Bin, Hwang HJ, Kim E, Lim SH, Chung CH, Choi EH. Hyperglycemia-activated 11β-hydroxysteroid dehydrogenase type 1 increases endoplasmic reticulum stress and skin barrier dysfunction. Sci Rep [Internet]. 2023;13(1):1–13. Available from: https://doi.org/10.1038/s41598-023-36294-y
5. Snelson M, de Pasquale C, Ekinci EI, Coughlan MT. Gut microbiome, prebiotics, intestinal permeability and diabetes complications. Best Pract Res Clin Endocrinol Metab [Internet]. 2021;35(3):101507. Available from: https://www.sciencedirect.com/science/article/pii/S1521690X21000245
6. Stecher B. The roles of inflammation, nutrient availability and the commensal microbiota in enteric pathogen infection. Metab Bact Pathog. 2015;297–320. 
7. Andersen CJ, Murphy KE, Fernandez ML. Impact of obesity and metabolic syndrome on immunity. Adv Nutr. 2016;7(1):66–75. 

Histamine intolerance is a recently identified but increasingly considered condition that, whilst not life-threatening, can trigger a range of uncomfortable and often debilitating symptoms. The disparity and variety of symptoms that can be attributed to this condition are so widespread that it took time for the scientific community to observe the common denominator, and it is often misdiagnosed in general practice. 
 
This, the fifth and last article in my ‘histamine’ series, will delve into this condition that is grabbing the attention of the healthcare community, providing you with information that may help you unravel whether histamine intolerance may be a factor in your health. The article covers: 

• What is histamine intolerance?
• Which symptoms hint at a possible histamine intolerance? 
• What are the possible contributory causes? 
• The genetics of histamine intolerance 
• My top tips for lowering your ‘histamine load’.

 
What is histamine intolerance? 
 
Histamine intolerance, also known as histaminosis or histamine sensitivity, is an increasingly recognised condition that affects a significant number of people worldwide. (1,2) is usually defined as the inability to adequately breakdown histamine. 
 
Histamine is a neurotransmitter, found throughout the body, but specifically in the skin, respiratory tract, and the digestive system. It is involved in numerous processes including stomach acid production, and vasodilation (the widening of the blood vessels), but is more commonly known for its pivotal involvement in the immune response. 
 
It is believed that individuals who suffer from histamine intolerance have a deficiency or dysfunction of the DAO (diamine oxidase) or HNMT (histamine-N-methyltransferase, enzymes, which are responsible for breaking down histamine in the body. This slowing of histamine degradation leads to a possible accumulation of histamine, leading to a variety of symptoms, depending on the individual. 
 
It is thought that histamine intolerance prevalence is higher in children than in adults (3), but further studies are needed. My clinical experience, working with many infants and young children with digestive and skin symptoms, is that when true IgE allergies have been ruled out, histamine intolerance is often a route to be explored. Lowering an overall histamine load, rather than assuming that multiple food intolerances are at play, can allow children to retain the all-important macro and micronutrient variety, rather than putting them at risk of strict and restrictive elimination diets which oftentimes worsens the situation and puts their health at risk.
 
Histamine intolerance has, in the past, often been misdiagnosed as whole host of other diseases including food allergy and intolerances, urticaria, eosinophilic gastroenteritis amongst others.  When clients come to see me with negative allergy/intolerance testing, but who swear blind that such and such a food triggers a reaction, histamine intolerance is something that immediately springs to mind. 
 
Which symptoms hint at a possible histamine intolerance? 
As I’ve already explored in previous articles (see links at the end of this feature), histamine intolerance can manifest in a variety of different symptoms, hence the diagnosis difficulty. Common symptoms include: 

• Digestive issues including abdominal cramps and pain, diarrhoea, nausea, and vomiting, bloating and flatulence and acid reflux.
• Skin problems including itchy skin, urticaria and eczema.
• Respiratory symptoms including sneezing, runny or blocked nose, coughing, shortness of breath and wheezing.
• Headaches and migraines

 
What are the possible contributory causes? 
There are several possible contributory causes to histamine intolerance, but the main theory involves the concept of an overall histamine ‘load’ or the cumulative effect of several factors, including: 

• DAO and HNMT enzyme deficiencies, as mentioned above, can contribute to histamine being inadequately broken down and, therefore, more histamine circulating within the body.
• Histamine containing foods. Some foods are known to be high histamine such as spinach, avocados, and dried fruits. An accumulation of too many of these foods in the diet, can add to the histamine load.
• Histamine liberating foods. Whilst these foods don’t contain high histamine levels themselves, they are known to either provoke the liberation of histamine or slow down the action of either DAO or HNMT. These include alcohol, fermented foods and citrus fruits. 
• Gut health. Conditions such as intestinal hyperpermeability (leaky gut), small intestinal bacterial overgrowth (SIBO), or irritable bowel syndrome (IBS) can contribute to histamine load and histamine load also has a worsening effect on the symptoms of these conditions.
• Medications – some medication such as non-steroid anti-inflammatory medications which can bought over the counter and some anti-depressants can also slow histamine metabolism or trigger histamine release. 
• Stress. When your cortisol levels rise in response to stress, it may trigger mast cells to release histamine. 

 
Please note that not every individual will be affected by all the above, and this overview should only support the notion of how your overall histamine load could add up. 
 
The genetics of histamine intolerance 
 
For some experiencing histamine issues, the question of low or slow DAO or HNMT activity may stem from their genetics. DAO inactivates histamine in the gut and HNMT within the nervous system and lungs. Genetic variants on these enzymes or their pathways can lead to histamine intolerance. 
 
Nutrigenomics testing, which I offer through Lifecode Gx, can provide information on our own genes which then informs us on the nutrition and lifestyle changes we can make to align with any variants to optimise health and wellbeing. Lifecode Gx offers a specific Histamine Intolerance test. You can find out more, by clicking the link.   Nutrigenomic testing is the only form of testing that is available from the youngest age. Whilst how you eat and live your life will have an effect on whether a gene variation may have an impact, your genes themselves never change. 
 
My top tips for lowering your histamine load. 

1. Consider your histamine ‘genetics’, do you have variants that slow the metabolism of histamine? 
2. Review your daily histamine load – are you stressed? Have you eaten lots of histamine containing or histamine liberating foods? Are you taking a NSAID or other histamine releasing medication. Now consider, what out of the list you’ve drawn up can you reduce or remove so that your overall load is lessened? 
3. Be aware of food sources of histamine and histamine liberating foods. Try to not have too many in one day or all at one time. Eliminating more and more foods is not the answer and could be very dangerous for your health. Consulting with a nutrition professional is recommended. Follow this link for a list of common high-histamine foods.
4. For some, but not all, DAO supplementation before higher histamine meals can be helpful. 
5. Increase antioxidant and anti-inflammatory foods such as green leafy vegetables (except for spinach, which is high histamine), oily fish and ginger. 
6. Introduce daily activities that help balance your stress. What activity can you do without leaving your home, for 10-15 minutes that brings you joy and lowers your heart rate? Consider drafting a list and committing to doing at least one of those activities daily. 

 
If on medication, please speak to your GP/consultant before making any changes to your diet. 
 
If you are interested in histamine and its impact on symptoms, this article is the second in a series I am currently publishing covering.  The series in total will include:

1. What is the histamine and eczema/dermatitis link? (Already published, view using the link)
2. What’s the histamine and gut health connection? (Already published, view using the link)
3. What is the histamine and auto-immune conditions link (Already published, view using the link)
4. Histamine and oestrogen – why histamine may trigger skin and gut issues at the menopause. ((Already published, view using the link)
5. Histamine Intolerance is it really a thing? (Today's article)

 
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Read more by clicking below to see my previously published articles: 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• Autumnal Allergies – Yes, it is a thing
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now? 
  
  

Who Am I? 
​
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
References: 

1. Schnedl WJ, Enko D. Histamine Intolerance Originates in the Gut. Vol. 13, Nutrients. 2021. 
2. Zhao Y, Zhang X, Jin H, Chen L, Ji J, Zhang Z. Histamine Intolerance—A Kind of Pseudoallergic Reaction. Biomolecules. 2022;12(3):40–8.
3. Martin H, Radoslav D, Huorka M, Wawruch M. Histamine Intolerance — The More We Know the Less We Know. Nutrients. 2021;13:1–21. 

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