Unravelling the impact of histamine on gut health

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Histamine is often thought of in relation to hay fever and skin reactions, such as atopic eczema, but did you know that histamine is also implicated in digestive health conditions including reflux, irritable bowel syndrome (IBS) and Inflammatory Bowel Disease (IBD)? 
 
Today’s article, the second in the series, focuses on histamine and its link to gut health and includes: 

• What role does histamine play in digestion? 
• Which digestive disorders are linked to histamine?
• The possible causes that trigger a histamine reaction in the gut
• My top tips for managing histamine as a digestive trigger.

 
What role does histamine play in digestion? 
Histamine, a neurotransmitter, and immune system mediator, plays a crucial role in a whole range of processes and is found throughout the body, including the gastrointestinal tract.
 
Histamine is released by mast cells and basophils in response to allergens, pathogens, tissue damage, amongst other stimuli and plays a dual role in the digestive system, at times being pro-inflammatory and at others anti-inflammatory. It has several roles including (1): 
 

• Helping to regulate the digestive process by stimulating the release of stomach acid, aiding in the digestion of food.  
• Contributing to gut motility, ensuring the good passage of food all the way through the digestive tract. 
• Increasing the permeability of the gut mucosa, or ‘leaky gut’.
• Disrupting mucosal ion secretion (transport of charged ions across the lining or mucosal epithelium or gut lining). 

 
Which digestive disorders are linked to histamine? 
 

• Gastric acid regulation and acid-related disorders (reflux):  As mentioned above, histamine is a key player in controlling stomach acid production. It binds to specific receptors (H2 receptors) that line the stomach and triggers the release of stomach acid. If there is an imbalance in histamine productions or H2 receptor function, digestive conditions such as GERD (gastroesophageal reflux disease) or peptic ulcers can occur. GERD is the result of excess stomach acid that flows back up to the oesophagus, causing the common symptoms, heartburn, and discomfort. Peptic ulcers are open sores that develop within the stomach lining, which are also linked to too much acid. (2,3)
• Irritable Bowel Syndrome (IBS): histamine’s role in motility and function means that individual with IBS may suffer from altered histamine metabolism leading to gastrointestinal symptoms including stomach pain, bloating and irregular bowel movements. (1)
• Inflammatory Bowel Disease (IBD): Whilst histamine isn’t directly implicated in conditions such as Crohn’s disease and ulcerative colitis, histamine is released as part of the inflammatory and immune responses. An overall inflammatory state within the gut can exacerbate symptoms and potentially lead to disease progression. (4)
• Food intolerances and allergies: histamine intolerance (which will be covered in more detail in a future article), is a condition whereby histamine is broken down inefficiently, leading to it remaining within the body. Gut symptoms linking to histamine intolerance include nausea, vomiting, diarrhoea and abdominal pain.  In addition, histamine-rich foods can add to the histamine load, further affecting digestive health. (5)

 
What are the possible triggers of a histamine reaction in the gut? 

• Genetic factors: Mutations (SNPs) on genes encoding for the enzymes which are responsible for breaking down histamine include HNMT and DAO amongst others, can contribute to histamine intolerance and related digestive symptoms.
• Dietary factors: eating histamine-rich foods or histamine releasing foods such as aged cheeses and alcohol, can worsen histamine triggering digestive conditions. 
• Dysbiosis (gut bacterial imbalance): an imbalance in the gut microbiome can have an impact on histamine metabolism as certain bacterial strains, such as Enterobacter species, Morganella morganii, Proteus species, Klebsiella species and Enterococcus species, can produce or degrade histamine, potentially adding to the already existing histamine load.  
• Medications: certain medications including NSAID (e.g., Ibuprofen) can disrupt the gastrointestinal barrier and increase histamine release. 
• Stress: stress can also contribute to histamine related symptoms by influencing gut permeability (leaky gut) and mast cell activation e.g., histamine release.

 
In summary, here are my top tips for managing histamine as a trigger for gut disorders: 
 

1. If you suffer from a histamine-related, digestive disorder then following a lower-histamine diet may be appropriate. Follow this link for a list of common high-histamine foods , which might help you identify whether histamine may be triggering your symptoms.  HOWEVER, histamine can be found in many foods and there are many, many contradicting food lists available on the internet. Eliminating more and more foods is not the answer and could be very dangerous for your health and consulting with a nutrition professional is recommended. If you are interested in finding out more, sign-up here to keep up to date with my publications.
2. Address potential dysbiosis and gut health. Consuming probiotic-rich foods may help restore the balance in your gut microbiome, potentially improving histamine metabolism and digestive symptoms. A stool test examining your microbiota can, in some cases be helpful.  I will be addressing stool tests in my Histamine Masterclass in September 2023. 
3. Stress management. Include daily stress management techniques to keep yourself calm such as meditation, low impact exercise or hobbies that make your heart sing. 
4. Find out how your genetics may impact your relationship with histamine. The Lifecode Gx Histamine Intolerance test analyses the genes and nutrients needed to breakdown and remove histamine, showing where disruptions occur and how to support optimal function.  As a Lifecode Gx practitioner I can offer this testing as part of my practice. Click here to find out more.

 
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. The series 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? (today’s article)
3. What is the histamine and auto-immune conditions link? 
4. Histamine and oestrogen – why histamine may trigger skin and gut issues at the menopause.
5. Histamine Intolerance is it really a thing? 

 
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 and 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.           Chen M, Ruan G, Chen L, Ying S, Li G, Xu F, et al. Neurotransmitter and Intestinal Interactions: Focus on the Microbiota-Gut-Brain Axis in Irritable Bowel Syndrome. Front Endocrinol (Lausanne). 2022;13(February):1–12. 
2.           Rettura F, Bronzini F, Campigotto M, Lambiase C, Pancetti A, Berti G, et al. Refractory Gastroesophageal Reflux Disease: A Management Update. Front Med. 2021;8(November):1–19. 
3.           Zaterka S, Marion SB, Roveda F, Perrotti MA, Chinzon D. Historical perspective of gastroesophageal reflux disease clinical treatment. Arq Gastroenterol. 2019;56(2):202–8. 
4.           Melgarejo E, Medina MÁ, Sánchez-Jiménez F, Urdiales JL. Targeting of histamine producing cells by EGCG: a green dart against inflammation? J Physiol Biochem [Internet]. 2010;66(3):265–70. Available from: https://doi.org/10.1007/s13105-010-0033-7
5.           Kanikowska A, Janisz S, Mańkowska-Wierzbicka D, Gabryel M, Dobrowolska A, Eder P. Management of Adult Patients with Gastrointestinal Symptoms from Food Hypersensitivity—Narrative Review. Vol. 11, Journal of Clinical Medicine. 2022.