The Difference Between Histamine Intolerance and Food Allergies

You’ve been diagnosed with histamine intolerance. But now you feel confused. What is histamine intolerance? Is that like a food allergy? (Hint: it’s not.)

If you find this confusing, you are not alone. Many of my patients feel puzzled at first when they receive a histamine intolerance diagnosis. Food allergies, food sensitivities, and histamine intolerance share some common symptoms. However, the root causes of these issues can be quite different. This means that they will require different treatment strategies.

So what is the difference between histamine intolerance, food allergies, and food sensitivities? Let’s get into it.

What Are Food Allergies and Food Sensitivities?

By definition, food allergies are characterized by immunologic hypersensitivity or an IgE reaction and food sensitivities are identified by delayed immunologic reactions or IgG and IgA reactions. But what do all of these letters mean? First, we will explain what these proteins are and then we will elaborate the difference between IgE and IgG reactions.

What’s the Difference Between IgE and IgG Reactions?

To understand the difference between food allergies and food sensitivities, we have to talk about immunoglobulins and their role. Immunoglobulins (that’s the Ig part) are proteins made by your immune system. They function as antibodies to protect your body from viruses, bacteria, other pathogens, and toxins. (https://www.microbiologybook.org/mobile/m.immuno-4.htm – i thought this was a good reference)

When your body recognizes something as a pathogen or harmful foreign substance, it will send an immune response to fight these invaders. Your body makes immunoglobulins to support this fight. You can think about immunoglobulins as a ‘key’. You need the right key to fit into and open a lock. Each immunoglobulin is designed to fit into a specific antigen or foreign substance in your body. When the immune system recognizes an invader, it will send the right immunoglobulin or key to neutralize the pathogen. Sometimes the immune system will react to infections or chemicals that look similar to our tissues in a process called molecular mimicry and this can lead to autoimmune conditions, which is a topic for another day!

Major Types of Immunoglobulins

There are two major types of immunoglobulins that fight pathogens, IgG and IgE. Understanding the difference between them will help you to grasp the difference between food allergies and food sensitivities:

• Immunoglobulin E (IgE): IgE leads to an immediate response to a foreign substance entering your body (1). We think of this as a classic allergy reaction
• Immunoglobulin G (IgG): IgG leads to a more prolonged and subtle delayed reaction to a foreign substance (2).

And just to be complete in our discussion on Immunoglobulins…

• Immunoglobulin A (IgA): IgA is the immunoglobulin that is present in the mucus membranes but its effect on food reactions is still being worked out (3).
• Immunoglobulin M (IgM): IgM is the first immunoglobulin that is made when there is a foreign invader, so it indicates an acute infection or exposure, however, it is not involved in food allergies or sensitivity reactions (4).

What Are Food Allergies?

Food allergies are driven by IgE reactions and can be defined as IgE allergies. They lead to an immediate allergic response.

For example, peanut allergies are very common. If you are allergic to peanuts and accidentally eat a dessert with peanuts in it, your body will immediately recognize it as harmful. Your body will begin creating IgE antibodies, which then attach to your mast cells. These IgE antibodies will stay there on standby in case you come in contact with peanuts again. The next time you eat something with peanuts, these IgE antibodies will trigger your mast cells to release histamine and other chemicals to cause an immediate allergic reaction.

Again, this allergic reaction is immediate. You will notice symptoms within a few seconds or minutes after exposure. These symptoms can be severe and in the case of an anaphylactic shock, life-threatening without treatment (1, 5).

Symptoms of IgE Food Allergies

Symptoms of food allergies may include:

• Hives
• Swelling
• Rashes
• Itching
• Throat closing
• Difficulty breathing
• Anaphylactic shock

What Are Food Sensitivities?

Though some people mix these two up, food sensitivities are not the same as food allergies. Food sensitivities are  IgG or sometimes IgA reactions. Some may refer to them as IgG food allergies or delayed food allergies, which is confusing and so I will avoid using this description.

If you are sensitive to gluten, a common food sensitivity, you won’t experience an immediate or severe allergic response. Instead of IgE antibodies, your body will produce IgG antibodies. These IgG antibodies will trigger inflammatory processes that will only lead to symptoms hours or often days after exposure.

Because symptoms are delayed, you may not realize that your skin rashes, tummy troubles, or migraines are connected to a specific food you ate two or three days earlier. If you consume foods you are sensitive to regularly, you may experience chronic symptoms without recognizing the cause. Most people go for years or even their entire lives without connecting the dots between their health issues and food sensitivities.  (6, 7).

Symptoms of Food Sensitivities

Symptoms of food sensitivities are generally more subtle but can become chronic. They may include:

• Migraines and headaches
• Skin rashes, eczema, or swelling
• Fatigue and sleep issues
• Gas or bloating
• Diarrhea or constipation
• Heartburn or acid reflux
• Congestion, runny nose, or other sinus issues
• Joint pain and muscle aches
• Brain fog and other cognitive issues
• Depression, anxiety, irritability, and mood disturbances
• Poor immune function
• Malabsorption of vitamins and minerals

Food sensitivities may also increase your risk of intensifying your symptoms of various health issues, including irritable bowel syndrome (IBS), asthma, ear infections, various skin disorders, migraines, arthritis, and autoimmune disease.

What About Food Intolerances?

So we’ve talked about food allergies and food sensitivities. What about food intolerances? Are they different or just another term for the same thing? Great question!

Food intolerances are non-immunologic reactions to food, meaning that the immune system doesn’t make immunoglobulins. The symptoms of food intolerances are often similar to symptoms of food sensitivities or even food allergies, but they tend to develop because of a deficiency of an enzyme you need to digest a certain food or food ingredient.

For example, if you have lactose intolerance, it means that your body doesn’t make enough lactase enzyme to break down the sugar called lactose found in cow’s milk. Casein intolerance is another food intolerance connected to dairy. In this case, your body doesn’t have enough enzymes to break down casein, a protein found in cow’s milk (8, 9).

Symptoms of Food Intolerances

Symptoms of food intolerances may include:

• Bloating or gas
• Abdominal pain or cramps
• Nausea
• Vomiting
• Headaches or migraines
• Rashes or other skin problems
• Runny nose or congestion
• Fatigue
• Joint pain or muscle aches
• Irritability or nervousness

What Is Histamine Intolerance?

The term histamine intolerance can be a bit confusing. You may think that it refers to a reaction to histamine, but remember what happens in a food intolerance? Histamine intolerance means that you have too much histamine and your body can’t break it down

But what is histamine? Is it bad for your body? When you think about antihistamine medications for allergies, it’s easy to think that histamine is bad — you need something anti for it, after all. But histamine is not bad. It’s actually critical for your body, at the right amount.

Histamine is a chemical that’s naturally made by your body to serve various functions. The main role of histamine is to support your immune system and aid in the removal of allergens. Histamine also communicates with your brain and supports neurological processes. It also supports the release of stomach acid and supports normal digestion. As you can see, we need histamine for our bodies to function normally!

Excess of Histamine

However, too much histamine can turn into a problem. Histamine intolerance means that your body has a buildup of histamine that it cannot handle. While your body can make histamine on its own, you can also get histamine from many foods. Consuming too many high-histamine foods can lead to histamine intolerance. However, gut health issues, environmental toxins, stress, nutritional deficiencies, and other factors may also increase your histamine load.

In a healthy body, your body sends certain enzymes to break down histamine and prevent buildup. If there is too much histamine, your body may not be able to keep up. It may become difficult to break down everything at the pace it’s needed. Imagine your body as bucket that can only take so much histamine. If your bucket has some histamine but not too much, it shouldn’t cause any issues. But if your bucket is full, any extra will start spilling out. This spillage can create a mess within your body and lead to health issues. You don’t want your histamine bucket to get too full.

Certain enzyme deficiencies may also increase the risk of histamine intolerance. Diamine oxidase (DAO) enzyme helps to break down excess histamine in your body. Histamine N-methyltransferase (HNMT) enzyme is an enzyme that helps to metabolize histamine. If your body doesn’t make enough DAO or HNMT enzymes, it won’t be able to break down excess histamine, which can lead to histamine intolerance and related symptoms (10, 11, 12).

Symptoms of Histamine Intolerance

Histamine intolerance can affect your entire body, including your gut, brain, respiratory system, and cardiovascular system. It may lead to complex and widespread chronic symptoms. Symptoms of histamine intolerance may include:

• Eczema or other skin problems
• Hives
• Flushing
• Crawling skin sensations on the skin or scalp
• Seasonal allergies
• Increased symptoms of asthma
• Headaches or migraines
• Acid reflux
• Diarrhea or constipation
• Abdominal pain, gas, or bloating
• Low blood pressure
• High blood pressure
• Heart palpitations or racing heart
• Fatigue
• Sleep issues
• Brain fog
• Dizziness or vertigo
• Anxiety or panic attacks
• Difficulty regulating body temperature
• Abnormal menstrual cycle
• Premenstrual syndrome (PMS)

Recommendations for Histamine Intolerance

If you are experiencing symptoms of histamine intolerance, there is nothing to worry about. You can reduce your symptoms and improve your health naturally with a few dietary and lifestyle strategies. Here is what I recommend for histamine intolerance:

Rule Out Food Allergies and Food Sensitivities

Work with your doctor to spot and rule out food allergies and food sensitivities. An immediate reaction is usually bulletproof evidence for a food allergy. However, if you want to look into unknown food allergies, you can get an IgE test. Your doctor can offer you various testing options for food intolerances, such as lactose intolerance.

There are also various blood tests out there to test for food sensitivities. However, these tests only look at certain foods and false results are not uncommon. An elimination diet is generally the best way to gain personalized insights into your body’s reaction to food and food sensitivities. It goes without saying, but if you find any triggering foods, remove them from your diet.

Follow a Low-Histamine Diet

If you are experiencing symptoms of histamine intolerance, following a low-histamine diet is the first step. Remove high-histamine foods, histamine-liberating foods, and DAO enzyme-blocking foods and drinks, including alcohol, and caffeinated beverages like tea, coffee, and energy drinks. Follow a low-histamine, nutrient-dense diet full of greens, vegetables, sprouts, herbs, spices, seeds, organic grass-fed meat, organic pasture-raised poultry and eggs.

Reduce Your Histamine Load

Besides a high-histamine diet, other factors can increase histamine intolerance as well. I recommend that you decrease your histamine load to reduce histamine intolerance by lowering stress, improving your sleep, moving your body regularly, and reducing exposure to environmental toxins.

Try Supplements for Histamine Intolerance

I recommend the following supplements to improve histamine intolerance:

• HistDAO: HistDAO is a unique enzyme formula that contains diamine oxidase (DAO), the main enzyme clinically tested and shown to effectively degrade food-derived histamine, providing relief from histamine-related symptoms like migraines, hives, nausea, and diarrhea.
• DHist: DHist is a fantastic blend of flavonoids, antioxidants, proteolytic enzymes, and botanicals. It is great for mast cell activation, histamine intolerance, and allergies.
• Quercetin: Quercetin is one of the most well-researched flavonoids and one of the most effective mast cell stabilizing agents available. Quercetin decreases inflammation all the way down to the genetic level and stabilizes mast cell membranes, reducing the release of histamine and other inflammatory compounds.
• Enzalase: Enzalase includes 12 digestive plant enzymes formulated to help you break down and digest food better.

Next Steps

Navigating an elimination diet is challenging, especially when you get to the reintroduction phase. The good news is that my functional nutritionist, Sarah, is a great resource to get you moving forward.

Schedule a session with Sarah today!

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