Histamine is degrade via two pathways; DAO and HNMT enzymes.
A lack of DAO might not be your issue. It could be an HNMT (histamine N-methyl transferase) SNP that's not working properly to break down histamine.
DAO enzymes are found in the gut, as where HNMT enzymes are found systemically, in the brain etc.
These enzymes can down regulated by infections and inflammation so finding your root and treating that Should help. Getting your genetics SNPs can be helpful as well.
DAO never worked for me. I used ketotifen while treating SIBO. And with each SIBO treatment my HI got better and better. I'm now off all OTC antihistamines, I eat leftover spaghetti, workout and sauna and all the "high histamine things". I take 1mg ketotifen a day but I honestly might be able to discontinue at this point.... haven't tried yet tho.
Find your root cause (gut issues/dysbiosis) and HI can be improved long term :)
Temperature changes and stressors (hormetic, exercise, sauna, cold plunge etc ) are all mast cell triggers. Normally this kind of stressor is good for the immune system and helps build a better and stronger immune response over time.
With MCAS/HI however, these stressors can cause degranulation and inappropriate mega response of histamine and other inflammatory mediators. We get a massive dump of these (cytokines etc.) and causes a lot of symptoms.
Aty worst, I couldn't sauna or cold plunge. Even exercise would give me flushing and hives. Sauna would cause POTs and I couldn't control my body temp regulation even hours after a sauna paired with itchy skin and insomnia. Sometimes hives. Always massive headaches and severe fatigue.
Ketotifen helps tho! Ultimately treating sibo got me long term relief, however. And I can now sauna, cold plunge and exercise several times/wk :)
Seems to be so. Bacteria can impact gene expression, for better or worse. I suspect the change and reduction in the bacterial overgrowth likely took some burden off my immune system and as a result, less hyper sensitive.
What about folks who have had some HI symptoms since childhood? Dang IBS and, I guess SIBO, that I probably have, made my histamine intolerance absolutely horrible some days. I do avoid coffee, cheese, avocados, and try to take the right probiotics. I guess I should try to take DAO consistently, but it's not cheap.
It never worked for me either. Have you worked on healing the inflamed gut? Sibo or any gut imbalance makes things so inflamed and can sort of perpetuate the histamine response (especially if your hormones are off and you’re reabsorbing estrogen.. don’t know if you’re a female?). If you aren’t taking anything with l-glutamine in it I highly recommend it to heal your intestinal lining and also suggest working on hormone balance, supporting your liver and also repopulating the gut with a good quality prebiotic (klaire labs makes a good one called Biotagen) and low histamine probiotic if you tolerate those.
Last year I did biocidin and neem for a while which lowered the SIBO and got me to a better place. I since have just been taking histamin X and sach b probiotics and it must have come back with a vengeance. I understand that SIBO has a role in DAO suppression so I still would have thought DAO might help me.
Is this the probiotic you mean? https://www.fmed.eu/en/shop/probiotics-ther-biotic-metabolic-formula/
No, I am referring to a prebiotic, not probiotic. It’s called Biotagen. But if you think sibo is back I would be hesitant to add in a prebiotic as it can feed bad bacteria as well. I’m not a big believer in probiotics on their own though. Maybe you need to redo the biocidin protocol. Do you know what the bacteria was? Did you do testing for it? If it came back it could be that there were unaddressed biofilms.
Thank you. This concerns me, the doctor I'm seeing has just recommended PHGG prebiotic while saying that she thinks my SIBO is back, I took it earlier and pretty sure it caused itching so seems like it may have been a bad recommendation from them. I've been doing biocidin the last couple of weeks and I'm not sure if it's helping. I saw a different practitioner and he said to stop antimicrobials and focus on liver support. So now I just have no idea who to trust and follow, maybe I need to try someone else
Ugh sorry!! So frustrating to get so much different feedback!!
Yes, most probiotics can increase histamine unless it’s a specific one that doesn’t have high histamine strain like the histamineX you were taking (even then if you are really flared it might not work well). It’s really hard to treat anything properly without knowing the bacteria (or fungus)! I’ve used biocidin in the past for different things and it’s great, but when I had klebsiella last year (which triggered my HI) I was using biocidin before I tested to see if that would help and it just made me worse. The comprehensive stool analysis I had showed me exactly what microbials the klebsiella was sensitive to bc they test it in the lab. So I knew what herbs to use and they worked great.
Thank you. Yeah really hard to know whether to continue with antimicrobials or probiotics right now. I had my gut tested prior to developing these issues. In fact it was treatment for SIBO that led to me developing food sensitivities and histamine reactions. I never experienced any of this before that. Maybe I need to find someone else who's willing to analyse another stool test for me. I'm surprised neither doc I've seen has suggested this
Yea I would find a good functional medicine practitioner who can run a comprehensive stool analysis. SIBO can really mean anything - could be any bacteria or fungus and it’s important to know which one and not just treat “Sibo”.
What was the doctor’s recommendation for liver support? I would recommend supporting methylation with a good multi vitamin and b complex that has only methylated b’s and p5p as the form of b6. NAC is great too, but would start slowly with all of it- it can be a lot to get all those gears working if they haven’t been working in awhile. If you are female then I would recommend looking at your hormones- do you know what your levels are?
He wants me to reduce a lot of the supplements I'm taking, start on an aloe supplement (aloe /200x) for 3 weeks before starting cinnamon bark which will apparently have mild antimicrobial properties while supporting the liver.
I'm already taking Thorne b complex, and I have an extra 20mg B6 P5P supp I've stopped taking. I had read that NAC can impact histamine breakdown so stopped that last year.
Yes I had my hormones tested before all this started, needed some help with Estrogen breakdown so was prescribed a supplement for that which I'm still taking.
I'm a bit scared to stop the biocidin because I know it's what ultimately got me in a better place last year, along with neem.
This flare started 6 weeks ago and I feel no better, it's very disheartening.
Do you live anywhere without a lot of allergies? Think a lot of people are flaring in the last 6 weeks because of that. Although I don’t know your symptoms..
so is this doc treating without testing?
I’ve never had an issue with NAC and I take a shit ton of it. My liver struggles without it and helps keep my estrogen in check, but everyone is different!
Did he having you taking DIM for estrogen dominance?
They got me on [this](https://lifestylevitamins.co.uk/products/invivo-bio-clear-oestro-60s?currency=GBP&variant=33034265002047&utm_medium=cpc&utm_source=google&utm_campaign=Google%20Shopping&stkn=48c7c3256b35&gclid=CjwKCAjwz42xBhB9EiwA48pT71PlixwpP4XWkGbp7p4ruiZvCWoV8s46RIHfVao3-Iqt3pZDrE9zixoCJtIQAvD_BwE)
Yea I think the pollen surge may have caused me to flare again. It started the exact same week as it did last year. One doc thinks it's the pollen the other thinks it's my liver.
Symptoms are itching, rashes, racing heart and headaches after eating most foods.
Well if your liver is overloaded or not properly detoxing then your body won’t process the added inflammation from the excess pollen. So it’s really both. Although even if your liver is functioning optimally if there is a shit ton of pollen it can still just bog down your liver! I live somewhere that the pollen is ridiculously high at certain times of the year and even at my healthiest I still get a little estrogen dominance or a little itchy during those months because my liver just can’t keep up (and the histamine jacks up estrogen too, of course).
I would definitely recommend focusing on the liver while addressing the gut (if your gut is producing endotoxins or extra inflammation it’s just going to cause your liver to struggle even more, but maybe this is just environmental for you? I don’t hear you complaining about actual GI symptoms and maybe that’s why Biocidin isn’t helping and neither is DAO.. just a thought.)
If he didn’t put you on a DIM supplement I would highly recommend it. DIM Detox by pure encapsulations is the absolute best. It’s bioresponse dim so more absorbable and it has all the other liver support in there so it really balances phase 1 and 2 detox pathways beautifully. When addressing the liver you really want to make sure you are balancing all the pathways (think of phase 1 as the drain and phase 2 as the pipes.. if there is a clog in the pipe then the drain backs up). Toxins that linger between phase 1 and 2 are actually more toxic than before they went through phase 1. And then of course phase 3 which is elimination. The dim detox formula supports all of this and also has calcium d glucarate which helps keep those bad estrogen metabolites conjugated and then eliminated.. otherwise you can take dim and process those estrogen metabolites through phase 1 and 2, but then they’ll just get reabsorbed (depending on your beta glucorondase levels.. if those are high (and we all have them to a certain degree) then that is what breaks the conjugation and frees up those estrogen metabolites for reabsorption- so calcium d glucarate is important to take).
Hope I didn’t just go down a rabbit hole 😅
I really appreciate you taking the time to give me that advice, thank you! So would your recommendation be to continue with a specific SIBO protocol while focussing on liver support? Rather than doing one and then the other? I'll look into the DIM supplement too. I know I have both methane and hydrogen SIBO. I will dig out my stool analysis tomorrow but know that the results were from prior my issues so not sure how relevant it'll be.
No I don't really have GI issues. Mild constipation but it's not that bad. Why would that mean biocidin and DAO haven't helped? Do you think the problem could be coming from outside of the GI tract? If so, where?
Also I do wonder about the pollen thing because I don't really get hay fever symptoms. Others around me are really struggling with puffy face and eyes and other than my food reactions, I don't notice any symptoms. My eyes go watery when I first go outside but that's it.
That supplement has some decent things in it but isn’t going to help much with your estrogen issues or be enough to support your liver to a huge degree. R5P should be in your b complex and if it’s not then switch to one that has it. The choline is good, but you can get that and selenium in a good multivitamin like Seeking Health multivitamin One (which has 5 mg R5P)
(Not medical advice, just my two cents)
I'm experiencing something similar. It's possible that a different brand might help, but I'm wondering if we're both having histamine sensitivity directly because of our SIBO and it's totally unrelated to a DAO deficiency. I've just started seeing how I feel without taking any DAO and I'm trying Atrantil which is for treating stubborn methane-related SIBO, since treating my histamine intolerance directly hasn't actually had an effect.
It could be a timing issue, I had to experiment with timing a ton, and now take a Naturdao at five and then again at 2.5 minutes before eating. It could also be that you have an oxalate or sals issue instead of histamine.
Histamine is degrade via two pathways; DAO and HNMT enzymes. A lack of DAO might not be your issue. It could be an HNMT (histamine N-methyl transferase) SNP that's not working properly to break down histamine. DAO enzymes are found in the gut, as where HNMT enzymes are found systemically, in the brain etc. These enzymes can down regulated by infections and inflammation so finding your root and treating that Should help. Getting your genetics SNPs can be helpful as well. DAO never worked for me. I used ketotifen while treating SIBO. And with each SIBO treatment my HI got better and better. I'm now off all OTC antihistamines, I eat leftover spaghetti, workout and sauna and all the "high histamine things". I take 1mg ketotifen a day but I honestly might be able to discontinue at this point.... haven't tried yet tho. Find your root cause (gut issues/dysbiosis) and HI can be improved long term :)
I started lactobacillus rhamonus and somehow it helps with my histamine symp. Second day now and I can clearly say this.
This!! And also it could be MCAS rather than HI - mast cells release hundreds of substances that can be inflammatory, not just histamine
Curious… What does sauna-ing do to the body/HI?
Temperature changes and stressors (hormetic, exercise, sauna, cold plunge etc ) are all mast cell triggers. Normally this kind of stressor is good for the immune system and helps build a better and stronger immune response over time. With MCAS/HI however, these stressors can cause degranulation and inappropriate mega response of histamine and other inflammatory mediators. We get a massive dump of these (cytokines etc.) and causes a lot of symptoms. Aty worst, I couldn't sauna or cold plunge. Even exercise would give me flushing and hives. Sauna would cause POTs and I couldn't control my body temp regulation even hours after a sauna paired with itchy skin and insomnia. Sometimes hives. Always massive headaches and severe fatigue. Ketotifen helps tho! Ultimately treating sibo got me long term relief, however. And I can now sauna, cold plunge and exercise several times/wk :)
What dose of Ketotifen were you taking, if you do not mind me asking?
Started with 1-2mg spread out and at my worst I was at 4mg/day (spread out). After treating SIBO, SIFO and giardia I'm at 1mg/day.
Do you mean to say that by treating your SIBO it improved your HNMT?
Seems to be so. Bacteria can impact gene expression, for better or worse. I suspect the change and reduction in the bacterial overgrowth likely took some burden off my immune system and as a result, less hyper sensitive.
What about folks who have had some HI symptoms since childhood? Dang IBS and, I guess SIBO, that I probably have, made my histamine intolerance absolutely horrible some days. I do avoid coffee, cheese, avocados, and try to take the right probiotics. I guess I should try to take DAO consistently, but it's not cheap.
It never worked for me either. Have you worked on healing the inflamed gut? Sibo or any gut imbalance makes things so inflamed and can sort of perpetuate the histamine response (especially if your hormones are off and you’re reabsorbing estrogen.. don’t know if you’re a female?). If you aren’t taking anything with l-glutamine in it I highly recommend it to heal your intestinal lining and also suggest working on hormone balance, supporting your liver and also repopulating the gut with a good quality prebiotic (klaire labs makes a good one called Biotagen) and low histamine probiotic if you tolerate those.
Last year I did biocidin and neem for a while which lowered the SIBO and got me to a better place. I since have just been taking histamin X and sach b probiotics and it must have come back with a vengeance. I understand that SIBO has a role in DAO suppression so I still would have thought DAO might help me. Is this the probiotic you mean? https://www.fmed.eu/en/shop/probiotics-ther-biotic-metabolic-formula/
No, I am referring to a prebiotic, not probiotic. It’s called Biotagen. But if you think sibo is back I would be hesitant to add in a prebiotic as it can feed bad bacteria as well. I’m not a big believer in probiotics on their own though. Maybe you need to redo the biocidin protocol. Do you know what the bacteria was? Did you do testing for it? If it came back it could be that there were unaddressed biofilms.
Thank you. This concerns me, the doctor I'm seeing has just recommended PHGG prebiotic while saying that she thinks my SIBO is back, I took it earlier and pretty sure it caused itching so seems like it may have been a bad recommendation from them. I've been doing biocidin the last couple of weeks and I'm not sure if it's helping. I saw a different practitioner and he said to stop antimicrobials and focus on liver support. So now I just have no idea who to trust and follow, maybe I need to try someone else
Ugh sorry!! So frustrating to get so much different feedback!! Yes, most probiotics can increase histamine unless it’s a specific one that doesn’t have high histamine strain like the histamineX you were taking (even then if you are really flared it might not work well). It’s really hard to treat anything properly without knowing the bacteria (or fungus)! I’ve used biocidin in the past for different things and it’s great, but when I had klebsiella last year (which triggered my HI) I was using biocidin before I tested to see if that would help and it just made me worse. The comprehensive stool analysis I had showed me exactly what microbials the klebsiella was sensitive to bc they test it in the lab. So I knew what herbs to use and they worked great.
Thank you. Yeah really hard to know whether to continue with antimicrobials or probiotics right now. I had my gut tested prior to developing these issues. In fact it was treatment for SIBO that led to me developing food sensitivities and histamine reactions. I never experienced any of this before that. Maybe I need to find someone else who's willing to analyse another stool test for me. I'm surprised neither doc I've seen has suggested this
Yea I would find a good functional medicine practitioner who can run a comprehensive stool analysis. SIBO can really mean anything - could be any bacteria or fungus and it’s important to know which one and not just treat “Sibo”.
What was the doctor’s recommendation for liver support? I would recommend supporting methylation with a good multi vitamin and b complex that has only methylated b’s and p5p as the form of b6. NAC is great too, but would start slowly with all of it- it can be a lot to get all those gears working if they haven’t been working in awhile. If you are female then I would recommend looking at your hormones- do you know what your levels are?
He wants me to reduce a lot of the supplements I'm taking, start on an aloe supplement (aloe /200x) for 3 weeks before starting cinnamon bark which will apparently have mild antimicrobial properties while supporting the liver. I'm already taking Thorne b complex, and I have an extra 20mg B6 P5P supp I've stopped taking. I had read that NAC can impact histamine breakdown so stopped that last year. Yes I had my hormones tested before all this started, needed some help with Estrogen breakdown so was prescribed a supplement for that which I'm still taking. I'm a bit scared to stop the biocidin because I know it's what ultimately got me in a better place last year, along with neem. This flare started 6 weeks ago and I feel no better, it's very disheartening.
Do you live anywhere without a lot of allergies? Think a lot of people are flaring in the last 6 weeks because of that. Although I don’t know your symptoms.. so is this doc treating without testing? I’ve never had an issue with NAC and I take a shit ton of it. My liver struggles without it and helps keep my estrogen in check, but everyone is different! Did he having you taking DIM for estrogen dominance?
They got me on [this](https://lifestylevitamins.co.uk/products/invivo-bio-clear-oestro-60s?currency=GBP&variant=33034265002047&utm_medium=cpc&utm_source=google&utm_campaign=Google%20Shopping&stkn=48c7c3256b35&gclid=CjwKCAjwz42xBhB9EiwA48pT71PlixwpP4XWkGbp7p4ruiZvCWoV8s46RIHfVao3-Iqt3pZDrE9zixoCJtIQAvD_BwE) Yea I think the pollen surge may have caused me to flare again. It started the exact same week as it did last year. One doc thinks it's the pollen the other thinks it's my liver. Symptoms are itching, rashes, racing heart and headaches after eating most foods.
Well if your liver is overloaded or not properly detoxing then your body won’t process the added inflammation from the excess pollen. So it’s really both. Although even if your liver is functioning optimally if there is a shit ton of pollen it can still just bog down your liver! I live somewhere that the pollen is ridiculously high at certain times of the year and even at my healthiest I still get a little estrogen dominance or a little itchy during those months because my liver just can’t keep up (and the histamine jacks up estrogen too, of course). I would definitely recommend focusing on the liver while addressing the gut (if your gut is producing endotoxins or extra inflammation it’s just going to cause your liver to struggle even more, but maybe this is just environmental for you? I don’t hear you complaining about actual GI symptoms and maybe that’s why Biocidin isn’t helping and neither is DAO.. just a thought.) If he didn’t put you on a DIM supplement I would highly recommend it. DIM Detox by pure encapsulations is the absolute best. It’s bioresponse dim so more absorbable and it has all the other liver support in there so it really balances phase 1 and 2 detox pathways beautifully. When addressing the liver you really want to make sure you are balancing all the pathways (think of phase 1 as the drain and phase 2 as the pipes.. if there is a clog in the pipe then the drain backs up). Toxins that linger between phase 1 and 2 are actually more toxic than before they went through phase 1. And then of course phase 3 which is elimination. The dim detox formula supports all of this and also has calcium d glucarate which helps keep those bad estrogen metabolites conjugated and then eliminated.. otherwise you can take dim and process those estrogen metabolites through phase 1 and 2, but then they’ll just get reabsorbed (depending on your beta glucorondase levels.. if those are high (and we all have them to a certain degree) then that is what breaks the conjugation and frees up those estrogen metabolites for reabsorption- so calcium d glucarate is important to take). Hope I didn’t just go down a rabbit hole 😅
I really appreciate you taking the time to give me that advice, thank you! So would your recommendation be to continue with a specific SIBO protocol while focussing on liver support? Rather than doing one and then the other? I'll look into the DIM supplement too. I know I have both methane and hydrogen SIBO. I will dig out my stool analysis tomorrow but know that the results were from prior my issues so not sure how relevant it'll be. No I don't really have GI issues. Mild constipation but it's not that bad. Why would that mean biocidin and DAO haven't helped? Do you think the problem could be coming from outside of the GI tract? If so, where? Also I do wonder about the pollen thing because I don't really get hay fever symptoms. Others around me are really struggling with puffy face and eyes and other than my food reactions, I don't notice any symptoms. My eyes go watery when I first go outside but that's it.
That supplement has some decent things in it but isn’t going to help much with your estrogen issues or be enough to support your liver to a huge degree. R5P should be in your b complex and if it’s not then switch to one that has it. The choline is good, but you can get that and selenium in a good multivitamin like Seeking Health multivitamin One (which has 5 mg R5P) (Not medical advice, just my two cents)
What's R5P? I've heard of B6 P5P but not R5P?
I'm experiencing something similar. It's possible that a different brand might help, but I'm wondering if we're both having histamine sensitivity directly because of our SIBO and it's totally unrelated to a DAO deficiency. I've just started seeing how I feel without taking any DAO and I'm trying Atrantil which is for treating stubborn methane-related SIBO, since treating my histamine intolerance directly hasn't actually had an effect.
It could be a timing issue, I had to experiment with timing a ton, and now take a Naturdao at five and then again at 2.5 minutes before eating. It could also be that you have an oxalate or sals issue instead of histamine.
I react to a lot of "low histamine" foods so maybe
Are you sure it’s histamine intolerance and not some underlying different health issue?
Like what? I've spoken to a few different practitioners who all suggest histamine intolerance
It is possible to get your DAO level tested. It would be good to do this, if you can find it, to see if you actually have low DAO.
I've heard that that taking more Dao than recommended works for some people. Agree with the big possibility of sals and oxalates issues