A tavern in the city of Vienna is place for many different people and tastes, but some of them might have a very interesting reasons for being there…. Observing the visitors of a wine tavern, you may come across those who say they get a blocked nose after consuming just a small quantity of wine. Some others would say they prefer to drink Schilcher wine, a type of drink described to have a little sour taste. They would say this type of wine does not give them a blocked nose. Still others would prefer to drink nothing having alcohol, not even beer, and not because they are the driver, but because they have been diagnosed with histamine intolerance.
Histamine is a chemical substance secreted by normal immune cells and present in many different foods and drinks. It is the principal substance that signals and triggers inflammation in conditions such as asthma, allergic rhinitis, and urticarial. It has a role in the gastrointestinal system because the production of histamines by our body stimulates the secretion of gastric juice. It also controls appetite, and it acts as a neurotransmitter.
Histamine is essential for our normal functioning, but it also has undesirable effects such as headaches, runny nose, rapid pulse, arrhythmia, diarrhea, skin rash, and many other. But histamines are not an ally nor a foe, it all depends on how balanced this chemical is in our system. This is where diamine oxidase comes, an enzyme that breaks down excess histamines and avoids all of these adverse effects it triggers when it’s out of control.
Histamine intolerance is a condition in which there’s not a balance in how much histamine we have and how much is broken down. Therefore, there’s an accumulation of this chemical, and a handful of allergic symptoms start to appear. It is often confused with food allergy because they both share the same principle, but the main problem with histamine intolerance is not an excessive response to foreign material –as in food allergy-, but an overt lack of sufficient amine oxidase to break down histamines.
A close relationship between histamines and the gut
The first barrier against histamines is located in the intestines because almost every type of food contains at least a bit of this substance. This is why the gut is one of the places where amine oxidase is more concentrated. The cells in the mucosal linings of the intestines produces this enzyme continuously and secrete it into the intestinal lumen. Here, amine oxidase typically breaks down excess histamines before nutrients can be absorbed into the bloodstream.
In histamine intolerance, the gut amine oxidase is either deficient because the intestinal mucosa does not produce enough, or inactive and not capable of breaking down histamines. The situation becomes worse when we eat foods with a high content of histamines, or when there’s an overgrowth of bacteria that produces a high amount of this substance. Many studies have identified several histamine-producing bacteria on various foods, like tuna, cheese and wine. Some of the histamine-producing strains are Clostridium perfringens (a common cause of food poisoning), Enterobacter aerogenes (a cause of gastrointestinal disease in many hospitals worldwide), Vibrio alginolyticus (a common bacterium in seafood), and Proteus mirabilis (a bacterium commonly found in the gut).
What’s more, certain fermented foods are in the black list because they exacerbate the problem. So, while a common reasoning would be to prevent overgrowth of histamine-producing strains with probiotics, this should be done with extra care. First off, fermented foods have many different strains, and some of them might be off limits. So, the safest way to act when there’s histamine intolerance is through probiotic supplements with bacterial strains that counteract histamine and promote anti-inflammatory substances.
Up until now, there’s not enough body of evidence to point out the absolute best and safe option, but according to the available studies, the species we would need to avoid are Lactobacillus bulgaricus and Lactobacillus casei. On the other hand, the best choices might be Bifidobacterium infantis, Bifidobacterium lactis, Bifidobacterium longum, Lactobacillus rhamnosus, and Lactobacillus plantarum. Some specialists also recommend Lactobacillus reuteri because, even though it is considered to increase histamines, it produces a special type of anti-inflammatory histamine that would fight the common allergic symptoms of histamine intolerance.
The best probiotics for histamine intolerance are the ones that modulates the behavior of the immune system to stabilize mast cells and promote anti-inflammatory substances (Lactobacillus rhamnosus), or help breaking down histamines (Bifidobacterium longum and Bifidobacterium lactis). Still others strains are under debate, as in the case of Lactobacillus lactis and Lactobacillus acidophilus. Overall, there’s no sufficient data on many questions, and most of them remain partially answered. What we know is that gut microbiota can also influence histamine intolerance, and the current strategy to fight this condition with probiotics is always being revised by new studies. So, in the near future maybe we won’t really need to cut wine or limit ourselves to drink sour options with lower histamine levels.
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