Why can Histamine Intolerance be linked with Lipedema?
First We need to understand what Histamine is and what it does to the body.
Histamine is a an important compound released by immune cells called Mast Cells in response to an allergen that triggers an immune response and it is a vital compound in the inflammatory response. These can be a foreign bacteria or virus or from a cut to the skin but it can also come from high histamine foods. The body is normally able to eliminate histamine trough an enzyme called DAO and HNMT. But when Histamine Intolerance is present these enzymes aren't functioning correctly and there is a buildup of Histamine in the body which can cause many adverse symtpoms including swelling.
Histamine causes blood vessels to dilate and therefore increase their permiability and increase tissue swelling. Heat can also increase histamine levels so it also explains why Lipedema patients are very sensitive to heat coming from the Sun but also from Saunas and heat produced during exercise. Lipedema patients may have more sensitive Mast Cells which can get triggered and therefore start the degranulation process more easily and without a true allergen trigger. It is important to note that Histamine Intolerance is not the same as MCAS(Mast cell activation syndrome). The latter involves more inflammatory chemicals than just histamine.
What can impact the DAO and HNMT enzymes?
The main difference between these two enzymes is that DAO breaks down histamine in the gut compared to HNMT which breaks down intracellular Histamine and mainly present in the central nervous system. DAO still remains the primary enzymes in the degradation of histamine.
Estrogens:
There is a strong correlation between elevated estrogens and higher Histamine levels. This can be seen around peak hormonal levels during a womans menstrual cycle such as ovulation and around day 26 of a normal 28 days cycle. Estrogen blocks the DAO enzyme. So if you are struggling with PMS you are likely struggling with Histamine Intolerance too. That is because PMS is often linked with low progesterone levels during the luteal phase which makes estrogen the most dominant hormone.
SIBO or small Intestinal Bacteria Overgrowth:
Genetic expression of DAO happens in the small intestine and the presence of SIBO can also cause interstinal permiability and damage to the intestinal lining which can therefore decrease DAO production but also increase production of Histamine from other bacteria strains that become overpopulated due to a dysbiotic gut. Curing the SIBO infection can often alleviate a lot of the Histamine Intolerance symptoms. Mold infections can also trigger high histamine levels by the direct activation of Mast Cells.
Nutrient deficiencies:
A deficiency in Zinc, copper, vitamin B6, B12 and vitamin C. The latter being one of the most effective natural anti histamine. The use of Anti acids can inhibit the production of B12 and greatly reduces the absorption of zinc. An optimal stomach acid level will also aid in the production of DAO. Alcohol also greatly diminishes the activity of this enzyme. Histamine rich foods can also increase histamine levels and decrease the activity of these enzymes.
Viral infections:
It was reported that SARS-CoV-2 virus can greatly increase histamine release and caused the so called cytokine storm. Individuals with the AOC1 gene mutation which regulates DAO production where more suscetible to have Histamine Intolerance symptoms over a prolonged period of time. Other Viruses and Bacteria can also trigger Histamine release which can accumulate in the body. Viruses and bacteria also weakens the intestinal barrier which can therefore decrease DAO production.
Drugs and toxic exposure:
Some medications can increase Histamine levels such as:
antibiotics.
antidepressants.
gastrointestinal medicines.
antiarrhythmics, which treat heart rhythm irregularities.
antihypertensives, which treat high blood pressure.
muscle relaxants.
narcotics.
local anesthetics.
Exposure to environmental toxins and plastics can also put more burden on the liver and all the detoxification organs reducing the liver methylation ability and therefore diminishing levels of both DAO And HNMT. Constipation can further increase circulating histamine levels.
What foods are high in Histamine?
These are the most common high Histamine foods but the list is more extensive and the sensitivity depends on the individual and severity of histamine intolerance:
Fermented foods (Kombucha, Kefir, Sauerkraut, Kimchi)
Meat and Fish leaftovers
Tinned fish( anchovies, tuna and sardines)
Aubergines
Tomatoes( particularly raw)
Strawberries
Dark chocolate
Red wine
Aged cheese
Vinegar
Citrus fruit
Dried fruits
It is important to note that when Histamine Intolerance is present it can also accompany other intolerances to Oxalate compounds and Salicylates which are both Mast cell triggers. However it is important to establish this with your healthcare provider before cutting out any foods.