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Histamine Sensitivity & Intolerance during the Menopause 

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Histamine intolerance is a condition characterised by histamine overload.  Histamine is an important chemical messenger, found in certain foods and produced by the body's immune & digestive systems. Histamine intolerance or HIT can lead to symptoms affecting several systems of the body, most people will experience one or two of the following;

Skin: hives, flushing, itching, eczema

Respiratory: constant runny nose, sinusitis, wheeze, shortness of breath, chronic cough

Gut: acid reflux, nausea, constipation, diarrhoea, bloating, wind

Vascular: dizziness, fainting, migraine, fluid retention, palpitations

Neurological: irritability, anxiety, brain fog, insomnia, fatigue, tinnitus

Other: joint pains, breast pain, painful and/or heavy periods, bladder pain syndrome

Menopause & Histamine Intolerance

Oestrogen has an important role in histamine regulation and vice versaOestrogen stimulates mast cells to release histamine and it deregulates DAO (diamine oxidase) the enzyme involved in the elimination of histamine. Histamine also encourages greater release of oestrogen from the ovaries forming a vicious cycle where more histamine leads to more oestrogen and more oestrogen leads to more histamine.

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Many women entering perimenopause, often experience what seems to be the onset of new allergies or intolerances, possibly towards substances like alcohol or specific foods. Additionally, they may find that conditions such as hay fever, eczema, or asthma either emerge for the first time or become more severe.

If you are still menstruating, your oestrogen levels peak during the middle of your cycle at ovulation and then again to a lesser extent just before your period. Consequently, it is common to observe symptoms of histamine intolerance during these phases of your menstrual cycle. You might notice increased congestion or easily becoming flushed after consuming wine, but this may only occur during these specific times of the month. Keeping a record of these symptoms and noting when they occur in your cycle can prove valuable in identifying the issue.

HRT & Histamine Intolerance

Hormone replacement therapy (HRT) can potentially exacerbate histamine intolerance in some individuals, although it may not affect everyone the same way. Some women do not realise they have HIT until they start HRT, when symptoms develop due to higher  oestrogen levels. It is important to inform your health care professional if you suspect HIT.

Managing histamine intolerance during menopause often involves dietary adjustments, identifying trigger foods, antihistamines, gut health improvement, and stress management. Personalising your HRT is important if you suffer with HIT as the right combination of oestrogen to treat your symptoms and potentially exacerbate your HIT can be balanced with progesterone and testosterone which can stabilise your mast cells and immune responses.
 

Diagnosis of Histamine Intolerance (HIT)

HIT is normally made after completing a low-histamine diet for 4 weeks under medical or nutritionist supervision. We recommend using a food diary.
We sometimes recommend a blood test,  looking at your histamine levels & DAO (Diamine Oxidase) to assess whether you have low production of DAO, the enzyme involved in histamine excretion and high histamine. This is only accurate if not following a low-histamine diet and is often completed before completing a low-histamine diet. 

How to treat Histamine Intolerance?

Adjustments to diet and gut health are crucial in controling HIT. There are some medications and supplements which can be used to reduce the histamine response or increase your levels of DAO. Medication we often prescribe for histamine intolerance:
 

Antihistamines H1 & H2 - block histamine receptors

DAO supplements & Vitamin B, helps to increase DAO

Vitamin C & L-glutamine - are natural antihistamines

​Quercetin 500mg- natural mast cell stabiliser

If you suspect you may have histamine intolerance speak to one of our menopause specialists who will be able to support your treatment.

View our article for further information on Histamine Intolerance 

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