The Link Between Histamine Intolerance and Endometriosis

Last updated: August 2022

Histamine intolerance occurs when there is too much histamine build-up in the body, which can worsen endometriosis symptoms.

What is histamine?

Histamine is a naturally occurring chemical produced in the body and found in food. Histamine is involved in various bodily functions but is best known for being released in allergic reactions, causing red, swollen, and itchy skin.

The link between histamine excess and endometriosis

Endometriosis is a disease marked by inflammation and immune system dysfunction, which prevents the immune system from removing endometriosis lesions. This can result in a vicious cycle of inflammation.

A type of immune cell known as mast cell plays an important role in endometriosis. Mast cells release histamine and other compounds such as prostaglandins that contribute to inflammation.1-3

Histamine changes during your cycle

Histamine levels in your body can fluctuate depending on your cycle. During your cycle, when estrogen rises as it usually does during the follicular phase, it stimulates the production of histamine and can down-regulate the DAO enzyme that clears histamine.

Histamine can also stimulate estrogen production, leading to a cycle of elevated histamine and estrogen, which can cause various symptoms listed below.

Histamine levels are balanced by an enzyme called diamine oxidase (DAO). However, some people have a deficiency of DAO, which causes histamine to build up.

What are the side effects of histamine intolerance (HIT)?

Some of the symptoms of excess histamine or HIT include:

You may experience a few of these or more, as symptoms can vary from person to person.

Foods high in histamine

Many foods either contain histamine or cause the body to release histamine. Some foods that are high in histamine include:

  • Aged cheese
  • Alcohol
  • Tinned fish and cured or processed meat such as salami, sausages, and bacon
  • Pickled or tinned foods
  • Chocolate
  • Shellfish
  • Eggplant
  • Tomatoes

Some foods contain more histamine than others, and some foods are known as histamine liberators. In other words, they release histamine:

  • Citrus fruit
  • Chocolate
  • Tomatoes
  • Wheat
  • Vinegar
  • Food additives such as sulphites and nitrates

Some foods can block the DAO enzyme resulting in histamine excess:

  • Alcohol
  • Black, green and mate tea
  • Yeast
  • Energy drinks

Histamine and gut health

There is a link between compromised gut health and HIT. The DAO enzyme, which helps clear histamine, is primarily in the gut.

In cases of poor gut health, an imbalance of gut flora (known as dysbiosis) can increase levels of bacteria that release histamine and cause impaired DAO activity, contributing to excess histamine.

How is HIT diagnosed?

Recording your diet and symptoms in a food diary is a good place to start. Allergy testing can be completed to rule out other conditions. No specific tests diagnose HIT, so an elimination diet normally identifies it.

How do you treat endometriosis and HIT?

Firstly, removing high histamine foods for about four weeks is a good place to start, improving gut health, reducing or managing stress through lifestyle changes, and supporting the body with supplements that lower inflammation and help the body clear histamine.

A low histamine diet should not be a forever diet. It is best to work with a qualified health professional such as a dietitian to treat HIT.

Some of the supplements that can be helpful for HIT include:

  • Vitamin C, which helps clear histamine
  • Vitamin B6, helps support the DAO enzyme
  • Quercetin, reduces the release of histamine from mast cells
  • DAO enzyme can help improve the clearance of histamine

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