Histamine Intolerance - when HRT doesn't seem to be working!

Histamine Intolerance - when HRT doesn't seem to be working!

Histamine Intolerance (HIT)

Histamine intolerance is a poorly understood condition where a person has an excessive amount of histamine build-up in their body. It is thought to affect at least 1% of the population and is more common in women, particularly in mid-life. Symptoms such as flushing, itching, rashes, IBS, anxiety, migraines and joint pains are very similar to those of menopause, making it difficult to know whether symptoms are due to menopause or histamine intolerance.

What is histamine and how does intolerance occur?

Histamine is an important chemical in our bodies. It is essential for gut, brain, nerve and immune function. It is made in our bodies and we also consume it in food and drinks. Intolerance can occur when levels increase, which can be caused by any of the following: increased production by our bodies; increased intake from foods; or decreased breakdown (removal) of histamine.

HIT is not the same as a food allergy. Food allergies present with acute and severe symptoms. HIT is more chronic and never fatal. Often, people with HIT have recognised that they are intolerant to certain foods.

Why does it matter to me?

Increased production of histamine can occur as a result of the oestrogen in HRT. Thus, if a woman notices a worsening of symptoms (rather than the anticipated improvement) when starting HRT, HIT can be the reason. Alternatively, it may be that symptoms thought to be menopause-related were in fact due to HIT and therefore will not improve as expected with HRT either.

What can I do to help?

Certain foods either contain a lot of histamine or cause our bodies to produce more histamine, both of which will contribute to symptoms. Avoiding or significantly limiting these foods can help. This website is an excellent starting point: histamineintolerance.org.uk

If you plan to do a dramatic food exclusion diet you should always work with a dietician to ensure you do not miss out on vital nutrients.

As a minimum, cutting out alcohol, fermented foods and many dairy products can help.

Also, the fresher the food is, the less histamine it will contain. Shopping little and often, and avoiding leftovers might help.

Some people will follow a strict histamine diet for 4 to 6 weeks before gradually trying to reintroduce foods. A food diary may be invaluable. This downloadable one is ideal: histamineintolerance.org.uk/wp-content/uploads/2012/03/ food-diary.pdf

Other actions you can take

  • Taking an antihistamine can be helpful, or there are supplements which can be trialled such as vitamin C (250mg taken 3 times a day), L-glutamine and DAO (expensive).
  • Keeping stress to a minimum, although sometimes easier said than done, can also help keep histamine levels under control.
  • Review your medication with your doctor. Medications such as antidepressants, painkillers and HRT can increase histamine levels, which, ironically, are often prescribed for the symptoms of unrecognised HIT. Please don’t stop any medications suddenly: always review with a doctor first.
  • Often women will find the symptoms they associated with menopause will ease with these measures. If not, HRT can then be slowly reintroduced whilst controlling histamine levels with the diet changes.

Are there any tests I can have?

While there are expensive tests available, they are neither reliable nor widely available. By far the most reliable way of making the diagnosis is to perform a 4-week exclusion diet.

I hope that you found this useful. Do get in touch if you need some more help.


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