Red wine, oranges, chocolate, aged cheese are all common food triggers of migraine.  What do these foods have in common? They are all high in histamine!

Histamine increases nitric oxide, which causes vasodilation (ie expansion) of blood vessels.  Vasodilation increases blood flow to the brain.  The nervous system responds to this increased blood flow with symptoms of pain, flashing lights, double vision, vertigo, increased sensitivity to light, smells and noise as well as nausea, vomiting and diarrhoea.

Histamine doesn’t just come from food!  Histamine is increased from:

1. Gut dysbiosis – there are certain bacteria found in the gut that release histamine.
2. SIBO – an overgrowth of bacteria in the small bowel will release histamine.
3. DAO enzyme overload – the DAO enzyme that resides in both the small and large intestines degrades histamine. Dysbiosis and SIBO can cause the DAO enzyme to become overloaded with histamine.
4. Oestrogen – oestrogen increases histamine release from mast cells and down regulates the DAO enzyme.
5. Mould exposure.

Histamine is reduced by:

1. DAO enzyme which resides in the small and large intestine degrades histamine. This enzyme is produced by the DAO gene.  Having a mutation on the DAO gene can cause a reduction in DAO enzyme functioning.
2. HNMT enzyme which takes over the degradation of histamine from the DAO enzyme when it has become overloaded. This enzyme needs a methyl group to function. If the methylation cycle is not working optimally then the methyl groups are not available.  You can read more about methylation here.
3. Treating SIBO and gut dysbiosis to take the load off the DAO enzyme.
4. Liver detoxification of oestrogen as oestrogen stimulates the release of histamine from mast cells.
5. Reducing intake of high histamine foods.

Why do women suffer more from migraines?

Oestrogen stimulates mast cells to release histamine, but what also happens is that histamine stimulates the ovaries to produce more oestrogen! So you can see it’s a vicious cycle of histamine – oestrogen – histamine!!!

To compound issues even further, oestrogen down regulates the DAO enzyme, which is required to degrade histamine in the gut.  Progesterone increases DAO enzyme activity so you want to make sure you have good progesterone levels.

References

Vollesen AL et al 2018, ‘Migraine and cluster headache – the common link’, The Journal of Headache and Pain, vol 19, no. 1, p99

Lassen LH, Thomsen LL & Olsen J 1995, ‘Histamine induces migraine via the H1-receptor. Support for the NO hypothesis of migraine’, Neuroreport, vol 6, no 11, pp1475-9

Krabbe AA & Olesen J 1980, ‘Headache provocation by continuous intravenous infusion of histamine. Clinical results and receptor mechanisms’, Pain, vol 8, no. 2, pp. 253-9

Alstadhaug 2014, ‘Histamine in migraine and brain’, Headache, vol. 54, no. 2, pp.246-59

Izquierdo-Casas J et al 2018, ‘Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: A randomized double-blind trial’, Clinical Nutrition, vol 18, no, 1

Izquierdo-Casas J et al 2018, ‘Low serum diamine oxidase (DAO) activity levels in patients with migraine’, Journal of Physiology & Biochemistry’, vol 74, no 1

Garcia-Marin E 2015, ‘Diamine oxidase rs10156191 and rs2052129 variants are associated with the risk for migraine’, Headache, vol 55, no. 2, pp.276-86

Gupta S, Nahas SJ & Peterlin BL 2011, Chemical Mediators of Migraine: Preclinical and Clinical Observations’ Headache, vol. 51, no 6, pp.1029-1045

Bryant B & Knights K 2011, ‘Pharmacology for Health Professionals’, 3d edn, Mosby Elsevier, Chatswood

Lynch B 2018, ‘Dirty Genes’, Harper One, New York