Histamine Intolerance & Migraine
Introduction
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 diarrheas’.
Histamine doesn’t just come from food! Histamine increases from:
1. Gut dysbiosis
Certain bacteria found in the gut release histamine, causing gut dysbiosis.
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.
To reduce histamine, one can:
- DAO Enzyme which resides in the small and large intestine degrades histamine. The DAO gene produces this enzyme.. Having a mutation on the DAO gene can cause a reduction in DAO enzyme functioning.
- 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.
- Treating SIBO and gut dysbiosis to take the load off the DAO enzyme.
- Liver detoxification of oestrogen as oestrogen stimulates the release of histamine from mast cells.
- 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 reduces the expression of the DAO enzyme, which is necessary for degrading histamine in the gut. Progesterone increases DAO enzyme activity so you want to make sure you have good progesterone levels.
References
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- 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 PMID: 7402688
- Alstadhaug 2014, ‘Histamine in migraine and brain’, Headache, vol. 54, no. 2, pp.246-59 PMID: 24433203
- 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 PMID: 29475774
- 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 PMID: 28624934
- 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 PMID: 25612138
- Gupta S, Nahas SJ & Peterlin BL 2011, Chemical Mediators of Migraine: Preclinical and Clinical Observations’ Headache, vol. 51, no 6, pp.1029-1045 PMID: 21631491
- Bryant B & Knights K 2011, ‘Pharmacology for Health Professionals’, 3d edn, Mosby Elsevier, Chatswood
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