histamine intolerance after menopause

Posted by bjklemme @bjklemme, May 26, 2023

Just a few months after menopause I got a strange cluster headache (it was like being electrocuted on one side of my head every few seconds) that lasted for days and would only go away after an ER visit and prednisone. Prior to the headache my ears were ringing, I had rhinitis, my ears would start to itch in the evening and my blood pressure was low. I thought it was a one-off but then it repeated 1 1/2 years later on the other side.

Accepting that I had a chronic migraine I put up with tinnitus on and off in my left ear. About a year ago I got chronic diarrhea and gastric reflux. I thought they were unrelated until the symptoms got so bad that I noticed there was a direct connection between the symptoms and eating food with histamine. Basically, within minutes of eating the food, my left ear itches, then starts to ring, and my nose runs. The same night I will have heart palpitations while falling to sleep and then pulsatile tinnitus during the night. I wake up every morning between 3 and 5AM flushed, with my ears ringing and nose running. I also get rosacea, eczema, (and now dermatographia), which correlate with the histamine reactions. Benadryl is very effective in aborting the reactions but other antihistamines don't work or seem to make it worse. Propranolol also works but I don't like taking it because my blood pressure is already low.

I could get no help from doctors and specialists. Now a year later (on a low histamine diet) I am free of the diarrhea and reflux but still cannot eat histamine. I talked a gynecologist into measuring my estrogen level and it came out to 17 pg/ml, which strikes me as very high for 5 years past menopause. I started on progesterone cream and used a lot ( a blood test confirmed that I had increased my progesterone a lot) and for the first time my symptoms abated.

I am still trying to figure out what is going on and what I should do. I am not sure I should keep using so much progesterone. Also, I have recently noticed that my symptoms are consistent with high prolactin levels. That is why benadryl, propranolol, and progesterone all seem to work but other antihistamines don't (if my guess is correct). An MRI has shown a normal pituitary.

I read that this could be caused by gluten sensitivity, although I don't seem to be reaction to gluten. My current plan is to go cold turkey on gluten, histamine, and progesterone and then measure my prolactin. Then add the histamine, and gluten back individually.

Any help would be greatly appreciated! This has turned my life upside down. I am unable to eat normally, in restaurants, and travel is difficult. I continue to have the "migraine" symptoms every single night.

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krp823 | @krp823 | 6 days ago

One thing I would do is stop taking the propranolol. Beta Blockers don’t directly raise the histamine level in your blood like some other medications do. But they lower the threshold at which your mast cells degranulate. Basically it makes the cells that contain the histamine more likely to dump it into your bloodstream. I got very sick before i figured that out!

Progesterone is a mast cell stabilizer, which is why your symptoms got better on it.

Benadryl is helpful but not optimal long term so hopefully you can find other interventions that help!

Estrogen is a histamine liberator, so it’s interesting that it got worse AFTER menopause. I would check all your medications for how they impact histamine levels before you do anything. This was the most invaluable step for me. I would ditch food dyes (even in medications) because a lot of people (myself included) have histamine reactions to them.

I agree with removing gluten from your diet. Dairy is another common cause of inflammation. Low histamine diets are very hard so i typically suggest everything else first, but I get that you’re struggling!

One last piece of advice is to get genetic testing done to see how you metabolize medications. I found out that i don’t have a couple of important liver enzymes that metabolize common medications. That might be why you can take Benadryl but have literally no effect with another. You might not have the enzymes necessary to be able to process it.

This is also important because I’ve found sources that say if your liver can’t process a substance (because you don’t have the enzymes) it can cause an increase in your histamine level. In other words, you may be taking medications that are unknowingly raising your histamine level. Good luck 🙂