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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@bjklemme

Another thing I would like to point out is that when my symptoms became so bad that it was obvious I was reacting to foods, I got into a cycle that made it worse: Recommendations for histamine-reduced diets and ways of managing the condition found on the internet all encourage avoidance of the foods that trigger the reactions. That, combined with the intensity of the reactions, got me in a downward B6 spiral: At one point, I could not eat bananas, avocados, fish, or chicken -all foods rich in B6 that would have helped me. Also, a lot of the processed foods that I could not eat are fortified with B vitamins. So it was self-perpetuating.

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This is very interesting. I too have begun taking a b6 supplement in the form of p5p I believe it is called. Supposedly it may be better utilized by some people who may have trouble with the pyridoxine version that is in most supplements, although it is also less stable in storage. I ordered it as a powder and put it in capsules but I do not ever take an entire capsule. Rather I open the capsule and tap out the smallest amount possible into a spoon. I do the same with all my supplements. I think we are learning that too much of almost anything can be as bad as too little.
Eating a small quantity of meat (including chicken and fish) each day may also help increase iron absorption from the foods it is consumed with, and dairy and eggs both impede iron absorption. Looking at a simplified diagram of histamine metabolism by DAO, I noticed that iron is also one of the co-factors. People often think of iron-deficiency anemia when we think of low iron, but it affects other things, too.

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@scolio

This is very interesting. I too have begun taking a b6 supplement in the form of p5p I believe it is called. Supposedly it may be better utilized by some people who may have trouble with the pyridoxine version that is in most supplements, although it is also less stable in storage. I ordered it as a powder and put it in capsules but I do not ever take an entire capsule. Rather I open the capsule and tap out the smallest amount possible into a spoon. I do the same with all my supplements. I think we are learning that too much of almost anything can be as bad as too little.
Eating a small quantity of meat (including chicken and fish) each day may also help increase iron absorption from the foods it is consumed with, and dairy and eggs both impede iron absorption. Looking at a simplified diagram of histamine metabolism by DAO, I noticed that iron is also one of the co-factors. People often think of iron-deficiency anemia when we think of low iron, but it affects other things, too.

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Thank you for the tip on the p5p. I think I will try it. My blood work also came out borderline deficient in iron. The nutrients more commonly cited in the literature for DAO production are B6, vitamin C, and copper. With my near-vegetarian diet it is likely I was deficient in both iron and B6 and last year and also had symptoms of B12 deficiency (it was horrible). I did stock up on B12 and thought that was the end of the story because it's hard to find information linking vegetarianism with B6 deficiency. I had not made the connection with not eating meat. Vegetarianism gets such glowing reviews I didn't think there was any issue with it.

Unfortunately, there are going to be a lot more people with this problem (they say histamine intolerance is "on the rise") because I did look up the single reference that gives the impression that there is no issue with B6 deficiency in vegetarians and it really just measures one point in time where it is likely all of the vegetarians in the study either supplemented with B6 or were careful and got it from other foods. That's because prior studies showed there was B6 deficiency with not eating meat. Now with everyone citing the new study (and not actually reading it) many people are just going to stop eating meat (like I did) and not worry about it. It really made me sick.

Hindsight is 20/20 and in retrospect this was pretty obvious. The timescales and symptoms all pointed to it. I had a number of things out in my blood work and other symptoms but not a single smoking gun that a physician could point to to make a diagnosis: My ALP was elevated, white blood cell count down, iron saturation low. It would have taken a bit of detective work and a doctor who had the time and inclination -and also believed me. Many doctors just dismissed my symptoms and were just checking the boxes: interpreting my blood work as if I did not have any. It was very frustrating and I know now what people with long covid go through.

I continue to recover and can eat most anything now (with the notable exception of Hollandaise Sauce 🙂 although I've not had the guts yet to try pickles or tomatoes. I need to give it some time. I still have nighttime symptoms but they are usually mild enough to be handled with a 12 hour Allegra.

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@laberg1

Thanks for all the information. I have histamine intolerance, for the past 3 years. I break out in hives. Antihistamines do not help. Once I get into the state of huge hives the only thing that can get me out of it is prednisone.

I take B6 and Saccharomyces Boulardii (the only probiotic that I can tolerate) They are precursors to the DAO enzyme that breaks down histamine.

I also take: Vitamin C, quercetin, bromelain, stinging nettle and NAC. And Ashwagandha for sleeping. These seem to control it a bit.

But: If I eat or drink: wine, vinegar, lemon, orange, fermented foods and chocolate. Or foods containing cinnamon, nutmeg then the hives return.
Today, I was googling and found that a lack of progesterone and too much estrogen can be a cause of histamine intolerance . I am planning to get those numbers checked.
Hope this helps. And wishing you well!
Linda

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I am sorry about your symptoms. Hives are terrible! I really went through a lot of research and so many specialists and your case makes me wonder if you may actually have chronic urticaria. It can be triggered by foods.

On the progesterone/estrogen imbalance thing: I did read about that last year and gave it a try. Progesterone is thought to up-regulate DAO. It worked spectacularly! For awhile 🙁 . The pills worked, but only if I took them in the morning because they only last in your system for a few hours. Also, they make you feel sick and dizzy and it's dangerous to drive. My advice to you is to use the creams: it is absorbed through the skin fairly efficiently and does get in to your system (I checked with blood work). It stays around for about 48 hours. I had to use A LOT to get any benefit. I don't know how healthy it is in the long-term. My guess is that it stopped working when I literally ran out of B6 to make DAO.

Best of luck.

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@laberg1

Thanks for all the information. I have histamine intolerance, for the past 3 years. I break out in hives. Antihistamines do not help. Once I get into the state of huge hives the only thing that can get me out of it is prednisone.

I take B6 and Saccharomyces Boulardii (the only probiotic that I can tolerate) They are precursors to the DAO enzyme that breaks down histamine.

I also take: Vitamin C, quercetin, bromelain, stinging nettle and NAC. And Ashwagandha for sleeping. These seem to control it a bit.

But: If I eat or drink: wine, vinegar, lemon, orange, fermented foods and chocolate. Or foods containing cinnamon, nutmeg then the hives return.
Today, I was googling and found that a lack of progesterone and too much estrogen can be a cause of histamine intolerance . I am planning to get those numbers checked.
Hope this helps. And wishing you well!
Linda

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Another thing about the progesterone: It is known to cause skin flare-ups and after taking it for awhile at such a high dose (I think I was rubbing in 150 mg a day) it did just that. So it added skin inflammation to my list of histamine intolerance symptoms: If I took a 1/4 teaspoon of olive oil (my histamine intolerance measuring device) within 1/2 hour I would have red patches and dermatographia all over my skin. So it could make the hives worse.

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I am doing even better with beef liver. I chase it with some vitamin C crystals dissolved in water. Nice package of iron, copper, and B6 all together.

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@bjklemme

Thank you for the tip on the p5p. I think I will try it. My blood work also came out borderline deficient in iron. The nutrients more commonly cited in the literature for DAO production are B6, vitamin C, and copper. With my near-vegetarian diet it is likely I was deficient in both iron and B6 and last year and also had symptoms of B12 deficiency (it was horrible). I did stock up on B12 and thought that was the end of the story because it's hard to find information linking vegetarianism with B6 deficiency. I had not made the connection with not eating meat. Vegetarianism gets such glowing reviews I didn't think there was any issue with it.

Unfortunately, there are going to be a lot more people with this problem (they say histamine intolerance is "on the rise") because I did look up the single reference that gives the impression that there is no issue with B6 deficiency in vegetarians and it really just measures one point in time where it is likely all of the vegetarians in the study either supplemented with B6 or were careful and got it from other foods. That's because prior studies showed there was B6 deficiency with not eating meat. Now with everyone citing the new study (and not actually reading it) many people are just going to stop eating meat (like I did) and not worry about it. It really made me sick.

Hindsight is 20/20 and in retrospect this was pretty obvious. The timescales and symptoms all pointed to it. I had a number of things out in my blood work and other symptoms but not a single smoking gun that a physician could point to to make a diagnosis: My ALP was elevated, white blood cell count down, iron saturation low. It would have taken a bit of detective work and a doctor who had the time and inclination -and also believed me. Many doctors just dismissed my symptoms and were just checking the boxes: interpreting my blood work as if I did not have any. It was very frustrating and I know now what people with long covid go through.

I continue to recover and can eat most anything now (with the notable exception of Hollandaise Sauce 🙂 although I've not had the guts yet to try pickles or tomatoes. I need to give it some time. I still have nighttime symptoms but they are usually mild enough to be handled with a 12 hour Allegra.

Jump to this post

Another reason why we may need more B6 when we aren't eating any meat is that b6 is needed to manufacture carnitine. If there is no carnitine coming from diet, the body can make it. In fact, most of us make at least half of what we need, even when we do get some from meat. But it would make sense that with zero meat, we'd need to make up the difference, and that would presumably mean a higher requirement for b6, too.

I really feel like flexitarianism is a very healthy way to eat, to keep both brain and body healthy, but I think it works best when it includes a small amount of meat such as fish or chicken (2 or 3 oz per day for example) at least a few days out of the week, and/or supplements used in a judicious way.

I think most of us are eating more meat than is good for us, and that an excess of protein can be detrimental in the long run, like our sugar overconsumption is. But I feel like taking a middle road of reducing the balance of meat in favor of increasing whole grains, fruits, and fresh veggies would be the most beneficial for most of us.

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@scolio

Another reason why we may need more B6 when we aren't eating any meat is that b6 is needed to manufacture carnitine. If there is no carnitine coming from diet, the body can make it. In fact, most of us make at least half of what we need, even when we do get some from meat. But it would make sense that with zero meat, we'd need to make up the difference, and that would presumably mean a higher requirement for b6, too.

I really feel like flexitarianism is a very healthy way to eat, to keep both brain and body healthy, but I think it works best when it includes a small amount of meat such as fish or chicken (2 or 3 oz per day for example) at least a few days out of the week, and/or supplements used in a judicious way.

I think most of us are eating more meat than is good for us, and that an excess of protein can be detrimental in the long run, like our sugar overconsumption is. But I feel like taking a middle road of reducing the balance of meat in favor of increasing whole grains, fruits, and fresh veggies would be the most beneficial for most of us.

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Yes! You are definitely right! The problem with what I did is that I did not think about it at all. The most that was running through my mind was something like "you just have to make sure you get enough protein". When things started to happen, I did not connect the dots. I am definitely eating enough fruits, grains, and vegetables -especially since not being able to eat any process foods or at restaurants for nearly 2 years! It did not cross my mind that I could be malnourished in some way. The B12 issue did come up (after I got really sick) and I fixed that. The B6 caught me by surprise. I am probably not going to do flexitarianism in any fashion after this. It might be totally OK, but this experience was really crazy and frightening and who knows what else there is about it that people don't know yet. It might be that things don't show up for years.

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@bjklemme

Yes! You are definitely right! The problem with what I did is that I did not think about it at all. The most that was running through my mind was something like "you just have to make sure you get enough protein". When things started to happen, I did not connect the dots. I am definitely eating enough fruits, grains, and vegetables -especially since not being able to eat any process foods or at restaurants for nearly 2 years! It did not cross my mind that I could be malnourished in some way. The B12 issue did come up (after I got really sick) and I fixed that. The B6 caught me by surprise. I am probably not going to do flexitarianism in any fashion after this. It might be totally OK, but this experience was really crazy and frightening and who knows what else there is about it that people don't know yet. It might be that things don't show up for years.

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It sounds to me like what you had accidently fallen into wasn't so much flexetarianism, but maybe more like an extreme version of vegetarianism, but in such a way that it wasn't obvious that that is what was happening. So you couldn't prepare for it by researching what you might need to stay healthy.

I have heard of at least one supplement marketed to vegans that contains only b12 and b6, so someone somewhere recognizes that extra b6 is important when our meat consumption drops to zero.

I think there is a big difference between zero and moderation (2 or 3 ounces per day). I think of myself as a person who struggles with moderation, and I know I tend to take things to extremes. What I've realized lately is that almost everyone can fall into this kind of trap.

We end up eating too much of something (added sugar in all of our foods and drinks, more meat than is really good for us) or go to the other extremes of zero meat or 'low-carb' diets, both of which can be harmful in their own way.

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@scolio

It sounds to me like what you had accidently fallen into wasn't so much flexetarianism, but maybe more like an extreme version of vegetarianism, but in such a way that it wasn't obvious that that is what was happening. So you couldn't prepare for it by researching what you might need to stay healthy.

I have heard of at least one supplement marketed to vegans that contains only b12 and b6, so someone somewhere recognizes that extra b6 is important when our meat consumption drops to zero.

I think there is a big difference between zero and moderation (2 or 3 ounces per day). I think of myself as a person who struggles with moderation, and I know I tend to take things to extremes. What I've realized lately is that almost everyone can fall into this kind of trap.

We end up eating too much of something (added sugar in all of our foods and drinks, more meat than is really good for us) or go to the other extremes of zero meat or 'low-carb' diets, both of which can be harmful in their own way.

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It wasn't "extreme" so much as disorganized. I wasn't really very attentive to eating issues and had a lot of other things going on. I think I was going in and out. Then at one point (ironically when I started to pay more attention to dietary issues) I thought a good way to reduce meat consumption was to only eat it at restaurants. When it became extreme was during the pandemic: I had got into the habit of preparing meatless dishes at home and did not go out to restaurants (which means I ate no meat) and didn't even think about.

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@bjklemme

It wasn't "extreme" so much as disorganized. I wasn't really very attentive to eating issues and had a lot of other things going on. I think I was going in and out. Then at one point (ironically when I started to pay more attention to dietary issues) I thought a good way to reduce meat consumption was to only eat it at restaurants. When it became extreme was during the pandemic: I had got into the habit of preparing meatless dishes at home and did not go out to restaurants (which means I ate no meat) and didn't even think about.

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I make similar miscalculations all the time, and not just with diet.
I try to remind myself that at least I learn from some of those mistakes.
Every once in a while I 'learn' something that turns out to be another mistake, though!
Oh, well, I'm not the only one. Henry Ford made production more efficient partly by observing that workers were spending time walking around from one task to another, and cut down on that to save time. Now we are realizing that getting in our 'steps' is important for our health and we go around wearing pedometers. Progress?

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