Histamine intolerance in HPU

Histamine intolerance common with HPU

With histamine intolerance (HIT), the relationship between the uptake, formation and breakdown of histamine in the body is out of balance. In HPU, both histaminosis (high histamine levels, less frequent in HPU) and histapenia (low histamine levels, frequent in HPU) occur.

Since the conversion of histidine to histamine depends on P5P (activated form of vitamin B6), it is clear why HPU sufferers often suffer from histamine intolerance. At the same time, the activity of the DAO is increased by the often high copper levels (counterpart of zinc, which is often lowered). DAO stands for diamine oxidase – a copper-dependent enzyme in the small intestine that breaks down histamine.

The MaO enzymes are also dependent on copper. The monoamine oxidases (MaO) are mitochondrial enzymes that break down monoamines. They are also involved in the degradation of histamine.

Histapenia due to to high copper level

Since both enzymes work faster at high copper levels, histamine is degraded very quickly in untreated HPU patients.

This results in a constantly lowered histamine level – histapenia.

Background: Zinc and copper are opponents. As the untreated HPUler excretes more zinc with the defective haem, the copper level usually rises.

People with histapenia often react even more sensitively to histamine-containing foods or histamine liberators than people with a permanently elevated histamine level.

Note: In the course of life, the histamine level decreases naturally. Younger people can therefore be expected to have higher histamine levels than older people.

Diagnosis of histapenia

It is important that histamine is not determined in blood serum but in whole blood. The histamine concentration inside and outside the cell is measured. The Keac laboratory in Holland offers this test for about 82 euros.

For histamine in whole blood, the Keac laboratory gives the following reference values: 28 – 51 µg/l

Below 28 µg/l a histapenia is present, above 51 µg/l a histaminosis.

An activity measurement of the DAO (or MaO) has no diagnostic value here, since it is often even increased, as described above.

An elevated copper value measured in whole blood can also be an indication of histapenia.

Complaints with Histapenia

Keac mentions the following possible complaints that can occur with histapenia:

  • Overweight
  • sun sensitivity
  • chronic fatigue
  • poor dental health
  • strong hairiness
  • diminished pain
  • Anxiety/panic attacks
  • Cysts / ulcers in the mouth
  • proliferating wounds
  • Depressivity and sleep problems

Histamine is a tissue hormone that influences the permeability of the vascular walls, among other things. In histapenia, the vessel walls are too dense. This makes gas exchange and the transport of micronutrients into the tissue more difficult. Also the removal of toxins and metabolic degradation products in histapenia is only possible with difficulty due to the dense vessel walls – therefore skin complaints often occur.

Depending on the severity of histapenia, smaller amounts of histamine are still well tolerated. Complaints only occur when the individually tolerated amount has been exceeded by direct histamine intake (via histamine-containing foods) or via histamine-releasing foods. The tolerable amount of histamine not only varies from HPU patient to HPU patient, but can also vary from day to day. Keac writes: “Factors such as stress, smoking, alcohol and high physical exertion can lower the individually tolerable threshold, which can cause earlier complaints”.

Histaminosis (increased histamine levels) with HPU

Although elevated histamine values (histaminosis) also occur in HPU patients (Dr. Joachim Strienz speaks of 10 %), they are significantly less common than low histamine values (histapenia) (approx. 50 %). Reduced DAO activity can be an indication of histaminosis. Activity measurements of the DAO as well as the determination of histamine in blood serum are carried out by the IMD laboratory in Berlin.

The histamine content in the stool can also indicate a disturbance in histamine degradation.

Therapy and nutrition for histamine intolerance

Under the usual HPU therapy with zinc, activated vitamin B6 (P5P) and manganese the histamine level normalizes according to Dr. med. Joachim Strienz (author of the book “Life with KPU”) in most HPU patients within one year.

Kyra Kaufmann also confirms this trend. “All you need is a little patience,” said book author and alternative practitioner Kyra Kaufmann at the Online Allergy Congress 2019.

If this is not the case, a treatment should take place.

Low histamine diet

In both histaminosis and histapenia, a low-histamine diet has proven to be useful. Long stored or matured foods contain a lot of histamine and should therefore be avoided. This also applies to reheated foods. The Swiss Association for Histamine Intolerance provides detailed information on nutrition and drug therapy for histamine intolerance (HIT).

These foods should be avoided in the event of histamine intolerance, as they themselves contain large amounts of histamine (list not complete):

  • Alcohol (especially red wine and sparkling wine)
  • spinach
  • long matured cheese
  • salami
  • pork
  • Sauerkraut, tomatoes
  • vinegar
  • smoked fish
  • Glutamate (flavour enhancer in convenience food)
  • soy sauce
  • yeast extract

These foods are histamine liberators. They can stimulate the body’s own mast cells to release histamine (list not complete):

  • Tomatoes
  • avocados
  • grapes
  • rhubarb
  • pineapple
  • pepper
  • strawberries
  • seafood
  • Pork and lamb meat
  • cocoa

Drug therapy of histamine intolerance

An antihistamine helps in acute cases. It prevents the histamine from “docking” to the specific histamine receptors by occupying them.

The enzyme DAO (diamine oxidase) can be taken in tablet form before a meal if there is a mild HIT and reduced DAO activity.

If Keac diagnoses histapenia (via histamine determination in whole blood), the patient receives a therapy recommendation. Keac recommends taking Depyrrol ProHis for 4 months at a very low level (< 24 µg/l), followed by a maintenance dose of niacinamide (=nicotinamide) (250 mg) twice daily one tablet. If the histamine value is only slightly lower (up to 24 µg/l), only niacinamide is recommended.

Hista plus from Heidelberger Chlorella is a suitable alternative. Ritter and Baumeister-Jesch recommend chelated (organically bound) calcium and methionine (500 mg per day).

Zeolite and humic acid (e.g. Activomin) are also used to bind excess histamine.

Histapenia and sunlight

A low histamine level increases sensitivity to sunlight. This can result in headaches, nausea and weakness due to inadequate UV protection in the skin. It is suspected that people with histapenia have a lack of histidine in the skin, from which natural skin protection is built. Without this, free radicals can form in the upper layers of the skin under UV radiation, which can severely affect the body.

“Copper, lithium, histidine and St. John’s wort should be avoided as they are counterproductive.”

Dr. Tina Maria Ritter and Dr. Liutgard Baumeister-Jesch in their guidebook “Metabolic Disorder HPU“. 

Explanation: Copper is a co-factor of the histamine-degrading enzymes diamine oxidase (DAO) and monoaminooxidase (MaO). Histidine is the amino acid from which the body produces histamine. Lithium and St. John’s wort increase light sensitivity.