In the intricate complexity of the human immune response, histamine acts as the conductor in regulating the body's inflammatory reaction. Issues can arise when the body doesn't break down histamine properly, resulting in elevated levels, which can cause several allergic-type reactions. However, with appropriate care and management, the impact of high histamines can be greatly reduced. This is where lab testing can offer support. Functional labs are an excellent resource for detecting underlying factors that contribute to elevated histamine levels and play a vital role in ensuring that you have the protocol that fits your patient's specific needs.

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What is Histamine?

Histamine is a signaling chemical released by the immune system to communicate between different cells. It serves several functions, but it primarily triggers allergic and anaphylactic symptoms.

When a patient has an allergy, their body reacts to harmless proteins (allergens) as if they are threats. This overreaction leads to a cascade of responses, releasing histamine, which causes allergy symptoms. Usually, these symptoms stay confined to a specific area of your body. However, in severe immune reactions, anaphylaxis can occur, affecting most of the body and posing a life-threatening condition known as anaphylactic shock.

The body stores histamine mainly in mast cells found in connective tissues under the skin, near blood and lymph vessels, nerves, and in the lungs and intestines. Additionally, basophils, another type of white blood cell, also play a role in histamine release.

What is a High Histamine Response?

The body produces much of its histamine through granules in immune cells called mast cells and basophils. When exposed to foreign allergens, these cells release histamine at mucosal surfaces, causing an inflammatory immune reaction. Normally, enzymes break down histamine, but if this process is inefficient, histamine can accumulate, leading to histamine intolerance. This intolerance occurs when there's an imbalance between accumulated histamine and the body's ability to metabolize and eliminate it, causing a variety of symptoms.

What Causes a High Histamine Response? 

A high histamine response occurs with excessive histamine production and deficiencies in the enzymes responsible for breaking it down.

Enzyme deficiencies can occur due to impaired enzymatic function or reduced enzyme levels. Two main enzymes, diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT), are involved in histamine breakdown. Genetic variations and certain medications can hinder enzyme activity, including antiarrhythmics, antibiotics, antidepressants, antihypertensives, muscle relaxants, narcotics, and non-steroidal anti-inflammatory drugs (NSAIDs). Gastrointestinal (GI) disorders like leaky gut, IBS, SIBO, and IBD can also contribute to enzyme deficiency since DAO is synthesized in the gut.

Histamine overproduction can be caused by dietary histamine from histamine-rich foods or foods that trigger histamine release in the body. Exposure to environmental and dietary allergens can also lead to histamine release from immune cells. Some individuals with mast cell disorders experience overactivation, producing excess inflammatory chemicals, including histamine. Additionally, estrogen excess or dominance states can increase histamine burden and worsen histamine-related symptoms.

High Histamine Response Symptoms

High histamine response symptoms related to histamine intolerance are closely linked to the body's normal functions of histamine. They typically appear after consuming high-histamine foods or encountering allergens that trigger histamine-related immune responses. These symptoms can be pretty similar to allergy symptoms, making diagnosis challenging. Common signs include gastrointestinal issues, sneezing, nasal congestion, headaches, flushing, hives, itching, and fatigue.

In more severe cases, high histamine can lead to abnormal and painful menstrual cycles, insomnia, irregular heart rate, asthma, anxiety, difficulty regulating body temperature and blood pressure, as well as dizziness.

What Are The Benefits of Regular Lab Testing For Patients With a High Histamine Response?

There are several benefits of regular testing for patients with a high histamine response. Firstly, it can help identify histamine intolerance, so personalized treatment and nutritional plans can be created to address those enzyme deficiencies. Regular testing also allows for monitoring progress over time to hone in on the specific triggers for histamine responses. Lab tests can also detect underlying health conditions that increase the risk for high histamine responses, enabling proper treatment approaches to manage those conditions. Tracking histamine levels can prevent life-threatening situations for those prone to severe reactions. Overall, lab testing helps patients monitor progress, make adjustments, and improve the impact of high histamines.

Top Labs To Run Bi-Annually On Patients With a High Histamine Response

Functional medicine labs provide the necessary clinical information for practitioners to customize treatment options for their patients. Here are some of the most common labs ordered for individuals experiencing histamine intolerance:

Advanced Intestinal Barrier Assessment (IBA)

The Advanced IBA profile directly measures DAO and histamine levels. Low DAO levels reveal if the patient is unable to break down histamine. This blood test also assesses gut health and markers of intestinal permeability that can affect DAO levels and the body's ability to process histamine properly. The test provides a Histamine-to-DAO ratio, helping clinicians understand the balance between histamine and the enzyme responsible for degrading it (DAO) in the patient's body. This test should be a common go-to for patients experiencing high histamine responses to monitor progress and histamine levels and to optimize treatments based on the results.

GI Effects Comprehensive Profile

The GI Effects test is another gut health assessment test that should be regularly run for patients with high histamine response. This stool test evaluates digestive function, intestinal inflammation, and the intestinal microbiome. This test is designed to aid in managing GI health and provide insights into conditions such as dysbiosis, IBS, and IBD. These GI conditions can decrease DAO production leading to high histamine responses. Therefore, the results of this test can help with treatment protocols to address the underlying GI conditions associated with excessive histamine levels.

Female Hormone Panel

Excess or dominant estrogen levels promote the release of histamine and other inflammatory responses from mast cells and basophils. These excess levels can lead to an increased histamine burden and worsen symptoms associated with high histamine response. The female hormone panel is a comprehensive test that measures major female hormones in the blood serum. It can detect hormonal imbalances in women, such as excess estrogen levels that can indicate estrogen dominance and increase histamine levels. Thus, this test should be completed regularly for women with high histamine levels associated with hormonal imbalances. Rebalancing those hormonal levels is vital in reducing histamine reactions and overall health.

Genetic Test + Blueprint Report

Genetic testing can help assess genetic variations or polymorphisms such as DAO and HNMT for patients with high histamine response. This genetic test is completed through a saliva sample. It examines more than 134 genes affecting various aspects of our body, such as metabolism, inflammation, detoxification, performance, weight, hormones, cognition, and responses to diet and supplements. Although this test only needs to be completed once, it was essential to discuss this lab as understanding one's genetic makeup helps us grasp how our body works. The genetic report offers personalized and practical recommendations based on these test results, empowering patients with these genetic variations to create customized treatments to counteract them and improve their health outcomes.

Food + Environmental Allergy Test

Before diagnosing histamine intolerance or assessing potential triggers of histamine overproduction, it is essential to rule out IgE-mediated allergies, both environmental and dietary, as they can mimic symptoms of histamine intolerance or can induce high histamine responses. This serum test analyzes 88 common food and environmental allergens responsible for histamine-type reactions. Antihistamines must be avoided 72 hours before testing.

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Summary

Histamine is crucial in regulating normal bodily processes. However, when the body overreacts to harmless allergens, it can cause significant disruptions, including high histamine and severe allergic responses that can be life-threatening. High histamine responses may be impacting the daily lives of your patients. Therefore, utilizing functional labs is essential for identifying specific allergies, histamine response, or underlying factors that increase histamine levels. These tests can provide valuable insights into various individualized approaches to manage high histamine response effectively and appropriately.