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Histamine Degradation Rate – Meaning and Influencing Factors

The histamine degradation rate describes how quickly the body enzymatically breaks down ingested histamine. It is key to tolerating histamine-rich foods.

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Things worth knowing about "Histamine Degradation Rate"

The histamine degradation rate describes how quickly the body enzymatically breaks down ingested histamine. It is key to tolerating histamine-rich foods.

What is the Histamine Degradation Rate?

The histamine degradation rate refers to the speed at which the human body enzymatically breaks down and inactivates histamine. Histamine is a biogenic amine that occurs naturally in the body and is also found in many foods. It plays an important role in immune responses, gastric acid production, and as a neurotransmitter. When histamine is not broken down quickly enough, it can accumulate and trigger a wide range of symptoms known as histamine intolerance.

Enzymes Responsible for Histamine Degradation

Histamine is primarily broken down in the human body by two enzymes:

Diamine Oxidase (DAO): This enzyme is mainly responsible for breaking down histamine from food. It is located primarily in the intestinal mucosa and degrades histamine in the small intestine before it enters the bloodstream.
Histamine N-Methyltransferase (HNMT): This enzyme is predominantly active intracellularly and breaks down histamine within body cells, particularly in the liver and central nervous system.

The individual histamine degradation rate is largely determined by the activity of these two enzymes. Reduced DAO activity is the most common cause of a low histamine degradation rate and thus of histamine intolerance.

Factors Influencing the Histamine Degradation Rate

Various factors can affect the histamine degradation rate by inhibiting or promoting enzyme activity:

Diet and Food

Histamine-rich foods such as red wine, aged cheese, canned fish, and fermented products increase the histamine load.
Certain foods such as alcohol, strawberries, and tomatoes directly block DAO activity.

Medications

Numerous medications can inhibit DAO, including certain antibiotics, antidepressants, older-generation antihistamines, and pain relievers such as acetylsalicylic acid.

Genetic Factors

Genetic variants in the DAO gene (AOC1) can lead to a congenital reduction in enzyme activity.

Intestinal Disorders

Chronic inflammatory bowel diseases, celiac disease, and leaky gut syndrome can reduce DAO production in the intestinal mucosa.

Nutrient Deficiencies

DAO depends on specific cofactors, particularly vitamin B6, copper, and vitamin C. A deficiency of these nutrients can lower the histamine degradation rate.

Clinical Significance of the Histamine Degradation Rate

When the histamine degradation rate is too low, histamine accumulates in the body and can trigger a wide variety of symptoms, often affecting multiple organ systems simultaneously:

Skin reactions: redness, itching, hives (urticaria), flushing
Gastrointestinal complaints: abdominal pain, bloating, diarrhea, nausea
Headaches and migraines
Cardiovascular symptoms: palpitations, drop in blood pressure
Respiratory symptoms: runny nose, sneezing

Diagnosis

The histamine degradation rate is typically assessed by measuring DAO activity in the blood (serum or plasma). Low DAO levels are considered an indicator of impaired histamine degradation. This can be supplemented by measuring histamine levels in blood or urine, as well as a detailed dietary history. However, a standardized reference range has not yet been uniformly established.

Treatment Approaches to Improve the Histamine Degradation Rate

Treatment aims to reduce histamine load and support enzyme activity:

Low-histamine diet: Avoiding histamine-rich and DAO-inhibiting foods
DAO enzyme supplements: Oral intake of diamine oxidase as a dietary supplement to support the breakdown of dietary histamine
Micronutrient supply: Adequate intake of vitamin B6, copper, and vitamin C to promote enzyme function
Antihistamines: Temporary symptom relief through H1 and H2 receptor blockers
Treatment of underlying conditions: Therapy of underlying intestinal disorders to restore DAO production

References

Maintz L, Novak N. Histamine and histamine intolerance. The American Journal of Clinical Nutrition, 2007; 85(5): 1185-1196.
Schwelberger HG. Diamine oxidase (DAO) enzyme and gene. Journal of Neural Transmission, 2007; 114(6): 757-762.
Reese I et al. Guideline on the management of suspected histamine intolerance. Allergologie, 2017; 40(5): 235-245.

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