There’s an interesting link between histamine and endometriosis.

Histamine is a naturally occurring chemical in the body involved in immune reactions, but also has a number of other functions in the body.

Endometriosis and excess histamine

Endometriosis is an inflammatory condition, with research showing that it involves the activation of mast cells, which in turn release histamine (1, 2).

During your cycle, when estrogen rises as it normally does during the follicular phase, it stimulates the production of histamine and can down-regulate the DAO enzyme that clears histamine. As a result of this, elevated histamine can be a contributor to PMS.

Histamine can also stimulate the production of estrogen, leading to a vicious cycle of elevated histamine and estrogen.

Additionally, there is a link between IBS, Small Intestine Bacterial Overgrowth (SIBO) and histamine intolerance; IBS and SIBO have a high prevalence in those with endometriosis. In cases where gut health is compromised there may be an imbalance of gut bacteria (known as dysbiosis), leading to greater levels of bacteria that release histamine and impaired DAO activity, contributing to excess histamine.

Histamine excess causes a range of symptoms such as persistent fatigue, brain fog, rashes or hives, headaches or migraines, racing heart or low blood pressure, period pain, bloating, constipation and abdominal pain. This is a short list of the potential symptoms caused by HIT or histamine intolerance. There are many more symptoms that can occur, which can vary greatly from person to person.

While histamine is produced within the body, it’s also consumed through food.

There are many foods that either contain histamine or cause the body to release histamine.

Some examples of histamine rich foods include:

• Fermented dairy products such as aged cheese

• Alcohol

• Tinned fish

• Cured meats such as salami

• Fermented or pickled vegetables such as sauerkraut

• Eggplant

• Tomatoes

• Avocado

How is it diagnosed?

It’s important that allergy testing is completed to rule out specific allergens. If nothing specific is identified or the problem isn’t solved by eliminating specific allergens, then further testing may be conducted, but testing for histamine intolerance isn’t completely accurate, so it is usually identified through an elimination diet.

How is histamine intolerance and endometriosis treated?

Removing high histamine foods for a period of time, improving gut health, lifestyle changes and targeted supplements that help clear estrogen, support DAO activity and lower histamine and inflammation are also used.

Some examples of anti-histamine supplements include vitamin C, quercetin and bromelain.

Natural progesterone can also be extremely helpful for those with endometriosis and histamine intolerance as progesterone has anti-histamine effects, is anti-inflammatory, it lightens periods and increases GABA, a naturally occurring chemical that calms the nervous system.

References

1.      Binda, M. M., Donnez, J., & Dolmans, M. M. (2017). Targeting mast cells: a new way to treat endometriosis. Expert opinion on therapeutic targets, 21(1), 67–75. https://doi.org/10.1080/14728222.2017.1260548

2.      Vallvé-Juanico, J., Houshdaran, S., & Giudice, L. C. (2019). The endometrial immune environment of women with endometriosis. Human reproduction update, 25(5), 564–591. https://doi.org/10.1093/humupd/dmz018