Here's some testing that can be useful
for histamine intolerance.
Hi. I'm Dr. Chris Masterjohn of chrismasterjohnphd.com.
And this is Chris Masterjohn Lite,
where the name of the game is
"Details? Shmeetails. Just tell me what works!"
And today we're going to talk about some
testing for histamine intolerance.
I'll link to the last episode in
the description of this one, where I
describe histamine intolerance in a lot
more detail. But briefly, it means that
you suffer from diarrhea, or headaches, or
any symptoms that are reminiscent of
allergies in response to the histamine
content of the foods that you eat.
And one thing we might want to know in
something like this is, is it histamine
intolerance, or is it allergies, or
is it something else? And in particular,
could it be that you have an increased
burden of mast cells, which are one of
the main types of cells that release
histamine. Now, food allergies that cause
these types of symptoms are generally
classical food allergies, where the
standard testing that an allergist would
use would be the right approach to
identifying those food allergies.
In terms of histamine intolerance, the two
tests that are useful are serum diamine
oxidase activity. Diamine oxidase is an
enzyme that gets rid of histamine. It's
the main enzyme present in the gut, so
it's the most relevant enzyme when
talking about tolerating food histamine,
and blood levels of serum diamine
oxidase, or DAO, are low in histamine
intolerance. Histamine intolerance could
be mimicked by mast cell activation
syndrome or an overburden of the cells
that produce histamine. You could have a
chronic excess of histamine because of
the excess mast cell burden, and the food
coming in provides more histamine that
fills up your histamine bucket and
pushes you over, or you could have mast
cells accumulating, for example, in the
gut where something in the diet is then
activating them to release the histamine,
but that burden of mast cells is the
actual problem more so than your inability to clear
histamine in the gut normally.
You can look for the excess burden of
mast cells by looking at serum tryptase.
Now, serum tryptase is a very easy test
to get. LabCorp has it. Quest has it.
In general, most doctors would be able to
easily order it. Serum diamine oxidase
activity is not easily available. As far
as I can tell, the major laboratories
that I would think to use in the
United States do not carry it. There's
a laboratory Medichecks, based in England,
that does carry diamine oxidase activity.
If you happen to know of other labs that
offer diamine oxidase activity
commercially, please let me know in the
comments. So it might not be realistic to
measure diamine oxidase activity, but
measuring serum tryptase activity could
be very useful in the sense that if
serum tryptase is elevated, it indicates
an excess burden of mast cells, and that
indicates two things, number one, that
when you're thinking about nutritional
approaches, you want to focus on ones
that may reduce mast cell burden instead
of focusing on ones that may increase
diamine oxidase activity, increase
your ability to clear histamine. And then
number two, that might indicate something
very important about why those mast cells
are there that your doctor—that
you can then work with your doctor to
try to address because if you have an
inflammatory burden somewhere, that might
be an indication of another disease
process that needs investigation. Now, in
terms of the nutritional approaches to
stabilizing mast cells, or reducing mast
cell burden, or to supporting histamine
clearance, I'm going to deal with these—
I'm going to deal with these
successively in a series of episodes
that will culminate in an episode that
ties it all together and all the
different nutritional approaches that
you could use. So stay tuned for future
episodes for that. Now, if you look in the
literature, many people advocate using
more advanced testing that is even more
impractical. For example, many will argue
that the gold standard should be taking
samples of your intestines to look at
your intestinal expression of diamine
oxidase or even other enzymes that are
involved in histamine metabolism, and
some would advocate as the gold standard
giving you a blinded histamine challenge
where you are exposed to histamine doses
that have been added to tea, for example,
versus a placebo to see
whether your symptoms respond
specifically to the histamine.
These are deeply
impractical in most cases, but I think
the serum tryptase measurement,
and if you can find it, serum diamine
oxidase measurement, although they might
not give you the absolutely definitive
answer to what's going on,
they can certainly point you in the right
direction and be useful.
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All right, I hope you found this useful.
Signing off, this is Chris Masterjohn of
chrismasterjohnphd.com, and this has
been Chris Masterjohn Lite.
And I will see you in the next episode.