Which probiotics for histamine intolerance?
What is histamine?
Histamine is a chemical involved in the immune system and central nervous system. It is also a component of stomach acid so crucial for proper digestion too. Histamine's role in the body is to cause an immediate inflammatory response. It serves as a red flag for the immune system, notifying the body of any potential attackers and causing blood vessels to swell, or dilate, so that white blood cells can quickly find and attack the infection or problem. This is a natural immune response. Histamine is inflammatory and a build up can cause headaches and leave people feeling flushed, itchy and miserable. This is a natural immune response, but if you don’t break down histamine properly, you could develop what is called histamine intolerance which is fundamentally a result of an imbalance between the breakdown of histamine and its build up.
In addition to histamine produced in the body there are also foods which contain it and also foods which inhibit the enzyme which breaks it down. Histamine is broken down by various enzymes according to where it is in the body. However, the American Journal of Clinical Nutrition claims that Diamine Oxidase (DAO) is the main enzyme for breaking down ingested histamine so if you have a lack of this you are more likely to have an intolerance.1
There are many possible causes (other than histamine rich foods and a lack of DAO) for histamine intolerance but top of the list are Intestinal Permeability and SIBO (bacteria imbalance/overgrowth). So fundamentally a disturbance in the gut biome plays a significant role in creating histamine intolerance.
Probiotics and histamine intolerance
It would, therefore, follow that probiotics should be helpful in alleviating histamine intolerance; strangely though fermented foods are top of the avoidance list for this allergy. This underlines how vital it is to understand that there are hundreds of different strains of bacteria and that they all have different roles. Limited research shows that some play a positive role in histamine intolerance and others should be avoided as they can exacerbate the problem. Those probiotics which appear to have a positive effect on histamine intolerance symptoms do so by downregulating the IgE and histamine receptors, up-regulating anti-inflammatory agents in the gut therefore helping reduce intestinal permeability or pathogenic bacteria from adhering to the gut wall.2-4, 6
Species that may need to be avoided:
Based on the small amount of research available, it is thought that some of the bacteria used to ferment yoghurt and fermented foods could potentially exacerbate histamine production, so many people with histamine intolerance choose to avoid these type of foods. Typically, these are strains of Lactobacillus casei and Lactobacillus bulgaricus. We would say that it’s important to remember that strains within a species of bacteria may react in a different way, and so not all strains within these species will have this effect, but if you're in doubt then avoid these species to be sure.
Species that may be beneficial:
Based on limited research into probiotics and histamine intolerance, the species considered to be beneficial because they are thought to downgrade biogenic amines (of which histamine is one) are Lactobacillus rhamnosus, Bifidobacterium infantis, Bifidobacterium longum, Lactobacillus plantarum, and possibly Lactobacillus reuteri. *
It’s also important to point out that everyone is different, and therefore what works for one person may not work in exactly the same way for another. So finding the right probiotic may involve a little trial and error or even a combination of a couple of these.
Another thing to consider is that both histamine intolerance and allergies may be linked to compromised gut health, as 70% of the immune system is believed to reside in the gut, and our gut bacteria are thought to be an integral part of the immune response. So it’s also worth considering supporting all-round intestinal health with powerful probiotic strains such as Lactobacillus acidophilus NCFM® and Bifidobacterium lactis BI-04. Whilst neither product contain any of the species thought to downgrade biogenic amines, nor do they contain any histamine-producing species, and therefore should be fine for anyone with histamine issues to take.
If you're interested in learning more, our Probiotic Myths...BUSTED! is a guide that dispels common myths about probiotics!
To find out more information - take a look at our Probiotics Database.
* Historically it’s been recommended that people with histamine intolerance should avoid this particular strain as it increases histamine production. However a recent study suggests that it raises the production of a type of histamine that is actually anti-inflammatory and therefore could be beneficial to those with histamine intolerance5.
References:1. Laura Maintz and Natalija Novak (2007) Histamine and histamine intolerance. American Journal of Clinical Nutrition 85:5 (1185-1196)
2. Deepika Priyadarshani, W. M. and Rakshit, S. K. (2011), Screening selected strains of probiotic lactic acid bacteria for their ability to produce biogenic amines (histamine and tyramine). International Journal of Food Science & Technology, 46: 2062–2069. doi: 10.1111/j.1365-2621.2011.02717.x
3. Vittorio Capozzi, Pasquale Russo, et al. (2012) Biogenic Amines Degradation by Lactobacillus plantarum: Toward a Potential Application in Wine. Front Microbiol. 2012; 3: 122. Published online Apr 2, 2012. Prepublished online Mar 4, 2012.doi: 10.3389/fmicb.2012.00122
4. SPILLER, R. (2008), Review article: probiotics and prebiotics in irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 28: 385–396. doi: 10.1111/j.1365-2036.2008.03750.x
5. Thomas CM, Hong T, van Pijkeren JP, Hemarajata P, Trinh DV, et al. (2012) Histamine Derived from Probiotic Lactobacillus reuteri Suppresses TNF via Modulation of PKA and ERK Signaling. PLoS ONE 7(2): e31951. doi:10.1371/journal.pone.0031951
This FAQ has been answered by Joanna Scott-Lutyens, BA (hons), DipION, Nutritional Therapist; and Kerry Beeson, BSc (Nut.Med) Nutritional Therapist.