Migraine and Histamine: Part 2

Yesterday we started talking about histamines, DAO, and migraine.  If you missed that post, you’ll need to go back in order to get background before you go on with this post.

The theory is that low diamine oxidase (DAO) levels in migraineurs may be a cause or at least a trigger of migraine attacks in some (or maybe most) migraineurs.

Migraine and Histamine - part 2

We talked about a study yesterday that suggested that low DAO was common in migraineurs.  Now there are reasons to be positive about this study, but also reasons to be suspicious.  First let’s look at some reasons in each category.  But I’ll tell you from the start that I think there is some merit in the theory.

More reasons why this theory might work

First, a list of foods rich in histamine may look very familiar.  It includes, for example, fermented and aged foods, such as red wine and aged cheese.  Chocolate and nuts may also be on the list.  Sound familiar?  That’s right, these are all common migraine triggers, and foods often avoided in a low tyramine diet, which is probably the most well-known migraine diet.  Could it be that, while avoiding tyramine, we’ve really been cutting down on histamine?

And what about symptoms?  Yes, headache can be a symptoms of histamine intolerance.  So can congestion (very common in migraine), and gastrointestinal symptoms (also common in migraine or comorbid with migraine (IBS for example)).

We do know that headache can actually be triggered by administering histamine (example).

Reasons to be suspicious

First, this was a fairly small study, especially when it comes to filtering other factors, such as medications that people were taking.

There could be other reasons why migraineurs had lower DAO levels.  There are also a number of reasons for migraine symptoms.

In other words, other studies have shown common issues in migraine patients, such as genetic factors, low magnesium levels, neurological factors, etc.  You simply cannot throw out all that information and say that this is now the only cause of migraine.  Either it fits into the web of triggers and causes, or it is a trigger in some and not others, or it is actually a result of other migraine issues, not a main cause.

We cannot take one small study and claim we can now cure migraine.

But let’s take the DAO connection seriously…

That being said, there are good reasons to take this study seriously.

This is not just a vague theory from beginning to end.  We already know that histamine levels can cause sometimes severe symptoms, and we have a pretty good idea how it works.  We already know that many of these foods do trigger migraine attacks.  We already know there are links between migraine and histamine.  There’s a lot of science behind this idea.  The main question is, just how much do low DAO levels impact migraine symptoms, and how many migraineurs may be in this category?  It will take time before we know the answer.

Should I take action?

As with most neurological diseases such as migraine, it’s a challenge to generalize.  Symptoms of both migraine and histamine intolerance can vary drastically from person to person.  Tests may not be reliable.  And treatment will work to varying degrees.

If you have symptoms that might suggest histamine intolerance, you should certainly look into lowering your histamine levels.  We’ll talk about that more in a moment.

Here are some common symptoms... Skin problems, such as itchiness and hives.  Swelling of tissues (including tightening in the throat).  Headache.  Congestion/runny nose.  Fatigue.  Indigestion and heartburn.  Red or watery eyes.  Irregular heart beat.  You’ll especially notice these symptoms after eating histamine rich foods such as alcohol, foods with yeast, and cheese.  Other symptoms common to migraine, such as nausea, may also occur.

The best way to see if you’re histamine intolerant – and this may not be what you want to hear – will be to change your diet for several months.

Tests may not be reliable (example).  And remember, this is different from an allergy, which you may be tested for.

It is wise to talk to your doctor, particularly if you see clear symptoms after eating histamine rich foods (you are keeping a headache diary, right?  You are including other symptoms and possible triggers, right?).  You may actually have an allergy, or your doctor may have other recommendations.

Your doctor may not, however, know a lot about histamine intolerance.

Now here’s the tricky part.  Even if you can’t see an obvious connection, it is possible that histamine is triggering at least some of your migraine attacks.  And the diet may be the only way to find out for sure.

Finally, here are some common treatments for histamine intolerance:

  • A low-histamine diet:  This one isn’t optional.  If you do the things below, the assumption is that you’re already on a low-histamine diet.  This will start out very strict, and last for several months in order to see if it’s a help.  Don’t take a shortcut here.  You’ll also have to watch out for some medications which could raise histamine levels.  (An example of a low histamine diet)
  • Vitamins:  Your doctor or specialist may recommend vitamins that will help support the diet.  Vitamin C and vitamin B6 are commonly prescribed.
  • DAO supplements:  DAO supplements can also support your diet.  Some of these include HistDAO, DAOSin, and Histame.
  • Other supplements:  Other supplements may help, such as a good probiotic.  Some people find that their histamine levels get out of balance due to imbalanced flora in the intestinal tract.
  • Antihistamines:  It might be surprising the antihistamines are low on the list.  They’re not always a good preventative or treatment generally, but they can sometimes help in case of emergency (ie if you accidentally ate something high in histamine).

Thanks for sticking with us through all this information!  Let us know if you have experience with histamine intolerance, or if anything else is consistent with your symptoms or treatment.

Want to learn even more?  Start here: Histamine and histamine intolerance

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8 comments… add one
  • helen Jun 9, 2013

    MHNI was treating patients with intravenous antihistamines as a preventative. Maybe it still is. Maybe it did some pertinent research.

  • Bibi Jun 11, 2013

    Since I started taking Sandomigran (a weak antihistamine) as a preventive drug my migraines come once a week instead of twice a week. Changing my diet to gluten free and low histamine the migraines now come 3 weeks apart. – A major improvement for me 🙂
    In the US a similar drug named Cyproheptadine seems to be available.

  • Sunny Jun 12, 2013

    Cutting down on high histimane foods has lessened the amounts of migraines I get. Aged cheeses, chocolate, can fish, yogurt, basically all aged and fermented foods. Taking Benadryl at night helps with the am headaches/migraines.

    • chris Jun 17, 2013

      “am headaches/migraines.” If you are getting migraine in the morning check yourself for bruxism – open and close your mouth and if you hear a clicking/grinding noise this is a classic sign of bruxism, you will need a hard sleeping mouth splint which is very effective. If you are getting migraine about 20-30mins after showering in the morning don’t put the shower over your head, doing this makes you uses your corrugator muscles; wash your face and head separate being very careful to apply and remove soap with a flannel, don’t splash water on your face, again this will make you use your corrugator muscles. Bright glaring sun light will also make you use the corrugator muscles, do your best to keep them relaxed, better still stay out of very bright sun, also the infrared helps the body make nitric oxide and that triggers migraine.

  • Meggan Mar 1, 2014

    So, going low histamine AND DAO questions;
    Is it safe for your body to be perpetually low histamine? AND, If you start DAO, so it help jumpstart your system into making its own again?

    • Kerrie Smyres Mar 28, 2014

      DAO supplements are relatively new, but taking it isn’t thought to kickstart the body’s production of DAO. It just temporarily adds in the enzyme that you’re missing. It’s like people who are lactose intolerant taking Lactaid. It works for the time they’re both in the digestive tract, but that’s it.

      It’s OK to be on a low-histamine diet for an extended period. Your body is still making histamine, you’re just controlling the amount of additional histamine you introduce to your system.

  • Kerrie Smyres Mar 28, 2014

    Thanks for this great information, James. I wish I’d seen it before I figured out on my own that DAO deficiency was such a problem for me! I’ve also noticed that most foods on typical migraine diets are high in histamine. Seems like more than a coincidence to me, although that could be because I’m doing SO much better now that I’m taking DAO and eating a low-histamine diet.

  • Nancy Mills Jun 27, 2014

    Hi, I have been on a histamine elimination diet. It is helping the itching. Antihistamines (H1 blockers) give me a headache. I have chronic migraine, at 68 yo. They can be quite severe at times. Histamine is a problem for me causing sever vulver itching as well as itching all over. Watchout for Ibuprofin it can suppress DAO and damage your gut too. The elimination diet is the place to start. Nancy

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