Asthma and Histamine: The Connection

Asthma and Histamine: The Connection

Asthma is a chronic condition that affects the airways in your lungs and your breathing. Nearly 1 in every 10 individuals in the United States is dealing with asthma. Conventional treatment strategies focus on removing triggers and medication to reduce asthma attacks. There may be a missing link though. 

Histamine intolerance may be making your asthma symptoms worse. I have worked with hundreds of patients over the years with histamine intolerance and asthma. I found that addressing underlying histamine intolerance and reducing their histamine bucket has helped them to reduce their symptoms of asthma as well.

In this article, I will discuss the connection between asthma and histamine. You will learn what asthma is. I will discuss the symptoms, types, triggers, and risk factors of asthma. You will learn about diagnosis and conventional treatment options. I will go over everything you need to know about histamine, histamine intolerance, and symptoms of histamine intolerance. I will discuss the connection between histamine intolerance and asthma. Finally, I share my top natural strategies for histamine intolerance and asthma.

What Is Asthma

According to the Centers for Disease Control and Prevention (CDC), about 7.8 percent of people (8.4 percent of adults and 5.8 percent of children) in the United States have asthma (1). Clearly, it’s not a rare issue and we need to talk about it.

Asthma is a chronic or long-term lung condition. The airways in your lungs are the tubes that transport air in and out of your lungs as you breathe. Asthma affects these airways and makes them become inflamed and narrowed at times. If your airways become inflamed and narrowed due to asthma, it will become more difficult for the air to move out when you are breathing out. This can lead to difficulty breathing and asthma attacks (2). 

Asthma may be triggered by or worsened by viral infections, pollen, exercise, cold air, and other factors. Histamine intolerance may also play a role in your asthma attacks. Though there is no known cure for asthma, an effective asthma action plan, including monitoring symptoms, avoiding triggers, and sometimes, using a short-term or long-term medication can help you manage the condition and reduce your symptoms. If histamine intolerance is among the underlying factors behind your asthma, reducing your histamine levels may also help. I will discuss the role of histamine in asthma later in this article (2).

Symptoms of Asthma

Asthma causes inflammation and swelling inside your airways. At the same time, the muscles around your airways tighten and squeeze. Mucus buildup may also block airflow in your airways. This may lead to various symptoms of asthma. Symptoms of asthma are also known as asthma attacks, asthma episodes, or asthma flare-ups.
Symptoms of asthma may vary from person to person. They may be mild only lasting for a few minutes. They may be more severe and may last for hours or days causing serious breathing issues. You may experience all symptoms of asthma during an asthma attack, but you may only experience a few (4, 5).

Symptoms of asthma may include:

  • Feeling like you are breathing through a straw-stuffed with cotton
  • Wheezing
  • Shortness of breath
  • Coughing, especially at night or early in the morning
  • Tightness in your chest
  • Waking up at night because of your symptoms
  • A drop in peak flow meter reading

Types and Triggers of Asthma

There are two main types of asthma, allergic and non-allergic asthma. Allergic asthma is triggered by allergens and non-allergic asthma is triggered by other, non-allergen factors (4).

Triggers of allergic asthma may include:

  • Mold
  • Dust mites
  • Pollen  from weeds, grass, flowers, and trees
  • Pets
  • Waste from cockroaches, mice, and other pests

Triggers of non-allergic asthma may include:

  • Air pollution
  • Household chemicals
  • Tobacco smoke
  • Cold air
  • Certain medications
  • Respiratory infections, including the cold and the flu

You may also experience exercise-induced asthma triggered by exercise, especially exercising in dry air, or occupation asthma triggered by industrial dust or chemicals.

Risk of Asthma

Asthma can affect anyone regardless of age, sex, race, or ethnicity. However, certain factors may increase your risk for asthma (4, 5).

Risk factors for asthma may include:

  • Secondhand smoke exposure before birth or during early childhood years
  • Genetics or family history, especially if you have a parent or parents with asthma
  • Exposure to dust and chemical irritants at work
  • Being black or Puerto Rican
  • Obesity, allergies, lung issues, and other health conditions
  • Frequent viral respiratory infections as a child
  • In children, asthma is more common in males, but in adolescents and adults, it is more common in females.

Diagnosis and Treatment of Asthma

Diagnosis of asthma requires a visit to your doctor. They will go over your symptoms, health and family history, and perform a physical exam. They will likely do some lung function tests, including spirometry to check for lung function. Certain tests will measure how your airways respond to exposure to allergens, medicines, and other substances. A peak expiratory flow (PEF) will check how fast you are able to blow air with maximum effort and a fraction exhaled nitric oxide (FeNO) test will check for inflammation. FeNO looks at the nitric oxide level in your exhaled breath. High levels of nitric oxide suggest inflammation in your lungs. Your doctor may also order some allergy blood or skin tests to look at allergies and immune reactions (4, 6).

A conventional asthma care plan usually involves avoiding your asthma triggers and medication. Short-term relief medications offer quick relief. You can use them to prevent symptoms or reduce them at the first sign of asthma attacks. Short-term relief medication usually come in form of an inhaler you can carry with you in case you need it. Control medications are for everyday use for prevention. They help to decrease inflammation, reduce the narrowing of the airways, and help to reduce the risk of symptoms (4, 6).

There is one important factor conventional doctors often miss: histamine intolerance. Histamine intolerance can trigger or worsen your asthma symptoms. Reducing histamine intolerance through dietary changes, lifestyle strategies, and supplementation may help to decrease your symptoms and even reduce or eliminate your reliance on asthma medication. Let’s discuss the role of histamine intolerance in asthma.

What Is Histamine

Histamine often gets a bad rap. When you think about histamine, chances are that anti-histamines for allergies come to mind. Because of the ‘anti’ part of anti-histamine, histamine often gets a bad rap. You may think histamine is a problem. But histamine is not bad, it’s rather the opposite. Histamine plays a critical role in your immune health and body’s healthy functioning.

Histamine is a chemical in your body. It helps to remove allergens as part of your immune response. Histamine helps your digestion by releasing hydrochloric acid to break down food and bacteria. It also supports your brain and mental health by serving as a chemical messenger between your brain and the rest of your body.

What Is Histamine Intolerance?

Healthy levels of histamine and a healthy histamine response are necessary for your overall health and wellness. Having too much histamine, however, can turn into a serious health issue. If your body is releasing too much histamine that your body can breakdown, it will cause a histamine buildup. 

Histamine intolerance is not a sensitivity to histamine. It means that there is too much histamine in your body. Under normal circumstances, your body sends DAO and other enzymes to break down excess histamine and prevent build-up. However, if your body is making too much histamine, these enzymes won’t be able to keep up and break everything down. This will lead to histamine intolerance. If your body is struggling to make enough enzymes, it can also lead to histamine intolerance. Histamine intolerance can affect your entire body, including your gut, brain, lungs, and cardiovascular system causing widespread symptoms (7). 

Symptoms of Histamine Intolerance

Histamine intolerance can affect your entire body. This means that your symptoms can be widespread affecting multiple areas of your body. Symptoms may differ from person to person. You may only experience a few symptoms, or you may experience most or all symptoms of histamine intolerance. Your symptoms may only cause mild discomfort or annoyance but may also be severe, interrupting your everyday life. 

As you will notice, asthma is one of the possible symptoms of histamine intolerance. Allergies and allergic reactions, which may trigger your asthma, are also on the list. If you have histamine intolerance, you will most likely notice other symptoms from this list beyond asthma and allergies. 

Symptoms of histamine intolerance include the following:

  • Itchy skin, eyes, ears, and nose
  • Eczema or other types of dermatitis
  • Hives
  • Red eyes
  • Facial swelling
  • Crawling sensation on the skin or the scalp
  • Tightness in the throat
  • Difficulty regulating body temperature
  • Sudden drop in blood pressure when standing up
  • Low blood pressure
  • Fast heart rate
  • Heart palpitations
  • Dizziness or vertigo
  • Difficulty falling asleep or sleep issues
  • Fatigue
  • Confusion
  • Brain fog
  • Irritability
  • Anxiety or panic attacks
  • Congestion or runny nose
  • Seasonal allergies 
  • Asthma
  • Migraines and headaches
  • Acid reflux
  • Diarrhea
  • Abnormal menstrual cycle
  • Premenstrual syndrome (PMS)

Asthma and Histamine

The connection between asthma and histamine intolerance is not a new concept. A 1977 study published in The Journal of Allergy and Clinical Immunology discussed the mechanism of histamine-induced bronchoconstriction and asthmatic reactions (8). They found that using an H1 receptor antagonist before a histamine challenge reduced the bronchial response and asthma attacks to histamine. This suggests that targeting histamine may reduce asthma attacks. 

A 1989 study published in The Journal of Allergy and Clinical Immunology also discussed the use of antihistamines in asthma (9). Researchers explained that histamine is a vasoactive and bronchoactive mediator that can naturally cause asthma attacks when encountering allergens. Allergens can activate your mast cells, cause histamine release, and trigger a histamine response. Researchers found that using antihistamine therapy targeting the H1 receptors may reduce asthmatic response and asthma attacks. They may also help to reduce chronic cellular events related to asthma.

A 1987 study published in Chest Journal suggests that mast cells, mast cell mediators, and histamine may play a role not only in allergic asthma but also in non-allergic forms of asthma, including exercise-induced and nocturnal asthma (10). This is not surprising, since mast cells (the cells that release histamine) and histamine play a vital role in your immune health. Encountering an allergen, such as pollen, mold, or dust mites can trigger a mast cell reaction and a histamine response. However, common triggers of non-allergic asthma, including tobacco smoke, air pollution, household chemicals, and certain medications, can also trigger mast cell activation and inflammation.

Since these early studies from the 1970s and ‘80s, we have increased scientific evidence suggesting that mast cells and histamine play a role in asthma. A 2005 comparative study published in Allergy has found that mast cell activation can cause structural alterations in smooth muscle thickness of the airways in allergic asthma (11). They didn’t find the same effect in non-allergic asthma participants. A 2007 study published in Thorax and a 2008 review published in Allergy, Asthma, and Clinical Immunology have both found that mast cell activation may play a role in abnormalities in submucosal glands and asthmatic airway smooth muscle function (12, 13).

A 2010 review published in the Yonsei Medical Journal has explained that mast cells play a critical role in adaptive immune responses, thus mast cells and mast cell-produced mediators may play a role in allergic airway diseases, including allergic asthma (14). According to a 2012 review published in Respiratory Medicine, mast cells help to protect you from pathogens and as a result, they may play a role in the development of allergic inflammation and related conditions, including asthma (15).

Since mast cells and histamine may play a role in the development or increase symptoms of asthma, it makes sense to look at targeting mast cells and histamine in therapeutics for asthma. A 2002 study published in The American Journal of Medicine has found that using H1 receptor antagonists may have therapeutic potential for asthma (16). A 2018 review published in Frontiers in Immunology has discussed that some H1 receptor antagonists show promise in reducing asthma, though some studies found that they are not always clinically effective (17). They noted that H4 receptor antagonists may work in a similar way and may offer similar benefits but studies are still ongoing and reports on clinical efficiency haven’t been published yet.

A 2019 review published in the International Journal of Molecular Sciences has found that some antihistamines may show potential in asthma therapy (18). A 2019 study published in the International Journal of Molecular Sciences, H1 receptor antagonists may be effective for certain subtypes of asthma, but not all types (19).

Problems Using Antihistamines for Asthma

Though anti-histamines show some promise for some types of asthma, there are some problems with this approach. Though anti-histamines may reduce histamine and offer temporary relief, they will not eliminate the root cause of your issue. If you are dealing with histamine intolerance or mast cell activation syndrome (MCAS) and these issues are triggering your syndromes, anti-histamines offer a temporary bandaid solution at best. Because they don’t eliminate the root cause of your issues – histamine intolerance or MCAS –, your symptoms will keep coming back. Over time, they may become less effective and won’t offer even temporary relief. It may become increasingly difficult to fight your symptoms with anti-histamines or other pharmaceuticals. 

Not to mention that these anti-histamine medications may have side effects and can interrupt your body’s balance and cause issues in the long run. Anti-histamines may cause dizziness, dry mouth, drowsiness, irritability, decreased appetite, or blurry vision. They may not be right or need precautions for people with diabetes, overactive thyroid, epilepsy, asthma, other breathing issues, glaucoma, high blood pressure, or heart disease (20, 21). Finding a solution without these risks and side effects is a safer idea.

If histamine intolerance or MCAS is triggering your symptoms of asthma, you have to start thinking about addressing the root cause of your symptoms instead of only relying on antihistamines. This means that you have to address your diet, environmental and lifestyle causes of histamine intolerance, the triggers of your asthma, and underlying gut microbiome imbalances. According to a 2020 study published in Nutrients, following a low-histamine diet may help to improve airflow and reduce symptoms in mild intermittent asthma (22). Instead of reaching for anti-histamine medication, you can reduce your histamine load and histamine reactions through diet, lifestyle, and supplementation. 

Natural Solutions for Histamine Intolerance and Asthma

Reducing histamine intolerance may help you to reduce your risks and symptoms of asthma. Fortunately, these are some dietary modifications, lifestyle strategies, and supplements you can try to reduce histamine intolerance and lower your risk of asthma attacks naturally. Here is what I recommend:

Remove Your Triggers

Removing your triggers is the first step to reducing your risk of asthma attacks. Completely removing triggers may be difficult. For example, all of us are exposed to pollen during the spring and summer. But you should still reduce your exposure as much as possible. Your asthma triggers may include pollen, mold, dust mites, pets, waste from pests, tobacco smoke, household chemicals, air pollution, certain medications, and cold air. Most of these factors are also triggers of MCAS making it even more important to reduce your exposure.

Eat an Anti-Inflammatory & Low-Histamine Diet

I recommend following a low-histamine, anti-inflammatory, nutrient-dense, whole foods diet. Remove inflammatory foods, including refined sugar, refined oils, canned and processed meat, artificial ingredients, junk food, and highly processed foods. Remove high-histamine foods. Follow a nutrient-dense, anti-inflammatory, and low-histamine diet rich in greens, vegetables, herbs, spices, fruits, healthy fats, and organic meat. If you are dealing with symptoms of histamine intolerance, I recommend that you follow my 4-Phase Histamine Reset Plan outlined in my book, The 4-Phase Histamine Reset Plan: Getting to the Root of Migraines, Eczema, Vertigo, Allergies and More. Try new recipes. I recommend all the low-histamine recipes in The 4-Phase Histamine Reset Plan and my recipe books, Fifty One Low Histamine Air Fryer Recipes and Low Histamine Cooking in Your Instant Pot.

Reduce Your Histamine Bucket

Diet is the first step toward reducing your histamine levels. However, your histamine bucket can fill up in many other ways. A lack of exercise, stress, sleep and toxin exposure can increase your histamine bucket as well.

Move Your Body

Moving your body is a great way to reduce stress, improve detoxification, boost your mood, and support your overall health. Stay active throughout the day by dancing to your favorite songs, taking a stroll in the park, stretching regularly, and playing with your kids or pets. Exercise at least 20 to 30 minutes five days a week and move your body regularly. I recommend getting 10 to 15K steps in a day if you can. Add resistance and strength training to your routine. If you are new to exercise, I recommend the MAPS program from MindPump Media. According to a 2017 study published in the Asian Journal of Pharmaceutical and Health Sciences, yoga may provide relief from symptoms of asthma (23). If you are experiencing exercise-induced asthma, talk to your doctor to introduce strategies to reduce your risk of asthma attacks while exercising.

Reduce Stress and Improve Sleep

To reduce stress and improve sleep, I recommend practicing breathwork, meditation, positive affirmation, journaling, yoga, grounding, and time in nature for stress and anxiety reduction. I really love this breathwork course and use it frequently to reduce anxiety, stress and help clear my body of any built up tension. Taking an Epsom salt bath is another great way to relax your muscles, calm your mind, and detoxify your body. Make sure to sleep at least 7 to 9 hours a night.

Reduce Environmental Toxins

Environmental toxins can not only increase histamine intolerance but can also trigger MCAS and asthma. Reduce your exposure to environmental toxins. Use a HEPA indoor air filtration system to improve your indoor air. Avoid unpurified tap water and use a water purifier instead to improve your water quality. Avoid conventional cleaning, hygiene, body, and beauty products, and choose natural, organic, and homemade options instead. Avoid plastics, especially BPA, and choose glass, bamboo, ceramic, stainless steel, organic cotton, and silicone products and tools instead. Choose organic foods to reduce exposure to pesticides, herbicides, hormones, and artificial ingredients in your diet.

Improve Your Gut Health

Your gut health affects your entire body. Poor gut flora can increase your risk of histamine intolerance, inflammation, and related symptoms. Along with a gut-friendly anti-inflammatory diet, I recommend that you take a high-quality probiotics supplement, such as ProBiota HistaminX probiotics, to support your gut microbiome balance. To take it a step further, I recommend working with a functional medicine practitioner (like me) to test your gut and see if opportunistic bacteria, yeast overgrowth, parasites, H. pylori and/or leaky gut can be what is driving your histamine issue. 

Try Omega-3 Fatty Acids

Omega-3 fatty acids are anti-inflammatory fatty acids that help to reduce inflammation. According to a 2004 review published in the Journal of Alternative and Complementary Medicine, omega-3 fatty acids may help to improve airflow and reduce inflammation in asthma (24). To improve your omega-3 levels, I recommend eating wild-caught fresh fish and seafood (make sure it’s fresh! Fish that isn’t extremely fresh can trigger histamine intolerance) and flaxseeds, hemp seeds, and chia seeds. 

Improve Your Vitamin D

Low vitamin D levels can increase the risk of inflammation and various health issues. Unfortunately, since we spend so much time indoors and many of us live in a colder climate with long months of cloudy and gloomy weather, vitamin D deficiency is quite common. According to a 2004 review published in Cureus, improving vitamin D levels through supplementation may help to reduce asthma (25). Besides spending time outside in the sun, I recommend daily supplementation with vitamin D.

Try Supplements for Histamine Intolerance

I recommend my Histamine Essential Kit to anyone with histamine intolerance. This kit includes Optimal Reset Liver Love, which is a synergistic formula designed to support healthy liver function made with a blend of botanical and mushroom extracts, along with N-Acetyl-L-Cysteine (NAC). It also includes Optimal Reset HistoRelief, a synergistic blend of nutrients, such as quercetin, nettle leaf, and vitamin C, and Tinofend® that provides natural support to help balance the immune response during allergy season. 

The kit also contains Optimal Reset Optimal Multi™ which is a superior multi that contains optimal amounts of many nutrients not easily obtained in most diets. If you have further questions or think you may benefit from other supplements, working with a functional health practitioner can offer valuable guidance with a personalized supplement regimen alongside personalized dietary and lifestyle strategies.

Final Thoughts

Asthma is a chronic lung condition that affects your airways and your lung. Histamine intolerance is a common underlying factor that may trigger or worsen your symptoms. Addressing underlying histamine intolerance, on the other hand, can reduce your risks and symptoms of asthma. I recommend following my natural strategies for histamine intolerance and asthma to improve your health and well-being. This should not replace the plan you and your pulmonologist/primary doctor have in place, but compliment it.

If you are dealing with symptoms of asthma, allergies, histamine intolerance, or MCAS, I invite you to schedule a consultation with us. We can help identify the root cause of your condition and recommend a personalized treatment plan to repair your body and regain your health and well-being. Schedule your consultation here.

Sources:

 

1. Most Recent National Asthma Data. CDC. Link Here
2. What Is Asthma. NIH. Link Here
3. Asthma. CDC. Link Here
4. Asthma. Medline Plus. Link Here
5. Asthma, Symptoms, Causes, and Risk Factors. American Lung Association. Link  Here
6. Diagnosing and Treating Asthma. American Lung Association. Link Here
7. Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr. 2007 May;85(5):1185-96. doi: 10.1093/ajcn/85.5.1185. PMID: 17490952
8. Casterline CL. Further studies on the mechanism of human histamine-induced asthma. 1977. Link Here
9. Stephen T. Holgate, Jim P. Finnerty, Antihistamines in asthma, Journal of Allergy and Clinical Immunology, Volume 83, Issue 2, Part 2, 1989. Link here
10. Mast Cell mediator and asthma. Chest Journal. 1987. Link  Here
11. Amin K, Janson C, Boman G, Venge P. The extracellular deposition of mast cell products is increased in hypertrophic airways smooth muscles in allergic asthma but not in nonallergic asthma. Allergy. 2005 Oct;60(10):1241-7. doi: 10.1111/j.1398-9995.2005.00823.x. PMID: 16134989
12. Begueret H, Berger P, Vernejoux JM, Dubuisson L, Marthan R, Tunon-de-Lara JM. Inflammation of bronchial smooth muscle in allergic asthma. Thorax. 2007 Jan;62(1):8-15. doi: 10.1136/thx.2006.062141. PMID: 17189531
13. Bradding, P. Asthma: Eosinophil Disease, Mast Cell Disease, or Both?. All Asth Clin Immun 4, 84 (2008). Link Here
14. Reuter S, Stassen M, Taube C. Mast cells in allergic asthma and beyond. Yonsei Med J. 2010 Nov;51(6):797-807. doi: 10.3349/ymj.2010.51.6.797. PMID: 20879044
15. Kawa Amin, The role of mast cells in allergic inflammation, Respiratory Medicine, Volume 106, Issue 1, 2012, Pages 9-14. Link Here
16. Gelfand EW, Role of histamine in the pathophysiology of asthma: immunomodulatory and anti-inflammatory activities of H1-receptor antagonists.  2002. The American Journal of Medicine. LInk Here
17.  Thangam Elden Berla, Jemima Ebenezer Angel, Singh Himadri, Baig Mirza Saqib, Khan Mahejibin, Mathias Clinton B., Church Martin K., Saluja Rohit.The Role of Histamine and Histamine Receptors in Mast Cell-Mediated Allergy and Inflammation: The Hunt for New Therapeutic Targets. Frontiers in Immunology. 2018. Link Here
18. Yamauchi K, Ogasawara M. The Role of Histamine in the Pathophysiology of Asthma and the Clinical Efficacy of Antihistamines in Asthma Therapy. Int J Mol Sci. 2019 Apr 8;20(7):1733. doi: 10.3390/ijms20071733. PMID: 30965592
19. Yamauchi K. The Role of Histamine in the Pathophysiology of Asthma and the Clinical Efficacy of Antihistamines in Asthma Therapy. Int. J. Mol. Sci. 2019, 20(7), 1733;Link Here
20. Antihistamines for Allergies. Medline Plus. Link Here
21. Antihistamines.NHS. Link Here
22. Vassilopoulou E, Konstantinou GN, Dimitriou A, Manios Y, Koumbi L, Papadopoulos NG. The Impact of Food Histamine Intake on Asthma Activity: A Pilot Study. Nutrients. 2020 Nov 5;12(11):3402. doi: 10.3390/nu12113402. PMID: 33167542
23. Impact of Yoga in Asthma TReatment. Asian Journal of Pharmacutical and Health Sciences. 2017. Link Here
24. Mickleborough TD, Ionescu AA, Rundell KW. Omega-3 Fatty acids and airway hyperresponsiveness in asthma. J Altern Complement Med. 2004 Dec;10(6):1067-75. doi: 10.1089/acm.2004.10.1067. PMID: 15674003
25. Ali NS, Nanji K. A Review on the Role of Vitamin D in Asthma. Cureus. 2017 May 29;9(5):e1288. doi: 10.7759/cureus.1288. PMID: 28680776

 

EXPLORE THE RECIPES, THE STORIES, THE METHODS AND CHANGES TO GET YOU BACK WHERE YOU WANT TO BE.

DR. BECKY CAMPBELL

Hi, I am Dr. Becky Campbell. I work with men and women who’ve had a health set back and are willing to do whatever it takes to reach optimal health so they can perform their best in their careers and be fully present with their family again.

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