If you have been following my recent blog posts, you’re not going to be surprised that an overabundance of histamine can be related to the presence of anxiety, depression, and panic attacks in those with histamine intolerance or sensitivity. With those that suffer with histamine intolerance, anxiety can be caused by:
1) An unhealthy gut related to a histamine intolerance and/or
2) The presence of tachycardia (rapid heart beat) related to the over-activation of the sympathetic nervous system (part of the autonomic nervous system which activates what is often termed the fight or flight response).
Let’s look at the two scenarios in more detail
Remember there may be many reasons why histamine in our bodies is increased:
1) We’re producing too much histamine (like with mast cell activation syndrome, MCAS)
2) We’re eating too many histamine-rich or fermented foods that our bodies aren’t breaking down effectively
3) Our DAO enzyme capabilities are low and we aren’t able to break down histamines as fast as we’re producing it, and/or
4) We have small intestinal bacterial overgrowth (SIBO), which is defined as an overabundance of bacteria and an increase in histamine production from the proteins of undigested food. SIBO can cause a leaky gut, which is an intestinal permeability syndrome where the gut lining is damaged. With leaky gut, food particles, bacteria, and environmental toxins seep into the bloodstream and cause problems in the body, like chronic inflammation due to a persistent autoimmune response.
What does all of this have to do with anxiety?
Usually anxiety is blamed on a “chemical imbalance” in the brain, but as it turns out, this likely isn’t the whole story. Our brain and our GI tract communicate with each other via the vagus nerve, which is a cranial nerve that carries out very important functions in the brain like swallowing, taste and movement. This nerve can be activated by various compounds found in the gut, forming the basis for the conceptualization of the microbiome-gut-brain axis. Problems with these pathways result in neurotransmitter (chemical messengers) disruption, chronic inflammation, and overactivity of the hypothalamic-pituitary-adrenal axis (HPA-axis). The research suggests that a disrupted gut microbiome, which is a vast ecosystem of microbes that help us control our weight, fight infection, regulate our sleep, and so much more (9), may contribute to a variety of cognitive and mood disorders including anxiety, Parkinson’s disease, Alzheimer’s disease, ADHD, sensory processing disorder, obsessive compulsive disorder, schizophrenia, psychosis, and autism (1,2,3).
Gut microbes are capable of producing most of the neurotransmitters found in the brain, including GABA (responsible for reducing anxiety), serotonin (responsible for a feeling of well-being and happiness), dopamine (responsible for motivation) , and neurotransmitter modulators, like brain-derived neurotrophic factor (BDNF). Oddly enough, over 90% of our total serotonin and over 50% of our total dopamine are formed in the gut and not in the brain (4,5). Because of this, bacterial colonization is imperative to early brain development and continues to influence the brain throughout the lifespan. Think of the gut microbiota as an essential brain “peacekeeper.”
When we are stressed, our bodies release cortisol, which signals the nervous system needs to take action. This is more commonly referred to as our ‘fight or flight’ mode. This is what causes our sympathetic nervous system to take over, so all of our resources are pooled into energy conservation, meaning things like the digestive process shut down in order to make sure there are enough resources available for us to escape to survive. As the sympathetic nervous system stays activated, mast cells release more and more histamine into the bloodstream. More stress equals more histamine release.
Remember there are many different types of histamine receptors, but the most prevalent ones are the H3 histamine receptors. These are located in both the brain and throughout the body and are responsible for histamine synthesis and release. Histamine acts as a neurotransmitter in the brain, which can also affect the amount of mood altering neurotransmitters, like GABA, dopamine, and serotonin. An excessive amount of these chemical compounds will increase the amount of anxious and/or depressive feelings.
Excess histamine can also be associated with the presence of panic attacks. Anxiety or feelings of panic make sense when one considers the progression of a reaction to excessive histamine. Histamine causes the vasodilation, or widening of blood vessels, throughout the body. This is part of the job of the sympathetic nervous system: when you are in danger, the body needs to be sure that the resources it needs can be accessed quickly. What better way to do this than to make your blood flow faster?!
There is less resistance to the heart moving the blood throughout the body because of the widened vessels, so now you’ll see a decrease in blood pressure. In order to make sure that you are still getting a consistent level of blood to the newly widened vessels, your heart has to pump faster (tachycardia). So now, we are in a situation where your body has ensured that your heart needs to race in order to make sure the blood gets to the right place. You also may experience shortness of breath, dizziness, a pounding heart, flushing, and/or redness in the face – can we panic now? Because of the cumulative nature of more stress causing more histamine release, more stress and excessive histamine can also cause more panic attacks.
How to we get stress & histamine intolerance under control?
Keep in mind that stress does not cause histamine intolerance – it merely aggravates it. Figuring out a way to not only keep our histamine release under control in addition to identifying and managing stress effectively are going to be our keys to success.
- Magnesium Supplementation
Increased stress can delete your magnesium levels and decreased magnesium can augment your reaction to stressful events. Magnesium is prevalent in many vegetables, nuts, and seeds, but taking a supplement may be an option during especially stressful times.
Diet is one of best ways in which to keep your histamine levels under control. Start by treating any pathogens that may be present; no food you eat will help you if you have an underlying gut infection. Also consider eating more fiber as low fiber diet reduces microbial diversity, and add (low histamine, see video here) bone broth to your diet in order to assist in repairing your gut integrity and reducing leaky gut symptoms. Similarly, in order to manage biological stress as well as calm stress-induced histamine levels, try a low histamine diet. You won’t have to avoid histamine-rich foods forever, but it is a good idea until you can get your symptoms under control. Here is a great article to know what foods are high in histamine.
- Avoid Allergens
While it isn’t always possible, avoiding known allergens that will trigger your allergic response may be helpful, so you don’t go over your histamine threshold. See my blog post on “Why Eating Healthy May Be Making You Sick” for more details on this.
Polyphenols are phytochemicals founds in most fruits and vegetables. Specific types of these chemicals are known mast cell stabilizers. For example, pomegranates contain both tannins and anthocyanin, which are two types of polyphenols. Apples also contain polyphenols, which inhibit the release of histamine from mast cells.
5. Diamine Oxidase
If your DAO levels are too low, you will be unable to effectively break down histamine. You can take DAO supplements (Histamine Block from Seeking Health) with meals. However, keep in mind these supplements are not able to enter your bloodstream and will therefore only be able to break down histamines that you are consuming and not the histamine that is being produced by your mast cells. Including omega-3 fatty acids, saturated fats, phosphorus, calcium, zinc, magnesium, iron, and vitamin B12 in your diet are also way in which to naturally improve your DAO levels. Also make sure you are avoiding DAO-blocking foods, especially alcohol, since it is also a histamine-rich food.
6. Vitamin B6
Vitamin B6 will also help you naturally increase the production of DAO. It is found in low histamine foods like many vegetables and poultry. It can also be taken as a supplement. Make sure you are taking it in its active form – pyridoxal 5’-phosphate – for maximal absorption and utilization.
- Mast Cell Stabilizers
Mast cell stabilizers will help you reduce both your biological stress and your internal histamine release. Looking for foods that contain ascorbic acid, quercetin, vitamin B6, omega-3 fatty acids, and riboflavin can help reduce the amount of histamine you are producing. Another natural option I recommend to patients is a supplement called histo-relief, which includes quercetin as one of its primary ingredients. This supplement supports immune function, as well as the body’s response to food and environmental factors. I also recommend my Histamine Support Kit, which will provide you with a synergistic blend of nutrients that will provide natural support to help balance the immune response, support the liver and support the gut lining, to allow you to widen your food choices without as intense of a reaction.6,7,8
It is imperative to determine if your anxiety and panic attacks are related to an actual chemical imbalance in the brain or an overabundance of histamine. Sometimes by modifying your diet and getting your stress under control, you can reduce your feelings of anxiety and panic and rediscover yourself. If you’ve already tried this and hit a roadblock, please feel free to set up a consultation with me. I would love to help you get a grip on your symptoms and take your life back!
- Dr. Chris Kresser. Your Gut Microbe and Anxiety: What’s the Connection? Accessed 4/13/19. https://chriskresser.com/your-gut-microbiome-and-anxiety-whats-the-connection/.
- Bruce-Keller, A.J., et al. Harnessing Gut Microbes for Mental Health: Getting from Here to There. Biol Psychiatry. 2018 Feb 1;83(3):214-223.
- Dinan, T.G., et al. The Microbiome-Gut-Brain Axis in Health and Disease. Gastroenterol Clin North Am. 2017 Mar;46(1):77-89.
- Sudo, N. Microbiome, HPA axis and production of endocrine hormones in the gut. Adv Exp Med Biol. 2014;817:177-94.
- Yano, J.M., et al. Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell. 2015 Apr 9;161(2):264-76.