Hair Loss, Mast Cells, and Histamine: What’s the Connection?

You are shedding hair everywhere you go. Your brush is full of hair after each time you use it. Your shower drains are clogged. You notice some hair thinning or a receding hairline. What’s going on, and what can you do about it? Nobody likes to lose their hair. It can be frustrating or even embarrassing. Yet, many people struggle with hair loss for a variety of reasons.

Genetics, age, hormones, stress, medications, health issues, and so many other reasons can cause hair loss. One of the least talked about factors behind hair loss are mast cell activation and histamine intolerance. Yet, addressing potential underlying mast cell issues and histamine intolerance can reduce hair loss, improve hair health, boost your health, and skyrocket your confidence.

In this article, I want to talk about how hair loss may be linked to mast cell issues and histamine intolerance. You will learn about hair loss, different types of hair loss, and their potential causes. You will learn what mast cell activation syndrome and histamine intolerance are. I will go over how mast cell activation and histamine intolerance may be causing your hair loss. You will understand why I don’t recommend antihistamines for mast cell or histamine-related hair loss. Finally, I will share my best natural strategies for hair loss, mast cell activation problems, and histamine intolerance. Let’s get into it.

What’s Normal Hair Loss

Hair loss or shedding hair is normal to a certain extent. If you lose 50 to 100 hairs a day, that’s considered normal. Most healthy people have about 100,000 hairs on average, making this hair loss not noticeable at all. Since new hair will replace the ones you shed, such normal hair loss will not lead to a visible difference (1).

When Hair Loss Becomes a Problem

Losing more than 50 to 100 hairs a day is not normal if it happens on an ongoing basis. Losing too much hair and your body not replacing the lost hair can lead to a receding hairline, bald patches, and other signs of hair loss. 

Hair loss is also known as alopecia. It is more common in men and older adults. However, it can occur at any age, in anyone, sometimes even children. Depending on the issue, it may be sudden and fast or more gradual. In some cases, it may be temporary. For example, hormonal fluctuation, stress, pregnancy, chemotherapy, and other medical treatments may cause temporary hair loss. In other cases, hair loss is permanent. For example, middle-aged and older men often experience hair loss that continues with age.

Signs and Symptoms of Hair Loss

If you have hair loss, you may experience the following symptoms:

• Receding hairlines
• Widening part on your hairline
• Bald patches that likely increase in size over time
• Loose hair
• Shedding too much hair when brushing your hair
• Losing hair in the shower and possibly clogging the drains
• Itching or redness if there is a specific underlying hair or skin condition
• Pain if there is a specific underlying hair or skin condition

Types of Hair Loss

There are a variety of different types of hair loss. Each type of hair has a specific reason.

Androgenic alopecia:

This type of hair loss affects about half of the population. It is a hereditary condition. It is responsible for both male pattern baldness and female pattern baldness. Most people don’t experience symptoms until middle age. However, children, teens, and young adults can experience the condition as well (2).

Alopecia aerate:

This type of hair loss is an autoimmune disease that causes hair loss. It is characterized by bald patches on your head and loss of the eyelashes, eyebrows, or hair in other areas (3).

Telogen effluvium:

This type of hair loss is usually the result of a traumatic event, extreme stress, emotional shock, physical shock, or serious illness. It may also develop due to hormonal shifts, such as menopause, pregnancy, or giving birth. It may happen because of endocrine issues, malnutrition, and certain medications (4).

Anagen effluvium:

This type of hair loss happens because of chemotherapy, radiation, and other medical treatments. It is a rapid hair loss that’s temporary. The hair tends to regrow after the treatment is over (5).

Traction alopecia:

This type of hair loss can develop due to physical tension and pressure on the hair and head, such as pressure from braids or tight ponytails (6).

Tinea capitis:

This type of hair loss develops because of a ringworm that leads to small and itchy bald patches. If it’s addressed with an antifungal treatment, it is temporary and short-term (7).

Other types of hair loss:

Other issues may also cause hair loss, including lupus and lichen planus (8, 9). Mast cell activation issues and histamine intolerance may also trigger or increase hair loss. In the next sections in this article, I will discuss the potential connection between hair loss, mast cell issues, and histamine.

Hair Loss, Mast Cells, and Histamine 

Mast cell activation issues and histamine intolerance may trigger or increase hair loss. Before I get into this connection, I want to go over what are your mast cells, what histamine is, why you need them, and potential problems.

What Is Mast Cell Activation Syndrome

Your mast cells are essential for your immune and overall health. They are white blood cells that store histamine and other inflammatory mediators. They are located in your digestive tract, respiratory tract, urinary tract, skin, and blood. 

When your body is attacked by an allergen, toxin, or other triggers, it will lead to mast cell activations. Your mast cells will cause an allergic response and release histamine along with other chemicals. This protective mechanism is essential for your immune health.

However, if your mast cells become dysregulated or overactive, it can turn into a serious issue. Mast cell activation syndrome (MCAS) means that your mast cells release too much histamine and other chemicals. This can lead to a variety of symptoms and affect your entire body. You may develop MCAS due to a variety of triggers, including mold, chemicals, toxins, heavy metals, allergens, medications, infections, viruses, food, and alcohol. 

Symptoms of MCAS may include the following:

• Rashes
• Hives
• Itching
• Heart palpitations
• Low blood pressure
• Headaches
• Chest pain
• Weight changes, including rapid weight loss or weight gain
• Digestive trouble, including diarrhea, nausea, and vomiting
• Loss of appetite or low appetite
• Anxiety
• Fatigue
• Vision changes
• Weakness
• Dizziness

As you will learn later, MCAS may also lead to hair loss.

What Is Histamine Intolerance

Histamine gets a bad rap because of antihistamine medications. The  ‘anti’ part of antihistamine, may make you believe that histamine is bad. It’s the opposite. Histamine is absolutely necessary for your health.

It is a chemical that supports your body in getting rid of allergens. It also supports your digestion by releasing hydrochloric acid to break down food and your brain health by serving as a chemical messenger. Too much of a good thing is rarely good, though.

If your body is releasing too much histamine and your body is unable to keep up and break down all the excess histamine, it will lead to histamine buildup. Histamine intolerance means that there is too much histamine in your body. 

Under normal circumstances, your body sends enzymes to break down excess histamine and prevent build-up. If you have too much histamine or you don’t have enough of these enzymes, it won’t be able to break everything down, which can lead to histamine intolerance. Histamine intolerance can affect your entire body and lead to widespread symptoms.

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
• Hair loss
• Acid reflux
• Diarrhea
• Abnormal menstrual cycle
• Premenstrual syndrome (PMS)

Mast Cell Activation Syndrome vs Histamine Intolerance

I believe that MCAS is the primary cause of histamine intolerance, but it may not be the cause for everyone. But considering the similarities between the symptoms of MCAS and histamine intolerance, you may feel confused. 

Are these two conditions the same? No, they are not the same. Though symptoms of MCAS and histamine intolerance can be similar and are both caused by high levels of histamine, MCAS and histamine intolerance are not the same.

If your body has too much histamine and it can’t handle it, you may develop histamine intolerance. This usually happens due to a high-histamine diet. However, stress, poor sleep, environmental toxins, certain medications, and other factors may add to your histamine bucket as well. If your body has trouble breaking down the extra histamine, it will lead to histamine build-up and histamine intolerance. 

While histamine intolerance simply means you have too much histamine in your body, you develop MCAS if your mast cells get triggered all the time. If you have MCAS, your mast cells get triggered by mold, allergens, or other triggers, they will release histamine and other chemicals into your body. Increased histamine release from mast cell activation can lead to too much histamine in your body. This can lead to a wide range of symptoms that are very similar to the symptoms of histamine intolerance. 

As I mentioned before, MCAS is one of the primary causes of histamine intolerance. However, it is not the cause for everyone. You can have histamine intolerance without MCAS. You can also have MCAS without histamine intolerance. But you may have both MCAS and histamine intolerance. I see patients who have both conditions regularly (1, 2, 3). 

If you have both conditions, your body will have increased difficulty breaking down the excess histamine. This can lead to widespread symptoms of MCAS and histamine intolerance. To figure out, whether you are dealing with symptoms of MCAS, histamine intolerance, or both. I recommend working with a functional medicine doctor who is well-versed in both conditions. (Tips: My team and I would love to help you with your diagnosis and treatment. Schedule your consultation here.)

To learn more about MCAS and histamine intolerance, I recommend reading my book, The 4-Phase Histamine Reset Plan: Getting to the Root of Migraines, Eczema, Vertigo, Allergies and More. 

The Link Between Hair Loss, Mast Cell Activation, and Histamine

Your mast cells and mast cell activation issues may play a role in hair loss in a variety of different ways.

Male and Female Pattern Hair Loss Due to Inflammation

According to a 2010 review published in the Journal of Inflammatory Research, inflammation may be an underlying factor behind the male pattern and female pattern hair loss (11). Furthermore, according to the review, high levels of inflammation and mast cell infiltration have been found in about one-third of tissue samples in male pattern hair loss. 

According to one of the studies, perifollicular inflammation may be present in almost three-fourths of all male pattern and female pattern hair loss samples. Based on these results, researchers believe that addressing underlying inflammation and mast cell activation may help to reduce male pattern and female pattern hair loss.

Autoimmune Hair Loss due to Stress and Immune Dysfunction

According to a 2018 review published in Skin Appendage Disorders, immune dysfunction and high stress, can increase the risk of autoimmune hair loss issues, such as lichen planopilaris and alopecia areata (12). Immune dysfunction and immune-mediated inflammation can increase mast cell degranulation, perifollicular inflammation, pro-inflammatory cytokine release, and related hair loss. 

Stress itself may lead to temporary hair loss. However, researchers found that chronic stress is often the trigger of mast cell degranulation and inflammation. This may lead to an autoimmune reaction and autoimmune hair loss.

Hair Loss Due to Mast Cell Degranulation

According to a 2017 study published in the International Journal of Trichology, mast cell degranulation may increase the risk of telogen effluvium (13). In this study, researchers compared the scalp biopsies of patients with various different hair loss. They found higher levels of mast cells in telogen effluvium than in other types of hair loss they examined. 

Other studies, including a 2014 study published in PLoS One and a 2003 study published in the Journal of Cutaneous Pathology, have found increased mast cell degranulation and inflammation in alopecia areata and scarring alopecia as well (14, 15). According to a 2020 review published in the Journal of Biomedical Science, mast cell activation may also increase androgenic alopecia, cicatricial alopecia, and other hair loss disorders (16).

Hair Loss and Skin Microbiome

According to a 2019 study published in the Journal of Allergy and Clinical Immunology, your skin microbiome may also play a role in mast cell-related hair loss (17). The study found that the scalp microbiome may activate toll-like receptors and trigger progenitor cells from a type of skin cell called keratinocytes to become mast cells. 

They also noticed a change and an increase in mast cell behavior, immune inhibition, and increased inflammation. They found that in alopecia areata, a change in the skin microbiome of the scalp can interfere with immune cells, leading to hair loss. On the other hand, they found that in androgenic alopecia, the skin microbiome interferes with how mast cells behave, leading to symptoms and disease.

Hair Loss and Histamine Intolerance

A 2022 study published in Experimental Dermatology has linked high histamine levels to scalp inflammation and scalp or hair issues (18). A 2021 review published in Dermatology and Therapy has found that using antihistamines may help to reduce symptoms and improve hair growth in certain hair loss, such as androgenic alopecia (19). 

These results indicate that histamine intolerance can increase the risk of hair loss. This, however, doesn’t mean that antihistamines are the answer. In the next sections, I will discuss potential problems with antihistamines and what to do instead.

Hair Loss, Estrogen Dominance, and Histamine

Estrogen Dominance may also play a role in hair loss. According to a 2012 study published in PLoS One, estrogen can lead to hair cycle retardation (19). According to a 2012 study published in the British Journal of Dermatology, excess estrogen may increase hair loss due to an ESR2 gene variation (20).

Noting the potential role of estrogen dominance here is important because estrogen dominance and histamine intolerance are often linked. I’ve written about the histamine-estrogen connection in this article. Histamine, estrogen, and progesterone are closely linked in your body. They need to be in balance for ideal health and function.

Estrogen plays many roles in your body, including stimulating mast cells to make more histamine. By stimulating your mast cells, estrogen can increase the chances of a histamine response and histamine intolerance. Though men can also develop estrogen dominance and histamine intolerance, women are at a higher risk. This is not surprising since women tend to have more estrogen than men, which can increase the risk of histamine intolerance as well.

A 2012 study published in Frontiers in Immunology has found that estradiol, a form of estrogen, can affect mast cells and trigger asthma (21). According to a 2013 study published in Current Opinions in Allergy and Clinical Immunology, estrogen may increase the risk of histamine-triggered allergies and asthma (22).

If your estrogen levels are normal and you are leading a healthy lifestyle, keeping your histamine levels at bay should not be an issue. However, if you are dealing with estrogen dominance and/or histamine intolerance, this can turn into a vicious cycle.

Estrogen will trigger your mast cells to release histamine. Increased histamine levels will lead to higher estrogen levels. As a response, all that excess estrogen will prompt your mast cells to create even more histamine, which will lead to even more estrogen in your body. As this cycle continues, it will lead to more and more symptoms of histamine intolerance and estrogen dominance. The connection between estrogen dominance and histamine intolerance may explain increased hair loss.

What About Antihistamine for Hair Loss?

As I mentioned, according to a 2021 review published in Dermatology and Therapy,  that using antihistamines may help to reduce symptoms and improve hair growth in certain hair loss, such as androgenic alopecia (23). According to a 2021 study published in the Journal of the American Academy of Nutrition, antihistamines, corticosteroids, and cryotherapy combined may be effective for hair loss (24). According to a 2021 study published in the Journal of the American Academy of Nutrition has a 2018 review published in the Journal of Investigative Dermatology Symposium Proceedings, antihistamines may help to reduce hair loss by targeting mast cell-related histamine release (25). 

However, using antihistamines may not be a smart idea. Antihistamines are simply a bandaid that may offer a temporary solution but may also lead to further issues down the line. Antihistamines can interfere with your body’s ability to create enzymes that break down histamine. They may decrease your body’s ability to handle histamine and histamine intolerance by itself. 

Moreover, like many medications, antihistamines can cause uncomfortable side effects. Supporting your body’s ability to decrease mast cell activation and lower histamine intolerance naturally is a much better and safer idea. In the next section, I will share how to support your body in reducing mast cell activation and histamine intolerance through diet, supplementation, and lifestyle. This way, you may reduce hair loss naturally.

Natural Strategies for Hair Loss, Mast Cell Activation, and Histamine Intolerance

Reducing histamine intolerance and addressing mast cell activation issues may help to reduce hair loss and improve your hair health. Here is what I recommend:

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. Try new recipes. I recommend all the low-histamine recipes in The 4-Phase Histamine Reset Plan: Getting to the Root of Migraines, Eczema, Vertigo, Allergies and More and my recipe books, Fifty One Low Histamine Air Fryer Recipes and Low Histamine Cooking in Your Instant Pot.

Remove Certain Histamine-Increasing Foods

I recommend certain foods from your diet that can increase your histamine load. High-histamine foods that you should avoid include age cheese (e.g., goat cheese), citrus fruits, canned and cured meat (e.g., pepperoni, salami, bacon, lunch meat, hot dogs, and canned meat), dried fruits (e.g. apricots, dates, raisins, figs, and prunes), fermented foods (e.g., kefir, sauerkraut, soy sauce, and vinegar), fermented alcohol (e.g., beer, wine, and champagne), legumes (e.g., beans, lentils, soy, and peanut), certain nuts (e.g., cashew and walnuts), soured foods (e.g., buttermilk, sour milk, sour cream), smoked fish and certain types of fish (e.g., mackerel, mahi-mahi, anchovies, sardines, tuna, and fish sauce), certain vegetables (e.g., avocados, tomatoes, eggplant, and spinach), vinegar-containing foods (e.g., pickles and olives), and all overly processed foods because of the high histamine load from preservatives. 

Avoid histamine-liberating foods that are low in histamine but trigger histamine release in your body, including alcohol, nuts, bananas, papaya, pineapple, strawberries, tomatoes, chocolates, wheat germ, cow’s milk, shellfish, and many artificial preservatives and dyes.  Avoid DAO enzyme-blocking foods and drinks, such as alcohol, black tea, green tea, mate tea, and energy drinks.

Try Some Mast Cell-Stabilizing and Histamine-Reducing Foods and Supplements

I recommend adding some specific foods to your diet to reduce histamine and stabilize your mast cells. Quercetin helps to reduce histamine. Add quercetin-rich foods to your diet, such as grapes, apples, cranberries, black plums, cherries, black currants, chokeberries, blueberries, olive oil, cruciferous vegetables, kale, romaine lettuce, chicory greens, red leaf lettuce, cabbage, sprouts, asparagus, snap peas, peppers, and red onion. Furthermore, you may also try a quercetin supplement.

You may try some foods that help to stabilize your mast cells, including onion, peaches, nettle, apples, chamomile, moringa, watercress, Thai ginger, and fiber-rich foods. You may also try a DAO enzyme supplement to support histamine breakdown and HistoRelief. HistoRelief is a synergistic blend of nutrients that provides natural support to balance your immune response. This blend features Tinofend®, a patented and clinically researched extract derived from the plant Tinospora cordifolia, which has a powerful ability to support immune regulation and immune response. As a result, it boosts your body’s ability to fight interstitial cystitis symptoms. It includes quercetin, nettle leaf, vitamin C, and bicarbonate salt to help inhibit histamine release, support normal histamine metabolism, and improve immune health.

Move Your Body

A lack of movement can also increase the risk of histamine intolerance. 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. 

Reduce Stress and Improve Sleep

Stress and poor sleep are major contributing factors to histamine intolerance and can trigger MCAS as well. Stress may also contribute to hair loss, telogen effluvium specifically. 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. 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.

Improve Your Gut Health

Your gut health affects your entire body. Poor gut flora can increase your risk of histamine intolerance and related health issues, including hair loss. Poor gut health can also increase hormonal imbalance and estrogen dominance-related hair loss. Along with a gut-friendly anti-inflammatory diet, I recommend that you take a high-quality probiotics supplement to support your gut microbiome balance.

Remove Toxins

Toxin overload can increase chronic inflammation, mast cell activation, histamine release, and histamine intolerance. I recommend reducing your toxin load. Drink purified water to avoid toxins from your tap water. Use a high-quality air filtration system for better indoor air. Reduce the use of plastic and avoid BPA completely. Choose glass, bamboo, wood, organic cotton, silicon, and other natural alternatives instead of plastic. Avoid conventional cleaning, hygiene, body, and beauty products as they are loaded with chemicals. Choose natural, organic, and homemade options instead. Avoid overly processed food products that can contain artificial ingredients.

Remove Xenoestrogens

Xenoestrogens are artificial hormone-mimicking compounds that mimic the effects of estrogen and contribute to estrogen excess or prevent the beneficial effects of natural estrogen in your body. Xenoestrogens can increase estrogen dominance and related issues, including histamine intolerance and related hair loss. I recommend that you remove xenoestrogen-containing products, including conventional cleaning, body, and beauty products, and choose natural and organic alternatives.

Try Some Topicals and Supplements for Hair Health and Hair Loss

There are a number of topicals and supplements you may try to reduce hair loss and improve hair and scalp health. Research, including a 2021 study published in Scientific Reports and a 2015 study published in Skinmed, has shown that massaging coconut oil or geranium on your scalp may help to improve hair growth, hair health, scalp health, and scalp microbiome health (26, 27). A 2012 study published in The Journal of Dermatology has found that using onion juice may support circulation in the scalp and boost hair growth (28). According to a 2017 study published in BMC Complementary Medicine and Therapies, geranium oil may also be great against hair loss (29).

According to a 2012 study published in the Journal of Clinical Aesthetic Dermatology, biotin supplementation may help to reduce hair loss (30). A 2021 review published in the Journal of Cosmetic Dermatology has found that vitamin D may also help to reduce hair loss (31). According to a 2015 study published in the Journal of Cosmetic Dermatology, supplementing with antioxidants and omega-3 fatty acids for 6 months may decrease hair loss in women (32).

 A 2009 study published in the Annals of Dermatology has found that zinc supplementation may be helpful for hair loss (33). According to a 2015 study published in the Journal of Medicinal Food, red ginseng extract may also improve hair growth and hair health (34). 

According to a 2019 review published in Dermatology and Therapy, deficiencies in vitamin B, C, D, and E, iron, zinc, and selenium may all increase the risk of hair loss (35). Thus it may be a good idea to check for deficiencies in any of these vitamins and minerals and adjust your diet and supplementation protocol accordingly.

Final Thoughts

Hair loss is a fairly common problem, especially in older people and men. However, hair loss can occur at any age due to a variety of issues, including stress, hormonal changes, medications, and health issues. Mast cell issues and histamine intolerance can both play a role in hair loss. If you are dealing with hair loss, I recommend looking into potential underlying mast cells and histamine-related issues.

If you are dealing with symptoms of MCAS or histamine intolerance, 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. You can also get started on your own with my Histamine Online Program.

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