This article focuses on histamine intolerance and how the body's main enzyme for metabolizing histamine, diamine oxidase (DAO), can become inefficient. Certain diseases and medications can reduce DAO function, leading to higher histamine levels after eating histamine-rich foods like cheese and wine. The article highlights that histamine is metabolized through DAO release or histamine-n-methylation, and dysfunctions in these processes can cause gastrointestinal issues or asthma symptoms. The best treatment is often an histamine avoidance diet that excludes fermented foods, tomatoes, wine and cheese.

1. Article Review – by Cameron Shaw, B.Kin
Histamine Intolerance in Clinical Practice
This article by Maintz, Bieber and Novak (2007) focused on the body’s inability to regulate
histamine efficiently. Most notably, how diamine oxidase (DAO), the main enzyme, metabolizes
histamine.
Have you ever noticed a specific physiological response after eating certain foods or medications
(ie headache, flushing or gastrointestinal upset)? This article focused on how histamine, and
histamine degradation, affects one’s quality of life after eating certain foods or taking certain
medications.
This article highlighted that histamine is metabolized in two different ways, either through DAO
release or effective histamine-n-methylation. Notably, certain diseases like Crohn’s disease or
ulcerative may have a genetic disposition to a histamine dysregulation, as their DAO function
maybe insufficient. Furthermore, people that suffer from vascular headaches maybe subjected to
reduced DAO activity after consuming histamine rich foods like wine or cheese. Higher levels of
histamine can affect the gastrointestinal tract as their DAO have been seen to be lower. On the
contrary, a dysfunctional histamine-n-methylation cycle results can induce asthma related
symptoms in some people. Common medications such as antibiotics, anti-depressants and muscle
relaxants could inhibit the release of DAO.
Overall, this study concluded that often the best course of treatment for a histamine related
problem is the histamine avoidance diet. Fermented products, tomatoes, wine and cheese should
be avoided. Anti-histamine medications should be avoided, if at all possible, as these mediations
often maintain histamine intolerance.
As a rehabilitation specialist, involved in handling LTD case files, this article allows me to better
understand my clients with an allergic reaction to certain foods or medications and encourages
clients to keep a food diary to make better food choices to aide in their recovery.
For full details of this article see American Journal of Clinical Nursing 2007; 85 1185-96