If you’ve been dealing with histamine intolerance, you’re likely not living life to the fullest. With symptoms affecting your daily life like trouble sleeping, headaches, and nausea, you’ve probably been scrounging the internet trying to figure out the best way to treat histamine intolerance.

SIBO has a large role in many cases of histamine intolerance, and many people with histamine intolerance experience gastrointestinal (GI) issues among their symptoms.

Probiotics are often prescribed for GI issues, but they aren’t all treated the same. While some probiotics can help, other probiotics can worsen histamine intolerance.

Today we will go over all you need to know about histamine intolerance, how SIBO affects histamine intolerance, and what are the best (and worst) probiotics for histamine intolerance.

What is histamine intolerance?

Histamine is a chemical compound that helps with the immune response. The body creates histamine on its own and can extract it from certain foods. Foods that contain histamine include:

• Cheese
• Wine
• Spinach
• Fermented foods
• Meat and certain fish

There are four types of histamine receptors in the body (H1-H4). The majority of H1 and H2 receptors are found in the GI tract. The effect of these histamine receptors is more evident during inflammatory responses — think seasonal allergies.

There are some comorbidities of histamine intolerance. And those pose the chicken or egg debate. Which came first, did one cause the other, do they just coexist, etc.?

This being the case, sometimes histamine intolerance is overlooked as a problem and, if undiagnosed, can continue contributing to comorbidities. This cycle continues because many of the conditions that histamine intolerance coexists with share symptoms — especially conditions of the GI system related to dysbiosis.

Some of the most common symptoms of histamine intolerance include:

• Gastrointestinal symptoms (bloating, constipation, diarrhea, abdominal discomfort, nausea, vomiting)
• Fast heart rate
• Palpitations
• Headaches/migraines
• Skin conditions/reactions (swelling, redness, pruritis, hives, dermatitis, etc.)
• Allergy-type symptoms (sneezing, congestion, runny nose, etc.)
• Difficulty breathing/shortness of breath
• Trouble sleeping
• Vertigo/dizziness
• Abnormal menstrual cycle
• Fatigue
• Hypertension

Histamine intolerance happens when more histamine accumulates than the body can remove. Histamine levels can be affected by several things, including:

• Homocysteine levels
• Low DAO enzyme levels
• Seasonal allergens
• Mold
• Health conditions and diseases
• Medication use

While all of these contribute to changes in histamine levels, a major part of maintaining histamine is controlled by DAO enzymes.

In the digestive system, enzymes called intestinal diamine oxidase (DAO) help break down histamine. There are several different things that can affect DAO levels, which prevents the body from being able to break down the histamine that is present. Some things that affect DAO levels include:

• Medications (verapamil, clavulanic acid, isoniazid, and others)
• Certain diseases (IBD and other functional GI diseases, non-Celiac gluten sensitivity, SIBO, and others)
• Genetic factors/conditions
• Alcohol intake

The SIBO and Histamine Intolerance Connection

Small intestinal bacterial overgrowth — more simply, SIBO — is a condition where bacteria begin to colonize the small intestine. There should be few to no bacteria in the small intestine. When bacteria grow in the small intestine, it causes a lot of dysfunction within the GI tract and the immune system.

SIBO can contribute to DAO deficiencies because it creates inflammation in the intestinal tract. The inflammation causes more histamine to be released while inhibiting DAO enzyme production, so it cannot be removed. This is an endless and frustrating cycle to stop.

In addition to the histamine and DAO levels being affected, some of the bacteria that inhabit the small intestine can produce histamine themselves.

Histamine-producing bacteria add to the total circulating histamine. While this research is still fairly novel, some species of bacteria are classified as histaminogenic. Some of the most common histamine-producing bacteria include:

• Lactobacillus

• Morganella

• Staphylococcus

• Photobacterium

• Clostridium

There is a high prevalence of people who have dysbiosis and histamine intolerance. While this is often caused by SIBO, there are times where it is not. Your doctor will be able to help you test for SIBO and determine what the best next steps will be for you.

Here are some things to consider when choosing treatment for SIBO and histamine intolerance.

Treating SIBO and Histamine Intolerance

The best way to treat SIBO and histamine intolerance is by removing the bacteria from the small intestine that shouldn’t be there and repairing dysbiosis of the gut.

And the best way to start this treatment is by leading a healthy lifestyle. Healthy lifestyle choices help the gut stay healthy and this creates fewer situations where your immune system needs to react. Healthy lifestyle choices that can improve dysbiosis include:

• Having a good sleep schedule
• Exercising on a regular basis (at least 30 minutes a day a few times a week — check out this article for 5 great exercises for gut health)
• Eating a diverse diet that includes polyphenols, protein, fiber, and limits added sugars and sodium
• Limiting unhealthy habits like eating unhealthy foods, drinking alcohol, being sedentary, smoking, etc.
• Expose yourself to microbes to boost your immune health (spend time around other people, gardening, etc.)
• Take care of your mental health and reduce stress (this is important for the mast cell responses that contribute to histamine intolerance)
• Learn what foods cause flare-ups and work with your doctor on a diet plan that can limit these foods during treatment until you can slowly reintroduce them to see how much of an issue they are for you. This should only be done with doctor supervision to avoid nutritional deficiencies.
• Take probiotics and prebiotics that won’t exacerbate your symptoms.

Best (and Worst) Probiotics for Histamine Intolerance

Since certain bacteria can contribute to histamine intolerance, it’s important to choose probiotics that won’t make your symptoms worse. Oftentimes, the bacteria that you’ll find in probiotic-rich foods like yogurt include lactobacillus species. These are great for most people and have been linked to improved health.

However, lactobacillus is on the list of histamine-producing foods, along with some other typically healthy strains.

When it comes to histamine intolerance and SIBO, the best probiotics to use are spore-based or soil-based probiotics. This specific type of probiotic is low-histamine, making sure it doesn’t contribute to the problem.

These probiotics contain a protective casing that ensures they make it to the right part of your digestive system before being released. These species are able to determine which bacteria should live in your gut and which shouldn’t by analyzing the environment.

Once they determine what should be there, they’ll help replicate these species. They’ll also sit with the bacteria that shouldn’t be there and help eradicate them. This extends to those that are in the small intestine where they shouldn’t be. These bacteria are better suited for improving dysbiosis, reducing inflammation, and improving the state of the gut microbiome in addition to your immune system.

AtrantilPRO is the best product on the market for this because it not only contains the spore-based bacteria to help control the environment, but it also contains large polyphenols that help to transport them where they need to go. These polyphenols help them to be more useful in the body as well, which makes the whole process move a little faster.

AtrantilPRO can only be obtained by a prescription from your doctor. Because spore-based probiotics have had a controversial history and probiotics in general can be problematic for patients with a compromised immune system, the creators wanted to be sure it was only used by those that it would benefit.

Talk with your doctor about the best options for you and see if SIBO might be a part of your histamine intolerance issue.

Learn more about SBO probiotics, SIBO, and histamine intolerance in these articles!

• SIBO and Histamine Intolerance
• Spore-Based Probiotics vs Normal Probiotics
• Are Probiotics Adding Fuel to Your SIBO Fire?