title: Histamine-free diet: treatment of choice for histamine-induced food intolerance and supporting treatment for chronic headaches.
abstract: Histamine-induced food intolerance is not IgE-mediated. Skin-prick testing and specific IgE to food allergens are typically negative. Food rich in histamine or red wine may cause allergy-like symptoms such as sneezing, flush, skin itching, diarrhoea and even shortness of breath. The suspected reason is a diminished histamine degradation based on a deficiency of diamine oxidase. As diamine oxidase cannot be supplemented, a histamine-free diet was implemented to reduce histamine intake. Forty-five patients with a history of suffering from intolerance to food or wine (n = 17) and chronic headache (n = 28) were put on the diet over months to years. Fish, cheese, hard cured sausages, pickled cabbage and alcoholic beverages had to be avoided. Complaint intensity and drug-use per week prior to and 4 weeks after a histamine-free diet were compared. After 4 weeks on the diet 33/45 patients improved considerably (P < 0.01), eight of them had total remission. In 12/45 patients, however, no changes in symptoms were observed. Symptoms of food or wine intolerance significantly decreased (P < 0.02; treatment of choice), headaches decreased in frequency (P < 0.001), duration and intensity. After eating histamine-rich food symptoms were reproducible and could be eliminated by anti-histamines in most patients. These data indicate the role of histamine in food and wine intolerance and that histamine-rich food causes a worsening of symptoms in patients suffering from chronic headaches. Results obtained support the hypothesis of a deficiency of diamine oxidase in patients with intolerance to food or wine.
authors.affiliation: Dermatologic and Pediatric Allergy Clinic Vienna, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Wantke
authors.forename: M
authors.initials: M
authors.lastname: Götz
authors.forename: R
authors.initials: R
authors.lastname: Jarisch
mesh_terms: D000293:Adolescent; D000328:Adult; D006631:Amine Oxidase (Copper-Containing) / Q000172:deficiency; D000818:Animals; D002611:Cheese / Q000009:adverse effects; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005399:Fishes; D005512:Food Hypersensitivity / Q000178:diet therapy* / Q000188:drug therapy / Q000209:etiology; D006261:Headache / Q000178:diet therapy* / Q000188:drug therapy / Q000209:etiology; D006632:Histamine / Q000009:adverse effects*; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008461:Meat Products / Q000009:adverse effects; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000178:diet therapy / Q000188:drug therapy / Q000276:immunology; D014920:Wine / Q000009:adverse effects
chemical_list: D006634:Histamine H1 Antagonists; D006632:Histamine; D006631:Amine Oxidase (Copper-Containing)