How to tell whether your eczema is caused by histamine intolerance

In the previous post, I described the available research on histamine intolerance and eczema. These studies estimate that 30% of eczema patients can expect some degree of relief if they watch out for histamine in their diet. In the one case study available, a young boy avoided high histamine foods and had completely normal skin 7 months into his diet.

Food allergy vs histamine intolerant

First of all, let's back up a little and ask whether you have food allergies. If you are allergic to one type of food, it's easier to cut it out than to worry about the entire panel of high histamine foods. Talk to your doctor about food allergy testing, or simply just cut out foods one at a time to check. Common allergens are eggs, dairy, fish, nuts and tomatoes. You should try to cut out the food for at least a week, depending on the severity of your eczema. If it's severe, you may not expect to heal in a week, although you can start to see improvements.

Testing for histamine intolerance

Unfortunately, there is no test for histamine intolerance. It is not a food allergy, so your doctor won't be able to order tests for antibodies. Whether you react to a food will depend on how much histamine you've eaten in the last few days. What you're going to have to do is reduce the amount of histamine in your diet for at least a week, and see if you skin gets better. There are many websites about histamine intolerance with lists of foods that you should avoid. Here is an example of a list: The Histamine Intolerance Awareness Network. My current favorite reference is this list that is based on data collected from actual people: Food Intolerance Network.

What you will notice is that all the lists are slightly different. The best advice I've seen about this problem is to stick to one list. If you do notice that one food is making your eczema flare up, then make a note and avoid eating large amounts of it.

The next thing you will notice is that besides high histamine foods, there are two other categories of foods to watch out for: histamine liberators, and DAO-blockers.

Histamine liberators

These are foods that cause your body to release histamine into your blood. Your body naturally makes histamine, so you can't avoid having some. Under normal circumstances, your body mainly stores histamine in mast cells. Histamine liberators are a problem because they cause these stored up histamine to be released, triggering histamine reactions.

DAO blockers

These is a second class of foods that affect the degradation of histamine in your body. Diamine oxidase (DAO) is the enzyme that your body makes to degrade histamine. If your DAO is blocked, your body degrades the histamine you've ingested more slowly, meaning the levels of histamine in your body stays high for longer. If you happen to eat a high histamine food in the meantime, the accumulated amount of histamine could become high enough to trigger histamine reactions.

A lot of food end up delivering a double whammy, because they are both high in histamine, and either liberate or block DAO. For instance, alcohol could have high histamine, and simultaneously be a DAO blocker, making it hard for your body to process the histamine that you drink.

A litmus test for histamine intolerance

Chances are you can already begin to suspect whether you are histamine intolerant. When you drink, does your eczema flare up the next day? Because of the high histamine content and its second role as a DAO blocker, I personally find alcohol a good litmus test for histamine intolerance.

My histamine intolerance diagnosis story

On hindsight, it didn't need to take me over 30 years to realize that I am histamine intolerant. I've always had an itchy, tingling sensation when I eat high histamine foods like spinach and eggplant. But I never heard of histamine intolerance, and didn't think that mouth tingling had any relationship to my skin.

I cook my own meals frequently during the week, and on weekends I go out for more adventurous food. I also used to notice that my skin would get bad on weekends without fail. But everything changes on weekends -- I sleep over at my boyfriend's place (detergent, level of dust, different water pipes etc) -- so I blamed everything except my diet.

As my histamine intolerance grew more severe with age, I started noticing that certain foods consumed during lunch correlate with my cheek skin turning weepy at about 5pm. Chocolate, eggplant, pickled vegetables -- I had to avoid them all. But it didn't make any sense to me since the foods were so different. Was I developing multiple food allergies? But why was eating eggplant on one day a problem, but not on another day? I was really confused.

A few months ago, my husband was reading up on keto diets and noticed that keto dieters frequently mention developing a keto rash. Due to their keto diet, many people end up consuming a high histamine diet, which causes a rash. The foods I react to matches the foods on the high histamine list -- this could be it.

To confirm I am histamine intolerant, I watched the histamine levels in my diet. And a week later, my skin was much better. And if I eat one of the foods on the Avoid list, I flare up. Finally after so many years, I learned that my atopic dermatitis is not atopic. I am histamine intolerant.