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A overview of histamine intolerance and emerging innovation opportunities

29 May 2022

With World Digestive Health Day around, shortly followed by World Allergy Awareness Week (5-11 June), we’re exploring the increasing relevance of a relatively unknown digestive health disorder – histamine intolerance. Estimated to affect 1-3% of the global population[i], we’re highlighting five key things you need to know about histamine intolerance, including why it’s quickly becoming a new focus for innovation in the digestive health space. Read on to learn more about this common, yet unmet consumer need.

  1. What is histamine intolerance?

Histamine is a naturally occurring molecule produced in the human body and present in a wide range of foods and beverages. Histamine intolerance is a digestive health disorder associated with impaired dietary histamine metabolism, whereby this histamine is not degraded properly in the gut. Under normal conditions, dietary histamine is degraded in the gut by diamine oxidase (DAO), that inactivates histamine by removing its amino group.[i],[ii] Insufficient degradation is normally caused by having not enough DAO enzyme or low DAO activity. When there are low levels of DAO or its activity is compromised, an imbalance between the intake of histamine and the body’s ability to degrade it occurs – creating an excess of histamine that triggers allergy-like symptoms.

It's thought that genetics, certain diseases and some medications can increase the risk of histamine intolerance by impairing DAO functionality[i],[ii],[iii],[iv], inhibiting DAO activity[v],[vi] or decreasing DAO production[vii],[viii].


          2. What are the symptoms of histamine intolerance?

The most common symptoms of histamine intolerance include: gastrointestinal issues, sneezing, runny nose or congestion of the nose, headache, abdominal pain, hives, itching, flushing and asthma,[i],[ii],[iii],[iv],[v] which can significantly affect an individual’s quality of life.


         3. What triggers these symptoms?

Our diet plays a key role in triggering the symptoms of histamine intolerance, since histamine is present in many foods and beverages. Some foods are thought to promote the release of histamine (known as histamine liberators), others simply contain it, and some can even impair DAO activity. Either can provoke an adverse reaction, some foods or drinks may even have more than one effect. Cured meats, aged cheese and fermented alcoholic beverages, like wine, are ‘histamine rich’, meaning they contain high levels of the molecule.16,[i],[ii] Moreover, the alcohol in wine, can also impair DAO activity, further increasing histamine levels.1 Meanwhile, common histamine liberators include tomatoes, strawberries, pineapples, citrus fruits, crustaceans and chocolate.[iii] They work by stimulating the release of histamine from mast cells (which belong to the immune system), increasing histamine levels and triggering allergy-like symptoms.[iv] 


             4. What is the condition’s prevalence?

It’s estimated that histamine intolerance affects up to 3% of the global population,1 with incidence being higher among women (80%) around 40 years of age.[i] However, as the medical community and consumers become more aware of digestive health problems, including histamine intolerance, through better diagnostic tools and greater access to data, the number of people diagnosed with the condition is expected to rise.


            5. How can manufacturers support consumers with histamine intolerance?

There is no known cure for histamine intolerance – with many people resorting to a low-histamine diet or antihistamines to help manage the symptoms of the disorder. The former can be restrictive for consumers and difficult to follow long-term, while antihistamines can bring side effects like drowsiness, dry mouth and eyes, dizziness and headaches.

Innovating with DAO enzyme presents new opportunities to develop nutritional solutions targeted towards histamine intolerance. DAO supplementation can help to increase levels of DAO enzyme in the gut, allowing better management of histamine digestion. Taken before meals, it helps to break down histamine from foods and beverages, decrease histamine levels and reduce the symptoms of histamine intolerance. This allows people with the disorder to eat and enjoy the foods they love while reducing the allergy-like symptoms associated with the condition.

Want to find out more about the innovation opportunities the digestive health market has to offer? Download our latest report for insights on digestive health supplements, the emerging food intolerance market and more: visit this link.


These statements have not been evaluated by the Food and Drug Administration or other competent food authorities. The product is not intended to diagnose, treat, cure, or prevent any disease. This information is only for business-to-business use and not meant to be addressed to final consumers. Therefore, Bioiberica assumes no liability for the statements that the producer of the final product may include in its own publicity to consumers.

[i] Jarisch. Aktuelle Dermatologie, 2014;40:275-282.

[i] Halasz et al. Trends Food Sci Technol., 1994;5:42-49.

[ii] Izquierdo-Pulido et al. Lebensm Unters Forsch., 1996;203:507-511.

[iii] Sanchez-Perez et al. Nutrients, 2021;13:1395.

[iv] Shulpekova et al. Nutrients, 2021;13:3207.

[i] Jarisch & Wantke. Int Arch Allergy Immunol., 1996;110:7–12.

[ii] Curtis et al. Cardiovasc Res., 1993;27:703-719.

[iii] Endou & Levi. Eur J Clin Invest., 1995;25:5-11.

[iv] Lessof et al. Clin Exp Allergy, 1990;30:264-266.

[v] Pollock et al. Agents Actions, 1991;32:359-365.

[i] Enko et al. Can J Gastroenterol Hepatol., 2015;30: 1582-1590.

[ii] Pinzer et al. Allergy, 2018;73:949-957.

[iii] Enko et al. Clin Biochem., 2017;50:50-53.

[iv] Schnedl et al. Crit Rev Food Sci Nutr., 2021;61:2960-2967.

[v] Maintz & Novak. Am J Clin Nutr., 2007;85:1185-1196.

[vi] Sattler et al. Agents Actions, 1988;23:361-365.

[vii] Schmidt et al. Agents Actions, 1990;30:267-270.

[viii] Raithel et al. Intl Arch Allergy Immunol., 1995;108:127-133.

[i] Silla. Intl J Food Microbiol., 1996;29:213-231.

[ii] Bieganski. Acta Physiol Pol., 1983;34:139-154.

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