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Hives, Itchy Skin, Histamine Intolerance or Mast Cell Activation Disorder?

Getting hives and itchy skin? Do you have histamine intolerance? Or is it Mast Cell Activation Disorder (MCAD)?

Do you feel like you have an allergic reaction to almost EVERYTHING?

Is it possible you have a histamine intolerance? Not only are you allergic to many foods but even your dog, cat, trees, leaves, the list goes on. You feel you might have to live in a bubble.

What Is Histamine?

Histamine is a chemical that is released by cells during an inflammatory or hypersensitivity response as an immune response. Basically what happens is when you are exposed to an allergic compound (food or other particle), histamine is released turn on the inflammatory process to protect you from the allergic compound.

In addition to an important aspect of the immune response, histamine also triggers the release of stomach acid to aid in digestion and communicates messages to the brain.

Common Symptoms of Histamine Intolerance:

  • Hives

  • Itchy skin, eyes, ears and nose

  • Swelling of soft tissues (throat, face, mouth)

  • Watery and red eyes

  • Low blood pressure

  • Eczema

  • Nasal Congestion

  • Tinnitus (ringing in the ears)

  • Gastrointestinal issues

  • Muscle and joint pain

  • Anxiety & panic attacks

  • Fatigue

  • Irritability

  • Confusion

  • Rapid heart rate

  • Headaches or migraines

What Causes Histamine Intolerance?

  • Excess production of histamine

  • Diamine oxidase enzyme (DAO) deficiency

  • Poor liver methylation

  • Histamine N-methyltransferase mutation (HNMT)

  • Mast cell activation disorder (MCAD)

What is Mast Cell Activation Disorder?

Mast cells are white blood cells that are part of the immune system in ALL human tissues but mostly in the skin and gut which have the most interaction with the environment. (Can you see why most skin issues are usually gut issues?)

When part of this immune system becomes hyperactive it releases histamine along with other chemicals that can affect every organ system in the body. Think about that. That’s powerful!!!

When you consume foods high in histamine or stimulate the release of histamine there are common symptoms noted as described above.

So, in essence MCAD is when there an accumulation of genetically altered mast cells (Mastocytosis) or abnormal release of mast cell mediators (Mast Cell Activation Syndrome) or both that leads to histamine intolerance.

Other Hidden Dangers

Since this is an inflammatory response it has also been linked with diabetes, obesity, IBS, skin conditions, and even depression.

The challenge with MCAD is the ability to recognize it and diagnose it. There are no abnormal findings in routine lab testing and very little is known about it, since it was first recognized in 1991 but not officially termed as Mast Cell Activation Syndrome until 2007.

What Is The Root Cause of MCAD?

There is so much to learn about a new condition, but in the world of root cause medicine or the Functional Medicine approach, where discovering and fixing the root cause is what really helps the patient with true healing is where the digging begins. So here are some plausible theories:

Gut Infections & Dysbiosis

We know that 70% of our immune system is in the gut and that includes a large amount of mast cells. Pathogens (bacteria, viruses, fungus) infections and overgrowth stimulate the mast cells which can lead to MCAD.

Nutrition deficiencies

Zinc is important for the immune system and regulates the function of mast cells along with Vitamin D which maintains the stability of these cells. Since this is an inflammatory response a Magnesium deficiency can also be detrimental and essential in maintaining a health inflammatory response. Adequate nutrient dense foods are important.

Heavy Metal Toxicities

There are certain heavy metals that stimulate histamine and can destabilize mast cells. These include lead, cadmium, bismuth, aluminum and mercury. Many are food in foods, environment, your body and especially your mouth.

What Is A Natural Approach to MCAD

The traditional approach in conventional medicine are histamine blockers. Although these can be very effective temporarily this is not a long term solution.

Simple Changes You Can Start:

1. Follow a low histamine diet

These foods contain higher levels of histamine and should be avoided:

  • Fermented dairy products (cheese, yogurt, sour cream, buttermilk, kefir)

  • Pickles or pickled veggies

  • Kombucha

  • Fermented vegetables (sauerkraut and kimchi)

  • Fermented soy products (miso, soy sauce, tempeh, natto)

  • Tomatoes

  • Eggplants

  • Spinach

  • Cured or fermented meats (sausage, ham, salami)

  • Fermented grains (sour dough bread)

  • Vinegar

  • Tomato ketchup

  • Sardines and tuna

  • Wine, beer, alcohol and champagne

These are low histamine releasing foods but they still cause the body to release histamine:

  • Citrus fruits (lemon, oranges, lime, grapefruit)

  • Bananas, strawberries, papayas, pineapple

  • Tomatoes

  • Cow's milk

  • Chocolate

  • Nuts

  • Shellfish

  • Wheat germ

  • Artificial preservatives and dyes

Reduce DAO diamine oxidase blocking foods block DAO. Your body makes this enzyme that breaks down histamine.

  • Alcohol

  • Black tea

  • Energy drinks

  • Green tea

  • Yerba mate tea

2. Eat low histamine foods

  • Organic fruits: apples, apricots, blackberries, blueberries, cherries, coconut, melons, peaches, plums, pomegranate, and raspberries are the best choices

  • Organic vegetables: arugula, asparagus, bell peppers, beets, bok choy, broccoli, brussels sprouts, cabbage, carrots, cauliflower, garlic, greens, leeks, lettuce, onions, rhubarb, rutabaga, shallot, summer squash, sweet potato, turnip, watercress, winter squash, and zucchini, are the best choices

  • Grains: gluten-free options like amaranth, millet, quinoa, white rice, teff are less likely to exacerbate an irritated gut than gluten-containing grains although must be very cautious

  • Organic Fresh herbs

  • Olive oil

  • Fresh grass fed and sustainably raised animal proteins: chicken, beef, lamb, goat

3. Take nutritional supplements

  • Supplemental DAO enzymes like this one Histamine Block by Seeking Health

  • Other helpful supplements: Vitamin B-6, copper, zinc, quercetin

4. Other helpful tips

  • Consult with your doctor before beginning a low-histamine diet. This diet is not intended longer than 2-4 weeks, it can lead to malnourishment.

  • Cook all your meals

  • Eat foods close to their original state if possible

  • Keep a food journal to track sensitivities (time and amount you ate)

  • Eat only fresh food that has been refrigerated

  • Avoid junk food or highly processed foods

  • Reduce stress

  • Get enough sleep avoid blue light at night at least 1-2 hours before bed time


All the above may help but you still need to address the ROOT cause:

1. Remove infections - the best test available is the GI map a comprehensive stool test which helps identify pathogens that are contributing to mast cell activation

2. Heal your gut – this involves an extensive practitioner guided protocol that will focus on removing inflammatory foods, adding in super foods and healing food for your gut

3. Remove heavy metals from your body – it’s important to identify the heavy metal burden and use chelating agents to help remove them. This should be done under the supervision and guidance of a health care provider. Commonly overlooked is old mercury tooth fillings and should be removed by holistic dentist trained in the IAOMT safe amalgam removal protocol (see



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