In walks a patient with recurrent episodes of swelling (lips, fingers), hayfever and hive like eruptions all over – it’s got to be an allergy right? Not necessarily. Of course we should follow the classic allergy investigation path but what happens when you discover that your patient doesn’t have raised total IgE nor raised basophils/ eosinophils. This means it absolutely is not allergy. I’ve seen quite a few clients like this, some have even gone to the trouble of extensive skin-prick testing only to discover absolutely no allergens and no sign of allergy yet again…what is going on??
So with the classic features of swelling, itching, rash, +/- wheeze the presentation looks like an allergy, sounds like an allergy but you know…it simply can’t be a classic (IgE) allergy without these markers. What now? This is often the point at which practitioners might reach for IgA/IgG food allergy tests…but you know what…even though patients might produce some positive reactions in these, this is not the answer either! Because IgA and IgG allergies do not tend to produce these symptoms.
One thing that often masquerades like an IgE allergy but is not is histamine excess. An excess of histamine of course can produce all the same symptoms with itching, swelling, wheeze, rhinitis etc….so how do we get a histamine excess without raised basophils and exposure to allergens? Well there’s something called ‘Histamine Intolerance’ which refers to an inefficient or overloaded histamine detoxification system, and although well recognised in Europe is not really talked about here. While its incidence in the general population is low, it occurs more commonly in women and just might be the explanation behind your allergic patient who in fact doesn’t have any allergies!
But wait there’s more! Histamine excess can produce a raft of other signs and symptoms: digestive, cognitive, menstrual, that you wouldn’t necessarily think of and therefore its applicability to your patients goes way beyond the ones presenting with pseudo allergies.
When I learned about this, thanks to one of my patients who I discovered had the condition some years ago, it became a real game changer in my clinic. It’s now on my radar, I know how to recognise it and what to do about it. Histamine intolerance should not to be confused with the Pfeiffer/Biobalance concept of ‘high histamine’ individuals – but many people do.
For this month’s Update in Under 30 I’ve recorded a summary of everything you need to know in a nutshell regarding recognising, understanding and correcting Histamine Intolerance…I’m excited! This audio also comes with a couple of key papers on the topic which are easy to read and will really inspire you about this condition. If you’re not a subscriber but would like to download the audio and articles simply click here
The Update in Under 30 audios which are recorded each month are now available via a 12 month subscription. These Mp3 soundbytes are less than 30 minutes & recorded by Rachel on juicy clinically relevant topics. At under $14 per month, they’re a great way to stay up to date & earn CPE points on some of the most essential issues without leaving your desk!