The curious connection between estrogen and histamine
Updated: Aug 23
Could your bloating, headaches, asthma and anxiety be caused by histamine reactions? Do your symptoms appear worse at certain times of your menstrual cycle? This blog is about the curious link between estrogen levels and histamine.
The role of histamine intolerance in women's health can't be underestimated. In my Sydney clinic I meet many women with undiagnosed histamine intolerance. These women suffer with intense and baffling symptoms mid cycle and just before their period.
It's very common to work with women who have a wide range of daily and cyclical symptoms. What excites me about the connection between estrogen and histamine is that sometimes every single symptom that has previously seemed unrelated can all be improved by one simple intervention.
----- What is histamine? -----
Most of us are familiar with histamine triggering sneezing, coughing, watery eyes and itchiness when we come into contact with pollens or animals. This is an immune response to expel the allergen from our respiratory system. You might have been prescribed anti-histamines in the past to suppress this immune reaction.
When our immune system is triggered in response to an allergen, histamine is released from mast cells and travels through the blood stream. This is part of a healthy, balanced immune response.
However histamine reactions don't just occur in the respiratory system. The widespread occurrence of histamine receptors on the cells throughout our body accounts for the complex and varied effects of histamine reactions.
Histamine reactions can be caused by foods.
Histamines are found in many aged, leftover and fermented foods. Histamine reactions can also be triggered by food that don't contain histamine.
The banana smoothie that you have for breakfast could be making your bloating worse. The wine you enjoyed last night might have triggered your hot flushes. The walnuts with your salad might be triggering anxiety or heart palpitations. The reason for this is histamines! Let me explain a bit more:
We have receptors for histamine on the cells throughout most organs and tissues in our body. For this reason it is convenient to talk about how histamine symptoms are experienced in different parts of the body.
Typical digestive symptoms caused by histamine reactions
Histamine receptors are wide spread in our gastrointestinal tract. So some people's diarrhoea, abdominal pain and cramping, bloating or reflux could be a histamine reaction.
When I work with women experiencing these issues they often say "I ate this food yesterday and it didn't cause any problems, but today I ate the same meal and I felt bloated."
These women have tried to work out which food is bothering them but their symptoms appear random. Unlike food allergies, histamines have to reach a threshold before they cause symptoms. The symptoms caused by histamines, such as bloating and reflux, often seem to be worse at the middle and end of the day.
Typical central nervous system symptoms caused by histamines
We have histamine receptors throughout our central nervous system. For this reason headaches, migraine, dizziness, anxiety, insomnia and hot flushes can be caused by reactions to histamines.
If you are experiencing premenstrual or mid-cycle migraines I will always ask you about the foods you eat and look for histamine reactions. Vitamin B6 helps to improve some women's migraines and this may be because B6 is needed for the breakdown of histamine.
Typical skin reactions caused by histamines
The hives, itching and flushing caused by histamines can be mild or severe. I have worked with women with very severe skin symptoms and they have often occurred immediately after stopping hormonal birth control, as their body begins to make estrogen for the first time in a while.
Do you flush from your chest, up your throat and onto your cheeks after a few glasses of wine? Menopause symptoms such as formication (a feeling like ants walking under the skin), can be worse for consuming foods containing histamines.
Flares in eczema, rosacea and acne can sometimes be explained by histamine intolerance.
Typical vaginal, vulva and urinary tract symptoms caused by histamines
Histamine can play a role in genitourinary conditions. Burning, itching, a hypersensitive bladder, interstitial cystitis (that worsens before a period or at ovulation) and vulvodynia are all symptoms and conditions that may be linked to histamine. These symptoms often feel severe due to larger blood flow to these sensitive tissues.
If you have burning, redness or itching and your swab or test came back negative for an active infection, I might suspect a chronic infection or the involvement of histamines.
Typical respiratory symptoms caused by histamines
Sneezing, allergic rhinitis, nasal congestion, throat clearing, coughing and asthma can all by triggered by histamines. This can often be a flag for me in my clinic.
If I'm working with someone who is experiencing digestive or hormonal symptoms and they also report frequent nasal congestion or hay fever, I make a note to dig deeper about the possible role of histamine.
Typical cardiovascular symptoms caused by histamines
Heart arrhythmia, fast heart rate and heart palpitations can be caused by histamines. Of course if you are experiencing these symptoms regularly you should get them checked out by your doctor because they can be very serious.
I recently worked with a client who experienced heart palpitations from eating a daily salad soaked in balsamic vinegar overnight. Once we removed the balsamic vinegar, the heart palpitations stopped.
I typically see these histamine reactions in women before their menstrual period and most often in perimenopause. Histamine reactions at this time of the monthly cycle can be a result of estrogen fluctuations as I will now explain.
The link between estrogen and histamine
During a healthy menstrual cycle there is a hormonal pattern to the breakdown of histamine in the body. This breakdown of histamine corresponds to the levels of our reproductive hormones: estrogen, progesterone, luteinising hormone, and follicle stimulating hormone.
For simplicity I will just talk about estrogen, however the effect of estrogen on histamine is modulated by what other hormones are doing.
The interaction between estrogen and histamine goes both ways:
Histamine has an additive effect on estrogen, which can raise estrogen levels (think heavy periods, endometriosis, migraines).
When your estrogen levels are high, mast cells are stimulated to release more histamine.
Histamine can be the reason for:
menstrual related headaches and period pain
hormonal associated fluctuations in asthma and allergies
hot flushes and other perimenopause symptoms
low mood or anxiety before a period
bloating before a period
recurrent mid cycle symptoms such as migraines and dizziness
worse interstitial cystitis before a period
It's important to remember that it may not be histamine that is causing these symptoms for you. If your experience is severe, or if it does not improve with a low histamine diet, you should seek advise from your doctor, naturopath or other health care provider.
----- Action steps -----
1. Track your menstrual cycle
I encourage you to track your symptoms at the same time as your menstrual cycle, to see if the symptoms you experience could be related to fluctuations in estrogen.
Most period tracker apps allow you to add additional notes and comments, or keep your own journal. Everything is relevant including stool changes, headaches, itching, sneezing, hot flushes, insomnia, clotting, anxiety and low mood.
2. Cut back on foods containing histamine
At the times of your cycle that you expect symptoms, stick to foods that are fresh, unprocessed and not fermented. Steer clear of left over foods, slow cooked, aged and dried foods, as well as over ripe foods.
In my experience alcohol, ripe avocado and dairy products are the high histamine foods that often cause symptoms before your period.
3. Test for histamine intolerance
The most accurate way to test for histamine intolerance is to have a positive response to a low histamine diet, followed by a reaction when you reintroduce histamine containing foods. You only need to have a week or two on a low histamine diet to see a difference (or not).
Many foods that contain histamine are otherwise healthy foods. You should never eliminate healthy foods from your diet permanently. If these foods are causing symptoms, please get help to heal your histamine intolerance and balance your estrogen levels so that you can return to a balanced diet.
4. Uncover any food intolerances
You may discover that you have an intolerance to foods that don't contain histamine. In this situation the food causes an immune response in your body and a release of histamine into the blood stream.
Are there any foods that upset your stomach or cause symptoms for you? Common foods that trigger histamine responses are citrus fruit, spinach, eggplant and pork. Work with a naturopath who will help to support your immune system and resolve your food intolerance.
5. Reduce your stress levels
Stress is a major factor in disrupted hormones, upsetting gut bacteria, and causing digestive disturbance. Cortisol levels are often high when you are in a state of 'fight or flight' and this has a flow on effect to your reproductive hormones, often lowering progesterone levels and leaving you with relatively higher estrogen.
6. Balance with your gut microbiome
Bacterial, parasitic or yeast infections or other imbalance in your gut microbiome can all play a role in histamine reactions. I recommend GI map microbiome testing to find out what your gut microbiome profile is. I also recommend eating a wide variety of vegetables to support beneficial gut bacteria.
Small intestinal bacterial overgrowth, or SIBO, is another common reason for histamine intolerance. Your naturopath will recommend a breath test if this condition is suspected.
7. Work with me
I'm very excited to work in the area of histamine intolerance and women's health. I love being able to support women in this way. I want every woman to be able to eat and enjoy a wide variety of foods without experiencing symptoms every month.
Please find out more about working with me and learn how to read your body, find the underlying cause of your symptoms and reach your health goals with natural medicines.
Hi! I'm Simone Jeffries. I am a naturopath, nutritionist, herbalist and certified wellness coach. I am also a foodie and an advocate for a whole food diet.
The information in this blog is from my Bachelor of Health Science degree, experience from working with women in my clinic, and continuing research.
This blog is for information only and not intended to take the place of medical advice. Please seek assistance for any medical concerns.