Is histamine a cause of your PMS or PMDD?
Do you have PMS or PMDD symptoms related to histamine such as irritability, insomnia and/or headaches?
Do you also experience other histamine symptoms such as itching, nasal congestion, or flushing?
Do your PMS or PMDD symptoms also occur just before ovulation?
Did your PMS or PMDD symptoms worsen or begin with perimenopause?
If you have answered yes to any of the above, you may have elevated histamine levels which can be a cause of PMS and PMDD symptoms.
What is histamine?
Histamine is found in many foods and is also produced in the body.
Histamine is released by mast cells from the immune system and elevated levels are most commonly known for causing allergic and inflammatory reactions such as itching, redness, and swelling.
Histamine is also an excitatory neurotransmitter that can affect the brain, and elevated levels can cause mood disturbance and sleep problems.
What PMS and PMDD symptoms can elevated histamine levels cause?
Elevated histamine levels can contribute to PMS and PMDD symptoms such as:
irritability
anxiety
insomnia
fluid retention
breast tenderness
brain fog
headaches or migraines
period pain.
What is the link between oestrogen, histamine, and PMS and PMDD?
Oestrogen levels fluctuate throughout your menstrual cycle and high levels can stimulate mast cell activity, elevating histamine levels. In turn, elevated histamine levels cause a further increase in oestrogen production, creating a vicious cycle.
Oestrogen also reduces the activity of the DAO enzyme that clears histamine from the body, causing histamine intolerance.
Oestrogen levels are highest just before ovulation and in the mid-luteal phase, a few days before your period. If you experience premenstrual symptoms during these times, elevated histamine levels could be a cause of your PMS or PMDD.
Oestrogen levels can fluctuate wildly in the early stages of perimenopause, at times having an up to three-fold increase which can cause extremely high histamine levels. This is why the start of perimenopause can often trigger or worsen PMS and PMDD symptoms.
Progesterone has the opposite effect of oestrogen, it helps to increase DAO enzyme activity and stabilises mast cell activity, reducing histamine levels. This is why you may feel better in the first half of the luteal phase of your menstrual cycle, when progesterone is at its highest.
How do I know if I have elevated histamine levels?
In additon to the above-mentioned hormonal symptoms, elevated histamine levels can also cause:
rashes and hives
flushing
dermatographia, red and raised marks that appear after light scratching of the skin
hay fever symptoms such as sneezing, itchy eyes, and runny or stuffy nose
tinnitus (ringing in the ears)
nausea
diaorrhea.
How do I know if elevated histamine levels are causing my PMS or PMDD?
The best way to assess if histamine is a cause of your PMS or PMDD is to try an over-the-counter pharmaceutical antihistamine when you experience the symptoms.
You have a couple of options available:
loratadine is a non-drowsy H1 histamine blocker which can be taken during the day
diphenhydramine is a drowsy H1 histamine blocker and is best taken at night.
You should see symptom relief within 3 days, so if either medication helps ease your symptoms within that time, it is likely that histamine is a cause of your PMS or PMDD.
You can use over-the-counter antihistamines as needed to relieve PMS and PMDD symptoms. However, many of my clients find that a more effective long-term approach involving reducing dietary histamine, stabilising mast cell activity, and improving histamine breakdown to help maintain balanced histamine levels, works best.
What health conditions contribute to elevated histamine levels?
Several health conditions contribute to elevated histamine levels. These include:
gut dysbiosis (an imbalance of good and bad bacteria)
small intestinal bacterial overgrowth (SIBO), characterised by bloating and distention shortly after eating foods high in FODMAPs such as wheat, milk, and legumes
intestinal permeability (leaky gut)
excess or unopposed oestrogen levels.
You can ask your GP or naturopath to order a:
breath test to confirm or rule out SIBO
microbiome mapping testing for detecting gut dysbiosis as well as viral, fungal, and parasitic gut infections
lactose to mannitol ratio test to assess if you have intestinal permeability
a saliva hormone test to determine whether you have elevated oestrogen levels and/or low progesterone levels.
If testing confirms you have any of the above health conditions, a naturopath can devise a treatment plan to treat their cause/s including dietary and lifestyle advice as well as nutritional and herbal medicine, to balance histamine levels in your body.
What dietary modifications can help lower histamine levels to treat PMS or PMDD?
Reducing high histamine foods such as red wine, hard cheese, smoked or slow cooked meats, bone broth, and fermented foods can help to lower your body’s histamine levels.
Reducing alcohol consumption and A1 casein dairy will help stabilise mast cell activity to lower histamine production.
Increasing dietary intake of phytoestrogens such as flaxseed, brassica vegetables such as broccoli, and fibre will help to ensure the healthy metabolism and clearance of excess oestrogen, lowering histamine levels.
Which supplements help lower histamine levels to treat PMS or PMDD?
You could trial all or any of the following histamine reducing supplements*:
quercetin helps stabilise mast cell activity to lower histamine levels
vitamin B6 ** upregulates DAO enzyme activity to help break down histamine
activated B vitamins (especially folic acid and vitamin B12), choline, and SAMe all support methylation to help to encourage the healthy metabolism of oestrogen and break down of histamine
zinc and magnesium help stabilise mast cell activity and upregulate DAO enzyme activity.
*Consult with your naturopath or a pharmacist before purchasing supplements for advice on supplement dosage and duration safety. They can also check for any potential drug/herb/nutrient interactions or contraindications with health conditions, pregnancy, and/or breastfeeding.
**Excessive dosing of Vitamin B6 can increase the risk of peripheral neuropathy, symptoms include numbness, burning and tingling, especially in the hands and feet. The Therapeutic Goods Administration (TGA) recommends a dosage of no more than 100mg of daily across all supplements you take daily.
If you suspect high histamine levels could be causing your PMS or PMDD symptoms, trialling an over-the-counter antihistamine can be an effective way to test this theory.
If you experience symptom relief from the antihistamine, consider the following strategies to help regulate histamine levels and manage your PMS or PMDD long-term:
identify and address any underlying health conditions that may be contributing to elevated histamine levels
limit foods high in histamine, as well as those that trigger mast cell activation
include more foods that support healthy estrogen metabolism
trial supplements that help the break down and clearance of histamine from the body.
want to find out how I treat PMS and PMDD?
As a naturopath, I can develop a personalised treatment plan for you to treat PMS and PMDD to help you remain in control of your mood, improve your ability to cope with stress, and feel more calm and balanced throughout your menstrual cycle. Take a look at my PMS/PMDD service page for more info…