MEDICINES THAT CAUSE HISTAMINE INTOLERANCE

September 30, 2022 7:00 am

medicines, histamine intolerance, mast cell activation, alison vickery, health, Australia

Medicines can cause histamine intolerance.

In this blog post, I will outline the role of medicines in causing histamine intolerance and mast cell activation.

Of course, although some researchers have conducted studies on medicines, regulatory authorities do not require testing for histamine intolerance before listing medicines.

Despite my best efforts, I will almost certainly present incomplete information.

Nevertheless, I want to highlight how medicines can be the underlying cause of unwanted symptoms.

When Should You Seek Medical Advice?

Before we begin, I must make it clear that I am not a medical doctor. Therefore, stopping any medicines without consulting your doctor is ill-advised.

Medicines carry both risks and benefits.

As a result, use the information in this blog post to collaborate with your doctor to assess these risks and benefits and make an informed decision.

In summary, only you and your doctor can decide what is right for you.

MYTH #1

Antihistamines Reduce Histamine

If you have been told this

You probably weren’t told…
That some antihistamines block diamine oxidase

Specifically, cimetidine, chlorphoneoxamine, and promethazine (Phenergan) block DAO. 

The real issue is often fixable with the right knowledge.

I’ve helped hundreds, if not thousands, of people restore their health.

Antihistamine Medicines Histamine Intolerance and Mast Cell Activation

Which Medicines are Diamine Oxidase Blocking?

To begin with, it’s crucial to understand that certain medicines can inhibit the enzyme diamine oxidase (DAO), which is key to breaking down excess histamine in the body. 

My FREE eBook, Histamine Intolerance and Medicines, has a comprehensive list of medicines that block diamine oxidase. However, I’d like to highlight a few widely used medicines.

Firstly, Metformin strongly blocks the DAO enzyme. This was the initial cause of my histamine intolerance. 

Secondly, many antibiotics block DAO. However, as they are used only temporarily, they are unlikely to cause an ongoing issue.

Finally, some antihistamines, including cimetidine, chlorphoneoxamine, and promethazine (Phenergan), block DAO. 

Please check my eBook for a complete list.

Which Medicines Increase Diamine Oxidase?

In contrast, researchers have found that heparin medication increases plasma levels of diamine oxidase. Moreover, they believe this effect stems from its anti-inflammatory and immune regulatory properties.

However, researchers administered heparin continuously in the study, suggesting the effect might be temporary.

MYTH #2

Only Antibiotic Alter Gut Function

If you have been told this

You probably weren’t told…

Many medications alter gut function.

For example, even non-steroidal anti-inflammatories, antidepressants, and even some antihistamines.

The real issue is often fixable with the right knowledge.

I’ve helped hundreds, if not thousands of people restore their health.

Which Medicines Are Histamine Releasing?

Next, whole classes of medicines can stimulate histamine release.

These classes include:

  • Non-steroidal anti-inflammatory agents, such as aspirin,
  • Antibiotics, which often block diamine oxidase and thus present a dual problem,
  • Opioids,
  • Contrast agents,
  • Muscle relaxants,
  • Local anesthetics.

However, the impact of these medicines may vary depending on an individual’s ability to degrade histamine. Therefore, each person will individually determine whether these medicines pose a problem.

Download my FREE eBook, Histamine Intolerance and Medicines, for a comprehensive list of histamine-releasing medicines.

Which Medicines Alter Gut Function?

Then, the chronic use of many medicines can significantly alter gut function, which can profoundly impact histamine intolerance and autoimmunity.

For example, non-steroidal anti-inflammatory drugs can cause significant gut damage.

Moreover, proton pump inhibitors, cancer chemotherapy, opioid analgesics, antipsychotics, antidepressants, and antihypertensive agents, amongst others, cause adverse gastrointestinal reactions.

Additionally, many medicines, including several antihistamines, affect motility, predisposing individuals to small intestinal issues, which are often linked to histamine intolerance.

Importantly, researchers have not yet evaluated the effect of many medicines on gut function.

Download my FREE eBook, Histamine Intolerance and Medicines, for a comprehensive list of medicines that alter gut function.

MYTH #3

Antihistamines Can Be Used Longterm

If you have been told this

You probably weren’t told…
That long term use destabilises the immune system

Chronic use of antihistamines can alter the balance of histamine receptors in the body.

Therefore, the body can become dependent on them to maintain balance.

The real issue is often fixable with the right knowledge.

I’ve helped hundreds, if not thousands, of people restore their health.

Antihistamine Medicines Histamine Intolerance Mast cell Activation

What Other Medicines Are Concerning?

Researchers have not yet completed studies on the unintended side effects of medicines. Yet, there is strong clinical evidence that the following can cause histamine intolerance or mast cell activation type symptoms:

Antihistamine Medicines

Firstly, using antihistamine medicines long-term can destabilize the histamine system.

Consequently, chronic use of antihistamines can alter the balance of histamine receptors in the body, potentially leading to a dysregulated histamine system.

In summary, the body may rely on antihistamines to maintain balance; without them, the histamine system can then overreact.

Fluoroquinolone Antibiotics

Next, researchers have found a significant correlation between fluoroquinolone antibiotic medicines and histamine intolerance or mast cell activation.

Notably, the FDA has issued warnings about their effects on the central nervous system, positioning them as a high-risk alternative compared to other antibiotics.

Antidepressant Medicines

Then, antidepressant medicines interact with the histamine system and are linked to histamine intolerance and mast cell activation.

Notably, Professor Healy, a prominent expert in antidepressant pharmacology, has concluded that many antidepressant medicines are not ‘clean’ and interfere with the histamine system.

For example, a 2021 animal study found that antidepressants increased brain histamine levels, possibly explaining the connection to histamine issues.

I have written extensively about the role of antidepressant medicines in histamine intolerance and brain fog in my blog post, The Antidepressant, Brain Fog, and Histamine Connection.

Fillers In Medicines

Lastly, fillers in medicines can cause allergic reactions. Therefore, people often tolerate compounded medicines better.

histamine intolerance, masgt cell activation, medicines, Alison Vickery, Health, Australia

Conclusion

In conclusion, you should not discontinue your medicines without speaking to your doctor.

Instead, I aim to give you information that enables you to collaborate with your doctor to determine what is right for you.

Firstly, all medicines carry risks; while they are highly effective for some, they might offer minimal benefit to others. Furthermore, in some instances, they can even lead to severe histamine intolerance, drug allergies, and harm.

Sometimes, the solution is as simple as switching medicines. On the other hand, managing symptoms may involve dietary or lifestyle interventions, such as adopting a low-histamine diet.

Therefore, it is vital to consider that histamine intolerance or mast cell activation symptoms could result from medicines rather than an additional disease process.

To learn more about how genetics affects our medication choices, check out my blog post,  Pharmacogenomics: Drug Intolerances And Genes.

Follow me on Instagram and Facebook to continue the conversation.

Guidelines

Additional Reading

Kakolyri, Maria, et al. “Increased Basal Blood Histamine Levels in Patients with Self-Reported Hypersensitivity to Non-Steroidal Anti-Inflammatory Drugs.” International archives of allergy and immunology (2019): 1-7.

Yee, Sook Wah, et al. “Prediction and validation of enzyme and transporter off-targets for metformin.” Journal of pharmacokinetics and pharmacodynamics 42.5 (2015): 463-475.

Leitner, Roland, et al “Evaluation of the inhibitory effect of various drugs/active ingredients on the activity of human diamine oxidase in vitro.” Clinical and translational allergy 4.3 (2014): P23.

Agúndez, José AG, et al. “The diamine oxidase gene is associated with hypersensitivity response to non-steroidal anti-inflammatory drugs.” PLoS One 7.11 (2012): e47571.

Horton, John R., et al. “Structural basis for inhibition of histamine N-methyltransferase by diverse drugs.” Journal of molecular biology 353.2 (2005): 334-344.

Klocker J, Perkmann R, Klein-Weigel P, et Continuous administration of heparin in patients with deep vein thrombosis can increase plasma levels of diamine oxidase. Vascul Pharmacol 2004; 40: 293-300.

Roujeau, Jean Claude, and Robert S. Stern. “Severe adverse cutaneous reactions to drugs.” New England Journal of Medicine 331.19 (1994): 1272-1285.

Sattler, J., et al. “Inhibition of human and canine diamine oxidase by drugs used in an intensive care unit: relevance for clinical side effects?.” Agents and actions 16.3-4 (1985): 91-94.

Casale, Thomas B., et al. “Induction of human cutaneous mast cell degranulation by opiates and endogenous opioid peptides: evidence for opiate and non-opiate receptor participation.” Journal of Allergy and Clinical Immunology 73.6 (1984): 775-781.

Lorenz, Wilfried, et al. “Histamine release in man by propanidid and thiopentone: pharmacological effects and clinical consequences.” BJA: British Journal of Anaesthesia44.4 (1972): 355-369.

Ellis, Harry V. et al. “Selective release of histamine from rat mast cells by several drugs.” Journal of Pharmacology and Experimental Therapeutics 175.3 (1970): 627-631.