Histamine is a biogenic amine with complex physiologic
functions and pathologic reactions. Histamine intolerance
(HIT) is defined by increased histamine and low diaminoxidase
(DAO, histamine degrading enzyme) or both. Clinical
pictures of HIT comprise headaches, migraine, blocked
or running nose, cardiac arrhythmia, bronchial asthma,
gastrointestinal disturbances especially diarrhoea, low
blood pressure, dysmenorrhea and urticaria. Nausea and
vomiting in seasickness and pregnancy are caused by histamine.
In the first trimenon of pregnancy DAO increases
100fold and remains then stable from the 12th week of
pregnancy onward. Lack of DAO increase leads to elevated
histamine levels and hyperemesis gravidarum, risk for
abortion and preeclampsia. In high risk pregnancies repeated
measures of DAO therefore have been proposed. PONV (postoperative nausea and vomiting) is seen in one
third of operated patients and is treated routinely with
Intolerance of red wine is usually the first clinical sign
Diagnosis and treatment can be performed easily: determination
of histamine and DAO prior and after a 14 days
histamine free diet.
Clinical improvement, decrease of histamine and increase
of DAO underlines HIT.
Additional antihistamines, DAO containing capsules and
vitamin C is recommended. Whether supplementation
of copper (DAO contains copper) is helpful, has not been
proved in detail yet.
CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol
2017; 13(2): 104–114
Histaminintoleranz, Migräne, Seekrankheit, PONV,
FAZ Floridsdorfer Allergiezentrum Wien
Reviewer: Marcus Maurer, Berlin,
und Arndt Runge, Hamburg
Jarisch R. Histaminintoleranz ... Gynakol Geburtsmed Gynakol Endokrinol 2017; 13(2): 104–114 publiziert 31.07.2017 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2017 ISSN 1614-8533