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Dr. John W. Phelts, D.C.

SIX WAYS TO COMBAT ALLERGIES

If you are not famiiar with immunology, you may want to open the glossary in a separate window as a reference as you read this article

Millions of people around the globe have allergies.  They suffer from hives, eczema, itchy watery eyes, runny noses, asthma, nausea.  Allergies can mean misery for them.  Many need to have medication on hand to cope, like steroidal creams, inhalers, and oral medications.   They often imagine what life would be like, if they didn’t have allergies and need medication.  This article explores the allergic reaction process and natural methods of managing them. 


The main cause of allergy symptoms is excess of histamine in the body.  Contrary to popular belief, histamine is not bad.  It serves many important functions in our bodies.  It helps regulate our internal body clock (sleep-wake-cycle), makes us feel alert, is necessary for a healthy libido and sexual function, promotes proper digestion, and healthy immune function.  Histamine is good.  It only becomes a problem when there is too much of it.   Let’s explore six factors that can contribute to high histamine.

SIX CAUSES OF EXCESS HISTAMINE 

  1. Allergies- cause excess histamine release in response to foods, pollens, dust, pollutants, and topical chemicals (skin care products, perfumes, etc).

  2. Impaired metabolic breakdown of histamine

    1. Nutritional deficiencies

    2. Genetic Variants (SNPs)

  3. Bile in the gut

  4. Stealth / Chronic infections

  5. High Estrogen levels

  6. Diet- Eating foods that contain histamine

Let's review each of these factors.

1. ALLERGIES
Allergies occur when the body recognizes a non-pathogen as a pathogen (bacteria, parasites, viruses, yeast).  These can be pollen, dust, foods, chemicals (in household and skin care products), air pollutants, etc.  The immune system identifies it as an allergen and initiates an allergic reaction as described below:

When the body encounters an allergen, immune cells called dendritic cells present an antigen to a naïve T-cell (TH0).  When an allergen antigen is presented, interleukin-4 (IL4) is released which causes the TH0 cell to become a T-helper-2 (TH2) cell.  TH2 cells stimulate B-cells to become plasma cells which produce Immunoglobulins/antibodies.  Plasma cells release Immunoglobulin E (IgE) during allergic responses, which stimulates mast cells to release histamine and other inflammatory mediators including prostaglandins, leukotrienes, cytokines, proteases, heparin, and nitric oxide. This response produces inflammation and allergy related symptoms like runny nose, watery eyes, itchy mouth and throat, inflamed itchy skin, shortness of breath, heart palpitations etc.  Please refer to the glossary at the end of this article for definitions of the terms used.

Symptoms associated with allergic immune responses depend on where in the body histamine is released:    

  • Airways- runny nose, stuffy sinuses,

  • Eyes- itchy watery eyes

  • Skin- inflamed itchy skin, as seen in eczema, urticaria, and hives.

  • Stomach and Intestines- abdominal pain and bloating

  • Heart- Arrythmias- fast or slow heartbeat.  Some people experience this when they eat certain foods that they are allergic too.

  • Brian- insomnia, feeling sluggish

  • Genitals- Histamine promotes sexual desire.  It stimulates lubrication in women and erections in men.  Excess histamine can make genitals hypersensitive even to the point of pain (dyspareunia), and aversion to sexual activity.  This is true in males and females.
    The problem can be so severe that even their own clothing brushing against their clitoris, penis, or nipples can cause arousal or pain.   

 
2. IMPAIRED ABILITY TO BREAKDOWN HISTAMINE
Histamine levels can be high due to a diminished ability of the body to metabolize (breakdown) it.  This is most often due to nutritional deficiencies.  The body needs molybdenum, iron, vitamin B2, vitamin B3, and methyl to metabolize histamine.   These nutrients can be found in beef liver.

Diamine oxidase (DAO) is one of the enzymes the body uses to breakdown histamine.  It is made by the APB1 gene. Some people have a variant of the APB1 gene that is inefficient at making DAO.  These individuals need to consume it in their diet.  DAO can be found in beef kidney,

The body makes histamine from a compound called histidine. The more histidine that is available the more histamine the body can make.   If there is an impaired ability to breakdown histidine, then histidine levels will be high, which means that the body can make an increased amount of histamine.    The body needs B6 and Folate to metabolize histidine.  They can be found in beef liver.
 
3. BILE IN THE GUT
Bile salts stimulate the release of histamine by mast cells in the intestines.  Bile is made in the liver and stored in the gallbladder.  It helps us digest fats.  Normally the gall bladder only releases bile when we eat fatty foods.   Individuals who have had their gallbladder removed (cholecystectomy), no longer have controlled release of bile.  Instead, they have a continuous drip of bile in the gut, which means a continuous release of histamine.  Carbonized Charcoal can sequester bile salts.
 
4. STEALTH / CHRONIC INFECTIONS
All infections require an adequate T-helper-1 cell (TH1) and Th2 response to be eradicate it.  TH1 cells are responsible for eliminating pathogens by digesting them or producing reactive oxygen species (ROS) aka free radicals to kill them. A full discussion of the TH1 response is beyond the scope of this article.

An example of a TH2 response was described above, except in this case a pathogen triggered it, so different cytokines and antibodies are involved.  Infection eradication requires a TH2 response to produce antibodies so that the TH1 immune cells can recognize pathogens and kill them.  A TH1 dominate response is necessary to rid the body of a pathogen.

TH2 responses inhibit TH1 responses and vice versa.  An inadequate TH1 response and/or a dominate TH2 response can make an infection chronic, since it doesn’t get eradicated.  This is the case in TH2 dominant patients, and results in chronic high histamine. 

Stealth infections are infections that are missed, because their levels are too low to be detected by current testing methods.  Because their levels are so low, common symptoms associated with infections like pain, swelling, fever, etc. Are absent.  Instead they may be expressed as allergy symptoms, due to the chronic histamine release. The following pathogens are suspected of stealth infections:

  • Epstein Barr Virus – a cause of chronic fatigue syndrome

  • Cytomegalovirus

  • Human herpes virus–6 (HHV-6)

  • Herpes simplex virus-1 and 2 (HSV-1 and HSV-2)

  • Human Parvovirus

  • Coxsackie virus

  • Bacterial

    • Borrelia, Bartonella –Lymes disease

    • H Pylori- stomach and intestinal ulcers

    • Other cell wall deficient bacteria

  • Fungus, yeast, and parasites.  Biofilms often protect the fungi and bacteria making it difficult for the immune system to eradicate them.  An example would be toenail fungus.

  • Undetectable stealth infection is a controversial concept in traditional medicine

Th1 Support  by Pure Encapsulations is an herbal formula designed to support the Th1 immune response.
 
5. ESTROGEN
High estrogen stimulates mast cells to release histamine.  Estrogen suppresses histamine breakdown by decreasing DAO and monoamine oxidase (MAO) activity.  Histamine increases luteinizing hormone (LH) which increases estrogen.  This perpetuates a vicious cycle where histamine increases LH, which increases estrogen, which increases histamine, which increase LH and so forth.  In women, if allergy symptoms increase in the middle of the menstrual cycle, then it is likely that estrogen is contributing to the problem.  In men, estrogen levels increase as they age, which is evidenced by the formation of breast tissue (gynecomastia).  If their allergy symptoms increase as they age, then estrogen is most likely a contributing factor.  Diindolylmethane (DIM) helps the body detoxify estrogen and may help reduce the effects of excess estrogen.
 
6. DIET
Did you know that many foods contain histamine?  It’s true. You can lower your histamine levels by avoiding high histamine foods.  You can also avoid foods that trigger your mast cells to release histamine.  Stick to low histamine foods and incorporate antihistamine foods into your diet.  Avoid anything that you know that you are allergic to.  These foods are categorized below.  This is an abbreviated list.  You can request a complete list by calling us at (212) 286-2012.

HIGH HISTAMINE FOODS (AVOID)
Fermented alcoholic beverages:   wine, champagne, beer
Fermented foods:  sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc.
Vinegar containing foods:  pickles, mayonnaise, olives
Cured meats:  bacon, salami, pepperoni, luncheon meats & hot dogs
Soured foods:  buttermilk, soured cream/milk/bread, etc.
Dried fruit:  apricots, prunes, dates, figs, raisins
Most citrus fruits
Aged cheese (including goat cheese)
Nuts (walnuts, cashews, peanuts)
Vegetables (avocado, eggplant, spinach, tomato)
Smoked fish and certain fish species


If you ‘slip up’ and eat a high histamine food, beef kidney which contains DAO, can breakdown the histamine in your gut to minimize its absorption into your body.  It should be taken immediately after eating the food.

HISTAMINE RELEASING FOODS (AVOID)
Alcohol, Papaya, Bananas, Pineapple, Chocolate, Shellfish, Cow’s Milk, Strawberries, Nuts, Tomatoes, Many artificial preservatives & dyes, Wheat Germ

If you ‘slip up’ and eat a histamine releasing food, carbonized bamboo taken immediately after eating that food can bind to it and minimize its absorption into your body.

LOW HISTAMINE FOODS (OKAY TO EAT)
Freshly cooked meat or poultry- try to cook the same day you buy the meat. No leftovers
Freshly caught fish (preferably the same day)
Cooked eggs
Gluten-free grains:  rice, quinoa, corn, millet, amaranth, teff
Pure peanut butter
Fresh fruits:  mango, pear, watermelon, apple, kiwi, cantaloupe, grapes
Fresh vegetables:  except tomatoes, spinach, avocado, eggplant
Dairy substitutes:   coconut milk, rice milk, hemp milk, almond milk
Cooking oils:  olive oil, coconut oil, Leafy herbs & Herbal teas

ANTIHISTAMINE FOODS (OKAY TO EAT)  
Onions, apples, grapes, berries, broccoli, cherries, camu berries, red bell peppers, kiwi, broccoli, carrot, parsley, peppermint, thyme, basil, celery, artichoke, sweet bell peppers. beef liver.  

ALLERGY DESENSITIZATION TREATMENTS
I truly hope that you found this article useful.  I know that I listed many supplements and it can be overwhelming to decide which supplements would be best for you to take.  At my New York location, I do non-invasive testing to identify the possible sources of your allergic reactions and test to determine which supplements would be most beneficial for you.  The type of testing that I do is known as resonance testing, applied kinesiology (AK), or energy testing.   

I also perform allergy desensitization and allergy clearing treatments.  They are non-invasive treatments and involve the use of meridian therapy and applied kinesiology techniques.   

If you are interested in getting tested and treated, you may reply to this email or give us a call at (212) 286-2012.  We do in office, virtual, and telephone consultations.    

       A SUMMARY OF NATURAL SUPPLEMENTS THAT HELP MANAGE HISTAMINE

NATURAL ANTIHISTAMINES
Quercetin- found in onions, apples, grapes, berries, broccoli, and cherries.
Vitamin C- found in camu berries, red bell peppers, kiwi, broccoli, and papaya
Bromelain
Stinging Nettles (Utica Dioica) leaf
Luteolin- found in broccoli, carrot, parsley, peppermint, thyme basil, celery, artichoke, sweet bell pepper.
 
Natural D-Hist - a supplement by Orthomolecular Products with quercetin, vitamin C, bromelain, and stinging nettles leaf.  I recommend this product for seasonal allergies. 


NUTRIENTS NEEDED TO BREAKDOWN HISTAMINE:
Folate – found in beef liver, broccoli, Brussel sprouts, and spinach.
Vitamin B6- found in beef liver.
Betaine- found in beef and spinach.
Beef Spleen- this can be hard to find in supermarkets.  Beef spleen can be found in encapsulated supplement form.  Food allergies and chemical sensitivities stress the spleen, so it needs to be supported.
DAO- found in beef kidney


GATA-3 BLOCKERS
Gata-3 is a transcription factor that promotes the TH2 pathway.  Transcription factors are involved in genetic encoding.  They transcribe DNA into RNA which gives instructions to cells.  GATA 3 blockers may be useful in lowering histamine.  They are naturally found in the following herbs:
Sophora root (Ku Shen) contains oxymatrine which blocks GATA-3.  
Perilla frutescence
Astragalus
Chinese licorice (glycyrrhiza uralensis)- This can raise blood pressure, so it is contraindicated if you suffer from hypertension (high blood pressure).

ESTROGEN METABOLISM SUPPORT
Diindolylmethane (DIM)- found in broccoli, cauliflower, Brussel sprouts, and cabbage.  It can also be purchased in supplement form here

IMMUNE SUPPORT FOR TH1 RESPONSES

Zinc
Skullcap- an herb with anti-bacterial and anti-viral properties.
Berberine- a plant chemical with anti-viral, anti-bacterial, and anti-fungal properties.  Found in Golden Thread, European barberry and Oregon grapes.
Ginger 
Turmeric Root 
Th1 Support by Pure Encapsulations is a formula designed to support the TH1 response and contains zinc, skullcap, berberine, ginger, and turmeric root


AN IN DEPTH LOOK AT HISTAMINE’S FUNCTIONS IN THE BODY 
There are four types of histamine receptors; H1; H2; H3; H4. The effect that histamine has on the body depends on which receptor it attaches to.

H1 receptors are found in the cells of smooth muscles (organs), endothelial cells (inner linen of blood vessels). brain, and the heart.   These receptors can cause acute allergic reactions aka anaphylaxis, which can result in a severe drop in blood pressure and difficulty breathing due to swelling of the airways.  These receptors can also cause heart arrythmias (fast or slow heartbeat).

In a part of the brain called the hypothalamus, there are specialized nerves called histamine neurons.  They release histamine which acts as a neurotransmitter in the brain.  Histamine in the brain modulates the internal body clock (sleep-wake cycle) and causes central nervous system wakefulness (arousal).   So, excess histamine can cause insomnia

Many antihistamine drugs are H1 receptor antagonists and work by blocking the H1 receptors. Histamine makes a person feel awake, so when people take H1 blockers, it makes them feel drowsy.  Some non-sedating antihistamines counter the drowsy side-effect by blocking acetylcholine (a relaxing brain compound).  Because of this, their side-effects include anxiety and insomnia.  They stay in the body for eight hours, so don’t take within 8 hours before bed or you may have trouble falling asleep.   

H1 receptors are also implicated for the perpetuation of dizziness, vertigo, loss of balance, sea sickness and associated nausea.  H1 blockers can be useful to treat these conditions as well.  H1 blockers in these patients decrease the excitability of the labyrinth in the inner-ear and block conduction in the vestibular-cerebellar pathways.  These include Antivert, Bonine, and Benadryl.  If these medications help a person with vertigo, then most likely they have a histamine issue.  

H2 receptors- are found on the cells of the stomach wall called parietal cells.  When histamine attaches to the H2 receptors on parietal cells, it stimulates them to secrete hydrochloric acid (HCl) which helps form gastric acid.  ‘Gastric acid is important for digesting proteins, assimilating vitamins, and protection against harmful bacteria.   

Histamine attaching to H2 receptors promote sexual desire.  It stimulates vaginal lubrication in women and erections in men.  Excess histamine can cause hypersensitive genitals even to the point of pain, dyspareunia (painful sexual intercourse), and an aversion to sexual activity.  This is true in males and females.  The problem can be so severe that even their own clothing brushing against their clitoris, penis, or nipples can cause arousal or pain.  

A class of drugs designed to decrease gastric acid secretion by blocking histamine from attaching to H2 receptors. They are called H2 blockers.  They are used to treat gastric ulcers, GERD, duodenal ulcers, and Zollinger-Ellison disease (excess stomach acid production).  These drugs include Axid, Pepcid, Pepcid AC, and Zantac.  When histamine attaches to an H2 receptor it promotes sexual function, so when you block it, you can get side effects of low libido, poor vaginal lubrication, and penis erectile dysfunction.  

H3 receptors- are located throughout the central nervous system.  Histamine has neurotransmitter modulation effects.  Histamine nerves (histaminergic cell bodies) originate in a part of the brain called the hypothalamus (HPT) known as the tuberomammillary nucleus.  They project to almost every region of the CNS with extensive projections to the cerebral cortex (a part of the brain responsible for cognition). They are currently the focus of research to see if they might be targeted to treat cognitive and sleeping disorders.


H4 receptors- are found on immune system cells, including mast cells, eosinophils, T-cells, and Dendritic cells.  They modulate immune responses.  When histamine attaches to them, these cells migrate to the affected area.  Excess histamine can lead to amplification of histamine mediated immune responses and can eventually lead to chronic inflammation and allergic responses.  H4 receptors are also involved in dendritic cell activation and Th0 cell differentiation (I.e. Th0 becoming TH2 cells). 

INTERESTING FACTS

\INTERESTING FACT 1:  H1 receptors are implicated in the perpetuation of dizziness, vertigo, loss of balance, sea sickness and associated nausea.  H1 blockers can be useful to treat these conditions as well.  These include Antivert, Bonine, and Benadryl.  If these medications help a person with vertigo, then most likely they have a histamine issue 

INTERESTING FACT 2:  Many allergy drugs are Histamine type-1 receptor antagonists and work by blocking histamine from attaching to cells.  Histamine makes a person feel awake, so when the drug blocs histamine, they feel drowsy instead.  For this reason, they also put H1 blockers in sleep medications. 

INTERESTING FACT 3:  Non-sedating antihistamines counter the drowsy effect by adding an acetylcholine (a relaxing brain compound) blocker.  Be cautious about taking these, because the side effects include anxiety and insomnia.  These drugs are active in the body for eight hours, so don’t take within eight hours before bed or you may have trouble falling asleep.


GLOSSARY
Dendritic Cells-
are antigen-presenting cells. Their main function is to process antigen material and present it on the cell surface to the T cells of the immune system. 

Lymphocyte- a form of small leukocyte (white blood cell) with a single round nucleus, occurring especially in the lymphatic system.

T-cell- a  lymphocyte that develops from stem cells in the bone marrow and matures in the thymus gland.

Naïve T-Cell (Th0)- a T-cell that has not encountered an antigen within the periphery.

Allergen- An allergen is any substance (antigen) that is recognized as an invader by the immune system and causes an allergic reaction.

Antigen- a toxin or other foreign substance which induces an immune response in the body, especially the production of antibodies. - Oxford

Interleukin-4 (IL4)- IL-4 is a cytokine that functions as a potent regulator of immunity secreted primarily by mast cells and Th2 cells.

Cytokines- abroad and loose category of small proteins released by many different cells in the body, including those of the immune system where they coordinate the body's response against infection and trigger inflammation.

T-helper-2 (Th2)- T-lymphocytes that mediate the activation and maintenance antibody-mediated immune responses against extracellular parasites, bacteria, allergens, and toxins.

B-cell- a lymphocyte not processed by the thymus gland, and responsible for producing antibodies.

Plasma Cell- a fully differentiated B cell that produces a single type of antibody.

Immunoglobulin aka Antibody- A protein produced by plasma cells and lymphocytes.

Immunoglobulin E (IgE)- an antibody produced during allergic reactions.

Mast Cell- a cell containing granules that are rich in histamine, heparin, and other inflammatory mediators.

Inflammatory Mediator- a chemical messenger that acts on blood vessels and/or cells to promote an inflammatory response.

Prostaglandins (PG)- a group of lipid compounds called eicosanoids having diverse hormone-like effects.

Leukotrienes- a family of eicosanoid inflammatory mediators produced in white blood cells by the oxidation of the fatty acids arachidonic acid (AA) and the eicosapentaenoic acid (EPA)

Protease- an enzyme that breaks down proteins into smaller polypeptides or single amino acids by hydrolysis.

Heparin- produced by mast cells and basophils.  Acts as an anticoagulant (blood thinner), which can prevent of break up blood clots.

Nitric Oxide- dilates blood vessels, increasing blood flow and lowering blood pressure.

Reactive Oxygen Species- an unstable molecule that contains oxygen and that easily reacts with other molecules in a cell.

Free radicals- unstable atoms that can damage cells

Monoamine oxidase (MAO)- an enzyme that breaks down neurotransmitters including histamine.
 
SOURCES

Seminar: “TREATING THE HYPERVIGILANT IMMUNE SYSTEM: HISTAMINE”, February 2018,  by Kerry M. McCord, DC, DIBAK and Walter H. Schmitt, DC, DIBAK, DABCN 

https://en.wikipedia.org/wiki/Adaptive_immune_system 

https://en.wikipedia.org/wiki/T_helper_cell 

https://www.sciencedirect.com/topics/neuroscience/cytokines 

Food Chem Toxicol. 2020 Jan ;135:110924. Epub 2019 Oct 28. PMID: 31672514 

BMC Complement Altern Med. 2016 May 20 ;16:132. Epub 2016 Aug 20. PMID: 27207147 

Asian Pac J Allergy Immunol. 2018 Aug 13. Epub 2018 Aug 13. PMID: 30118241 

Cell Immunol. 2005 Sep;237(1):68-75. Epub 2005 Dec 6. PMID: 16337164 

Altern Ther Health Med. 2012 Sep-Oct;18(5):9-17. PMID: 22894886 

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