Histamin intolerance – a disorder with many faces

Dr. med. Jörg Reibig, Falkenberg, Germany

Dear colleagues,

Histamine intolerance (HIT) is the cause of numerous chronic conditions and is in fact a disorder with many facets. Unfortunately it often goes undetected. Patients have frequently spent a number of years fruitlessly visiting doctors and clinics, leading to frustration or even depression. Often they hear from the doctors treating them that it’s nothing, it’s psychological, or there’s nothing that can be done, or that it’s simply an iron deficiency, or that their stools need to be checked for parasites given their recurring diarrhoea. I myself have been closely involved in treating this disorder since I attended a workshop in Potsdam in May 2011, followed by an intensive discussion with Prof. Reinhart Jarisch from Vienna.

This discussion centred on the diagnostic options available and on whether the condition can in fact be treated at all. This is the subject of his book Histamine Intolerance, Histamine and Seasickness.

An estimated 1 -3% of the population suffer from HIT, 80% of which are middle-aged women.

It is similar to an allergic reaction, which is not lgE-related, but rather the result of the concentration of histamine in the body being too high.

Histamine intolerance symptoms 

Gastrointestinal tract: nausea, vomiting, stomach ache, flatulence, diarrhoea
Skin: redness, flushes, itching, urticaria
Respiratory tract: runny nose, nasal obstruction Cardiovascular system: hypotonia, tachycardia, arrhythmia

CNS: headache, dizziness Urogenital tract: dysmenorrhoea, cystitis

What is histamine?

Histamine is a biogenic amine synthesised from the amino acid histidine. In pharmacological terms it was first described as an endogenous substance in 1910,with a molecular weight of 111. It is a product of bacteria, which, for example,is found in food subject to a maturation process through bacteria. Histamine is also formed by the body itself via the enzyme histidine decarboxylase in mast cells, basophils, thrombocytes and in certain nerve cells.

It is a mediator for a number of biological reactions:
–  Allergies (allergic rhinitis, urticaria)
–  CNS: Neurotransmitters – regulates sleeping-waking rhythm
–  Appetite control- regulates the production of stomach acid and motility in the gastrointestinal trod
– In resistance to extraneous substances
–  Vasodilation
– Contracture of the smooth muscle in the uterus

Causes of histamine intolerance

It appears to be an acquired disorder, in which the production of diamine oxidase (DAO) is reduced as a result of inflammatory disorders, or DAO activity is restricted through external factors such as 52nd  International Congress for BICOM® Therapists, 28 to 30 April in Fulda, Germany alcohol or medication. Increasingly, genetic factors too are being included in the debate, however. We need to make a distinction between two forms – acute and chronic. The acute form (DAO) is characterised by a reduction in extracellular degradation through impairment of diamine oxidase, the enzyme responsible for breaking down histamine. The chronic form (HNMT) involves impairment of the histamine N-methyltransferase, which degrades intracellular histamine, particularly in the liver. Several gene variants are known for both enzymes, which means that there are also mixed forms. Both forms differ in terms of intensity and temporal progression, as well as in the type of symptoms. Time constraints prevent me from going into further detail today. Both forms lead to individual histamine thresholds being exceeded. Emergence of the abovementioned symptoms is dependent on theconcentration of histamine in the body.

This is further determined through:
– histamine generated in the body itself
– histamine formed in the intestinal bacteria
– exogenous histamine- absorbed through food
– medication and drugs derived from histamine released from mast cells

food rich in histamine

DAO inhibitors


If a patient comes to my practice with the above-mentioned symptoms, a stepwise concept is a tried and tested method of diagnosing their disorder.

As well as a detailed case history and examination we test using BICOM® with the biotensor as a first step. Since unfortunately the BICOM® BICOMmultisoft® Pilot does not contain any histamine, we use an ampoule from our prick test set in the input cup. I believe that it is possible to obtain a very good  diagnosis with a high success rate.

A second step is to measure the histamine concentration in the patient’s stool sample, which should be below 600 ng/g. In order to do this, I work closely alongside the Institute of Microecology in Herborn.

A third step is to measure the DAO activity in the blood, which has a normal range of 9-23 U/ml.

A fourth option is evidence of histamine­ forming microorganisms in stools.

In order to correlate the methods with the symptoms and correct diagnosis I will now say something about my practice study.


As a basic measure the supply of histamine from food should be restricted until therapy is completed. The patient needs to be informed about the histamine content of various foods. Medication and alcohol which release histamine, particularly red wine  and champagne, should be avoided too.

Now treatment using bioresonance therapy (BRT) can be added, so that the patient is able to lead a normal life once this therapy has been successfully completed. Since most patients suffer intestinal dysbiosis, a microbiological treatment to supply the missing bacteria is essential. Lactic acid bacteria acidify the intestinal milieu and increase DAO activity as a result.

I attach great importance to antihomotoxic detoxification treatments using infusions.

I also include acupuncture as a complementary measure. In acute cases antihistamines, mast cell stabilisers, such as cromoglicic acid or diamine oxidase substitution preparations may be used.

I have been able to successfully treat a number of patients using this multi-modal treatment concept in my practice in the past few months. In order to monitor and also publicise the success of this method, I carried out this practice study in conjunction with the Institute of Microecology in Herborn.

Practice study

Between July and December 2011, 20 patients (17 women and 3 men) with HIT were examined and treated in my practice.

The average age was 43.88 years, where the youngest patient was 10.75 years old and the oldest 69.66 years old.

The reason for their visit covered a wide range of symptoms and primarily involved symptoms relating to the gastrointestinal tract with abdominal pain, nausea, meteorism, a feeling of fullness and diarrhoea, followed by cardiovascular symptoms and headaches. The aim of the examination was to find out whether by means of BRT the patient can be helped to improve their symptoms and to see how safe diagnostic methods are, such as determination of histamine in stool samples and of DAO in the blood.


Testing with the biotensor and BICOM®, test program 170 with the histamine ampoule in the input cup has proven to be the simplest, quickest and best diagnostic method.

When determining histamine in stool samples we only found an increase in histamine levels above 600 ng/g in nine patients (45%). In ten cases (50%) the level was normal and in the case of one female patient too little sample material was submitted.

When determining DAO concentration in the blood a normal value (9- 23 U/ml) was found in 13 patients (65%) and was lower in seven patients (35%).

Following diagnosis, which many of the patients were very happy about, as they finally had a reason for the symptoms they had been experiencing for a number of years, a histamine-free diet was prescribed and a course of BRT commenced.

In the case of 18 patients  (95%) “long-term therapy” treatment began immediately, which meant four treatments at weekly intervals using the following programs:

1st week:
– Basic program after conductance reading
– 970 toxin elimination
– 944 allergy

2nd week:
– Basic program
– 970
– 998

3rd week:
– Basic program
–  970
–  945

4th week:
– Basic program
– 970
– 998

5th week: – Post-testing

In the case of two patients, who had extreme symptoms and were also pressed for time, we carried out two acute treatments in advance within the space of a week:


1st day  :
– Basic program
–  970
–  963, 944, 998

2nd day: –  977, 977

Three weeks later “long-term therapy” was then carried out, as described above.

At the same time, 16 patients were also given an antihomotoxic treatment consisting of 8 to 10 infusions. The other four patients were given detoxification treatment using lymphomyosote tablets.

In 18 of the patients (90%) there was still a clear intestinal flora disorder, so these patients also received a microbiological treatment with Symbioflor and Symbiolact over the course of 3-4 months.

We diagnosed further allergies in all 20 participants, but lgE was only raised in five cases (25%). Therefore I administered acupuncture as an additional treatment method for eleven of the patients.

After BRT was completed and a negative re-test carried out, I questioned the patients based on the following criteria:

– Freedom from symptoms

–  Clear improvement

–  Slight improvement

– No change

–  Worsening symptoms

Three of the patients  (15%) were completely free of symptoms while 14 patients (70%) had seen a clear improvement, which means  that the outcome was very positive for  1 7 of the patients (85%).

Three (15%) of the patients recorded at least a slight improvement, although it should be stated that they had presented with a very complex range of symptoms.

In no case did patients feel worse or experience no change in their symptoms.

I believe this to be an incredible result, especially when you consider that almost all the patients had a case history dating back  a number of years without any discernible causes.

It will be most interesting to see the results in another six or twelve months.


In conclusion, it can be ascertained that histamine intolerance is a relatively common, often unrecognised disorder with a number of manifestations and symptoms.

In my opinion, the best, quickest and simplest diagnostic procedure is testing using the biotensor on the BICOM®.

In addition to the initial histamine-free diet, treatment using bioresonance therapy is the best and most promising method within a multimodal treatment plan, which also includes removing the intestinal dysbiosis and an antihomotoxic treatment.

Supplementary measures could include acupuncture and administration of antihistamines or DAO substitute preparations.

Many thanks.


Sources and literature available from the author: mail@dr-reibig.de