EFTA02324858.pdf

From: Karyna Shuliak Sent: Saturday, July 1 To: Jeffrey Subject: First Steps I Histamine Intolerance http://www.histamineintolerance.org.uk/about/first-steps/ First Steps Things to =iscuss with your doctor & what to consider before you start a =ow-histamine diet Making sure you really do have HIT Under normal circumstances your GP should be able to make a =iagnosis, or send you to the right medical department that could =nvestigate further. That would be for example a gastroenterologist if =ou have stomach or bowel problems, a dermatologist if you have skin =roblems, an allergologist or an immunologist, because they need to make =ure that you don't have any other illness. As =he information becomes more available there are more and more people =ho are able to get a diagnosis from doctors who have been able to read =p on the subject. Only in recent years has this been possible. Some =till have to really struggle to get to this point, but it is worth the =truggle. What is =istamine Intolerance in short? Histamine =ntolerance is an intolerance of histamine ingested with food. It is =aused by a deficiency of the histamine-degrading enzyme diamine oxidase =DAO) or an imbalance between histamine and DAO. As far as experts are =oncerned it is not normally caused by genetic factors but is an =cquired disease, often identified as a secondary condition to =nother. Differential =iagnosis Differential diagnosis, the =xclusion of possible other causes such as genuine food allergy, cross =eactions, non- allergic reactions such as fructose malabsorption, lactose intolerance sorbitol =alabsorption, or Coeliac Disease <https://www.coeliac.org.uk/home/> and the exclusion of any other illnesses =nd other imminently life-threatening disease such as cancer for =xample are of utmost importance. Some people may even have a rare =isease such as mastocytosis or mast cell activation syndrome (MCAS). HIT can be a secondary feature of all of these, but it is not = given that it will be. There are enough complaints =hat look like HIT but are not and vice-versa. That is why you put =ourself at risk if you self-diagnose. EFTA_R1_01241445 EFTA02324858  Getting =ested for HIT — Diamine oxidase activity and =istamine levels A test for diamine =xidase activity can bring you closer to piecing the puzzle together. If =he differential diagnosis has not solved the problem then it makes =ense to look into HIT. The diagnosis is established by =edical history taking and the determination of histamine and diamine =xidase before and after a 14-day histamine-free(sic) diet.' Details of the interpretation of results of these tests and =heir results can be found in the book Histamine Intolerance — =istamine and Seasickness by Reinhart larisch et al. (Spinger =ublishing, 2015). In the UK your GP can refer you to a =ab, where they can measure the DAO activity in your blood serum and =our histamine levels. Low DAO activity and high histamine levels are an =ndicator of HIT. Results are likely to be inaccurate if you are on a =ow-histamine diet when being tested. A diagnosis of =istamine intolerance is considered positive if two or more typical symptoms are present and improvement results from =ollowing a low-histamine diet and/or taking antihistamines.2 Keeping a food diary is essential so that you can track your =eactions to certain foods. This is also very helpful if you start an elimination diet. This would need to be worked out with a =a title="Useful Links" =ref="http://www.histamineintolerance.org.uk/index.php/useful-links/" =lass="">registered dietician. You will need to find out what your =hreshold is in what is called a re-introduction phase. Supplements Some scientific =esearchers recommend that HIT patients should take supplements of =strong class="">Vitamin B6 and a higher dosage of Vitamin C. Talk to your doctor about this =ecommendation. Antihistamines It has also =een recommended that as a precautionary measure HIT patients who tend =o have very severe reactions, such as anaphylactic shocks, should have = small emergency pack with them at all times. This would include some =orm of antihistamine. This is not a replacement for the diet, as =ntihistamines only block histamine and don't break it down the =ay DAO does. They may help reduce the symptoms, but they are not the =ure. The type of antihistamine: your doctor will need =o tell you which type is suitable for your individual situation. DAO food =upplements There are capsules containing =he enzyme diamine oxidase on the market but they do not in any way =eplace a low-histamine diet where you need to establish your threshold. =hether a constant long-term supplementation can lead to a worsening of =he condition still needs to be discussed further. Some pharmaceuticals =nhance symptoms If you are already =aking medication for the relief of symptoms or any other health reason, =our doctor will need to work out if this medication is =ounter-productive and you need to change to another product. There are substances used in different pharmaceuticals that =ave a negative effect on the DAO. For someone with HIT that means that =ymptoms get worse, not better. Do not change =edication before you have talked to your =edic, otherwise you may harm your health. 2 EFTA_R1_01241446 EFTA02324859  Only =nce you find out what is causing the symptoms in the first place can =ou start on the road to recovery. Help us make a change If you =ould like to help us make a change, please let us know about your =xperiences — positive and/or negative — via the contact page. We are not able to give any diagnosis or =edical advice, but we are actively campaigning for more awareness, and =our information helps us flag up the problems you are facing. You can also copy and paste the link of this website on pages =n the net wher you think this information might be helpful to other =eople. Useful information about Histamine Intolerance =or your GP can be found here: 'Histamine Intolerance — Histamine and =easickness Reinhart Jarisch Publisher: Springer ISBN: 978-3-642-55446-9 (Print) 978-3-642-55447-6 =Online) 2Histamine and Histamine Intolerance <http://www.ajcn.org/content/85/5/1185.full> Laura Maintz, Natalija Novak (2007) American Journal of Clinical Nutrition85 (5) p. =185-1196 3 EFTA_R1_01241447 EFTA02324860