What is your current activity level?
🧍‍♂️Sedentary
🚶 Moderately active
🏃 Very active
This will help us personalize your experience
Blog
>

The Connection Between SIBO & Histamine Intolerance

Published on
Updated on
The Connection Between SIBO & Histamine Intolerance

Table of Contents

Key Takeaways

  • Small intestinal bacterial overgrowth (SIBO) and histamine intolerance produce similar symptoms, including bloating, abdominal pain, skin changes, headaches, and mood changes.
  • Gut bacteria changes linked with SIBO can predispose or worsen histamine intolerance. 
  • Diagnosis and dietary treatment can reduce symptoms significantly. Working with a registered dietitian can help you take a confident step forward in managing your gut health.

Small intestinal bacterial overgrowth (SIBO) and histamine intolerance are relatively new health diagnoses.

In the past, symptoms for both conditions were lumped with other gastrointestinal (GI) conditions, food allergies, or intolerances.  

Current research indicates SIBO and histamine intolerance are treatable GI conditions.

Proper testing can help you determine the cause of your symptoms and help you on your way to recovery. 

Common symptoms for both SIBO and histamine intolerance include bloating and abdominal pain, skin changes, headaches, and mood changes.

Gut bacteria changes linked with SIBO can predispose or worsen histamine intolerance. 

Both conditions can be treated with dietary changes that significantly improve symptoms.

Learn how a registered dietitian can help you manage these conditions. 

{{splash}}

What is SIBO? 

SIBO occurs when excess bacteria found in the large intestine (colon) is present in the small intestine.

The large intestine should contain bacteria, whereas the small intestine normally maintains low amounts.   

Most research reports that about 2 to 22% of the general population is affected by SIBO.

Usually, stomach acid and the speed at which food and beverages pass through the intestines limit small intestinal bacteria growth.

Alterations in gastrointestinal tract anatomy (diverticuli, adhesions, etc.) can also predispose someone to SIBO. 

When these protective measures no longer work, along with other causes, SIBO can occur, causing unpleasant GI side effects, including nutritional deficiencies and intolerances to certain foods. 

What is Histamine Intolerance? 

Histamine intolerance is a condition that affects 3 to 6 % of the population and is often misdiagnosed as a food allergy due to similar symptoms (itching, rash, or diarrhea). 

An intolerance occurs when the body can’t break down histamine well and leads to histamine accumulation, producing skin, blood pressure, or GI side effects. 

Histamine is a compound found in certain foods and beverages, like aged or fermented foods.

Additionally, the body naturally makes histamine in response to allergies or inflammation, which can’t be broken down with histamine intolerance.  

Histamine intolerance is usually caused by genetics, intestinal bacteria changes, food and drugs, or other related diseases (allergies or intestinal and GI disease). 

The Science Behind SIBO and Histamine Intolerance

Research indicates that histamine intolerance is multi-factorial and may be linked to GI bacteria alterations (including SIBO) and a reduced ability to break down histamine and related diseases. 

The body makes an enzyme, diamine oxidase (DAO), that breaks down histamine.

Genetic alterations cause some people to produce less DAO.

Bacteria changes and GI symptoms like bloating and abdominal pain, seen with SIBO, can overlap with histamine intolerance symptoms

Additionally, abnormal changes in gut bacteria can lead to increased histamine levels.

Certain bacteria (yeasts and molds) can make histamine in the GI tract, increasing some people’s sensitivity to foods and beverages with histamine, leading to worsened symptoms. 

Some people may have both SIBO and histamine intolerance.

Various tests (DAO levels and breath testing) can help determine an effective and tailored treatment plan for both conditions.

Symptoms of SIBO and Histamine Intolerance

Symptoms vary between individuals with SIBO or histamine intolerance. 

Some people produce certain symptoms, but not all, making diagnosis and treatment difficult.

Both conditions are often categorized as food allergies or GI disorders like IBS (irritable bowel syndrome). 

{{splash}}

Digestive Issues 

For both SIBO and histamine intolerance, digestive or GI issues are common. 

With SIBO, two-thirds report bloating, abdominal distension and fullness, gas, abdominal cramps, and diarrhea.

Many people describe chronic fatigue and trouble concentrating. 

In severe cases of SIBO, diarrhea can lead to weight loss, malnutrition, and vitamin deficiencies.

With histamine intolerance, it is important to understand that the GI tract contains most of the histamine receptors, resulting in GI symptoms like stomach ache, bloating, gas, diarrhea, or constipation with accumulations of histamine. 

Skin Problems

Skin problems are commonly associated with GI conditions, including SIBO and histamine intolerance. 

Rosacea is an immune-related skin condition that exhibits facial redness, rashes, visible blood vessels, and irritation to the skin.

Research indicates a relationship between rosacea and SIBO. 

SIBO can lead to intestinal cell injury, causing system-wide inflammation, which affects body systems like the skin.

Successful antibiotic treatment for SIBO resolved rosacea in almost all patients.

Treating the root cause resolved GI and skin issues.

The skin contains some histamine receptors, which can exhibit alterations due to histamine accumulation.

These uncomfortable symptoms include itchy skin, redness, swelling, and eczema.  

Headaches and Migraines

Headaches and migraines are side effects of histamine intolerance.

Research connecting SIBO to headaches and migraines is limited, although, in theory, GI issues and pain can lead to headaches. 

Migraines were reported in almost 90% of individuals with a DAO deficiency.

The histamine content of foods and beverages like wine triggered migraines and headaches. 

When 100 patients with DAO deficiency were given oral capsules of these lacking enzymes to break down histamine, headache occurrence, duration, and severity were significantly reduced. 

Mood Changes 

Mood changes can be a symptom of SIBO and histamine intolerance, although limited research exists.

For SIBO, small studies have found higher rates of anxiety and stress in people with SIBO compared to those without.

It's thought that altered gut bacteria and unpleasant GI side effects after eating can lead to a depressed mood. 

In individuals with higher levels of histamine (including histamine intolerance), there were higher rates of depression.

Histamine is released in response to the immune system and may play a role in regulating feelings of depression.

Elevated histamine levels are thought to suppress serotonin levels, which can depress mood. 

These non-specific symptoms with a wide range of causes make it difficult to determine the root problem.

Many factors can also cause GI symptoms, skin changes, headaches, and mood changes.

Working with a specialist can help you rule out causes, keep track of symptoms, and see improvement.

Causes of SIBO and Histamine Intolerance 

As mentioned earlier, causes of SIBO can be multifactorial—motility, anatomy changes, immune system, gastric acid levels, and other health conditions predisposing someone to SIBO.

Histamine intolerance is often caused by genetics and intestinal bacteria changes like SIBO, high-histamine foods, certain medications, or other related diseases (allergies or intestinal and GI diseases).  

Some medications reduce DAO levels, allowing for increased accumulation of histamine.

About 20% of people take routine medications that lower DAO levels, including nonsteroidal anti-inflammatory drugs. 

Both conditions can coincide.

Testing can help determine if you have SIBO, histamine intolerance, or other GI conditions.

{{splash}} 

Managing and Overcoming SIBO and Histamine Intolerance 

Working with a knowledgeable healthcare provider can ensure proper testing. 

SIBO is generally diagnosed with a breath test and symptoms.

Treatment involves antibiotics to stop the bacteria overgrowth and allow for the repletion of nutrients.

About 45% of people will have recurrent SIBO and require further antibiotic treatment.

Dietary changes can reduce bacteria growth while taking antibiotics.

The low FODMAP diet followed for up to six weeks can help reduce symptoms and growth of bacteria until the antibiotic reduces any overgrowth. 

Histamine intolerance can be diagnosed with testing of DAO levels and discussion of symptoms.

More expensive testing, like intestinal biopsies, can be done to confirm a lack of DAO (the enzyme responsible for breaking down histamine). 

Following a low-histamine diet requires no medications, testing, or supplementation of DAO enzymes.

Consuming low-histamine foods can reduce histamine levels in the body. 

Usually, after four to eight weeks of a low-histamine diet, histamine intolerance symptoms significantly improve and should be considered a simple diagnosis and treatment plan. 

{{local}}

Takeaway

SIBO and histamine intolerance symptoms often overlap and can be confused with other GI, food allergy, or intolerance symptoms.

GI symptoms, skin changes, headaches, and mood changes can be symptoms of both conditions (or other health conditions). 

Seeking professional help and testing can help you determine the cause of your symptoms and help you on your way to recovery. 

Both conditions can be treated with dietary changes that significantly improve symptoms.

Working with a registered dietitian is critical for long-term management. 

How a Dietitian Can Help 

Partner with a knowledgeable, compassionate gut health RDN

Registered dietitians can help you develop an eating plan that makes sense and manages your SIBO and histamine intolerance symptoms.

They can help you know what foods to avoid and eat for the best improvement.   

Find a dietitian that accepts insurance through Nourish.

Frequently Asked Questions

Can you have SIBO and histamine intolerance?

Yes, you can have both SIBO and histamine intolerance.

Gut bacteria alterations can increase histamine levels.

The prevalence of both conditions is lower but still possible.

Can gut bacteria cause histamine intolerance?

Certain bacteria, yeasts, and molds can make histamine in the GI tract, increasing some people’s sensitivity to foods and beverages with histamine leading to worsened histamine intolerance.

How do you cure histamine intolerance in the gut?

Restoring gut bacteria can help resolve histamine intolerance along with following a low-histamine diet and DAO enzymes.

References

View all references
Nourish has strict sourcing policies and prioritizes primary sources, including medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about our medical review process and editorial guidelines.

See a Registered Dietitian with Nourish

  • Covered by insurance
  • Virtual sessions
  • Personalized care
Schedule an appointment

Frequently asked questions

No items found.

Find a virtual dietitian in {State}

Find a dietitian near you

Covered by insurance.
Question 1

Are you more thirsty than usual?

Question 1

Are you urinating more than usual?

Question 1

Is your blood sugar level consistently high?

Question 1

Do you experience extreme hunger or fatigue?

Question 1

Do you have blurry vision or numbness and tingling in your hands and feet?

Question 1

Do you experience frequent infections or slow-healing wounds?

Question 1

Do you have a family history of diabetes?

Your Result

Your results are in!

While you don’t seem to be at risk for prediabetes or type 2 diabetes based on this quiz, please contact your healthcare provider with any concerns. If you want to learn more about diet and lifestyle changes with diabetes, find a registered dietitian covered by insurance with Nourish.

Your Result

Your results are in!

You should seek guidance from your healthcare provider about the possibility of prediabetes or type 2 diabetes.

If you want to learn more about diet and lifestyle changes with diabetes, find a registered dietitian covered by insurance with Nourish.

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Charleston
SC
South Carolina
32.7884363, -79.9399309
Paterson
NJ
New Jersey
40.916611, -74.172188
Palmdale
CA
California
34.576469, -118.116096
Lancaster
CA
California
34.697472, -118.144524
Murfreesboro
TN
Tennessee
35.845619, -86.390266
Santa Rosa
CA
California
38.547134, -122.816383
Eugene
OR
Oregon
44.052151, -123.091187
Shreveport
LA
Louisiana
32.523659, -93.763504
Clarksville
TN
Tennessee
36.527279, -87.360336
Cary
NC
North Carolina
35.7882893, -78.7812081
Salem
OR
Oregon
44.944099, -123.040283
Newport News
VA
Virginia
37.087082, -76.473015
Chattanooga
TN
Tennessee
35.0457219, -85.3094883
Akron
OH
Ohio
41.0842496, -81.6777863
Providence
RI
Rhode Island
41.823990, -71.412834
Tallahassee
FL
Florida
30.438255, -84.280731
Peoria
AZ
Arizona
33.7528919, -112.4902079
Sioux Falls
SD
South Dakota
43.536388, -96.731667
Yonkers
NY
New York
40.930790, -73.898293
Fayetteville
NC
North Carolina
35.052666, -78.878357
Rochester
NY
New York
43.156578, -77.608849
McKinney
TX
Texas
33.214561, -96.614456
Moreno Valley
CA
California
33.920891, -117.261162
Fremont
CA
California
37.548271, -121.988571
Frisco
TX
Texas
33.150673, -96.823608
Spokane
WA
Washington
47.658779, -117.426048
Boise
ID
Idaho
43.6008183, -116.2421086
Port St. Lucie
FL
Florida
27.273270, -80.342148
Irving
TX
Texas
32.814018, -96.948891
Winston-Salem
NC
North Carolina
36.096260, -80.243736
St. Petersburg
FL
Florida
27.773056, -82.639999
Laredo
TX
Texas
27.507130, -99.507500
Jersey City
NJ
New Jersey
,
Buffalo
NY
New York
42.8867166, -78.8783922
St. Louis
MO
Missouri
38.627003, -90.199402
Chandler
AZ
Arizona
33.3062031, -111.841185
Durham
NC
North Carolina
35.994034, -78.898621
Lincoln
NE
Nebraska
40.806862, -96.681679
Pittsburgh
PA
Pennsylvania
40.440624, -79.995888
Greensboro
NC
North Carolina
36.072701, -79.793900
St. Paul
MN
Minnesota
44.954445, -93.091301
Newark
NJ
New Jersey
40.735657, -74.172363
Lexington
KY
Kentucky
38.040585, -84.503716
Stockton
CA
California
37.957703, -121.290779
Honolulu
HI
Hawaii
21.306944, -157.858337
Cleveland
OH
Ohio
41.499321, -81.694359
Arlington
TX
Texas
32.7355816, -97.1071186
Oakland
CA
California
37.804363, -122.271111
Long Beach
CA
California
33.770050, -118.193741
Raleigh
NC
North Carolina
35.779591, -78.638176
Omaha
NE
Nebraska
41.256538, -95.934502
Colorado Springs
CO
Colorado
38.833881, -104.821365
Fresno
CA
California
36.737797, -119.787125
Albuquerque
NM
New Mexico
35.084385, -106.650421
Memphis
TN
Tennessee
35.117500, -89.971107
Washington DC
WA DC
Washington, DC
38.889805, -77.009056
Las Vegas
NV
Nevada
36.169941, -115.139832
Seattle
WA
Washington
47.606209, -122.332069
Charlotte
NC
North Carolina
35.2272086, -80.8430827
Sacramento
CA
California
38.590576, -121.489906
Richmond
VA
Virginia
37.540726, -77.436050
Surprise
AZ
Arizona
33.629002, -112.330170
Mesa
AZ
Arizona
33.415184, -111.831474
Louisville
KY
Kentucky
38.252666, -85.758453
Des Moines
IA
Iowa
41.586834, -93.624962
Lakewood
CO
Colorado
39.704708, -105.081375
Kansas City
KS
Kansas
39.112701, -94.626801
Reno
NV
Nevada
39.529633, -119.813805
Tacoma
WA
Washington
47.258728, -122.465973
Aurora
CO
Colorado
39.7405111, -104.830994
Oxnard
CA
California
34.197659, -119.175949
Amarillo
TX
Texas
35.221996, -101.831299
Henderson
NV
Nevada
36.039524, -114.981720
Vancouver
WA
Washington
45.633331, -122.599998
Gilbert
AZ
Arizona
33.352825, -111.789024
San Bernardino
CA
California
34.115784, -117.302399
Columbus
GA
Georgia
27.800583, -97.396378
Hayward
CA
California
37.668819, -122.080795
Milwaukee
WI
Wisconsin
43.038902, -87.906471
Lubbock
TX
Texas
33.576698, -101.855072
Norfolk
VA
Virginia
36.850769, -76.285873
Tulsa
OK
Oklahoma
36.153980, -95.992775
Garland
TX
Texas
32.914341, -96.636559
Fort Lauderdale
FL
Florida
26.124161, -80.143593
Tucson
AZ
Arizona
32.248814, -110.987419
Salt Lake City
UT
Utah
40.760780, -111.891045
Corona
CA
California
33.875670, -117.568840
Madison
WI
Wisconsin
43.073051, -89.401230
Huntsville
AL
Alabama
34.7014286, -86.6597495
Kansas City
MO
Missouri
39.099728, -94.578568
Irvine
CA
California
33.684566, -117.826508
Chula Vista
CA
California
32.640072, -117.084038
Denton
TX
Texas
33.215530, -97.132446
Aurora
IL
Illinois
41.7571701, -88.3147539
Baton Rouge
LA
Louisiana
30.4494155, -91.1869659
Columbus
OH
Ohio
39.961178, -82.998795
Baltimore
MD
Maryland
39.2908816, -76.610759
Detroit
MI
Michigan
42.331429, -83.045753
Chesapeake
VA
Virginia
36.7183708, -76.2466798
Atlanta
GA
Georgia
33.7489924, -84.3902644
Birmingham
AL
Alabama
33.5206824, -86.8024326
Scottsdale
AZ
Arizona
33.501324, -111.925278
Cincinnati
OH
Ohio
39.103700, -84.513610
North Las Vegas
NV
Nevada
36.201946, -115.120216
Riverside
CA
California
33.980602, -117.375496
Plano
TX
Texas
33.019844, -96.698883
Minneapolis
MN
Minnesota
44.977753, -93.265015
Salinas
CA
California
,
Anaheim
CA
California
33.836594, -117.914299
Springfield
MO
Missouri
37.208958, -93.292297
Fort Wayne
IN
Indiana
41.077469, -85.137489
Phoenix
AZ
Arizona
33.448376, -112.074036
Bakersfield
CA
California
35.3738712, -119.0194639
Garden Grove
CA
California
33.774269, -117.937996
Anchorage
AK
Alaska
61.2163129, -149.894852
Indianapolis
IN
Indiana
39.768402, -86.158066
Nashville
TN
Tennessee
36.162663, -86.781601
Tempe
AZ
Arizona
33.425522, -111.941254
Mobile
AL
Alabama
30.695366, -88.039894
New Orleans
LA
Louisiana
29.951065, -90.071533
Knoxville
TN
Tennessee
35.960636, -83.920738
Grand Rapids
MI
Michigan
42.963360, -85.668083
Fontana
CA
California
34.102890, -117.435760
Elk Grove
CA
California
38.418129, -121.393257
Cape Coral
FL
Florida
26.5625742, -81.9438802
Grand Prairie
TX
Texas
32.745499, -97.003532
Fort Collins
CO
Colorado
40.588970, -105.082458
Killeen
TX
Texas
31.117119, -97.727798
Modesto
CA
California
37.639095, -120.996880
Oklahoma City
OK
Oklahoma
35.468491, -97.521263
Santa Ana
CA
California
33.745571, -117.867836
Ontario
CA
California
34.063343, -117.650887
Brownsville
TX
Texas
25.9015688, -97.4984005
Montgomery
AL
Alabama
32.379223, -86.307739
Hialeah
FL
Florida
25.857595, -80.278107
Springfield
MA
Massachusetts
42.102051, -72.585762
Toledo
OH
Ohio
41.652805, -83.537865
Pembroke Pines
FL
Florida
26.007765, -80.296257
Overland Park
KS
Kansas
38.974819, -94.683601
Little Rock
AR
Arkansas
34.746483, -92.289597
Glendale
CA
California
34.142509, -118.255074
Roseville
CA
California
38.752125, -121.288010
Wichita
KS
Kansas
37.687176, -97.330055
Huntington Beach
CA
California
33.659485, -117.998802
Augusta
GA
Georgia
33.4709714, -81.9748429
Worcester
MA
Massachusetts
42.271389, -71.798889
Virginia Beach
VA
Virginia
36.852924, -75.977982
Oceanside
CA
California
33.1958696, -117.3794834
Santa Clarita
CA
California
34.456043, -118.571335
Philadelphia
PA
Pennsylvania
39.952583, -75.165222
Corpus Christi
TX
Texas
27.800583, -97.396378
Portland
OR
Oregon
45.512230, -122.658722
Denver
CO
Colorado
39.739235, -104.990250
Boston
MA
Massachusetts
42.3554334, -71.060511
Atlanta
GA
Georgia
33.7489924, -84.3902644
Chicago
IL
Illinois
41.8755616, -87.6244212
Orlando
FL
Florida
28.538336, -81.379234
Jacksonville
FL
Florida
30.332184, -81.655647
Tampa
FL
Florida
27.950575, -82.457176
Long Island
NY
New York
40.757801, -73.940033
Queens
NY
New York
40.728226, -73.794853
Bronx
NY
New York
40.8466508, -73.8785937
Staten Island
NY
New York
40.643501, -74.076202
Brooklyn
NY
New York
40.6526006, -73.9497211
New York
NY
New York
40.712776, -74.005974
San Jose
CA
California
37.342205, -121.851990
San Francisco
CA
California
37.774929, -122.419418
San Diego
CA
California
32.834686, -117.130775
Los Angeles
CA
California
34.052235, -118.243683
El Paso
TX
Texas
31.761877, -106.485023
San Antonio
TX
Texas
29.387428, -98.496574
Dallas
TX
Texas
32.776665, -96.796989
Fort Worth
TX
Texas
32.755489, -97.330765
Houston
TX
Texas
29.760427, -95.369804
Austin
TX
Texas
30.2711286, -97.7436995

Book an appointment with a {category} dietitian

Covered by insurance.

Book an appointment with an online dietitian

Covered by insurance.

Find a

dietitian covered by insurance

No items found.
Weight loss medication
Mental Health
Intuitive Eating