Non-allergic food histaminosis syndrome (NAFLD) is a mechanism of food intolerance with a complex clinical picture, due to the heterogeneity of its symptoms.
Histamine is a vital molecule (necessary for life) with many extraordinary biological functions but an excess of it in tissues triggers alarms (symptoms) with loss of health.
The histamine content of food is not the cause of disease. It is only the histamine released by our cells with the ingestion of some foods that leads to chronic symptoms of disease.
Histamine diseases
Histamine diseases can be classified by their origin or by the clinical pictures they cause. Taking into account its origin, this can be:
1. Exogenous: means that histamine comes from our diet and, as it has not been conveniently deactivated in the digestive tract, it has passed into the blood, causing symptoms. Examples of this process are histamine intoxication (often due to consumption of poorly preserved food) and enteral histaminosis syndrome (occurs in individuals with little capacity to eliminate histamine even in normal concentrations).
2. Endogenous: it comes from histamine accumulated inside the individual’s cells. In this group there are different sections, depending on the mechanism that causes this release:
– If the process is mediated by a type of antibody called IgE, it is an allergic process that can be triggered by pollens, mites, fungi, food proteins or food. Its symptoms are usually very characteristic and well known by allergy specialists.
– If the process is not mediated by the IgE antibody, we are dealing with a non-allergic food histaminosis (HANA).
– Other situations of histaminosis where the release is influenced by stress, excessive exposure to the sun, etc.
Symptoms of non-allergic food histaminosis (NAFLD)
The problem in diagnosing HANA syndrome is its symptomatic character. In addition, the patient usually presents with a major symptom, which is why he/she goes to the appropriate specialist:
1. almost half of the patients diagnosed with HANA syndrome come from internal medicine, suffering from fibromyalgia or chronic fatigue.
2. To a lesser extent, they come from traumatology consultations for problems of dehydration of intervertebral discs or others.
3. Finally, some others come from digestive consultations.
4. A minority come from other consultations, such as neurology, allergy, dermatology, etc.
This may cause the specialist not to think about a differential diagnosis and not to distinguish whether there are other symptoms that make HANA syndrome suspicious. In addition, if digestive symptoms predominate, the patient often thinks that a certain food is bad for him/her and tries to diet on his/her own, eliminating, for example, lactose or gluten. Sometimes this reaction leads to modest improvements, although this does not usually resolve the problem.
Diagnosis of non-allergic food histaminosis (NAFLD)
For a physician trained in this discipline, the diagnosis of non-allergic food histaminosis is purely clinical.
For the correct etiological diagnosis of the HANA syndrome, histamine release studies in peripheral blood must be used, which consists of stimulating the patient’s cells in vitro with certain food antigens and thus assessing the type of histamine response produced.
Although during diagnosis one or several foods may be thought to have triggered the process, the HANA syndrome does not have a cause-effect relationship with the ingestion of the food as clear and immediate as an allergy, so empirical diagnosis on this basis is impossible.
Treatment of non-allergic food histaminosis (NAFLD)
The basis of treatment is a customized therapeutic diet, which will exclude foods that the patient cannot take. This usually includes milk or wheat, which is a major problem because of their ubiquity in industrial foods. A large number of foods contain, for example, milk proteins, many of which we do not suspect, such as cold cuts, sausages, types of bread, pasta, preserves, snack bags, etc.
The Andalusian Society for the Study of Food Intolerances (SAEIA) works to raise awareness among producers of the need for more natural and simple products, with fewer components and clear labeling, to facilitate and not limit the consumption of many people, and thus increase their quality of life.