rosacea blog

Top 10 Histamine Containing Foods

Thursday, July 30th, 2009 | histamine | 3 Comments

Histamine is a biogenic amine that triggers the immune response. Histamine also acts as a neurotransmitter and has some other physiological functions (such as in the gut). Histamine increases the permeability of small blood vessels so that immune cells and proteins are better able to fight an infection. Histamine is also involved in sleep regulation; too much histamine release in the brain increases wakefulness.

Histamine is also thought to make rosacea symptoms worse. Since we also ingest histamine through our diet, I thought it was helpful to look at what foods contain the highest amount of histamine. Aged and fermented foods are naturally high in histamine, so these kind of foods dominate the list. I have gathered the information below from various sources on the internet as well as from a number of scientific papers.

The amounts of histamine are given as mg per serving size (either 3.5 Oz., 4 Oz. or pint). Please note that the same food item from different sources vary tremendously in their histamine content: food items that are close to their expiration date have a higher histamine content. Therefore, the numbers given below are for illustrative purposes only.

Here are the top 10 foods high in histamine:

1. Champagne (76 mg/4 Oz.)
2. Sauerkraut (23 mg/3.5 Oz.)
3. Tofu (as high as 22 mg/3.5 Oz.)
4. Parmesan Cheese (15 mg/3.5 Oz.)
5. Beer (7 mg/pint) Beers vary in histamine content, with top fermented beers being higher in histamine.
6. Sausage (6 mg/3.5 Oz.) Fresh sausage is often lower in histamine than the cured/aged sausage.
7. Blue Cheese (5 mg/3.5 Oz.)
8. Red Wine (3.5 mg/4 Oz.)
9. Eggplant (3 mg/3.5 Oz.)
10. Tomato Ketchup (2 mg/3.5 Oz.)
11. Canned Fish (tuna, salmon, herring) (2 mg/3.5 Oz.)

“Numbers shown are approximate”

Foods that stimulate the release of histamine

Certain foods (even food that is low in histamine) can stimulate the release of histamine from mast cells (a type of immune cell). These foods include bananas, tomatoes, strawberries, pineapple, nuts, peanuts, shellfish, spinach, egg white and chocolate. Eating these foods can thus have an indirect effect on rosacea.

Some of the most tasteful food is high in histamine. High histamine levels however, can cause headaches, runny nose, sneezing, stomach aches/cramps and flushing skin.

Maintz, L. and Novak, N. (2007) Histamine and histamine intolerance. Am J Clin Nutr 85: 1185–96.

Tags: histamine

Stress and Depression Influence the Outcome of Rosacea

Monday, May 18th, 2009 | rosacea | 4 Comments

When stress takes over our lives, it can be damaging to our health. Stress not only weakens our immune system, but it also affects our skin’s barrier function. The skin’s barrier function is important for regulating the balance of water and temperature of our skin as well as blocking the entry of microorganisms.

Chronic stress activates the so-called HPA axis, which is the connection between the hypothalamus and pituitary gland in the brain and the adrenal glands on the kidneys. Activation of the HPA axis by stress leads to higher levels of the stress hormones corticotropin-releasing hormone (CRH) and cortisol, which have a profound effect on our health, skin and brain. The HPA axis is kept balanced by neurotransmitters such as serotonin, adrenaline and dopamine. However, if the HPA axis gets chronically stimulated by stress, a major imbalance in neurotransmitters can result and may lead to the development of anxiety and depression.

Research suggests that the breakdown of the skin’s barrier function (or matrix degeneration) in combination with excessive exposure to the sun, forms a central part of rosacea development. A breakdown of the collagen fibers is thought to play a major part in the degeneration of the skin’s matrix. Poor connective tissue support for blood vessels just underneath the skin can therefore result in the pooling of serum, metabolic waste and immune mediators, which over time leads to more flushing, edema, chronic erythema and telangiestacias. The involvement of a matrix breakdown in rosacea is likely, because blood vessels in rosacea are still able to respond to vasoactive substances.

An out-of-balance HPA axis (particularly prominent in depression and anxiety), results in high levels of corticotropin-releasing hormone (CRH). CRH has been shown to increase the permeability of peripheral blood vessels through the stimulation of mast cells, which in turn release immune mediators such as histamine and nitric oxide. Anti-depressant drugs are thought to “calm” an over-active HPA axis by increasing the availability of neurotransmitters such as serotonin, dopamine and adrenaline. Therefore, the use of antidepressants for a prolonged period of time may reduce the severity of rosacea symptoms. Reducing stress levels in our lives could have a significant impact on the progression and stabilization of rosacea symptoms.

Fimmel S. et al. (2008) New aspects of the pathogenesis of rosacea. Drug Discovery Today: Disease Mechanisms 5: 103-111.

More on Stress and Depression

• comment on mental health in the workplace: food for thought by … – a very well written article. unfortunately mental health isn’t openly discussed as much as it should be. maybe one day it will be.

Tags: depression rosacea, stress

Rosacea and Gluten

Thursday, April 9th, 2009 | rosacea | 2 Comments

I couldn’t find any scientific publication on the topic of gluten sensitivity and rosacea, but if you do a search online, then you’ll find plenty of information on the topic (mostly in forums and message boards).

As it turns out, many people with rosacea wonder if their rosacea symptoms are caused by a gluten sensitivity. Some have been successful in reducing their rosacea symptoms by following a gluten-free diet. As I and others have written before, there seems to be a digestive component to rosacea.

Gluten is a protein that’s abundant in certain grains, mostly wheat, barley and rye. The gluten itself is a protein made up of two protein parts, gliadin and glutenin. The gliadin part is responsible for the abnormal immune reaction that causes gluten sensitivity and celiac disease. Between 0.5 and 1% of the world’s population suffers from gluten-sensitivity. Gluten sensitivity is not the same as a gluten allergy. The gluten proteins of corn and rice lack the gliadin part and do therefore not cause any sensitivity.

The immune system’s overreaction to wheat’s gluten causes celiac disease, in which the lining of the small intestine becomes chronically inflamed. Symptoms of celiac disease include chronic diarrhea, cramps, bloating, fatigue and malabsorption of essential nutrients, which could result in secondary symptoms such as psychological and neurological problems.

The gluten sensitivity makes it difficult for the body to absorb vitamins, in particular vitamin D. This could explain the possible involvement of vitamin D in rosacea and autism that I described recently. Many children with autism have seen their symptoms improve after staring a gluten-free diet.

Whether a potential gluten sensitivity is involved in the development of rosacea symptoms, it is possible that the inflammation of the intestines contributes to an overall stronger inflammatory response in the facial skin of rosacea patients. While there are many rosacea trigger factors, pizza (loaded with gluten and histamine) is one food that probably should be limited in your diet if you have rosacea.

Tags: rosacea and gluten