How to Choose & Start Probiotics Safely with Histamine Intolerance

When histamine intolerance leaves your gut gurgling, in pain, and with unpredictable bathroom habits, it’s only natural to think taking a probiotic can help. After all, everything you read and hear about probiotics is positive in the way they heal the gut.

They have been shown to have significant benefits when it comes to all sorts of gut disorders. From restoring microbial balance - getting rid of the ‘bad’ and replacing them with ‘good’ - to improving digestion overall. So it’s logical for you to think they’re the holy grail of digestive health for all who take them, and that they’d be the answer to your histamine intolerance digestive symptoms. 

So, why are you not feeling better? Why are your symptoms… getting worse?

Well, when it comes to probiotics and histamine intolerance, there’s a catch. In this article, I’ll explain what that is, what to look out for when it comes to choosing the right probiotic, and how to use them to your benefit when you have histamine intolerance. 

Let’s start with answering the main question: what is it about probiotics that are contributing to your unpleasant histamine intolerance symptoms?

Probiotics and Histamine Intolerance: Not All Strains Are Equal 

The environment we live in is made up of trillions upon trillions of bacteria, yeasts and viruses, each with their own role in health and disease. 

A probiotic is a general term given to a strain of bacteria (or yeast) that has been identified to have a beneficial effect on the human system, most commonly the gut. 

How probiotics can help is multifactorial. When taken in higher amounts, they’re said to be able to crowd out less beneficial bacteria and, in doing so, are able to contribute to more diversity and harmony within the digestive environment. Additionally, they help to break down food substances and, through their own digestive functions, release beneficial nutrients back into your system you’re then able to absorb and use (1). They also have a role in training your immune system, helping it to identify when it’s time to jump into fight-mode to protect you from something harmful or whether it’s time to chill and allow another microorganism to continue to grow. 

But it’s the way some of these probiotics survive in the harsh gut environment that is the reason they can be intolerable to those living with histamine intolerance. You see, some of these little critters need some help in getting through the acidic stomach and they release histamine as a mechanism to do so. The histamine neutralizes the acid, allowing the bacteria to travel to the colon without being broken down (2). In doing so, it contributes to your overall histamine load. And if yours is already high, you’d better watch out, because any increase - no matter how tiny - can tip your histamine scales and leave you with a dramatic increase in histamine intolerance symptoms. 

So, if you’re experiencing more gut ache, bloating and gas, itching skin, anxiety and brain fog, or even more congestion and heart palpitations after starting a probiotic, it’s likely due to the histamine they’re releasing (3). 

There are a number of histamine-liberating strains to watch out for, but the most common ones you’ll see in many probiotics are certain subtypes of lactobacillus. While truly beneficial for the gut overall, and found in many commercial products aimed at targeting gut health, only a select few of these strains don’t produce histamine! 

Fortunately, there are many other probiotic strains you’re able to use to improve your gut health that are safe for those with histamine intolerance and can actually be beneficial for histamine intolerance root causes and symptoms. 

 

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Select the Right Probiotic When You Have Histamine Intolerance

Living with histamine intolerance doesn't mean you can’t use probiotics at all. There are a number of known bacteria and yeasts that enhance gut health without elevating your histamine levels (4). Some even boost the effects of the all-important histamine degrading enzyme called diamine oxidase (DAO). In the histamine intolerance community, they are called histamine degraders. 

There are also a handful of species found to be histamine neutral, which means they have no effect on your body’s histamine levels and are safe to use when you have histamine intolerance to focus on improving gut health without exacerbating symptoms of histamine intolerance. 

That’s why a combination of histamine-degrading and histamine neutral lactobacillus and bifidobacteria subtypes are my preferred options, and are the only ones I suggest you use while you’re searching for and addressing the cause of your histamine intolerance. 

There’s one more thing to look out for when you’re using a probiotic and you’re histamine intolerant, and that’s the other ingredients added to the product. Even if you’re choosing the right strains, you may still react because of these ingredients. While they may not necessarily be bad for you, they’re simply not right for you right now. 

There are three additional ingredients to look out for:

Prebiotics. Prebiotics provide fuel for and feed probiotics. In the general population, this can be extremely helpful as it supports the growth and diversity of the probiotics once they reach their desired environment in your colon. The trouble with prebiotics when you’re histamine intolerant is they will also feed the histamine producing bacteria you already have living in your gut, essentially feeding their ability to make histamine. More histamine means more symptoms! Additionally, in those with gut symptoms, prebiotics can cause more gas, bloating and digestive discomfort. So my advice is to stay away from any prebiotic such as fructooligosaccharides (FOS), galactooligosaccharides (GOS), and inulin for the time being.

Fermentation. Some probiotics are consumed through foods that undergo fermentation, allowing them to have a more natural and diverse variety. Of course, diversity is what you’re aiming for, but it’s hard to control. As you know, anything fermented typically contains more histamine-liberating species, which will contribute to your histamine levels and cause more symptoms. So, it’s good to stay away from any product that focuses on this method heavily - common examples include kombucha or most commercial yogurts, which are typically not recommended individuals with histamine intolerance.

Binders and fillers. They’re used in the manufacturing process to bulk up the content of the capsule to ensure there’s enough product to take as a capsule, or used to prevent the product from clumping together. They’re usually harmless in small doses… for the general population, that is. When you’re living with histamine intolerance, you can be extremely sensitive to them and even though you’re taking a low histamine probiotic, you can have reactions because of these additional ingredients. That’s why I recommend only using low histamine probiotics without them. 

As a side note, be sure to use a product that’s free from common allergens like gluten and soy. Any additional trigger or sensitivity can make even the best probiotic work against you. You’ll always want the cleanest, basic histamine-lowering probiotic you can get your hands on. 

Now you know what to look for, it’s important to talk about how to introduce a new probiotic into your routine. 

How To Safely Start Taking Low Histamine Probiotics

Ok, so you’ve gotten your hands on the best low histamine probiotic. Now what? Well, that’s half the battle won! 

But before you start popping them into your routine, it’s important to recognize even the safest addition can cause a histamine intolerance probiotic reaction if it’s introduced too quickly. Dive in and you’ll likely end up doing more harm than good. And with the gut symptoms you’ve already been experiencing as a result of histamine intolerance, it’s clear your gut is inflamed and unhappy (5), and it might need some time to adjust. Instead of an all-or-nothing approach, it’s more about being gentle and nurturing the environment to adapt in a way that’s going to be truly beneficial over the long run. 

That’s why my very first step is always to begin slow and start low. 

For my carefully created, scientifically formulated probiotic for histamine intolerance, I recommend 2 capsules per day, divided into one morning and one evening dose. If you're particularly sensitive, you can even start with one per day and work your way up - however, I urge you not to make the mistake of overloading yourself with higher dosages (of any supplement) in an attempt to fix things "quicker"

Starting at or below the recommended dosage - for all supplements addressing ongoing conditions - helps you to quickly assess how you feel and adjust to the new addition without throwing your system into a flat out flare. 

It’s important to take note of changes to your mood and energy alongside digestive and other histamine intolerance symptoms, especially in the first week or two. Often, bloating and gas may increase initially, but it’s important to note this is not necessarily a sign the probiotic is harming you. Gas and bloating (if it occurs) should subside within a few days as your gut bacteria rebalance. These symptoms should not be extreme, but are nevertheless often noticed during the early stages of change.

Next, I always suggest simplifying your routine when trying something new. Stick to a low histamine diet, and avoid any major life changes or stressors as much as you can when introducing the low histamine probiotic. It really makes it so much easier to identify whether it may be helping or causing a problem. 

Lastly, it’s always better to be consistent. A steady intake of smaller doses, building to the suggested daily amount over time will provide you with better results than rushing to the end goal. Over time, it will allow your gut and body to adjust, leaving you with long term results. 

If you do experience a flare for whatever reason, as these can happen in life and may overlap with a new supplement, but not necessarily be caused by that new supplement - in which case, here’s your game plan:

1. Stop taking the low histamine probiotic for 2 weeks. Eat simple very low histamine foods and avoid other triggers like stress and low or high blood sugar episodes. Rest and allow your body to recover.
   
   
2. Track your symptoms every day. Take note of new or changing symptoms as well as other triggers that may have caused a flare.
   
   
3. Continue to take nutrients you’ve found helpful to reduce your symptoms and allow your body to recover such as DAO, magnesium, and B vitamins as tolerated.
   
   
4. Expand your diet once you feel better. Eat more of the foods you have come to tolerate and keep tracking your symptoms.
   
   
5. Try the histamine safe probiotic again once you feel well starting with a slow dose.

 

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Probiotics and Histamine Intolerance: The Bottom Line 

Living with histamine intolerance doesn’t mean you have to grin and bear the discomfort while you’re getting to the bottom of your root cause. There are ways to safely and effectively support your gut to help decrease those bothersome symptoms. The key is to find the right products that work for you, the individual. 

With the correct strains and none of the funky ingredients, a low histamine probiotic can work wonders and allow you to continue working towards a histamine flare free journey. 

References: 

1. E. Barrett, R.P. Ross, P.W. O'Toole, G.F. Fitzgerald, C. Stanton, γ‐Aminobutyric acid production by culturable bacteria from the human intestine, Journal of Applied Microbiology, Volume 113, Issue 2, 1 August 2012, Pages 411–417
2. Keszthelyi, Daniel. Histamine-Producing Bacteria: The Missing Link in Irritable Bowel Syndrome? Gastroenterology, 2023. Volume 164, Issue 1, 160 - 161
3. Krell T, Gavira JA, Velando F, Fernández M, Roca A, Monteagudo-Cascales E, Matilla MA. Histamine: A Bacterial Signal Molecule. Int J Mol Sci. 2021 Jun 12;22(12):6312. 
4. Hrubisko M, Danis R, Huorka M, Wawruch M. Histamine Intolerance-The More We Know the Less We Know. A Review. Nutrients. 2021 Jun 29;13(7):2228.
5. Comas-Basté, O., Latorre-Moratalla, M. L., Sánchez-Pérez, S., Veciana-Nogués, M. T., & Vidal-Carou, M. C. (2020). Histamine intolerance: The current state of the art. Biomolecules, 10(8), 1181.
6. Kovacova-Hanuskova E, Buday T, Gavliakova S, Plevkova J. Histamine, histamine intoxication and intolerance. Allergol Immunopathol (Madr). 2015 Sep-Oct;43(5):498-506.