Endometriosis is a painful condition affecting millions of women worldwide, characterized by tissue growth similar to the uterine lining outside the uterus. This leads to chronic inflammation, scarring, and fertility issues. While the exact causes remain unclear, research reveals a connection between histamine, estrogen dominance, and immune system dysregulation. Understanding these factors can help manage endometriosis symptoms and reproductive health, including identifying foods to avoid with endometriosis.
What Are Histamine and Mast Cells?
Histamine is a natural chemical in the body primarily known for causing allergy symptoms like itching and swelling. However, it also plays vital roles in digestion, sleep regulation, and immune responses. Histamine is stored and released by specialized immune cells called mast cells, which act as the body’s “watchdogs,” releasing histamine in response to injury, allergens, or infections. While this release helps the body respond to threats, excessive histamine can lead to chronic inflammation, particularly problematic for women with endometriosis.
In women with endometriosis, increased mast cell activity results in excess histamine in areas where endometrial-like tissue grows outside the uterus. This localized histamine release exacerbates inflammation, contributing to the chronic pain and immune issues often associated with the condition.
The Role of Histamine in Endometriosis and Reproductive Health
Histamine and mast cells play a major role in inflammatory conditions, including endometriosis. Research shows that high histamine levels are linked to endometrial inflammation, worsening symptoms like pelvic pain and discomfort. This inflammation can also make it more challenging to conceive and maintain a healthy pregnancy, as histamine impacts uterine function, embryo implantation, and early pregnancy development.
For women with endometriosis, managing histamine levels may be essential for both symptom relief and improving fertility. Histamine release in the uterus and reproductive tissues creates an environment that can impair fertility, increase pain, and contribute to other health issues. By addressing histamine production and reducing inflammation, many women with endometriosis could experience improved quality of life and reproductive outcomes.
Estrogen Dominance and Its Relationship with Histamine
Estrogen dominance is a key factor in the development and progression of endometriosis. Excess estrogen relative to progesterone fuels the growth of endometrial-like tissue and worsens symptoms, leading to heavy periods, painful cramps, and other hormonal issues that impact reproductive health. Research shows that estrogen and histamine influence each other; estrogen can increase histamine release from mast cells, while histamine can amplify estrogen’s effects.
This cycle can intensify inflammation and pain for women with endometriosis. Understanding the relationship between estrogen and histamine can empower women to balance hormones, reduce symptoms, and enhance fertility.
How Histamine and Estrogen Imbalances Affect Fertility
Both histamine and estrogen dominance can negatively impact fertility, especially in women with endometriosis. Persistent pelvic inflammation can disrupt ovulation, embryo implantation, and overall fertility. High histamine levels may reduce the uterus's receptivity to embryos, lowering pregnancy chances.
Chronic inflammation from elevated histamine and estrogen levels impacts reproductive tissues, complicating conception. Additionally, histamine affects uterine muscle contractions, leading to painful periods and cramping, which can make managing endometriosis symptoms and achieving a healthy pregnancy more challenging.
Symptoms of Histamine Intolerance:
Digestive Issues: Abdominal cramps, nausea, vomiting, IBS/IBD
Respiratory Symptoms: Nasal congestion, sneezing, difficulty breathing
Menstrual and Hormonal Symptoms: Irregular menstrual cycle, estrogen dominance issues, PMS or PMDD
Neurological and Mental Symptoms: Anxiety, dizziness, difficulty falling asleep, fatigue (mental or physical), headaches/migraines, vertigo/dizziness
Cardiovascular Symptoms: Arrhythmia, accelerated heart rate, high blood pressure
Skin Reactions: Hives, flushing, tissue swelling
The Impact of GI Infections and Digestive Health on Histamine Levels
Gastrointestinal (GI) health is crucial for regulating histamine, especially in women with endometriosis. The gut microbiome helps break down histamine through enzymes like diamine oxidase (DAO). Infections like SIBO, H. pylori, or intestinal dysbiosis can reduce DAO production, leading to excess histamine.
High histamine levels can trigger systemic inflammation and worsen endometriosis symptoms, including pain and cramping. Women with GI issues may also experience bloating, food sensitivities, and nutrient malabsorption, further worsening hormonal imbalances and estrogen dominance. Supporting gut health through probiotics, a low-histamine diet, and addressing infections is vital for managing histamine levels and enhancing reproductive health.
High Histamine Foods to avoid for Endometriosis
High Histamine Foods:
Cured and processed meats (bacon, salami, lunch meats)
Aged and fermented foods (sauerkraut, kimchi, yogurt, aged cheeses, wine, beer)
Certain fruits (avocados, tomatoes, dried fruit, most citrus)
Vegetables (spinach, eggplant)
Nuts (walnuts, cashews, peanuts) and soured foods (sour cream, sourdough)
Leftovers, especially meat
Histamine Releasing Foods:
Although these foods may not be high in histamine, they can trigger cells to release histamine.
Alcohol
Artificial preservatives and dyes
Chocolate
Cow's milk
Nuts (cashews, walnuts, peanuts)
Certain fruits- papaya, pineapple, strawberries, bananas
Shellfish
Wheat germ
DAO Blocking Foods
These foods can interfere with the balance of HMT and DAO enzymes, making it harder for DAO to break down histamine:
Alcohol
Black tea
Energy drinks
Mate tea
Green tea
Low Histamine Foods
These foods may help to reduce symptoms of histamine intolerance.
Cooked eggs
Cooking oils (olive, coconut)
Dairy substitutes (coconut milk, rice milk, hemp milk)
Fresh fruits (mango, pear, watermelon, apple, kiwi, cantaloupe, grapes)
Fresh vegetables (excluding tomatoes, spinach, and eggplant)
Fresh fish and cooked meat or poultry
Gluten-free grains (quinoa, rice)
Herbal teas and leafy herbs
Managing Histamine and Estrogen Dominance for Better Reproductive Health
To effectively manage histamine and estrogen dominance, women with endometriosis can incorporate lifestyle changes that support hormonal balance and reduce inflammation. Here are some strategies:
Dietary Adjustments: Avoid high-histamine foods (aged cheese, alcohol, processed meats) and incorporate anti-inflammatory foods (leafy greens, berries, fatty fish). Foods high in quercetin (apples, onions) may also help lower histamine release.
Liver Support: Support liver function with cruciferous vegetables (broccoli, Brussels sprouts, cauliflower) to help metabolize estrogen.
Supplements: Consider supplements like vitamin C, magnesium, and B6 to stabilize mast cells and lower histamine. DAO supplements can aid in histamine breakdown, especially around menstruation.
Reduce Exposure to Endocrine Disruptors: Limiting exposure to endocrine-disrupting chemicals (EDCs) can help balance hormones. EDCs, found in plastics, pesticides, and personal care products, mimic estrogen in the body, potentially worsening estrogen dominance and endometriosis symptoms.
Medical Interventions: For severe cases, consult a healthcare provider about hormone therapies or surgical options to reduce estrogen levels and alleviate symptoms.
Conclusion
Understanding the connection between histamine, estrogen dominance, and endometriosis provides insights into improving reproductive health. By managing histamine levels, balancing hormones, and reducing inflammation, women with endometriosis can alleviate chronic symptoms and enhance fertility. Ongoing research will further clarify how histamine and estrogen affect endometriosis, leading to more effective, targeted treatments.
Work with me:
If you’re struggling with endometriosis and looking for personalized guidance, I offer tailored consultations to address your unique needs and challenges. Together, we’ll develop a comprehensive approach that includes dietary adjustments, lifestyle changes, and symptom management strategies to support your reproductive health. Whether you’re looking to reduce histamine levels, identify foods to avoid with endometriosis, or improve your overall well-being, I provide the support and resources you need on your journey to better health. Schedule your discovery call here.
Dr. Zaremba received her bachelor's degree from Western Michigan University in Biomedical Sciences and minored in Chemistry and Psychology. She completed her doctoral training at Palmer College of Chiropractic. During her time in school, she took post-doctoral training through The Clinic on Disease and Internal Disorders (CDID) earning her a Diplomate from the American Board of Chiropractic Internists (DABCI).
References
Harada, T., et al. (2022). Increased Mast Cell Activity in Endometriosis and Its Impact on Inflammation and Reproductive Health. Frontiers in Physiology. PMID: 36016927
Garcia-Peña, L., et al. (2019). Estrogen and Histamine Interactions in Female Reproductive Health: Mast Cell and Hormone Dynamics. Frontiers in Physiology. DOI: 10.3389/fphys.2019.01543
Becker, C. M., et al. (2021). The Role of Histamine in Uterine Receptivity and Endometrial Health in Endometriosis. Reproductive Health Journal. PMID: 33921522
Martin, M., et al. (1991). Histamine Release in Endometriosis and Its Effect on Uterine Muscle Contraction. American Journal of Obstetrics and Gynecology. PMID: 1652197
F.M. Menzies, M.C. Shepherd, R.J. Nibbs, S.M. Nelson, The role of mast cells and their mediators in reproduction, pregnancy and labour, Human Reproduction Update, Volume 17, Issue 3, May-June 2011, Pages 383–396, https://doi.org/10.1093/humupd/dmq053
Mlcek J, Jurikova T, Skrovankova S, Sochor J. Quercetin and Its Anti-Allergic Immune Response. Molecules. 2016 May 12;21(5):623. doi: 10.3390/molecules21050623.
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. doi: 10.3390/nu13072228.
Smolinska S, Winiarska E, Globinska A, Jutel M. Histamine: A Mediator of Intestinal Disorders-A Review. Metabolites. 2022 Sep 23;12(10):895. doi: 10.3390/metabo12100895
Rumph JT, Stephens VR, Archibong AE, Osteen KG, Bruner-Tran KL. Environmental Endocrine Disruptors and Endometriosis. Adv Anat Embryol Cell Biol. 2020;232:57-78. doi: 10.1007/978-3-030-51856-1_4.
Lin T, Zirpoli GR, McCann SE, Moysich KB, Ambrosone CB, Tang L. Trends in Cruciferous Vegetable Consumption and Associations with Breast Cancer Risk: A Case-Control Study. Curr Dev Nutr. 2017 Jul 18;1(8):e000448. doi: 10.3945/cdn.117.000448.
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