Dermatology can be annoyingly difficult to navigate, since each condition can have so many different presentations. My goal in this article is to introduce you to the possibility that histamine intolerance may be the root cause of many cases of atopic dermatitis. Histamine is a well-known cause of seasonal allergies and pruritic rashes; however, there is a whole other world of bodily functions that can be caused by histamine dysregulation Table 1. There are 2 main enzymes that break down histamine. The enzyme in the central nervous system is histamine N-methyltransferase HMT, and the enzyme within the digestive system is diamine oxidase DAO. This article will focus on dysfunction of the DAO enzyme. Many patients seek out naturopathic doctors because of gastrointestinal GI dysfunction, estrogen dominance, anxiety, chronic urinary tract infections, and rashes. An imbalance in histamine can cause any of these to occur, either simultaneously or intermittently. In a healthy person, a large production of histamine is normally produced within the GI system. However, impairments within the intestinal lining can cause the DAO enzyme to be produced in insufficient quantities by the enterocytes, resulting in excessive concentrations of histamine. This elevated level of histamine will promote inflammation in the GI tract, and its most obvious outcome will be diarrhea.
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