Many women in perimenopause find themselves dealing with unexpected symptoms like itching, hives, headaches, or digestive issues. Often, these symptoms are dismissed or misattributed, but they can be linked to histamine intolerance—a growing concern for women navigating midlife hormonal changes.
What is Histamine?
Immune cells called mast cells release histamine, which plays essential roles in the body, including:
• Regulating gut motility
• Acting as a neurotransmitter
• Supporting immune function by triggering an inflammatory response
What is Histamine Intolerance?
The body typically breaks histamine down using two key enzymes:
- Diamine oxidase (DAO) – primarily in the gut
- Histamine N-methyltransferase (HNMT) – mainly in the liver and tissues
However, some people overproduce histamine or struggle to break it down, leading to histamine accumulation and uncomfortable symptoms.
Common Symptoms of Histamine Intolerance
- Skin reactions: hives, itching, flushing, eczema, oedema, rosacea
- Headaches, migraines, dizziness, chronic fatigue, anxiety
- Joint pain, oseteoarthritis
- Nasal congestion, sinus issues, sneezing, cough
- Digestive discomfort: bloating, diarrhoea, nausea
- Dizziness or heart palpitations
- PMS-like symptoms, particularly worsened by certain foods, ovulation pain
Why is it Worse During Perimenopause?
Hormonal fluctuations in perimenopause directly impact histamine metabolism:
- Estrogen increases histamine release from mast cells and reduces HNMT, meaning histamine isn’t broken down efficiently.
- High estrogen also suppresses DAO, leading to histamine accumulation, especially in the gut.
- Progesterone helps regulate mast cells, so as progesterone declines, mast cells become more active, further increasing histamine levels.
- Excess histamine stimulates estrogen production, creating a vicious cycle.
Will Histamine Intolerance Improve After Menopause?
Generally, yes—but it depends on your gut health, inflammation levels, and overall resilience. Once hormones stabilise post-menopause:
- Mast Cells: Without estrogen fluctuations, mast cell activation tends to settle. However, chronic inflammation or gut dysbiosis can keep them reactive.
- DAO Activity: With estrogen no longer suppressing DAO, enzyme function can improve—especially with gut support and nutrient repletion (B6, copper, vitamin C).
- HNMT & Liver Detoxification: If methylation pathways (B12, folate, choline) are functioning well, HNMT can efficiently clear histamine. Sulforaphane (from broccoli sprouts) is one of the best activators of Phase II liver detox, which helps with estrogen and histamine clearance.
Natural Approaches to Managing Histamine Intolerance in Perimenopause
- Reduce High-Histamine & Histamine Liberating Foods
Consider limiting:
- Fermented foods (sauerkraut, kimchi, kombucha)
- Aged cheeses & cured meats
- Alcohol (especially wine and beer)
- Leftover meats & fish
- Tomatoes, spinach, eggplant, avocado
- Support DAO Production
Boosting DAO helps clear histamine more efficiently. Nutrients that support DAO include:
- Vitamin B6 (poultry, bananas, spinach)
- Copper (cashews, sesame seeds, shellfish)
- Vitamin C (capsicum, citrus fruits, strawberries)
- Reduce Histamine Triggers
Lifestyle factors can also increase histamine:
- Chronic stress – stimulates mast cells
- Poor sleep – disrupts histamine clearance
- Gut dysbiosis – reduces DAO function
Prioritising stress management (meditation, breathwork, gentle exercise) and optimising gut health can significantly help.
- Support Estrogen Clearance & Detoxification
Since histamine intolerance is often exacerbated by estrogen dominance, supporting healthy liver detoxification is key. Strategies include:
- Eating a fibre-rich diet for estrogen elimination
- Managing blood sugar to prevent hormonal swings
- Including cruciferous vegetables & broccoli sprouts to promote estrogen and histamine metabolism
How the G.E.M.M Protocol Can Help
I use the G.E.M.M protocol which focuses on restoring the gut-immune interface, helping to regulate histamine metabolism, inflammation, and hormone detoxification naturally. One of its key components is sulforaphane, a compound in broccoli sprouts that supports Phase II liver detoxification, aiding in both histamine and estrogen clearance. The sulforaphane yielding product we use in G.E.M.M is the highest yielding broccoli sprout powder in the world.
👉 If histamine intolerance is affecting your perimenopause journey, read more about G.E.M.M here. This is something that requires a personalised approach and 1-1 support.
Final Thoughts
If you suspect histamine intolerance is playing a role in your perimenopausal symptoms, addressing gut health, nutrient status, and estrogen detoxification can lead to significant symptom relief.
If you’d like personalised support, I offer 1:1 consultations to help you get to the bottom of your midlife symptoms and address underlying drivers like histamine intolerance. Learn more about working together here
