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SYMPTOMS and TESTS
Primary symptoms Group a:
hay fever, flushing, redness, wheezing, hay fever related symptoms also in winter, urticaria, asthma.
Primary symptoms group b:
IBS-related symptoms, bloating, diarrhoea, constipation, abdominal miraines, nausea, unspecified food intolerances, hypersensitivity to many foods which give different and changing symptoms, allergies to pollen and cross allergies with OAS (oral allergy symptoms).
Other primary symptoms (group c): low blood pressure, migraine, tension headaches, palpitation, anxiety, panic attacks, depression, over-emotional reactions.
Should I be worried, if I have one or two of the above list?
No, this is not a scary website. We do not want to exploit patients, but because histamine intolerance is so complex, it might be a good idea to investigate if you have e.g. 5 – 6 symptoms of the above AND all previous investigations and treatments by medical practitioners did not find a solution or did not make you feel much better.
TESTS
Different tests are available by our MSML laboratory:
- Histamine plasma level is determined with an ELISA and diaminoxidase serum activity with the help of radio extraction assays using [3H]-labeled putrescine-dihydrochloride as a substrate.
- Hydrogen Breath Test
(for details CLICK HERE)
- Intestinal permeability will evaluated by the cellobiose-mannitol sugar permeability test, as described by Strobel et al (1984). Patients will empty their bladders and then drink a solution containing 5 g cellobiose, 2 g mannitol and 20 g sucrose, diluted in 200 ml sterile water. Urine will be collected during the following 5 h.
- Lab/Research Tests related to Histaminosis, Mastocytosis and Histamine Intolerance:
DIAMINE OXIDASE
Blood is drawn after an overnight fast. Samples will be immediately centrifuged at 4 C (1000 rpm for 10 min) and plasma will be separated from blood cells. Proteins were precipitated by the addition of 10% perchloric acid. Heparin (15 000 I.U.) will be administered by an intravenous bolus. Blood (7 ml) is drawn 60 min after the injection, collected in heparinized tubes, and centrifuged. Plasma will be stored at and assayed for DAO within a week. Written informed consent has to be obtained from all patients.
DAO will be assayed in triplicate by a 14C-putrescine method The assay mixture
contains: 1.5 ml sodium phosphate buffer, 0.1 M, pH 7.2; 0.3ml sample; and 0.1 ml substrate, a mixture of putrescine dihydrochloride and 1-4 14C-putrescine dihydrochloride up to a final concentration of 5 nmol per tube with an activity
of 0.1 mCi. The samples will be incubated for 60 min at 37C. The labelled reaction product, 14C-1-pyridine, will be directly extracted in a toluene-based scintillation mixture and assayed for 14C by a scintillation counter. DAO activity is expressed as U=ml (1U.1 nmol of putrescine dihydrochloride
oxidised in 1 h at 37_C pH7.2). Based on previous studies, the normal range is considered to be 3.7 ± 7.7U=ml (d'Agostino et al, 1988).
SERUM TRYPTASE
Serum total tryptase is measured using a fluoro-enzyme immunoassay.
Tryptase concentration range: 1–30.7 μg/L). (There is a significant continual increase in tryptase with age)
Female gender and heavy ethanol use were negatively and independently associated with tryptase concentrations. Tryptase was higher in individuals that were non-atopic, overweight, or had metabolic syndrome compared to individuals that were atopic, normal weight, or did not have the metabolic syndrome.
N-METHYLHISTAMINE
For N-methylhistamine measurements, 1ml urine is purified with formic acid
after addition of an internal standard (1-methylhistamine D3) and pH
control by ion exchange. (Evaluation by t. mass spectroscopy with multiple monitoring).
Also: Renal function, weight and body size has to be related to creatinine excretion.
Value is therefore expressed as µg/mmol creatinine x m² body surface area
(BSA).
30 % increase in NMH is an acceptable value if patients eat a normal diet. A histamine low diet should not lead to any increase.
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