Longtime allergy issues continue

Dear Dr. Roach: What are your thoughts regarding histamine intolerance when eating highhistamine foods? I am a 65-year-old female who has suffered from sinus problems since my late teens. In my mid-20s, I underwent allergy testing. My results revealed that molds, many pollens and dust were my main culprits. No food reactions were noted.

I underwent six years of allergy injections and was prescribed antihistamines — Seldane, followed by Histmanal, until they were taken off the market. Overall, my high volume of mucus production was reduced, along with the number of severe sinus infections. (Environmentally, I have taken many precautions within my home: radiant floor heating, tile and wood floors, no pets, and a clean house.)

What continues is tremendous pressure in my sinus cavities. It is worse after a meal. The pressure can wear me out. (I was puzzled because I eat healthy foods, drink plenty of water, exercise daily, stay on the low end of a healthy BMI calculation and have a nice social community. My regular blood panel results were within the normal range.)

I recently came across information about histamine intolerance when eating high-histamine foods.

So many of my “healthy” foods are on the list! Does diamine oxidase (DAO) really help? Anon.

Answer: Although the term “histamine intolerance” is frequently used, there isn’t evidence that there is a deficiency in one of the enzymes that metabolize histamine, such as DAO. Treatment with this has not been proven effective in people with concerns similar to yours.

Since you received benefit from antihistamines, you should try one of the newer antihistamines such as cetirizine (Zyrtec) or fexofenadine (Allegra, which is very similar to Seldane). From my reading, using one of these along with an H2 antihistamine, such as famotidine (Pepcid), has been helpful to some.

Another approach is Cromolyn, taken as a liquid before eating.