Should gluten be avoided in a low histamine diet?

Currently, the problem of having so much information at our fingertips, often instead of informing us, it misinforms us, and the case of gluten is one of them. Surely you have heard of it as the bad guy in the movie. Although it is true that in certain contexts it is necessary to avoid it, there are other situations in which it has not been demonstrated that this is the case.

Gluten is a protein found in the seeds of some cereals such as wheat, barley, rye, triticale, kamut, spelled and some varieties of oats. In addition, due to its physicochemical properties, we can also find it artificially added to other food products such as meat.

In certain contexts, such as when there is a diagnosis of celiac disease, allergy or sensitivity to gluten, a gluten-free diet should be followed. In this way, a recovery of the intestinal wall that was damaged is achieved and the absorption of nutrients is normalized. As a consequence, the symptoms are diminished and the response of the immune system is more controlled.

On the other hand, in cases where there is only a deficit of Diamine Oxidase (DAO) activity and a low-histamine diet is followed, there is no evidence that gluten should be avoided. Thus, in general, all cereals and tubers would be safe.

However, we know that the deterioration of the function of the gastrointestinal mucosa due to certain diseases and/or medications can also reduce the activity of DAO. For this reason, it should be noted that it is common for people with celiac disease or those who are sensitive to non-celiac gluten to show some affectation related to the absorption of nutrients in the intestinal mucosa, such as DAO deficiency. Specifically, in the case of non-celiac gluten sensitivity, gastrointestinal and extraintestinal symptoms appear to be closely related to those found in histamine intolerance. For this reason, in these situations, a low-histamine diet and, in addition, a gluten-free diet should be followed. Different studies determine that gluten not only plays an important role in the pathophysiology of celiac disease and non-celiac gluten sensitivity, but also aggravates migraine attacks, a symptom that is very present in DAO deficiency.

In conclusion, we cannot generalize that we should avoid gluten or even think that the simple fact that a food does not contain gluten means that it is automatically healthier. It is necessary to contextualize each situation, make a correct diagnosis and personalize the dietary recommendations as a treatment at the hands of a dietitian-nutritionist.

If you want us to advise you in a personalized way, either in our Barcelona nutrition centre or by video conference from anywhere in the world, contact us and we will help you

Bibliography

Griauzdaitė K, Maselis K, Žvirblienė A, Vaitkus A, Jančiauskas D, Banaitytė-Baleišienė I, Kupčinskas L, Rastenytė D. Associations between migraine, celiac disease, non-celiac gluten sensitivity and activity of diamine oxidase. Med Hypotheses. 2020 Sep;142:109738. doi: 10.1016/j.mehy.2020.109738. Epub 2020 Apr 11. PMID: 32416409.

Schnedl WJ, Enko D. Histamine Intolerance Originates in the Gut. Nutrients. 2021 Apr 12;13(4):1262. doi: 10.3390/nu13041262. PMID: 33921522; PMCID: PMC8069563.

Schnedl WJ, Mangge H, Schenk M, Enko D. Non-responsive celiac disease may coincide with additional food intolerance/malabsorption, including histamine intolerance. Med Hypotheses. 2021 Jan;146:110404. doi: 10.1016/j.mehy.2020.110404. Epub 2020 Nov 21. PMID: 33268003.

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