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The Link Between SIBO and Histamine Intolerance




Histamine intolerance is a condition characterised by the body's inability to properly metabolize histamine, leading to a variety of symptoms.

While histamine intolerance is often associated with certain foods, an underlying condition called Small Intestinal Bacterial Overgrowth (SIBO) can also play a significant role.


Here we will explore the intricate connection between SIBO and histamine intolerance, shedding light on how SIBO can contribute to histamine-related symptoms and implications for diagnosis and management.


Understanding SIBO and Histamine Intolerance:

  • Small Intestinal Bacterial Overgrowth (SIBO): SIBO occurs when there is an abnormal overgrowth of bacteria in the small intestine, which can disrupt the normal digestive process. This overgrowth can lead to various gastrointestinal symptoms, such as bloating, gas, abdominal pain, and altered bowel movements.

  • Histamine Intolerance: Histamine intolerance arises when the body has difficulty breaking down histamine, resulting in an accumulation of histamine in the body. This excessive histamine can trigger a wide range of symptoms, including digestive issues, skin reactions, respiratory problems, headaches, and more.

The Connection Between SIBO and Histamine Intolerance:

  • Impaired Enzyme Production: In SIBO, the overgrowth of bacteria in the small intestine can interfere with the production of diamine oxidase (DAO) and histamine N-methyltransferase (HNMT), enzymes responsible for breaking down histamine. The reduced activity of these enzymes can lead to histamine intolerance symptoms.

  • Bacterial Histamine Production: Certain bacteria in the small intestine can produce histamine as a byproduct of their metabolic activity. In SIBO, the increased bacterial load can result in elevated histamine production, contributing to histamine intolerance symptoms.

  • Intestinal Permeability: SIBO can cause damage to the lining of the small intestine, leading to increased intestinal permeability, also known as leaky gut. Leaky gut can allow histamine and other toxins to enter the bloodstream, further exacerbating histamine intolerance symptoms.

Diagnosis and Management:

  • Comprehensive Testing: To determine the presence of both SIBO and histamine intolerance, comprehensive testing is essential. This may include hydrogen and methane breath testing for SIBO and measuring histamine levels or DAO enzyme activity for histamine intolerance.

  • Treating SIBO: Addressing SIBO through targeted treatment approaches, such as antimicrobial therapy, dietary modifications, and gut motility support, can help reduce the bacterial overgrowth and alleviate histamine-related symptoms.

  • Histamine-restricted Diet: Following a low-histamine diet for a period of time can be beneficial for managing histamine intolerance symptoms. This involves avoiding or minimising histamine-rich foods, such as aged cheeses, fermented foods, and certain preserved meats.

  • Gut Healing and Support: Restoring gut health and promoting intestinal barrier integrity is crucial for managing both SIBO and histamine intolerance. This can be achieved through targeted supplementation, stress management, and adopting a gut-friendly lifestyle.


The connection between SIBO and histamine intolerance highlights the importance of a comprehensive approach to diagnosis and management.

By addressing the underlying bacterial overgrowth in SIBO and reducing histamine levels, individuals can experience relief from histamine intolerance symptoms. If you suspect a connection between SIBO and histamine intolerance, it is advisable to work with a healthcare professional who can guide you through the necessary testing and create a tailored treatment plan. Remember, each person's journey is unique, and personalised care is key to finding relief and achieving optimal gut health.



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