Do you suffer from allergies? The culprit is histamine which your body produces in response to an allergen that enters your body. However, histamine is not inherently bad. In fact, it’s your body’s way of letting you know you’re allergic to something in your environment or something you ate.

Allergic rhinitis, atopic dermatitis, asthma, and food allergy affect approximately 20 per cent of the global population. Allergic rhinitis is an allergic reaction that causes sneezing, congestion, itchy nose, and sore throat. It is estimated that allergic rhinitis occurs in 500 million people around the world annually. The total direct medical cost of allergic rhinitis is $3.4 billion, with 46.6pc attributable to prescription medication.

Atopic dermatitis is a chronic, non-contagious inflammatory skin condition that causes itchy, red, and swollen skin. About 223 million people suffered from ectopic dermatitis in 2022. Food allergies affect approximately 10pc of the global population.

A study in India reported that of 1,000 patients (ages 18 and above), during a routine consultation, 80pc of them had a diagnosis of asthma and/or allergic rhinitis.

Around 500m people around the world annually are affected by allergic rhinitis

The direct costs for patients with allergic rhinitis as a primary diagnosis are around $215 per patient per year, with medication taking up the biggest chunk. Of those suffering from allergic rhinitis, 37pc went to work, despite the runny nose and eyes, and only 7pc took a day off from work.

Although the annual cost to manage a patient with allergic rhinitis is relatively low compared to, for instance, asthma, its high prevalence makes allergic rhinitis a costly disease to treat on a population basis.

These diseases have a serious impact on quality of life, in addition to direct and indirect costs. Regarding indirect costs, work productivity is mostly affected in the form of presenteeism. For example, if at office, your eyes are watering, and you can’t stop reaching for the tissues, you are not likely to do much more than push papers around and wish for the day to end.

It is important that one explores the means of preventing these diseases. Common allergens include pet dander consists of microscopic flecks of skin shed by animals and birds with fur or feathers that can remain suspended in the air and stick to furniture, bedding, fabrics, and many other household items. Pollen, consisting of fine, powdery, yellowish grains in flowers, is another example of a common allergen.

The indirect cost of the allergy is presenteeism where people show up for work but remain mentally checked out and unproductive

Mould or mildew is a fungal growth that forms and spreads on various kinds of damp or decaying organic matter. It is found both indoors and outdoors in all climates and can cause an allergic reaction. Similarly, mould spores spread by producing tiny reproductive cells called spores. They usually cannot be seen without magnification and are naturally present in indoor and outdoor air.

Dust and dust mites are microscopic bugs that live in household dust. They work their way into soft places like pillows, blankets, mattresses, and stuffed animals. Many people with asthma are allergic to dust but it’s the droppings produced by the mites, along with the body fragments of dead dust mites, that really cause allergic reactions. When breathed in, these can lead a person to develop allergies or asthma symptoms.

Certain foods such as milk, eggs, peanuts, other nuts, sesame, fish, shellfish, wheat and soy can also cause reactions.

Common sense measures to prevent allergies include changing pillow covers and washing bed sheets frequently, wiping down furniture instead of dusting, and using a vacuum cleaner instead of sweeping to prevent dust particles from floating in the air. Keep windows closed during peak pollen season and ensure the AC filters are cleaned regularly.

An immediate histamine response to something you ate or something in the air, such as pollen or dust, includes itchy, puffy, red, or watery eyes, runny or swollen nasal passages, sneezing or coughing, swelling or rashes, nausea, and /or vomiting, headaches or migraines, fatigue and irregular menstrual cycle.

Histamine becomes a problem when it’s constantly elevated and the body cannot metabolise or break down the excess histamine. Some foods also contain histamine.

Most people can tolerate foods high in histamine, but a very small percentage may have histamine intolerance. For these people, histamine builds up in the body and is not broken down sufficiently, therefore levels can rise and initiate symptoms.

The body naturally produces histamine along with the enzyme diamine oxidase (DAO), which is responsible for breaking down the histamine consumed from foods. If one develops a DAO deficiency and is unable to break down histamine, one could develop an intolerance to histamine.

DAO enzyme levels may be affected because of medications that block DAO functions or prevent production, for example, non-steroid anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin, and Voltaren. Gastrointestinal disorders and bacterial overgrowth are other factors influencing DAO levels.

Bacteria grow when food is not digested properly, causing histamine overproduction. Normal levels of DAO enzymes cannot break down the increased histamine levels in your body, causing a reaction.

If you suspect that you have histamine intolerance, talk to a nutritionist to help formulate a low-histamine diet that eliminates high-histamine foods and calms your body’s inflammation.

The author taught nutrition at Aga Khan University for 25 years

Published in Dawn, The Business and Finance Weekly, June 5th, 2023