The Role of Histamine and Mast Cells in PMS and PMDD

mast cells histamine PMDDHere’s something important about PMS or PMDD (premenstrual dysphoric disorder): At least some of the time it’s caused or worsened by histamine or mast cell activation

Histamine can cause allergy-type symptoms such as hives and nasal congestion. Or it can cause anxiety, headaches, fatigue, brain fog, insomnia, and breast tenderness, the typical symptoms of PMS.

How histamine causes premenstrual symptoms

It makes sense that histamine can cause premenstrual symptoms. After all, histamine is pro-inflammatory, and there’s growing evidence that PMS is fundamentally an inflammatory condition.

Also, histamine rises and falls with estrogen, so it’s high just before ovulation and then again during the premenstrual time. The tight link between histamine and estrogen is not all that surprising when you consider that histamine plays a key role in ovulation and female reproduction. Read The Curious Link Between Estrogen and Mast Cells and Histamine.

Finally, histamine is a neurotransmitter that can have a profoundly negative effect on mood. Drug manufacturers have long understood the link between histamine and premenstrual mood symptoms. That’s why they put antihistamines in PMS medications “to soothe tension and irritability.”

👉 Tip: Mast cell activation syndrome (MCAS) is when mast cells are stimulated to make histamine.

Is histamine playing a role in your PMDD?

If histamine is the main driver of your PMS or PMDD, then you’ll likely have one or more of the following signs and symptoms (in addition to the classic PMS symptoms):

Progesterone and the brain

The other cause of PMDD is an abnormal response to progesterone and its neurosteroid metabolite allopregnanolone.  Read Is Progesterone Good or Bad for Mood? (And How to Treat PMDD).

How to lower histamine and relieve PMS

  • Reduce mast cell-stimulating foods such as cow’s dairy and alcohol. Read What Dairy Does to Periods.
  • Reduce histamine-containing foods such as red wine, cheese, avocado, tomato, bone broth, and fermented foods (i.e. the sauerkraut and kombucha that you’ve been trying to eat more of).
  • Consider taking histamine-reducing supplements such as quercetin, magnesium, SAMe, and vitamin B6.
  • Take natural progesterone because it up-regulates the DAO enzyme that clears histamine. Progesterone capsules can also overcome the progesterone sensitivity associated with PMDD.

👉 Tip: Histamine reduction is a big part of why magnesium, vitamin B6 and natural progesterone work so well for PMS and other women’s health conditions.

What is your experience with PMS and PMDD?

Dr Lara Briden

92 thoughts on “The Role of Histamine and Mast Cells in PMS and PMDD”

  1. Hi Lara – thanks so much for your blog it is so insightful! I was wondering if there is a test you can get to check your histamine levels? Thanks 🙂

  2. HI Lara

    Im Sara from Costa Rica, im on chapter six of your book at the moment, and its been eye opening in so many ways. I’ve just ditched Qlaira after taking it for years and your book has being really helpful on not being panicking about it.

    My question is, as I was reading about histamine intolerance, I figured it really resonates, I crave a lot of sugar, tend to retain liquid, and my ear infections as a kid (and even as an adult) were so serious that I’ve lost my hearing on one side (cholesteathoma), the only thing is that I don’t find it hard to loose weight but I also have a pretty active life. Since I’ve been a vegan for almost three years now I don’t think dairy is the problem, is there any foods particularly in a plant based diet that could shoot histamine? I still get lots of allergies and bloating, and to my knowledge I don’t have gluten sensitivity. I end up taking a lot of allergy medicaments because of my ear condition, it would help if you point me in a direction in terms of things on my diet that could improve this.

    Thank you, your book is pretty awesome im very happy with, I really really wish every Practicing Gynecologist in the world should read it.

  3. Hello and thank you for your blog and for your great work. I usually take 50 mg B6 (P-5-P) in multivitamin. Is adding another 33 mg during high histamine times of my cycle safe and enough? Is additional B6 best taken at night or with meal? Also, once I’ve accidentally eaten something that produced a reaction, is there a way to bring symptoms down quickly without antihistamine? I take 750 mg of quercetin divided in 3 doses daily, 3-4 grams of vit. C. Thank you very much!

  4. Thank you, Dr. Briden.

    Serum hormone panel taken day 21, 10am.

    DUTCH test revealed issues with estrogen metabolization (4-OH and 16-OH pathways taken vs. 2-OH).

    I certainly have enough estrogen to be causing me problems.
    Problems started big time after going on the Pill for 10 yrs during my 20s. I’m 37.

    ***This is why I’m curious about the connection between the Pill and estrogen sensitivity …***

    Any thoughts or reading recommendations I could share with my docs?

    Any NDs you could recommend specifically? I’m in LA but could work with one remotely if possible.

    Would Dr. Jerilynn Prior be a good MD to consult with?

    Thanks very much for your attention and time.

  5. Hello, and many thanks.

    Yes, I have regular cycles. I bleed and spot heavily. Have had serum progesterone and estradiol taken: both low. Blood and DUTCH tests run on day 21/28. Hormone readings have diminished over the last two years (I’m 37), but I still bleed heavily.

    I suspect underactive thyroid + endo. MCAS is complex and will activate various areas of bodily vulnerability. Immunological hyperreactivity makes treatment challenging.

    Re. estrogen hypersensitivity: Could you please clarify what/whom you referenced to include the information on this topic you share in your book? I can’t seem to find as I review your references section (1st ed.).

    Again, thank you.

  6. Hello Dr. Briden,

    I recently contacted your assistant with a request. I sent two emails. Disappointingly, I never got a reply to the second, which was a polite clarification of the first. So I am reaching out to you here directly.

    I am a patient with an aggressive case of MCAS. It has stolen a third of my life. I am homebound and largely nonfunctional. My MCAS uses my menstrual cycles to progress, and estrogen is my kryptonite. My body responds violently to it all month long.

    DUTCH testing revealed my progesterone and estrogen are both very low, though progesterone surpassed estrogen, which is nearly post-menopausal. I am 37. This makes me suspect that I am severely estrogen hypersensitive, a concept I have only ever concretely come across in your book, despite having brought up my suspicions for years with conventional and alternative medicine practitioners. No one can grasp the concept of estrogen hypersensitization.

    The request I sent Lisa was to ask whether you could please refer me to any reading sources (scholarly, medical, articles, books, etc.) that specifically explore

    *estrogen hypersensitization (not “estrogen dominance”),
    *the subsequent downregulation of progesterone reception,
    *whether/how estrogen mediates reception of progesterone,
    *how the birth control pill might cause estrogen hypersensitivity (I developed MCAS while on Ortho Tri-Cyclen Lo during my 20s),
    *and if estrogen hypersensitization can elevate the risk for terminal illness.

    Every MD I’ve worked with wants to suppress menstruation indefinitely. Every naturopath becomes overwhelmed by how reactive my immune system is and backs away.

    I am my own first and best health advocate. Despite my struggle, I’m still determined not to resort to synthetic hormone treatments that may end up making my life even more miserable.

    Would you please be able to suggest any solid reading on the topics above that I could share with my medical care team? This could be a game-changer for me. I respect your time and know you must have umpteen commitments. Thank you sincerely for your help.

    • Just to clarify, do you have cycles? As in, do you ovulate? Because if so, then your estrogen is a lot higher than you think.

      I would not put too much confidence in one reading of low estrogen and progesterone on a DUTCH test. It would really depend on what day of your cycle it was taken, and even then, I would rely more on serum testing to answer this kind of question.

      As for your question about estrogen hypersensitivity, no, there’s not a lot of research. But it’s largely to do with histamine or mast cell activation.

  7. This is great! It was t until I saw a naturopath that I started to understand my body. I am so intrigued by the interrelationship of how histamine, female hormones, PMDD etc come together! I only have about 5-7 “hormone problemfree days” in the month and it is rough. I discovered I have the MTHFR gene, have high histamine levels (no systemic allergy symptoms though!)- I have had trouble with sever depression/pmdd throughout life. My dr. Recommended a few supplements including mag and P5P, and also diagnosed me with Pyroluria. I wonder what your thoughts are on Pyroluria and how it may relate to histamine, PMDD etc. I read something about high norepinephrine in the brain in people with high histamine, and notice that I have very bad reactions to any meds, like an SNRI with norepinephrine. I also happen to have Thanks for your input!

  8. Thank you for taking the time to respond to this Dr. Briden! I will research a new probiotic using this information.

  9. I don’t know of specific histamine reducing but if you have GI issues I have personal experience with VSL #3 (available behind the counter but without a prescription at many pharmacies but also on their site.) I am not as bad as many since I eliminated dairy and gluten a few years ago so I just take one capsule a night and it is very effective. They are refrigerated and over 100 billion per capsule. For stomache upset I take I and give my kid BioK, available in refrigerated area of natural food stores. Very effective but expensive. There is also Align which is made by proctor and gamble which has a strain they have patented and helped me immensely when recovering from some issues a while ago but only one strain and much in the literature talks about the effectiveness of multiple strains so that’s why I do VSL #3, the BioK only has three strains I think. I know you had several questions for Lara but I hope this helps with some reputable brands. It’s tricky to figure out what strains your body uses well when the brands can be so differing in terms of strength, real versus advertised. On another note, it is possible that intense amounts of collagen from the source (bone broth, chickens feet in soup—-yes I tried making it) which people say is also very good for the gut health can be VERY high in histamine. I learned the hard way!

  10. I wanted to thank you for all of this wonderful information! You’ve mentioned natural progresterone and also prometrium. Are these the same? Can prometrium be obtained without a prescription? If not, what other product might you recommend? Are you able to recommend a histimine reducing probiotic as well? There are a lot of products out there. I’ve been doing research for years, and am a bit overwhelmed about what is good quality and reputable. Thank you!

    • yes, Prometrium is natural progesterone. But it does need to be prescribed by a doctor.

      And that’s a very good question about a histamine-reducing probiotic. With my patients, I’ve been prescribing one with a few Bifido strains Bifidobacterium breve (M-16V), Bifidobacterium infantis (M-63), Bifidobacterium longum (BB536). But I’m open to other ideas!

  11. your reaction to red wine is a classic symptom of histamine intolerance, I would go to
    see a allegy specialist who understands MCAS, I wonder if you get a flush as well.

  12. Thank you for this awesome information. I deal with a decent amount of ins symptoms and sauerkraut and kambucha, and fermented foods really do help with that. So my question is, if you feel that lowering these foods may help with pms, what other things could you use to help with ibs (my body resists high fibre foods and whole grains, so I pretty much follow fodmaps diet with added fermented foods).

  13. Hi Dr. Briden, can you personally recommend any ND’s in the US who specialize in PMDD? I suspect my case is not histamine related and more likely GABA/Glutamate imbalance or allopregnanolone sensitivity.

    • No one comes immediately to mind, but I will definitely keep an ear out and try to remember to come back here and comment.
      I guess you’ve tried the usual magnesium and vitamin B6? Some of my patients need up to 150 mg vitamin B6 in divided doses.

      • Oh wow, perhaps I should up my dose then. I’m taking just 50mg of P5P, 300mg Mg Glycinate, 15mg Zinc pic, 2000iu Vit D.
        I’m not even completely sure I’m purely a PMDD case given I have some symptoms in my follicular phase. For example, nearly every month I experience incredibly low mood somewhere in Days 7-10 and usually a panic attack. But overall these and other symptoms are more concentrated in the luteal phase.
        Thank you so much for keeping it in mind. Of course I’d be willing to work with anyone remotely as well. I just want to feel better.

        • For what it’s worth that’s a fairly low dose of both zinc and B6, which are the two nutrients most important for mood.
          But ideally, you should find a clinician who can guide you in dosing.

  14. Hi Laura, could you comment on any differences and similarities you’ve seen between histamine intolerance and sulfur intolerance?

  15. Hello,

    I have mental health issues since I was a teenager. Bad things happened, so there is a “reason”, I have been in therapy now for four years and things get better.

    Last year in spring I visited a doctor and a nutritionist because I had ongoing stomach-ache and bloating, and found out that I had a histamine intolerence. I started to adjust my diet and suddenly my depression went waaaay better! I was really amazed. I still struggle in the week before my period, I have severe PMS, maybe PMDD. Somewhere I read there was a connection between histamine intolerance and PMS and while searching for information I found your book, which I immedialy bought and literally inhaled.

    I do have a really regular cycle with “normal” bleeding, I ovulate, and have pain I treat with painkillers, but are still “normal” period pain I guess. The PMS as I said is worse than “normal”. There might be an inflammation issue, which I don’t really know for sure but as histamine intolerance, pain and PMS can all be related to inflammation it might be.

    After reading your book my action plan is to avoid cow dairy (which is easy) and wheat/gluten (which is hard) and supplement magnesium, zinc and B6 for three month, and than see what changed. (I don’t drink alcohol anyway and I am not into sweet stuff, so sugar is not an issue).

    My questions are simple, but I didn’t find answers in your book:

    Is it more important to avoid gluten or wheat or both? It’s really hard for me to quit pasta, so if gluten was the problem I could still eat gluten free pasta, and if wheat (but not gluten) was the problem I could still eat spelt pasta. (I don’t have a known issue with gluten/wheat I just thought it might be worth a try because of the inflammation/histamine thing).

    I am also really interested in the SAM-e supplement although I guess, it’s better to wait and see if my strategy works. You wrote that SAM-e works fast so it could be taken if needed – does it mean to take it the moment I have a breakdown or rather take it the second half of my period when the breakdowns are more likely to occur? (I have of course emergency medication from my psychiatrist, but it has side effects and SAM-e might be worth a try?)

    Thanks in advance for your answer – thanks also if you don’t answer for your great great book!

    Best regards!

    • Hi Akino,

      I don’t often see that gluten is a problem for PMDD. I usually start with reducing dairy and histamine foods and taking magnesium, zinc, and B6 (as per your plan). The therapeutic dose of vitamin B6 is between 50-150 mg.

      You could try speaking to your psychiatrist about the SAM-e and whether it’s appropriate for you. She might know about it.

      • Hi Lara,

        I am really sorry, I didn’t thank you for your answer, but it just didn’t show until now (might be my fault). So thanks for your answer! I am somewhere in the middle of my three month experiment, but until now I don’t see any changes. The B6 troubles me a bit, I have pills which contain 40mg, but they cause me diarrhea, which is of course not good. I now split them in half (they are made to split) and with the half dosis everything is fine.

        I tried to speak with my psychiatrist, but he is rather sceptic about food supplements etc. and seems to have not heard much about sam-e.

  16. Hello there Lara! I came across your blog just like many others, looking for relief! I’ve spent the last 2-3 years trying to figure out what is wrong with me, and after months of symptom tracking, my OBGYN suspected PMDD. She prescribed a low dose of Prozac and I was really hesitant to start on an antidepressant for various reasons. Because of this, I went to a hormone specialist for a second opinion. He didn’t think it was PMDD and had me do a blood test to find out my hormone levels. He said I had low progesterone, DHEA, iron, and testosterone so he prescribed Biodentical hormones and some supplements the last 6 months. At first I noticed a fairly decent improvement, but it’s not consistent and honestly so hopelessly debilitating when I get these flares. (My Flares: Radiating pain in back of neck and shoulders, debilitating sinus headaches, extreme fatigue, crazy mood swings, feeling of a swollen brain that does not improve with pain meds, but improves with antihistamine) Not one doctor has ever mentioned anything about histamine intolerance, but everything you said fits my ailments to a T! This all started with a sudden intolerance to red wine. I used to have a glass every Sunday with my boyfriend, and out of nowhere I started getting these awful sinus headaches after only a few sips. This reaction has expanded to so many other foods, and the reaction/flare is either worse or not as bad depending on where I am in my cycle. Since you seem to understand the condition, I am just wondering if there is hope? Is hormone therapy helping or hurting? What are your thoughts on Prozac for PMDD? Does this get better once treated or is it a chronic for life? I appreciate your thoughts!

  17. Hi Lara

    You mentioned in a previous comment histamine-reducing probiotics – can I ask what strains are these?

    I have suffered from moderate period pain for years – I’ve tried cutting out cows dairy, high-strength omega-3, turmeric and magnesium. I take 30mg zinc daily and a B-complex. I also have very persistent acne which flares before my period. Other than that, my health is pretty good!

    I’m now starting to wonder if histamine intolerance could be the cause? But as you say, the root cause of histamine intolerance is an issue with digestion. What kinds of issues are these?

    Thanks for your insight! 🙂

  18. Is there a link between endometriosis and histamine intolerance?

    I am trying to repair my cycle and having trouble differentiating between endometriosis/adenomyosis, unopposed estrogen, and histamine intolerance.

    My cycle length is between 29-35 days. I’m 30 years old and haven’t taken any hormonal birth control for over 10 years. My BMI is 22. Daysy does show a clear temperature pattern for me. I have no uterine fibroids and all else appears normal. Planning to DUTCH later this month.

  19. Hi Lara

    Im so happy to read your blog and learning there actually is a real reason behind my symptoms.

    Im 46 and my symptoms started at age 28, with severe hives and feeling like Im having the flu. All allergy tests show up as negative, despite I can get pretty ill after specific foods like eggplant, tomatoes, leeks, goatcheese coffee among a few.

    Im also diagnosed with PCO and just recently also ADHD. Interestingly enough I read that a lot of people with ADHD also has “allergies”, I know several other woman whom also share the combo ADHD/PCO.

    The year my period started changing – my ADHD hit me like a train – I got reduced from superwoman to a vegetable on the couch. Previous I had pretty bad moody and foggy brain syndrom during my period, now I can add extrem fatique, migraine,nausea and feeling cold to the pool.

    I take Concerta and melatonin – and to some point they have reduced my allergy symptoms, but if the dose is too high, I get severe symptoms – it seems I have an odd metabolismrate – could this indicate problems with the DAO or MAO enzym?

    Since all this is linked to neurotransmitter imbalances, I would think there has to be 1 basic defect, causing havoc on the entire system. Do you have any suggestions on this?

    thank you.

    Camilla

  20. Hi Lara,
    I was recently tested for allergies because I am constantly stuffy and have post nasal drip. My histamine reaction in the allergy test was normal though…does that mean that I don’t have histamine intolerance? I am trying to get to the bottom of my chronic post nasal drip, which seems to have come on in my 40s. I have tried anti-histamines, reflux medicine and before I go to an ear nose & throat I was wondering if it might be hormonal. Do you have any ideas? Thanks!! Elisabeth

  21. What are your feelings on cramp bark, wild yam, black cohosh and red clover for PMS? I don’t have heavy periods but do have spaceyness and anxiety before my periods so I was hoping one of these might help. I’m a 41 year old whose cycle is generally 24-26 days long. Thank you!

  22. Hi, Lara! I wonder, could red wine consumption be the cause of cystic acne along the chin/jaw during ovulation and period? I started getting these five years ago and that is coincidentally when I started drinking red wine regularly. Never had a problem with beer. Would that make sense? I stopped drinking it a few months ago and this is the first time I have not had one of those cysts during my cycle in a few years. (Except when I was pregnant when my skin was perfect.) Just a thought, I don’t know if wine has more histamines than beer. I have noticed also that if I take a Benadryl at times it will help flare-ups.

  23. I feel so relieved reading this. I have been saying this all along. I grew up in a very dry, arid climate and maybe suffered 2 migraines. I move at the age of 30 to a wet climate and started having chronic migraines. It was debilitating. I moved back to a drier climate and the migraines ceased but seemed to come back around my period cycle. I started doing researched and found the histamine link. I am so thankful coming across this article. Bless you! I am taking the advice and upping my magnesium and b vitamins intake to help.

  24. Hello Lara! I’ve been nursing my baby for 8 months now. But after she has gone over eating more regular food she does not drink as much milk anymore. And my milk production has gone down. She now only wants milk during nighttime. I also got my period back two months ago. But I’ve noticed during this time that I’ve began getting some spots around my face. Is this normal, and how long can it take before my hormones are stable?

  25. Hi Lara, I would love your thoughts on this. I am in menopause and been off the oestrogen patch for about 6 months. I am still using progesterone cream, my last blood tests confirmed high insulin, which I have never had before, and my doc tells me it’s from the progesterone. But I still feel quite oestrogen dominant regardless of the low oestradiol. I still have inflammatory issues as well, being a persistent planter fascitis. I find aspirin helps somewhat with the feet and my mood, and wondered if there was a connection with this? But not something I would want to keep taking. The weight is piling on, and I can’t lose anything, I am doing all your recommendations with supplements and eating etc. Thankyou

  26. Hi Lara, I’m 19 and was diagnosed with PCOS age 16, when quite underweight during recovery of an eating disorder, I have very high DHEA’s but no LH / FSH issues, all other bloods are normal, recently i’ve increased my dietary fats which previously were cut out (dairy and meat) and regained a normal 30 days cycle after 2 years! my acne is dissapearing however, my hirsutism and hair loss remains the same, do you think my hormones are settling down, and do you have any general advice/ supplements for lowering DHEA’S levels? thank you x

  27. Hi Lara, how much does your period repair manual address histamine and PMS? I feel strongly histamine is the root of my problem. Its frustrating because I react to most vitamins….for example, magnesium (even transdermal) makes my sleep worse. Same with B6…its almost like I feel more tired but my brain is too “amped” up. I have been on this journey trying to figure this out for years. Even on the cleanest diet, I don’t have luck. Im just not sure why I react to B6 and magnesium this way. Have you heard of this before?

  28. Hi Lara,

    Thanks so much for this informative article. I have realized that my seasonal allergy symptoms (sneezing, watery eyes, etc.) are often much worse the morning after having a glass or two of red wine, so it is possible that histamine is contributing to my pms symptoms. I will avoid red wine and alcohol for now, and try to minimize some other low histamine foods to see if there is an improvement, but realistically, for me, following a complete low histamine diet is just too restrictive.

    I also suffer from seasonal and environmental allergies – dust, mold and ragweed. It is summer where I live, so my allergies are quite bad right now – and, really, impossible to avoid. Can these environmental allergens contribute to pms by increasing histamines? If so, do you have any suggestions for how to minimize this? Thank you!

  29. Hi Dr. Lara,
    First off, I think you’re just wonderful and thank you sincerely for being such a knowledgeable and dedicated advocate for women and women’s health.
    Secondly, I’d just like to offer a quick correction to something you’ve mentioned in this article: histamine intolerance can be considered a form of mast cell activation disorder (MCAD). Mast cell activation syndrome (MCAS) and histamine intolerance, however, are not one and the same. But both do fall under the MCAD umbrella.
    Thirdly, after more than a decade of failing health, I was recently diagnosed with MCAS. My particular variety of this disease uses my menstrual cycles (all month long, every month) to drive my inflammation levels through the roof. My gut health (and thus immunity) has been totally destroyed by this and the result has been systemic dysfunction that has rendered me homebound for years.
    I’m 37 and almost certain I have some degree of estrogen dominance, estrogen hypersensitivity, possible anovulatory cycles, and low progesterone. I spot-bleed (pretty copiously) from mid-month until menses. Menses lasts a week. Menstrual bleeding is full of clear mucous (kind of looks like bloody snot — sorry!). But I refuse to go on the Pill because I’m terrified of doing any more damage (was on Ortho Tri-Cyclen Lo through my 20s when my symptoms began). The doctor I’m working with, an MD who is very open to natural, integrative approaches to accompany the Rx treatment I’ve begun, is concerned that progesterone supplementation may worsen my condition because she says progesterone can also stimulate mast cell degranulation. She thinks that I might fare better by just stopping my cycles altogether. Would you be able to offer your thoughts on this?
    Thank you, Dr. Lara. I genuinely appreciate you and all that you do.

    • Thanks so much for that clarification–very helpful! And also for sharing your story.
      I’ve now heard from a couple of people that progesterone can also potentially stimulate mast cell degranulation, so I may need to clarify that in the post. Who is the MD you’re working with if you don’t mind me asking? I recently heard Dr Tania Dempsey speak about MCAS and period problems and she offered some valuable additional insights.

      At the end of the day, I just cannot see that suppressing menstrual cycles would be the most desirable option. It would rob you of the estrogen and progesterone you need for general health. My approach with my patients is to work to reduce mast cell activation using a variety of other strategies: 1) avoiding dairy, 2) histamine-reducing probiotics, 3) vitamin B6, 4) quercetin,]5) alkalizing minerals.

      • Thank you so much for your reply, Dr. Lara! You’ve offered some great food for thought. I’m working with a lovely young MD named Jennifer Curtin in LA. She is not only super bright but also brave enough to think outside the box in terms of diagnosis and treatment. I was passed off by a lot of doctors thinking I had psych issues before a POTS specialist confirmed my growing hunch that I have a histamine-related disorder. I always knew I’m not nuts!
        I’ve just now begun oral cromolyn sodium treatment for gut stabilization and will likely be trying supplementing with luteolin soon for systemic stabilization. I’ve been on almost 800mg daily each of Thorne’s quercetin and curcumin for almost a year, plus all sorts of other supplements including magnesium glycinate, zinc, glutamine, colostrum, rosemary extract, vitamin c, a complete mineral complex, S. boulardii, and mangosteen, all high-quality products. Interestingly, my H1 symptoms have greatly improved with this regimen. My menstrual cycles and gut, however, stubbornly persist in their misbehavior.
        Unfortunately, my MCAS has progressed to the point that I can tolerate only six foods now. I’ve been eating one meal/day for years. Dairy and gluten have been off my menu for a long time, and fruit sugar in strict moderation is the only sugar I consume (yet I still have candida issues — yikes!).
        My immune system is a wreck, as is my ANS. I’m considering methylation treatment as well as immunotherapy. But first, my menstrual cycles and hormones need to be evaluated properly. I think my doc is leaning toward micronized progesterone and DIM to see whether this area of my health can be brought into better balance. I hope so, as I’m not keen on stopping my cycles.
        I always struggled with heavy, prolonged periods in my youth, so I eventually went on the Pill. It did its job for a while, I guess, until I started spotting and getting nasty rashes and headaches before I was due to bleed every month. The rest of the story just led me to where I am now.
        Again, thank you so much for your concern, curiosity, courage, proactivity … the list could go on! You really are the bee’s knees!
        Oh, just wondering: Can HPA axis dysregulation occur while on the Pill? Can the body utilize a progestin to manufacture more cortisol?

  30. I have PCOS, PMDD and histamine issues. Where do you even start to look? Which do you fix first? I am already on a low histamine diet, on a biodentical progesterone, work out, eat clean, no soda since May 2015, and fixing my candida for a couple of months now. I’m detoxing too but I still have pcos and pmdd symptoms. I know healing takes time but it can be defeating.

  31. Great information as my wife has been in a very long journey to figure out what is causing her chronic face/head pain. I have always believed it had something to do with the fluctuations of her hormones typically before her cycle but can also occur any time during the month typically around high stress or lack of sleep. We have seen over 20 doctors including neurologist, neurosurgeon, gastroenterologist, pain specialist, accupuncture, immunologist, chiropractor, therapists and cognitive behavioral therapy. We have no answers and we are at the stage of “no hope.” Her pain lasts for three days and is completely debilitating. Any help or suggestions could save a life.

    • I’m so sorry your wife is going through this. I highly recommend reading Joe Dispenza- you are the Placebo. A wealth of wonderful and uplifting stories about people curing themselves of intractable and chronic diseases. You can check him out on YouTube, too. I am Using his meditations and having a lot of success with my chronic illness.

  32. Hi Lara, what is your take on someone with high progesterone, without any known cause. Estrogen within normal range, so definite progesterone dominance. Normal adrenal function with normal DHEA and cortisol and OH-progesterone. This person has seemingly high histamine, loads of allergies. No progesterone supplements, but been taking magnesium, B6 and quercetin, bromelain and omega 3… Could those supplements have caused the high progesterone? And why the high histamine if progesterone so high? Thanks in advance, Elaine

    • Basically, it’s not possible to have progesterone dominance. The more, the better for endogenous production. (Although it is, of course, possible to take too much progesterone.)
      Was it a blood test or a urine test? I’ve seen one high progesterone on a DUTCH test that did not make any sense from a clinical perspective.

      • Thanks for your response Lara, it is confusing me as doesn’t seem to make any sense. In most cases I try increase progesterone, however in this case she is suffering terribly with these levels and wanting to fall pregnant. There is premenstrual spotting for 4 – 10 days each month since stopping the pill 3 years ago, extreme mood swings and severe allergies and food intolerances. Day 21 serum progesterone was 103.92 nmol/l and estrogen 541.6 pmol/l. DUTCH test is only now being introduced here in South Africa. Your feedback is much appreciated x

        • There is some evidence that PMDD (severe mood swings) is associated with higher total progesterone levels. (I have the reference somewhere if you want it.) It makes sense if you think that the higher progesterone goes, the further it has to fall, so the main issue is progesterone-withdrawal and the “resilience” it takes to cope with that. My approach is to establish hormonal resilience by reducing chronic inflammation and by putting in place mag, zinc, iodine, B6. To shelter the nervous system from the big drop in progesterone. Reducing histamine could also really, really help!

          • That makes so much sense. I recalled you saying that we can’t have too much natural progesterone and yet since fixing my stress levels and short luteal phase issues, I’ve been suffering PMDD. My Dr says my progesterone is on the higher end and has recommeneed a PMDD counsellor in Sydney but I am certain it’s not emotionally related but rather hormonal.

            Is there anyway to now reduce my progesterone. I’m 44 and on no birth control or meds (but on all the vitamins you suggest).

            This may sound crazy but should I stop eating the rice and potatoes and go back to being a daily gym junkie to reduce my natural progesterone?

          • Keep your progesterone for its many benefits! The strategy is to cultivate ‘hormonal resilience,’ which is usually fairly straightforward. Are you in Sydney? Do you want to come in for a consult?

  33. Hi Lara,
    I’m unsure if my question is relevant to histamine intolerance, but I stopped taking birth control in October 2017 (a generic version of Marvelon) for a few years. Since stopping, I’ve noticed that my cycle seems shorter and I have spotting (not bright red) for a few days after my period ends. I didn’t previously experience spotting (during or prior to taking birth control). From reading your book and blog, it seems this could be a sign of anovulatory cycles? I notice the signs of fertility you discuss in your book, but I’m not sure that’s relevant here. I’m also wondering if there’s any connection with sugar intake and/or stress? Or if it’s not uncommon for cycles to still be “normalizing” this long after stopping BC. I have an appointment with my gynecologist soon, but the healthcare providers available to me are more focused on prescribing hormonal contraception than other methods of addressing menstrual-related issues.

  34. Hi Laura, I’m wondering how bad eggs are for histamine? Also, I am pretty sure histamine is the reason for my severe PMDD. This last cycle was horrific (awful depression) and I think it was mostly due to recently adding in coconut yogurt. I started eating it before my cycle quite frequently. I haven’t had a bad cycle like this in months and that’s the only thing o added in. No more yogurt for me. Question is if histamine is contributing to my severe PMDD and I am really anxious around ovulation, what days do you recommend starting progesterone cream?

  35. What if when you take antihistamine’s, they make you act hostile? I did research online and found they have that effect on a lot of people! Does that mean you have an intolerance or is the severe reaction and mood change, indicative of something else?

  36. Dear Lara,

    Would a value of 60 ng/dL 17-Hydroxyprogesterone be low for a 25 year old woman? I am not sure what part of my cycle I was in that month. If it helps to know, I also have elevated DHEAS, DHEA, Testosterone and Cortisol as well as IR. I was diagnosed with PCOS before receiving the 17-Hydroxyprogesterone test, and my doctor said my value was low or that I had a mild deficiency, but did not investigate further. I am wondering if it’s something I need to pursue. Thank you so much!

    • That’s a normal reading if you were before ovulation. Also, to assess ovulation, you want a test for progesterone (not 17-hydroxyprogesterone). 17-Hydroxyprogesterone is usually ordered only to rule out congenital adrenal hyperplasia.

  37. Thanks Lara. Your site has helped me lots. Is there a connection between Thyroid disorders and Histamine Intolerance. I have Hashimotos – and a lot of what you describe in this article rings true for me. My digestion gets much worse during/before my period. My thyroid symptoms started feeling much better when I started supplementing B6. Also, thyroid triggered by allergens like grain dust, mould dust. However, Ive cut out a lot of foods already – I don’t want to start cutting out more healthy foods if I don’t have to, especially bone broth and ACV, which I am hoping will heal the old gut. Are these conditions likely to be linked?

  38. First of all I want to thank you for writing about this. I’ve been combing through your book, The Period Repair Manual, as well, as you share so much helpful information and recommendations. I’ve struggled with migraines for about 25 years, but have been able to get rid of all of them that were dietary related by removing trigger foods. I noticed that some of my trigger foods were not on the common trigger lists, but I made a connection when I read a comment you made about bone broth being high in histamine. I looked up high histamine foods and those are exactly the ones that cause migraines for me. I also found out that hormones increase histamine and that’s the one I haven’t been able to work out. I still get migraines before,, during and after my period and sometimes at ovulation, too. I take 400 mg of magnesium daily and use a natural progesterone cream during that time, but it’s not enough. I’ve added a probiotic (for those with histamine intolerance) and melatonin. I was wondering about adding a DAO supplement. Would that help? Or would an antihistamine help? I also take B2 but want to add B6 as you suggest.

    • Hi, Jennifer, I just wanted to say that that is not very much magnesium. Raise that to boweltolerance and look into ReMag. It’s been a game changer for me. You’ll want to use a good form of magnesium like glycinate. Also be sure to add potassium supplements as raising mag will lower potassium. If your migraines are left temple/eye, that’s minerals. Back of the head and top or right temple is liver related. Using bee pollen for B 6 will be very helpful. My menstrual migraines are almost gone, down to a 2 and I can still function during them. Every month getting better 😊

      • Thank you so much for your reply! I took 400mg of magnesium bisglycinate chelate buffered for more than a year until I found out that it was the cause of my chronic diarrhea. So I am starting to take 266mg instead. I will check out the ReMag. It was very interesting about the potassium and the migraine location factors that you mentioned.
        I found antihistamines to be very effective. Benadryl alone took away about 80 percent of the pain. A prescription antihistamine, Cyproheptadine is even more effective.
        But I want something to completely take away the pain. So my OBGYN started me on 200mg natural progesterone as a preventative. I still had three days with a milder left sided headache at the onset of my period. What I am hoping to avoid is the three day disabling right sided migraine that usually follows the left sided one, by a day or two, sometimes visa versa.
        Anyway, I am also trying iron because of what Lara Briden recommends with migraine coming at the end of the period due to temporary iron deficiency from blood loss.
        What minerals do you recommend? Where have you gotten your information. I would like to read more about it. I am happy you are having success. Thank you again for sharing with me!
        I am also trying COQ10, Vit C as ascorbic acid, and Betaine HC1. It’s been a long road struggling with menstrual migraines for more than 25 years! I really want to find the cure!

  39. Thank you for sharing your knowledge!! It makes so much sense now why my hormonal issues flare in Spring and Fall… The flares coincide with high allergen season where I live.

  40. Thank you for this info! I’m 41 and I have been feeling very off-balance with my hormones since becoming a mother 5 yrs ago. I’ve assumed my difficulty has been symptoms of peri-menopause, but have never come across info on histamine intolerance! Right before and during ovulation are my worst symptoms. At about 12-14 days after my period, I suffer from 2-3am morning wake-ups, extreme fatigue, anxiety and brain fog. My symptoms occur again a week before my period, along with breast tenderness and a headache. So I’m struggling 2 weeks out of the month, with symptoms of depression. I take Magnesium Taurate and Magnesim Glycinate (450 mg total) and I take Progesterone (not Progestin) at bedtime. I am starting to pay more attention to nutrition (eating more protein in the morning, cutting down on sugar, reducing carbs and snacking on more veggies). I walk every day and am working on jogging a few times a week. I feel like I’m trying to do all the right things but my symptoms persist. Any other suggestions for me?

    • You can try removing histamine-stimulating and histamine-containing foods. And maybe the B6 and other supplements to help to reduce histamine.

  41. Hi there from Germany, i am so happy I found your blog and your book. I started delivering histamine intolerance symptoms around 38. it started with hives ( heavier in summer through sunshine) and nausea ( red wine), and digestion Problems. I started taking ceterizin daily and it got much better. Now at 41 I was diagnosed with endometriosis stage 4 and had two laparoscopies already (chocolate cyst). The docs only solution were hormones ( desogestrel). But after experiencing heavy mood swings and depression I stoped taking it after 6 month. I do not want to take hormones again and believe there must be another way. I am now going with your recommended Formular: Magnesium, Zink, Selen and B6 since 3 Month and still take ceterizin daily to control the hives. I cut out milk products and digestion problems have disappeared. Hives and nausea still appear from time to time but not as heavily as before. My periods are between 25-29 days, one month with heavy pms next month almost nothing. Very unbredictable. My period is heavy but got shorter and lasts only 2 days. I feel there must be a strong relation between histamine intolerance and endometriosis linked to auto immune system problems…

  42. No wonder I have such a hard time. Ever since coming off of a benzodiazepine that alters your gaba/glutamate system, I have struggled ten-fold with PMDD. This was especially made worse after the drop in progesterone after my pregnancy 17 months ago. What seems to help my symptoms is supplementing with P5P (b6), zinc and magnesium. I can only hope one day I will fullt resolve this imbalance because it is truly debilitating. Thanks for your suggestions, they have been truly a lifesaver!

  43. What are your thoughts on supplementing with a DAO supplement such as Xymogen’s HistDAO, as well as following a low histamine diet?

  44. I just love you, your posts and your book. Thanks to you, I am free of birth control pill for happy 2 years!!! (I was a slave of synthetic hormones for 15 years!) I am ovulating and my hair loss has totally stopped. I am also free from my acne! Everything is clear and finally understand my body! Thank you so much! The only thing I don´t totally agree with you is that I am vegan and I get enough protein, good fats and a lot of good carbs from whole fruits, vegetables, beans, grains, mushroons, nuts, seeds…, and I consider it is good, because my cycle is normal eating in a balanced and whole foods vegan way (it was crazy because os the pill). But anyway, I needed to come back and thank you =)

  45. Following the dietary and supplement recommendations in your book and blog have changed my life! My anxiety, cramping, breast tenderness, and other symptoms have been greatly reduced. I recommend your work to any woman who talks to me about what could be hormonal issues. Thank you for putting in another piece of my hormonal puzzle!

  46. For years I took Benadryl to help me sleep. A lot of my histamine intolerance symptoms started when I stopped taking Benedryl. Could something like that cause histamine intolerance?

  47. Thank you so miuch! I’m ovulating and I’ve had every symptom on your list today! I’ve not tried a low-histamine way of eating, but it seems like that’s a road I need to try. I appreciate you sharing your knowledge so much Dr. Briden!

  48. There is growin evidence that god sensitivities can be healed by healing the gut, among other things. Do you feel a histamine intolerance is something a person can overcome?

    Also, I read about two years ago that a histamine intolerance can be caused by an underlying dehydration problem, because proper hydration dilutes histamine in the body. What are you thoughts on that?

    • Histamine intolerance can definitely be overcome. The key step to long-term relief is to correct any underlying issue with digestion. And therefore support a healthy level of DAO enzyme (the enzyme that clears histamine).

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