There are a variety of ways in which people can experience adverse reactions to medications, whether pre- scribed or ‘over-the-counter’....
Vasoactive amines (also known as Biogenic Amines) are chemicals which occur naturally in certain foods and include histamine, tyramine and phenylethylamine.
High levels of vasoactive amines in foods can make anyone unwell but most people tolerate amounts found in a normal diet. However some people experience symptoms even to normal levels which may be due to a reduced ability to break them down in their digestive system. This is thought to be due to a lack of an enzyme called diamine oxidase. When they eat too many vasoactive amine containing foods they may suffer ‘allergy-like’ symptoms such as headaches, rashes, flushing, itching, swelling, runny or blocked nose, irregular heartbeat, diarrhoea, nausea, vomiting or abdominal pain. Symptoms may occur 30 minutes or longer after eating and level of tolerance will vary from person to person.
There are no reliable tests to diagnose Vasoactive Amine sensitivity. True food allergies should be ruled out by an experienced clinician before experimenting with the diet.
Once this has been done, the best way to find out if these are causing symptoms is to try avoiding them for 2-4 weeks. Symptoms should be monitored by keeping a food and symptom diary and reintroducing foods gradually to see how often and how much is tolerated. It is best to do this with the support of an experienced Dietitian, particularly if there are other foods are being avoided to ensure the diet remains well balanced. Foods and drinks that are particularly high in vasoactive amines include:
- Champagne ,wine, beer, cider
- Coffee, cocoa, chocolate
- Fermented soya products including miso and tempeh
- Blue cheeses, Parmesan cheese, Camembert, Emmental, old Gouda, Cheddar and other hard cheeses, fresh and hard sheep and goat cheeses
- Cured meat especially pork products e.g. sausages and other processed meats (ham, salami, pepperoni, bacon)
- Fresh or canned tuna, sardines, mackerel, salmon, herring, processed fish products e.g fish pastes, smoked or dried pickled fish
- Tomatoes, pickled cabbage (sauerkraut), broad beans, aubergine, spinach
- Peanuts, tree nuts
- Oranges, tangerines, bananas, pineapple, grapes, strawberries
Taking an antihistamine may help to relieve any symptoms so it is a good idea to carry them. Also ensure that any asthma is well controlled.