Gut
Histamine
Histamine in the stool, from food, gut bacteria and immune cells; does not demonstrate a food allergy or histamine intolerance.
Everything about this testWhat it measures
Histamine is a substance that immune cells (mast cells) release during an allergic reaction. It is also found in food, such as aged cheese, fish, wine and fermented products, and gut bacteria can make it. The test measures how much histamine is in a stool sample. The result does not show which source the histamine comes from.
- Histamine in the gut from food, gut bacteria or immune cells; the meaning for diagnosis has not been established
High
A raised value is often caused by histamine-rich food in the days before sample collection, or by gut bacteria that make histamine. It may also fit activity of mast cells in the bowel wall, for example during an allergic reaction. There is no condition for which histamine in stool is used to make a diagnosis. A raised value does not demonstrate a food allergy or histamine intolerance.
Low
A low value is the usual result and has no further meaning. It does not rule out a food allergy or food hypersensitivity.
If your result is abnormal
With an abnormal result without symptoms, no follow-up is usually needed. With bowel symptoms, the GP can request calprotectin in the stool and blood tests, and refer you to a gastroenterologist if there are signs of a chronic inflammation of the bowel.
Reliability
What an abnormal value means has not been established: there are no agreed cut-off values and the result does not show where the histamine comes from. There is no validated test for histamine intolerance, not in stool either. For symptoms after eating, the Dutch GP guideline (NHG) on food hypersensitivity and celiac disease starts from the symptoms and, if needed, leaving out a food and then trying it again.
Limitations
- Food in the days before sample collection, such as aged cheese, fish, wine and fermented products, largely determines the result.
- Histamine can be made or broken down by bacteria in the stool after the sample has been collected.
- Measurement methods and cut-off values differ between laboratories.
How common is this
Bowel symptoms are common: according to the guideline, irritable bowel syndrome affects about 4 in 100 adults in the Netherlands. Chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis are much rarer; the guideline gives no Dutch figure for them. How often an abnormal result for these markers occurs in people without symptoms is not known.
Who is this useful for
In people without symptoms, an abnormal result says little, because the meaning has not been established and a passing infection or a painkiller can raise the value. With long-lasting diarrhea or abdominal symptoms, the GP uses calprotectin in the stool to rule out a chronic inflammation of the bowel, and a blood test if celiac disease is suspected. With blood in the stool, unintended weight loss, diarrhea at night or new bowel symptoms after age 50, this test is no substitute for a visit to the GP.
Sources
Always discuss an abnormal result with your GP. If a result is strongly abnormal, we try to reach you as soon as possible. Read your result yourself as well and contact your GP if in doubt. A test does not make a diagnosis. Read more about risks and results