If You’re Suddenly Reacting To Red Wine & Cheese, This Might Be Why

Histamine is a naturally occurring chemical in the body that plays a role in immune response, digestion and even brain function. It helps regulate stomach acid, keeps us alert and is released during allergic reactions. It’s also found in a wide range of foods – particularly aged, fermented or preserved items, such as red wine, cheese, vinegar, cured meats and even seemingly healthy options like avocado and tomatoes. Under normal circumstances, histamine is broken down by an enzyme called diamine oxidase (DAO), which is produced in the gut. But when DAO levels are low or the histamine load is too high, it builds up in the body, leading to a cascade of symptoms that can appear unrelated on the surface—things like hives, migraines, anxiety, digestive issues, nasal congestion and more.

According to Dr Sejni Pattani, a GP and lifestyle medicine specialist, this can become especially problematic during perimenopause and menopause, when hormonal shifts significantly alter the body’s ability to regulate histamine. “Oestrogen has been shown to increase histamine levels,” she explains. “It also suppresses DAO activity. So, during times of hormonal flux, especially when oestrogen spikes or becomes erratic, histamine levels can increase.” Meanwhile, progesterone, which has a calming, stabilising effect on histamine, steadily declines with age. The result is a perfect storm: high histamine and low progesterone. “This can manifest in a wide range of symptoms that many women never connect to histamine," she says.

Because histamine influences so many systems – immune, digestive and neurological – symptoms are often misdiagnosed or dismissed. According to VJ Hamilton, registered nutritionist and functional medicine practitioner, the key is to look for clusters of symptoms, especially those that seem to fluctuate or worsen with hormonal changes or after eating certain foods. Common symptoms include flushing or feeling hot and itchy after eating or drinking, frequent headaches or migraines, digestive symptoms like bloating, gas or acid reflux, and emotional symptoms such as anxiety or heart palpitations. Others may notice a runny nose or sinus congestion, skin rashes or hives, persistent fatigue or restless sleep. “It’s often the combination that gives it away,” VJ says. “A woman might come to me with digestive complaints, insomnia and anxiety. When I dig into her history and symptoms, histamine often connects the dots. Especially if she’s reacting to wine, cheese or fermented foods – and if symptoms ebb and flow with her cycle.”

While hormonal changes are a large part of the story, they’re not the only factor. As women age, several physiological shifts happen that make histamine intolerance more likely. “By the time women reach their forties or fifties, many have accumulated low-grade gut issues or chronic stress that impair the body’s ability to break down histamine,” says VJ. DAO is produced in the gut lining and, if that lining becomes compromised – due to years of processed foods, alcohol, medications, chronic stress, or conditions like SIBO or IBS – histamine clearance slows dramatically. Additionally, gut permeability increases with age and microbiome diversity declines, both of which create an internal environment where histamine can build up. The liver, which also plays a role in detoxifying histamine, can become sluggish over time, especially if overburdened by toxins, alcohol or nutrient deficiencies. “This is why women suddenly find they can’t tolerate foods they used to eat all the time,” VJ explains. “It’s not just about hormones. It’s about the whole system becoming less resilient.”