انواع الحساسية وأعراضها

عدم تحمل الهيستامين

عدم تحمل الهيستامين

في أيامنا هذه قد نجد أشخاصا كثيرون يعانون من أعراض غامضة لا تفسير لها. وقد فشلوا في إيقافها وإيجاد حتى أي حل لها.

وقد يكون المسبب الغامض لديك في كل ذلك هو عدم تحمل الهيستامين .

إذ قد يعبر هذا عن نفسه بعدة أعراض :

من الممكن أن تعاني من إمساك شديد بشكل مفاجيء لمدة 3 أيام متتالية، يصاحبها صداع شديد جدا لاتفسير له؛ وعند البعض يرافقه طفح جلدي شديد ومزعج.

إذا كان يحدث لك كل هذا دون أي تفسير، سترتفع احتمالية إصابتك بعدم تحمل الهيستامين، مما يعني بأن جسدك يعاني من مشكلة في طرد مركبات الهيستامين من نظامك.

 

الهستامين

مادة كيميائية توجد في جميع أنسجة الجسم تقريبًا.
يتم تخزينه بشكل أساسي في الخلايا البدينة. إنه مكون طبيعي للعديد من الأطعمة وجزء مهم من جهاز المناعة والجهاز العصبي. كما أنه يلعب دورًا مهمًا في الالتهاب.

 

ماذا نقصد بعدم تحمل الهيستامين ؟

في الشخص السليم، يتم تكسير الهيستامين بواسطة إنزيمين:

DAO/ HNMT

إذ قد تحدث أعراض عدم تحمل الهيستامين عندما لا يعمل أحد هذه الإنزيمات بشكل صحيح.

يتكون DAO في الأمعاء. إذا كانت الأمعاء غير صحية، فقد لا يكون هناك ما يكفي من DAO لتحطيم الهيستامين بشكل طبيعي، فعندما يحدث التراكم، تحدث الأعراض كذلك.

 قد يفسر انخفاض مستويات DAO سبب ظهور أعراض عدم تحمل الهستامين بشكل أكثر شيوعًا لدى الأشخاص الذين يعانون من اضطرابات الجهاز الهضمي مثل مرض التهاب الأمعاء، والقولون العصبي، والاضطرابات الهضمية، و SIBO. يمكن أيضًا حظر نشاط DAO بواسطة بعض الأدوية.

على الرغم من أن الحالة ليست شائعة جدا، فنحن نتحدث عن 1% تقريبا من السكان إلا أن الاهتمام والوعي بهذا يتزايدان.

بسبب كثرة انتشار وتكرار هذه الأعراض عند أغلب السكان، مما يثبت أننا بحاجة لنشر الوعي عن هذا الموضوع، وإيجاد دراسات علمية جديدة بالأعداد المصابة .

عدم تحمل الهيستامين من الصعب جدًا تشخيصه، وربما يكون التعايش معه أسوأ (إذ لا يمكنك تناول الأفوكادو، أو الجبن، أو الشوكولاتة!.) ، ويبدو تمامًا مثل الحساسية. ولكن إذا كنت تتعامل مع هذا النوع من المشكلات التي لا يمكن تشخيصها، فإن معرفتها واتباع الحمية الصحيحة أخف وطأة عليك.

يعد عدم تحمل الهستامين أكثر شيوعًا لدى الأشخاص الذين يعانون من مشاكل الجهاز الهضمي الأساسية.
تزيد حالات مثل مرض التهاب الأمعاء، والداء البطني، والقولون العصبي، وفرط نمو البكتيريا في الأمعاء الدقيقة، من خطر عدم تحمل الهيستامين. هناك قدر ضئيل من المعلومات حول الوقوع الفعلي لعدم تحمل الهيستامين. علاقتها مع القضايا الصحية الأخرى آخذة في الظهور.

هنا، كل ما تريد معرفته عن عدم تحمل الهستامين. بدءا من الأعراض حتى الممنوعات.

 

أعراض عدم تحمل الهيستامين :

يرتبط الهستامين باستجابات وأعراض الحساسية الشائعة.
في حين أنها قد تختلف، تبدأ المشكلة عندما لا يتمكن شخص ما من استقلاب المركب. “الأشخاص الذين يعانون من عدم تحمل الهيستامين لديهم انخفاض في الإنزيمات الأساسية [تسمى ديامين أوكسيديز] التي تساعد على تكسير الهيستامين في الجسم. ويبدأ في التراكم بشكل أسرع مما يمكن تحطيمه ويسبب أعراضًا غير مرغوب فيها.

فإن بعض ردود الفعل الشائعة المرتبطة بعدم التحمل هذا تشمل:

  • الصداع أو الصداع النصفي
  • احتقان الأنف أو مشاكل الجيوب الأنفية
  • تعب
  • قشعريرة
  • مشاكل في الجهاز الهضمي
  • عدم انتظام الدورة الشهرية وصداع أثناءها
  • غثيان
  • التقيؤ

في الحالات الشديدة من عدم تحمل الهيستامين، قد تواجه:

  • تشنج في البطن
  • تورم الأنسجة
  • ارتفاع في ضغط الدم
  • عدم انتظام في ضربات القلب
  • القلق
  • صعوبة في تنظيم درجة حرارة الجسم
  • دوخة
  • الانتفاخ
  • طفح جلدي أو أكزيما
  • حكة غير مبرر
  • حكة في العيون
  • سيلان الأنف
  • احتقان
  • تقلصات أو صداع ما قبل الحيض
  • طفح جلدي شديد

الأطعمة الغنية بالهيستامين هي:
(((كل شيء مخمر )))

  •  الكحول والمشروبات المخمرة الأخرى.
  • منتجات الألبان مثل الزبادي.
  • المخللات.
  • فواكه مجففة.
  • افوكادو.
  • باذنجان.
  • سبانخ.
  • اللحوم المصنعة أو -المدخنة.
  • المحار.
  • الجبن المعتق.
  • الكافيار
  • ملفوف مخلل
  • الخل
  • الحمص
  • العدس
  • القرفة

هناك أيضًا عدد من الأطعمة التي تؤدي إلى إطلاق الهيستامين في الجسم ، مثل:

  • كحول
  • موز
  • طماطم
  • جرثومة القمح
  • فاصوليا
  • بابايا
  • شوكولاتة
  • فاكهة حمضية
  • المكسرات، وخاصة الجوز والكاجو
  • الفول السوداني
  • الأصباغ الغذائية والإضافات الأخرى
  •  والبطاطا الحلوة
  • الأفوكادو
  • السبانخ
  • الباذنجان
  • زيوت الطبخ مثل زيت الزيتون
  • فراولة

بعض حالات تشمل الأطعمة التي تمنع إنتاج DAO:

  • كحول
  • شاي أسود
  • شاي ماتي
  • شاي أخضر
  • مشروبات الطاقة

إذا كنت تعاني من عدم تحمل الهيستامين ، فإن دمج الأطعمة منخفضة الهستامين في نظامك الغذائي يمكن أن يساعد في تقليل الأعراض. لا يوجد نظام غذائي خالٍ من الهيستامين.
استشر اختصاصي التغذية قبل استبعاد الأطعمة من نظامك الغذائي.

تتضمن بعض الأطعمة التي تحتوي على نسبة منخفضة من الهيستامين ما يلي:

  •  اللحوم الطازجة والأسماك الطازجة
  • فواكه غير حمضيات
  • بيض
  • الحبوب الخالية من الغلوتين، مثل الكينوا والأرز

هل هو تحسس غذائي ؟

يمكن أن تؤدي بعض الأطعمة إلى ظهور أعراض عدم تحمل الهيستامين. لكنها تختلف عن حساسية الطعام.

تحاكي بعض أعراض عدم تحمل الهيستامين تفاعلًا تحسسيًا حقيقيًا، لكن رد الفعل يختلف عن الحساسية، لذا فإن اختبارات الجلد واختبارات حساسية الدم ستكون سلبية.

يُعتقد أن HIT قد لا تكون الأعراض فورية. قد تظهر الأعراض في أي وقت يتم فيه الوصول إلى “العتبة”. لهذا السبب، قد يكون من الصعب تحديد مادة معينة.

على سبيل المثال، ربما تكون قد تناولت أطعمة غنية بالهيستامين في الصباح ولكن تناولت طعامًا منخفضًا به في فترة ما بعد الظهر. على الرغم من أن الطعام في فترة ما بعد الظهر كان منخفضًا في الهيستامين، إلا أنه يضعك فوق مستوى التحمل. لذلك، تظهر الأعراض في فترة ما بعد الظهر. قد تعتقد أن أعراضك كانت بسبب طعام العصر، لكن أطعمة الصباح كانت أكثر إشكالية في الواقع.

عدم تحمل الهيستامين
عدم تحمل الهيستامين

اختبار عدم تحمل الهستامين

يتم وضع المريض على حمية خالية من الهيستامين ومراقبة الاعراض، إذ لا توجد اختبارات مثبتة لتشخيص عدم تحمل الهيستامين.

إذ أن اختبارات الحساسية في الدم أو الوخز لن تعطي أ نتائج دقيقة ، لأ عدم التحمل يختلف عن الحساسية ، إذ أن الحساسية رد فعل مناعي يعمل فحصه على الأجسام المضادة من نوع IGE

أما عدم تحمل الهيستامين لا علاقة له بالجهاز المناعي .

من المهم أن تتذكر أنه أثناء اعتبار HIT سببًا للأعراض، يجب عليك تقييم الاضطرابات ذات الصلة مثل الحساسية الحقيقية، واضطرابات الخلايا البدينة، ومرض التهاب الأمعاء، ومرض الاضطرابات الهضمية، وسوء امتصاص الفركتوز، والنمو المفرط للبكتيريا المعوية الدقيقة، والتهاب القولون، وما إلى ذلك.

بعد تقييم الاضطرابات ذات الصلة، يمكن اتباع نظام غذائي يستبعد الأطعمة عالية الهستامين. إذا تحسنت الأعراض عند خفض الهستامين أو التخلص منه من النظام الغذائي، فقد تكون غير قادر على تحمل الهيستامين.

 

علاج عدم تحمل الهيستامين

عالج أي اضطراب أساسي أولاً. هذا قد يحسن تحمل الهيستامين.

يفضل عمومًا التركيز على العلاجات الغذائية لأنه يفضل القيام بأكبر قدر ممكن من خلال النظام الغذائي بدلاً من الأدوية. ولكن، يتطلب عدم تحمل الهيستامين حقًا نهجًا تكامليًا، لأنه يحدث غالبًا بالاقتران مع الاضطرابات الأخرى التي يجب معالجتها بما يتجاوز التعديلات الغذائية.

 

عدم تحمل الهيستامين
عدم تحمل الهيستامين

النظام الغذائي:

 النظام الغذائي منخفض الهستامين هو العلاج المفضل (دع طبيبك يحدد لك القائمة الخاصة بك). قد يكون هذا صعبًا إذا كان شخص ما يتبع بالفعل نظامًا غذائيًا مقيدًا مثل نظام غذائي خالٍ من الغلوتين أو منخفض FODMAP ويجب أن يتم ذلك تحت رعاية ممارس الرعاية الصحية حتى يتم الحفاظ على المدخول الغذائي المناسب. يختلف تحمل الهيستامين من شخص لآخر ويجب استنتاج كمية الهيستامين التي يمكن تحملها عن طريق التجربة والخطأ. يمكن لبعض الناس تحمل كميات صغيرة جدًا ويمكن للآخرين أن يكونوا أكثر ليبرالية.

من المهم أن نلاحظ أن التسامح مع الهيستامين يبدو أنه يتحسن بمجرد معالجة المسببات الأساسية. على سبيل المثال؛ إذا تم علاج القولون العصبي أو فرط نمو البكتيريا في الأمعاء الدقيقة ، فغالبًا ما تنخفض ردود الفعل تجاه الهيستامين. من الضروري علاج الاضطراب الأساسي بالتزامن مع التغييرات الغذائية.

بمجرد الانتهاء من حمية الإقصاء، يجب على المرء أن يقيّم بشكل فردي التسامح تجاه أطعمة معينة وتحرير النظام الغذائي كما هو مسموح به حتى يتم الوصول إلى التغذية المثلى ونمط الحياة.

النوم: 7-8 ساعات في الليلة يساعد كل شيء!

الدعم: المشاكل الصحية والقيود الغذائية مرهقة وصعبة. اطلب الدعم من الأسرة، والمجتمع، والمنظمات، ومجموعات الدعم عبر الإنترنت، ومجموعات الدعم المحلية. تجنب أولئك الذين يقدمون تفاعلات سلبية. التفاعلات السلبية تؤخر الشفاء.

تمرين: أي تمرين مفيد. اهدف إلى 30-60 دقيقة يوميًا. لا تشعر بالضيق إذا كان عمرك 15 عامًا فقط – فلا يزال ذلك مفيدًا!

الاسترخاء: لا يمكن التأكيد على فوائد تقنيات الاسترخاء بما فيه الكفاية. تمارين التنفس أو استرخاء العضلات التدريجي سهلة ومحمولة ومجانية. اليوجا والتأمل رائعتان كذلك. قد يكون الاسترخاء بالنسبة لك هو القراءة أو الاستمتاع بالوقت مع الأصدقاء أو تشغيل الموسيقى.

الأدوية: مضادات الهيستامين ، والمنشطات / الكريمات الموضعية ، والمنشطات الفموية ، والكريمات الموضعية أو الكريمات النباتية ، ومستحضرات الطفح الجلدي تحت إشراف طبي

المكملات: هناك القليل من البيانات أو لا توجد أي بيانات عنها ، ولكن يتم استخدام ما يلي في بعض الأحيان. فيتامين ج ، ب 6 ، زنك ، نحاس ، مغنيسيوم ، مانغوستين ، كيرسيتين ، محفزات ومكملات داو ، كريمات موضعية. يرجى استخدام أي مكمل تحت إشراف طبيب ممارس. إذ يمكن أن يكون للمكملات آثار جانبية سامة.

https://pubmed.ncbi.nlm.nih.gov/32824107/

https://pubmed.ncbi.nlm.nih.gov/34579083/

عرض المزيد

Zahia Al Saleh

مبادرة متحسس لكن مش محروم مبادرة مجانية لخدمة جميع مصابي الحساسية من جميع أنحاء. الحساسية الغذائية المتعددة، تفرض حياة جديدة قاسية مكلفة ماديا واجتماعيا واقتصاديا عليهم.

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