The histamine-endometriosis infertility link
I’ve been avoiding writing about this for some time. Not because I’m worried about never having children, but because I don’t want to alarm anyone. And that’s still not my intention – please, take this post with a heaping spoon of salt. If you are suffering from unexplained infertility, or repeated miscarriage, you may want to follow the links to the studies I discuss, and print them all off for your doctor.
Please do not, I repeat do not, make any life decisions, flush your birth control pills down the toilet or worry yourself to death thinking you’ll never have children, based on what you’re about to read.
I’ve had the most horrific ovulation issues for most of my adult life. I’m talking about pain worse than the dreaded monthly mistress, in addition to an alarming number of corpus luteum cysts bursting on me, causing an excruciating event I can only describe as a blind medieval surgeon engaging my ovary with a hot poker.
Readers of my blog will no doubt be familiar with mast cells by now – these cells, an integral component of our white blood system, house histamine, and other inflammatory molecules, safely storing them until they’re needed for various things like: helping our brain neurotransmitters fire, getting digestion going, healing us from injuries, keeping viruses at bay, dealing with bacterial infection, and much more. Some people, like me, have mast cells that are leaky, or maybe just have too many of them. This means that we’re having tons of inflammation dumped into our body regularly. Others may have a histamine intolerance, which is basically too much histamine in the body, and not enough of the histamine-lowering enzymes (like DAO and HNMT) to deal with it. I personally think it’s possible to have all this going on at the same time and I really don’t care too much about naming things…to me, it’s inflammation, and healing is a matter of being good to yourself.
So, regarding fertility. Here’s a few things that caught my attention…
Mast cells are also in the ovaries. In animal studies – an increase in ovarian histamine has been found in rabbit follicles just before ovulation, and has been shown to provoke ovulation, in vitro, in experiments with rat ovaries. Meaning, not in live rats – eugh either way. Poor animals. In these animal tests, histamine-induced ovulation has been blocked using various antihistamines (read the study for the particulars) .
This would explain why many of us feel pretty rough around that time of the month (about 11-21 days into your cycle). I’m no longer a member of that club thankfully!
You would think this was great news though right? Histamine causes ovulation – yay! If we’re anything like these animals (which are experimented on because of their similarity to our own physiology), maybe we can help ourselves induce ovulation by getting crazy with the cheese whizz (yes I just quoted Beck in a “serious” post!). Sadly not so.
Again, in animal studies, histamine induced ovulation, produced immature eggs . According to the Stanford University medical website, true (my word) ovulation is rare if the eggs are immature, and the chance of fertilisation is “almost non-existent” .
Interestingly, the website, which notes dozens of contributing factors to infertility, doesn’t mention histamine. This may be because it’s not known, it’s overlooked, because it isn’t applicable to humans, or hasn’t been investigated. What it does list, that also caught my attention, was endometriosis. Which was to be the subject of another post, but it now seems fitting to add it here.
At my sickest, I was diagnosed with endometriosis. Naturally, the only way to properly find out is to get in there through (hopefully) keyhole surgery, and have a good poke around. They’ll dive in and clear it all out in one go if they do find it. Sadly though, in many cases, that I’ve come across in forums, FB groups and when people email me, it takes many goes to get it all out, if we ever do. I was scheduled for this surgery, along with another for uterine fibroids, when I put on the brakes. I was all “Yeah ok, but I read in forums that you might have to keep going back and there’s no guarantee that’ll get rid of my pain.”
I was pretty sure it was endometriosis – I felt like the wall of my uterus or something was glued to my pelvic bone. The pain was so severe that I once ended up in the ER, screaming in agony, my poor boyfriend having carried me out of the apartment as I scared the living hell out of him and the cabbie who agreed to take us there. I was diagnosed with pelvic inflammatory disease (yet another misdiagnosis I need to add to the list) and given antibiotics (that I had written in my chart I was allergic to) that made me barf immediately, for hours. As I lay there, burning up from a non-existent fever, they refused to give me water for 24 hours – standard in UK hospitals in case you need surgery. And we all know how great dehydration is for driving up histamine levels. When I got up to desperately search for a tap to glue my mouth to and suck dry, I was suddenly felled, mid stride, by a knife-like stabbing in my lower right quadrant, all the way up to my right shoulder. Collapsing on the filthy, no-doubt MRSA tainted floor, screaming once more, I swore I would figure out what was going on and heal myself, or die trying, because this sure wasn’t living.
30-40% of patients with endometriosis are infertile (but many go on to have kids even after being warned they may never manage it!) . A fascinating study, in humans this time, outlined that pelvic adhesions can arise due to pelvic infection (no doubt why I was misdiagnosed), endometriosis, peritonitis or surgery. They also found that women with dense pelvic adhesions had significantly elevated concentrations of histamine in follicular fluid, when compared to adhesion-free women. They concluded that this may lead to premature ovulation during a normal cycle, resulting in the release of immature eggs.
“It’s possible that this may contribute to the lower fertility in women who have pelvic endometriosis but patent fallopian tubes, and in those patients where tubal patency has been restored following tubal surgery,” they noted .
There’s quite a few studies out there on the relationship between histamine and just generally inflammation, and endometriosis. Enough to make you wonder how diet plays a role.
In my case, six months on a very high nutrient diet cleared up my uterine fibroids (much to my doc’s shock), but the pelvic glue took longer…how much longer I’m not sure of, but I got there in the end!
To sum up: histamine can induce ovulation, but the result is immature eggs, which do not lead to pregnancy. I’d like to know if this means that too much histamine, like in the case of those with mast cell and histamine intolerance disorders, means all our eggs are like this, or just once in a while – and what determines the histamine level in the ovaries. I’d also love someone to answer whether the elevated histamine levels are due to a primary cause, rather than being the problem itself, and how diet influences matters either way.
All I can say is that in my case, the answer seems to be yes, at least for the second part. I’m now 39, and I can honestly say that I’m no closer to deciding whether I will have children. Life so far has been challenging. For many years I was convinced I was dying, and therefore there was no way I could consider procreation. With the clock ticking, I can only say: my mom had me at 40, my cousin hers at 41, Halle Berry hers at 47. Whatever choice I make – it is now from a position of power, faith in my healing, and will only happen if I have the proper amount of time to lavish on a little one. For now, I have far, far too much to catch up on, way too much to share with you all, and all I can see for the near future, is me, at my desk, scouring the medical literature for clues on healing, and of course exploring the exotic lands I so love. That said, I have always used myself as a guinea pig, so how can I hope to share all you need to know about the topic, without experiencing it myself?
I’m sure it’ll all become clear one day. For now, it’s just me and my laptop, and all you wonderful folks who keep me blogging.