When a supplement contains both probiotic microorganisms and prebiotic fibers, it is called a synbiotic ( 39). The most common types are lactulose, inulin and various oligosaccharides ( 38). These are plant fibers that humans cannot digest, but that bacteria can consume as food. In addition to containing powerful probiotics, some supplements also contain prebiotics. Since a small number of people with lactose intolerance may experience unpleasant gas and bloating when consuming lactose-containing probiotics, they may want to choose lactose-free products. While studies suggest that most people with lactose intolerance can tolerate up to 400 mg of lactose in medications or supplements, there have been case reports of adverse effects from probiotics ( 35, 36, 37). Milk sugar, or lactose, is also used in many probiotic supplements ( 34). Instead, a bacteria-based probiotic should be used ( 33). Similarly, yeast-based probiotics should not be taken by those with yeast allergies. If necessary, read labels carefully to avoid these ingredients ( 32). These ingredients should be avoided by anyone who is allergic, as they may trigger an allergic reaction. People with allergies or intolerances should read the labels of probiotic supplements carefully, since they might contain ingredients they could react to.įor example, some of the supplements contain allergens such as dairy, egg or soy. Those with histamine intolerance may want to avoid these strains of bacteria. Some probiotics can produce histamine within the digestive tract. Some histamine-producing probiotic strains include Lactobacillus buchneri, Lactobacillus helveticus, Lactobacillus hilgardii and Streptococcus thermophilus ( 29, 30, 31). Theoretically, they may want to select probiotic supplements that do not contain histamine-producing bacteria, but to date, there has been no research on this specific area.
People with a histamine intolerance should avoid foods that contain excess histamine ( 28). The excess histamine is then absorbed through the lining of the intestinal tract and into the bloodstream, causing symptoms similar to an allergic reaction ( 27). However, some people with histamine intolerance have trouble properly breaking down the histamine in their bodies, seeing as they do not produce enough DAO ( 24, 25, 26). This enzyme inhibits histamine levels from rising enough to cause symptoms ( 23). Normally, histamine that is produced in your digestive tract is naturally degraded by an enzyme called diamine oxidase (DAO). This process creates redness and swelling in the affected area, and can also trigger allergy symptoms such as itching, watery eyes, runny nose or trouble breathing. The vessels also become more permeable so that immune cells can easily get into the relevant tissue to combat any pathogens ( 22). When histamine levels rise, blood vessels dilate to bring more blood to the affected area. Histamine is a molecule that is normally produced by your immune system when it detects a threat. Some bacterial strains used in probiotic supplements can produce histamine inside the digestive tract of humans ( 19, 20, 21). Some people may experience headaches after eating these foods, and should instead opt for probiotic supplements. Summaryįermented foods rich in probiotics naturally contain amines. If probiotic-rich foods trigger your symptoms, a probiotic supplement may be a better choice. Keeping a food diary including any headache symptoms you might experience can help clarify whether fermented foods are problematic for you. More research is needed to determine whether or not amines can be direct triggers of headaches or migraines in some people. However, a review of 10 controlled studies found no significant effect of dietary amines on headaches ( 17, 18). One study found that low-histamine diets reduced headaches in 75% of participants. The most common amines found in probiotic-rich foods include histamine, tyramine, tryptamine and phenylethylamine ( 14).Īmines can excite the central nervous system, increase or decrease blood flow and may trigger headaches in people sensitive to the substance ( 15, 16). Some probiotic-rich foods, like yogurt, sauerkraut and kimchi, contain biogenic amines ( 11, 12).īiogenic amines are substances that form when protein-containing foods age or are fermented by bacteria ( 13).
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