Talk:Histamine intolerance

GA Review

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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This review is transcluded from Talk:Histamine intolerance/GA1. The edit link for this section can be used to add comments to the review.

Nominator: Maxim Masiutin (talk · contribs) 17:12, 29 December 2024 (UTC)

Reviewer: IntentionallyDense (talk · contribs) 04:24, 5 January 2025 (UTC)

I'll review this shortly. IntentionallyDense ^(Contribs) 04:24, 5 January 2025 (UTC)

Rate	Attribute	Review Comment
1. Well-written:
	1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct.	On hold pending some changes to the prose. IntentionallyDense (Contribs) 23:56, 14 January 2025 (UTC) Issues addressed. IntentionallyDense (Contribs) 03:24, 16 February 2025 (UTC)
	1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation.	On hold pending changes to comply with MOS:LAYOUT IntentionallyDense (Contribs) 23:56, 14 January 2025 (UTC) Issues addressed. IntentionallyDense (Contribs) 03:24, 16 February 2025 (UTC)
2. Verifiable with no original research, as shown by a source spot-check:
	2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline.	ref list exists. IntentionallyDense (Contribs) 02:26, 7 January 2025 (UTC)
	2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose).	I checked and they were all good. There is a minor issue with one of the refs which I highlighted below. IntentionallyDense (Contribs) 05:27, 8 January 2025 (UTC) Issues addressed. IntentionallyDense (Contribs) 03:24, 16 February 2025 (UTC)
	2c. it contains no original research.	IntentionallyDense (Contribs) 05:27, 8 January 2025 (UTC)
	2d. it contains no copyright violations or plagiarism.	IntentionallyDense (Contribs) 05:27, 8 January 2025 (UTC)
3. Broad in its coverage:
	3a. it addresses the main aspects of the topic.	On hold until some things can be clarified. IntentionallyDense (Contribs) 23:56, 14 January 2025 (UTC) Issues addressed. IntentionallyDense (Contribs) 03:24, 16 February 2025 (UTC)
	3b. it stays focused on the topic without going into unnecessary detail (see summary style).	On hold until some repetitiveness can be addressed. IntentionallyDense (Contribs) 23:56, 14 January 2025 (UTC) Issues addressed. IntentionallyDense (Contribs) 03:24, 16 February 2025 (UTC)
	4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each.	Article is neutral. IntentionallyDense (Contribs) 23:56, 14 January 2025 (UTC)
	5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute.	stable. IntentionallyDense (Contribs) 02:26, 7 January 2025 (UTC)
6. Illustrated, if possible, by media such as images, video, or audio:
	6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content.
	6b. media are relevant to the topic, and have suitable captions.
	7. Overall assessment.	On hold until Maxim Masiutin can address my feedback. IntentionallyDense (Contribs) 23:56, 14 January 2025 (UTC) As detailed above, this article meets GA criteria. IntentionallyDense (Contribs) 03:24, 16 February 2025 (UTC)

• I feel like you could at least add some images here of either symptoms (such as flushing etc) or even a photo of histamine in the causes section. IntentionallyDense ^(Contribs) 02:26, 7 January 2025 (UTC)
• I don't think the lead here best represents the article. Take a look at Wikipedia:How to create and manage a good lead section. Specifically I'd expect a little bit of a longer lead and possibly written in a way that doesn't need citations. IntentionallyDense ^(Contribs) 02:26, 7 January 2025 (UTC)

  @IntentionallyDense i tried to work out a longer lead as I typically do for other articles that I edit, but for this one I didn't have ideas. Do you have a suggestion besides what is given in WP:LEAD ? Maxim Masiutin (talk) 08:27, 8 January 2025 (UTC)

  I’ll get back to you on this one once I’ve read through the entire article but it may just be that one paragraph is appropriate. IntentionallyDense ^(Contribs) 19:02, 8 January 2025 (UTC)

• The one bare URL should be fixed as these are prone to link rot. IntentionallyDense ^(Contribs) 02:26, 7 January 2025 (UTC)

  I replaced that bare reference with "cite news", and added "archive-url" attribute to each "cite" where there was an "url" attribute. Maxim Masiutin (talk) 08:50, 8 January 2025 (UTC)

• ref 25 doesn't verify the info given as it just opens to the ICD 10 search. Is there any way you could link to the actual codes? IntentionallyDense ^(Contribs) 05:27, 8 January 2025 (UTC)

  The ICD10 website didn't provide direct links, but I linked to direct items on another website Maxim Masiutin (talk) 16:06, 23 January 2025 (UTC)

@IntentionallyDense ok, let me do this in a few days Maxim Masiutin (talk) 08:25, 8 January 2025 (UTC)

Signs and symptoms

• The manifestations of histamine intolerance, or, adverse reactions to ingested histamine, are not confined to the gastrointestinal system, and are usually systemic, affecting the entire body; still, these symptoms are often sporadic and non-specific: symptoms attributed to histamine intolerance are wide-ranging and may affect various physiological systems, including the skin, gastrointestinal, cardiovascular, respiratory, and nervous systems. This sentence is really long and kind of doesn't say much while also using a lot of words. I find myself writing a lot of these kinds of sentences that have a lot of words but don't say much in medical articles. Maybe this could be reworded as Manifestations of histamine intolerance tend to affect multiple organ systems and are often sporadic and non-specefic. adding in more detail as you see fit. Either way I think for readability reasons this sentence needs to be shortened and possibly condensed. IntentionallyDense ^(Contribs) 04:31, 9 January 2025 (UTC)

  Yes, this is a great idea. I just wanted lay persons to understand the meaning, but shortening definitelys help.

  I think that we should keep "including the skin, gastrointestinal, cardiovascular, respiratory, and nervous systems".

  Maybe we should expand how them manifest in skin (redness, itching), gastrointestinal (gut pain, and manifestation similar to those of irritable bowel syndrome), etc...? Maxim Masiutin (talk) 17:36, 9 January 2025 (UTC)

  I think listing the organ systems is probably a good idea as a lay person may not know exactly what people mean by manifesting in multiple organ systems. And yes the listing symptoms by organ systems would most likely be helpful! IntentionallyDense ^(Contribs) 03:58, 10 January 2025 (UTC)

  OK, I modified that section and listed symptoms to organs Maxim Masiutin (talk) 16:07, 23 January 2025 (UTC)

• These symptoms are not specific to histamine intolerance and may overlap with other conditions or disorders. This overlaps with the nonspecific symptoms part in the last paragraph. I think it may be more beneficial to put this with the other paragraph if at all. IntentionallyDense ^(Contribs) 04:31, 9 January 2025 (UTC)
• Is there any information on symptom onset or duration? Like do people tend to get these symptoms immediately after ingesting certain foods? You mentioned they are sporadic but is there anymore detail on this? IntentionallyDense ^(Contribs) 04:31, 9 January 2025 (UTC)

  There is anecdotal evidence on symptoms onset, but they are not confirmed by reliable reviews or publications such as clinical practice guidelines.

  Anecdoatal evidence is that onsets are usually not immediate: it takes time for the histamine intolerance to build it up. This is not an allergy that can be immediately trigger. If a sensitive person eat "bad" food once, it will not happen, probably because enough DAO enzyme accumulated, but on frequent consumption of such food symptoms will show up and then last about 3 month, so that the full elimination diet gives effect in 3 months. That's why it is hard to diagnose. There are food compatibility lists such as SIGHI "Food Compatibility List", these lists are very helpful, but not yet approved by mainstream medical community.

  What would you recommend? Maxim Masiutin (talk) 17:40, 9 January 2025 (UTC)

  It could be worth mentioning (keep in mind I haven't read the whole article so I'm not sure if this is mentioned elsewhere) that symptom onset isn't immediate if there is a reliable source to say that. Mostly because even when I think of something like lactose intolerance or non celiac gluten sensitivity, from my understanding, symptom onset is somewhat immediate (like eating dairy and then stomach pain etc). This is more of a suggestion from someone who knows medical articles and not apart of GAN criteria so you can disregard this if it would be a lot of effort to include. IntentionallyDense ^(Contribs) 04:01, 10 January 2025 (UTC)

  I found low-quality publications and included the statement "The onset of symptoms is usually shortly (within a few hours) after specific food or drink consumption, and subsequent remission usually happens in 4-8 weeks of dieting, that is excluding food that causes the onset of symptoms.", backed by two MDPI publications.

  Until we have better publications, can we please keep this statement, because at least it does not contradict to official position on medical associations which have no yet position on this issue. Maxim Masiutin (talk) 12:45, 29 January 2025 (UTC)

  Mainstream theory suggests to treat symptoms by excluding the causes. It recommends lifestyle and diet modifications without any specifics what should be modified or eaten. Maxim Masiutin (talk) 17:43, 9 January 2025 (UTC)

• To comply with MOS:LAYOUT I think these two paragraphs should be combined as they are both very short. IntentionallyDense ^(Contribs) 04:31, 9 January 2025 (UTC)

  Thank you! I have combined these paragraph and augmented the lead section slightly. Maxim Masiutin (talk) 16:21, 23 January 2025 (UTC)

Causes

• Would you be opposed to possibly moving the second para of causes (Histamine, a biogenic amine found in various food products) to be the first para? I mention this because it seems to be more of an introduction to the causes then the current first paragraph. Also the third paragraph goes into more detail on the theory presented in the first para. IntentionallyDense ^(Contribs) 04:14, 10 January 2025 (UTC)

  Good idea! I implemented that. Maxim Masiutin (talk) 12:47, 29 January 2025 (UTC)

• A small number of studies have attempted to elucidate this relationship through the rigorous methodology of double-blind, placebo-controlled oral food challenges involving histamine. However, the results yielded from these investigations have been notably heterogeneous, further complicating the interpretation of the data. This chunk of text is quite technical. Is there any way you could simplify it a bit by either wikilinking terms (such as placebo) or using more simple terms (such as results being varied instead of heterogeneous). I understand that this topic is going to be technical but this bit seems a bit overly technical for what it is trying to convey. IntentionallyDense ^(Contribs) 04:14, 10 January 2025 (UTC)

  I simplified this sentence: made simpler text, deleted superfluous text, split into paragraphs. Maxim Masiutin (talk) 13:00, 29 January 2025 (UTC)

• either due to genetic factors, medications, or gastrointestinal diseases I'm going to assume that there isn't any hard evidence on which disorders or medications play a role here? If there is evidence pointing to some disorder or medications it may be worth noting. IntentionallyDense ^(Contribs) 04:14, 10 January 2025 (UTC)

  According to clinical guidlines, there is no clear links and no conclusive findings on which disorders or medications play a role here Maxim Masiutin (talk) 13:01, 29 January 2025 (UTC)

• as well as a positive response to a low-histamine diet, and the treatment of histamine, involves avoiding I'm assuming you meant to put treatment of histamine intolerance here. IntentionallyDense ^(Contribs) 04:14, 10 January 2025 (UTC)

  Yes, diet is both a treatment and the diagnosis, acknoldedged by mainstream medicine. If symptoms go away in 4-8 weeks of diet excluding food that causes symptoms, than it was it Maxim Masiutin (talk) 13:03, 29 January 2025 (UTC)

  I also added small clarifications to this section "Causes" and split long sentences. Maxim Masiutin (talk) 17:14, 11 February 2025 (UTC)

Mechanism

• variations in both DAO and HNMT genes could play a role in its development Have reliable sources identified any specific genes that could play a role in this? IntentionallyDense ^(Contribs) 18:15, 10 January 2025 (UTC)

  @IntentionallyDense not yet Maxim Masiutin (talk) 18:58, 10 January 2025 (UTC)

  I figured. IntentionallyDense ^(Contribs) 04:20, 11 January 2025 (UTC)

  I added an introductory sentence: "The exact mechanism that lies behind histamine intolerance is not known." to the "Mechanism section" to give the essence of this section. Maxim Masiutin (talk) 17:15, 11 February 2025 (UTC)

Diagnosis

• For MOS reasons, some of the smaller one or two sentence paragraphs should be combined. How you choose to do this is up to you. IntentionallyDense ^(Contribs) 13:55, 12 January 2025 (UTC)

  I combined smaller paragraphs into larger ones Maxim Masiutin (talk) 17:35, 11 February 2025 (UTC)

• Histamine intolerance is not recognized as an explicit medical condition with that name in the International Classification of Diseases (ICD) Edition 11,[2] or any previous edition of the ICD. two things here, 1. you need a ref for the second part of the sentence. 2. The wording here could be a little clearer. Maybe something along the lines of The term "Histamine intolerance" does not appear in the 11th edition of the International Classification of Diseases (ICD) or any previous editions. The "with that name" part just sounds awkward to me. IntentionallyDense ^(Contribs) 13:55, 12 January 2025 (UTC)

  I will remove "any previous edition" and write as "The term "Histamine intolerance" does not appear in the 11th edition of the International Classification of Diseases (ICD) ". Maxim Masiutin (talk) 17:46, 11 February 2025 (UTC)

• involves a thorough analysis of patient history While not apart of the GANC consider using a different term than patient per WP:MEDMOS IntentionallyDense ^(Contribs) 13:55, 12 January 2025 (UTC)

  Thank you! Instead of using "patient history", I used "dietary habits and history of the person" Maxim Masiutin (talk) 17:52, 11 February 2025 (UTC)

• There are no specific tests that can definitively diagnose histamine intolerance—the primary approach is through a thorough evaluation of clinical symptoms and their improvement or resolution after following a low-histamine diet; an assessment should also be made to rule out other potential causes of similar symptoms, such as allergies, mastocytosis, gastrointestinal diseases, and medication-induced inhibition of diamine oxidase (DAO) enzyme activity; additionally, genetic testing for single-nucleotide polymorphisms (SNPs) in genes related to DAO function may provide supportive evidence for the diagnosis but cannot confirm it on its own; and other complementary tests have been proposed but require further validation before being widely accepted as diagnostic tools for histamine intolerance, such as measuring plasma DAO activity levels and conducting intradermal skin allergy tests with histamine. Is there any way you could split up this sentence a bit for readability reasons? Additionally, using terms like "should" (an assessment should also be made) seems a bit unencyclopedic. Instead I'd recommend saying something like xyz guidelines/society/whatever suggest...IntentionallyDense ^(Contribs) 13:55, 12 January 2025 (UTC)

  OK, thank you, I split this sentence. Maxim Masiutin (talk) 19:57, 11 February 2025 (UTC)

• Despite the common belief that consuming histamine can lead to nonspecific health issues, the scientific proof to back this claim is both scarce and inconsistent. This point is repeated elsewhere quite a bit and unless there's a strong reason why it needs to be in this section I'd recommend removing it. IntentionallyDense ^(Contribs) 13:55, 12 January 2025 (UTC)

  OK, thank you, I removed this sentence. Maxim Masiutin (talk) 19:59, 11 February 2025 (UTC)

• Whereas the concept of "histamine liberators" is frequently mentioned in discussions about histamine intolerance and dietary management, it is important to note that the scientific evidence supporting their existence and clinical relevance is currently limited and inconsistent. -> Whereas the concept of "histamine liberators" is frequently mentioned in discussions about histamine intolerance and dietary management, scientific evidence supporting their existence and clinical relevance is currently limited and inconsistent.? IntentionallyDense ^(Contribs) 13:55, 12 January 2025 (UTC)

  Great, thank you! Maxim Masiutin (talk) 20:00, 11 February 2025 (UTC)

• Using a questionnaire that encompasses symptoms associated with the four histamine receptors can be an effective tool for this purpose.[8] This questionnaire should include categories such as gastrointestinal, cardiovascular, respiratory, and skin symptoms.[8] Is there an established questionnaire out there? Also similar point to above with using the would "should". IntentionallyDense ^(Contribs) 13:55, 12 January 2025 (UTC)

  Thank you, I fixed that! Maxim Masiutin (talk) 20:28, 11 February 2025 (UTC)

• Is there any info on differential diagnosis? IntentionallyDense ^(Contribs) 23:56, 14 January 2025 (UTC)

  Yes, there is information on differential diagnosis in a book https://link.springer.com/book/10.1007/978-3-642-55447-6 -- let me give the information. Maxim Masiutin (talk) 20:42, 11 February 2025 (UTC)

  I added that information, see the paragraph that starts from "The differential diagnosis". Please let me know whether it makes sense. Maxim Masiutin (talk) 21:34, 11 February 2025 (UTC)

Treatment

• Several medications, including acetylcysteine, metamizole, verapamil, metronidazole, and metoclopramide, have been reported to negatively affect enzymes that break down histamine, particularly DAO, still, the data from these studies is inconsistent according to later literature reviews, therefore, the significance of specific drugs in relation to DAO's ability to break down histamine was not confirmed by reliable studies. This sentence is pretty long and a little wordy. Is there any way you could shorten it to be a little more readable? IntentionallyDense ^(Contribs) 23:56, 14 January 2025 (UTC)

  Thank you, I rewritten it and shortened. Maxim Masiutin (talk) 18:16, 12 February 2025 (UTC)

• Additional options in histamine intolerance include I believe you meant to write Additional treatment options for histamine intolerance include. IntentionallyDense ^(Contribs) 23:56, 14 January 2025 (UTC)

  I thought I missed the word "managing". The full sentence is now: "Additional options in managing histamine intolerance include antihistamines, mast cell stabilizers, and supplementation with exogenous DAO, in the form of capsules or tablets." Maxim Masiutin (talk) 18:17, 12 February 2025 (UTC)

• could alleviate patient symptoms per WP:MEDMOS the word patient should be avoided. IntentionallyDense ^(Contribs) 23:56, 14 January 2025 (UTC)

  fixed Maxim Masiutin (talk) 18:22, 12 February 2025 (UTC)

• with and without DAO use in 28 patients same as above. IntentionallyDense ^(Contribs) 23:56, 14 January 2025 (UTC)

  Thank you, I changed the word "person" to "individual" Maxim Masiutin (talk) 18:21, 12 February 2025 (UTC)

Epidemiology

• The diagnosis typically involves a thorough patient history, taking into account clinical manifestations associated with the ingestion of high-histamine foods as well as response to dietary changes such as low-histamine diets. I'm not sure this sentence needs to be included as it overlaps with the diagnosis section. IntentionallyDense ^(Contribs) 23:56, 14 January 2025 (UTC)

Research directions

• These two substances are known for their strong vasodilatory properties and have been observed to mutually stimulate each other's release within the trigeminovascular system, which could potentially contribute to the onset of migraines, so that individuals with genetic variants in the AOC1 gene encoding the diamine oxidase (DAO) enzyme, which lead to a deficiency in histamine degradation, often experience migraines when consuming a diet high in histamine, which suggests that ingested histamine could potentially aggravate migraines, highlighting the importance of ongoing research into the potential adverse reactions to dietary histamine For readability reasons I'd recommend shortening this sentence. IntentionallyDense ^(Contribs) 23:56, 14 January 2025 (UTC)

  I shortened and simplified the section. Maxim Masiutin (talk) 18:29, 12 February 2025 (UTC)

• Maxim Masiutin I apologize for my absence as of lately. I see that you've already gotten around to making some changes to this article. Keep up the great work! I'm just wondering where you are with implementing changes? IntentionallyDense ^(Contribs) 23:59, 28 January 2025 (UTC)

  @IntentionallyDense let me finish everything today Maxim Masiutin (talk) 11:28, 29 January 2025 (UTC)

  Sounds good. No rush or anything I just wanted to check in! IntentionallyDense ^(Contribs) 19:19, 29 January 2025 (UTC)

  @IntentionallyDense thank you that you gave me time, I have got family issues. Maxim Masiutin (talk) 19:28, 29 January 2025 (UTC)

  I totally understand. All of your responses thusfar have been good. Feel free to take your time. IntentionallyDense ^(Contribs) 04:28, 30 January 2025 (UTC)

• Maxim Masiutin, sorry to bug you again as I know you've expressed that you are busy off-wiki right now, but how are you doing with this article? Is there anything I could do to help? Anything you need clarified? IntentionallyDense ^(Contribs) 20:01, 10 February 2025 (UTC)

  Sorry, I just finished up to the last 3 sections, aim to finish them also today. Maxim Masiutin (talk) 20:44, 11 February 2025 (UTC)

  Sounds good! I'm excited to see it. IntentionallyDense ^(Contribs) 01:35, 12 February 2025 (UTC)

  I think that I resolved all your observation. Thank you again. Maxim Masiutin (talk) 18:30, 12 February 2025 (UTC)

  Sorry for the delay. Thanks for getting to those changes! IntentionallyDense ^(Contribs) 03:22, 16 February 2025 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.