Histamine Signaling in Exercise: Acute Physiological Responses, Performance, Training Adaptation, and Implications for Antihistamine Use
Izabela Ozga-Żak, Magdalena Dederko, Daria Irena Sztefka, Marta Ziobrowska, Marta Drogosz, Magdalena Anna Łuczak-Tabaka et al. · African Journal of Biomedical Research · 2026
Background: Histamine is increasingly recognized as a physiological mediator of exercise beyond its traditional role in allergy. This review examines how H1- and H2-receptor signaling influences acute physiological responses, exercise performance, and training adaptation.
Methods: A narrative review of human studies was conducted using a structured PubMed/MEDLINE search updated through 9 September 2026, supplemented by citation tracking and targeted searches for recent publications.
Results: H1/H2 signaling contributes to sustained post-exercise vasodilation and influences metabolic and transcriptional responses to exercise. Acute H1-receptor blockade alone did not consistently impair exercise performance, whereas strong combined H1/H2 blockade slowed 10-km cycling time-trial performance by approximately 1% but did not impair severe-intensity exercise tolerance. During endurance-oriented training, repeated combined H1/H2 blockade attenuated selected vascular, oxidative, metabolic, and performance adaptations, while improvements in maximal aerobic capacity were relatively preserved. In contrast, therapeutic-range H1-receptor blockade did not measurably impair muscle hypertrophy or strength gains during 10 weeks of resistance training.
Conclusions: Histamine signaling contributes selectively rather than universally to exercise responses and adaptation. Experimental high-dose or combined receptor blockade should not be equated with routine antihistamine therapy. Current evidence does not establish that routine therapeutic H1-antihistamine use meaningfully compromises exercise performance or training adaptation.