Overview

Histamine is a chemical, known as a biogenic amine. It plays a role in several of the body’s major systems, including the immune, digestive, and neurological systems. The body gets all the histamine it needs from its own cells, but histamine is also found in certain foods. People who experience an allergy-like response to histamine-rich foods may have a condition known as histamine intolerance.

People with histamine intolerance may experience a wide variety of symptoms involving different systems and organs. For some people, histamine-rich foods can trigger headaches, skin irritation, or diarrhea.

There are no reliable tests or procedures that doctors can use to diagnose histamine intolerance. However, some medical professionals will suggest an elimination diet. This involves removing certain foods from your diet and slowly adding them back in, one at a time. An elimination diet can help you determine whether histamine is the problem.

Foods to avoid on a low-histamine diet

Histamine levels in food are difficult to quantify. Even in the same food product, like a piece of cheddar cheese, the histamine level can vary significantly depending on how long it’s been aged, its storage time, and whether it has any additives. Generally, foods that have been fermented have the highest level of histamine. Fresh foods have the lowest levels. There is also a theory that some foods, though not histamine-rich themselves, can trigger your cells to release histamine. These are known as histamine liberators. This theory, however, has not been proven scientifically.

The following foods contain a high level of histamine:

  • fermented dairy products, such as cheese (especially aged), yogurt, sour cream, buttermilk, and kefir
  • fermented vegetables, such as sauerkraut and kimchi
  • pickles or pickled veggies
  • kombucha
  • cured or fermented meats, such as sausages, salami, and fermented ham
  • wine, beer, alcohol, and champagne
  • fermented soy products such as tempeh, miso, soy sauce, and natto
  • fermented grains, such as sourdough bread
  • tomatoes
  • eggplant
  • spinach
  • frozen, salted, or canned fish, such as sardines and tuna
  • vinegar
  • tomato ketchup

The following foods are suspected histamine liberators:

  • pineapples
  • bananas
  • citrus fruit, such as oranges, limes, lemons, and grapefruit
  • strawberries
  • papaya
  • tomatoes
  • nuts
  • spices
  • legumes
  • cocoa
  • alcohol
  • seafood
  • egg whites
  • food additives (in processed foods and drinks), such as colorants, preservatives, stabilizers, and flavorings

Pros and cons of a low-histamine diet

Low-histamine diets are extremely restrictive and can lead to malnutrition. Histamine intolerance is poorly understood. There is no evidence that a low-histamine diet will improve your quality of life in the long term.

The primary benefit of a low-histamine diet is that it serves as a diagnostic tool. By eliminating histamine-rich foods from your diet for several weeks (under the supervision of a doctor) and then slowly adding them back in, you can learn more about your individual tolerance to histamine.

Histamine tolerance varies significantly from one person to the next. When you add histamine back into your diet, you can carefully evaluate which foods trigger uncomfortable symptoms, if any.

Low-histamine diet tips

  • cook all your own meals
  • eat the freshest food possible
  • record everything you eat in a detailed daily food diary (be sure to include the time of day you ate each food)
  • record the times and dates of any uncomfortable symptoms for comparison
  • avoid junk food and anything processed (look at the ingredients listed on the package, if you see words you don’t recognize or understand, don’t eat it)
  • don’t be too hard on yourself, this diet is very restrictive
  • don’t plan on eating this diet for more than four weeks
  • eat only fresh foods that have been kept in a refrigerator
  • speak with a dietician or a nutritionist about getting all the nutrients you need while you’re on this diet
  • talk to your doctor about vitamin and mineral supplements (consider DAO enzyme supplements, as well as vitamin B6, vitamin C, copper, and zinc)

Takeaway and outlook

Consult with a doctor before beginning a low-histamine diet. Nutrient deficiencies can be harmful at any age, but this diet is especially dangerous for children. If you suspect your child has food allergies, take to your pediatrician about an alternative treatment.

If you experience dizziness, headaches, or any other complications, you should stop this diet immediately and consult a doctor. After you eliminate or reduce histamine in your diet for two to four weeks, you can begin slowly introducing histamine-rich foods back into your meal plan, one at a time. Talk to your doctor or nutritionist about how best to reintroduce these foods.

There is very little scientific evidence to support the effectiveness of a low-histamine diet and it can lead to malnourishment. Generally, a low-histamine diet is not a long-term treatment plan. It’s helpful in the diagnosis process and can help you rule out other food intolerances. Ultimately, you will need to determine your individual tolerance to different histamine-containing or liberating foods.