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How The Low Histamine Diet Works And What To Eat
The low histamine diet may help people who develop symptoms, such as sneezing, itching, or hives, in response to foods that contain histamine.
Histamine is a chemical that occurs naturally in the body and in some foods. The low histamine diet can help a person find out which foods cause their symptoms. By avoiding those foods, they may see an improvement. A nutrition professional can guide someone through this process.
This article looks at how histamine affects the body, what histamine intolerance is, and the foods people may wish to avoid. It also provides an example meal plan and tips for grocery shopping and food preparation.
Histamine is a chemical that regulates the body's response to foreign substances and injury.
When the body reacts to a substance it perceives as harmful, it releases histamine. This causes inflammation and dilates a person's blood vessels, leading to symptoms such as:
Despite the discomfort these symptoms can cause, histamine plays an important and complex role in the body's defenses. A 2018 review describes histamine as having a 'paradoxical nature', as it can both increase and decrease inflammation levels.
Some people develop symptoms in response to foods that contain or release histamine. Doctors call this condition histamine intolerance.
The symptoms of histamine intolerance are similar to that of an allergic reaction and can affect multiple systems in the body.
Diamine oxidase (DAO) is the enzyme that breaks down histamine in the body. People with lower levels of DAO have higher histamine levels and, therefore, may be more likely to develop allergies.
The impact of histamine varies depending on age, sex, and genetics. The gut lining and gut flora also seem to play a role in histamine intolerance. For example, a 2018 study compared people with histamine intolerance to those with food intolerances, and others with no intolerances at all. The group with histamine intolerance had lower bacterial diversity in their gut and an impaired gut lining.
The low histamine diet aims to reduce the symptoms of histamine intolerance and allergies. There is limited evidence to suggest the diet may be helpful for some people.
A small 2018 study showed that a 4-week low-histamine diet helped reduce symptoms in adults with hives.
However, more high quality studies on histamine intolerance to better understand the condition and the best treatments.
Alternatives
There is no one-size-fits-all approach to nutrition, and an individualized approach to diet is often best for people with intolerances, including histamine intolerances.
Factors such as medication, stress levels, and overall health affect what works for them.
Research in 2017 recommended a phased approach to the diet. This entails 10 to 14 days of avoiding histamine foods, followed by up to 6 weeks of reintroducing foods. This allows someone to determine their histamine tolerance.
Before trying any type of restrictive diet, people should seek expert nutritional counseling to ensure they are getting adequate nutrients, and to avoid an unnecessary reduction in their quality of life.
Freshness impacts the amount of histamine in food. It is a good idea to learn how different methods of production and storage impact histamine levels in food.
How a person shops for and prepares food is also important.
A person with histamine intolerance can monitor and potentially reduce their symptoms by:
Some medications and supplements also influence histamine levels. If a person suspects something they are taking is exacerbating their symptoms, they should speak to their doctor.
A low histamine diet may benefit someone with histamine intolerance. Planning varied meals, avoiding high histamine foods, and allocating time to prepare fresh foods may help a person manage their symptoms.
If someone suspects they may have histamine intolerance, it is essential that they consult their doctor for advice.
People need to ensure that they do not miss out on essential nutrients when following a limited diet. People should not follow long-term exclusion diets without seeking advice from a registered dietitian or nutritionist.
Foods High In Histamine
Histamine is a natural chemical that helps your cells communicate. It plays a few important roles in your body, including managing your sleep cycle and supporting your brain function. But it is best known for its role in allergies.
Allergies happen when your immune system overreacts to things such as pollen and mold. Your immune system might mistakenly think that these things, which are usually harmless, could be threats to your body. To defend against the so-called threats, your mast cells (a type of white blood cell) release histamine. The histamine tells your body to launch an allergic reaction.
Seasonal allergies are often the cause of histamine production in the body, but foods can also contain this chemical.
Most people can tolerate foods high in histamines, but approximately 1% of the population has a histamine intolerance. It tends to be more common in middle age. When you have this condition, you can't break down histamine correctly, causing it to build up in your body. Although it can lead to allergy-like symptoms, it's not considered a food allergy.
It's not clear why some people develop histamine intolerance. Some medications and gut conditions can make it harder for your body to break down histamines. Or you might not have enough diamine oxidase (DAO), the protein that is mainly responsible for breaking down histamine. Low levels of DAO can be caused by genetics (meaning it's passed down through your family), kidney disease, or liver disease.
Histamine intolerance symptoms
Too much histamine triggers an immune response. This can cause symptoms such as:
In severe cases, histamine intolerance could lead to a dangerous condition called anaphylaxis. Call 911 if you have:
How to know if you have histamine intolerance
If you have symptoms of allergies or histamine intolerance, talk to your doctor. They might recommend keeping a food diary. This involves writing down the foods you eat and symptoms you have each day. A food diary can help you find patterns and figure out if a certain food (or combination of foods) is causing your symptoms.
Your doctor also might suggest avoiding all foods high in histamines for a few weeks. If this helps you feel better, you may have a histamine intolerance. To find out if there's a particular food that triggers your histamine intolerance, slowly add foods back into your diet, one at a time. If you start getting symptoms again, the recently added food might be a trigger.
They may also prescribe:
Allergy testing. This can help show whether your symptoms are being caused by allergies. You might get a skin prick test, where the doctor pricks your skin with tiny drops of allergens to see if they cause a reaction. Or you might get a blood test.
Blood testing. Some blood tests can show whether you have high levels of histamine, low levels of DAO, or other irregularities.
Histamine testing. During a histamine skin prick test, a doctor pricks your skin with a tiny drop of histamine. This will probably cause a reaction. But if the reaction doesn't go away after 50 minutes, your body might have a hard time breaking down histamine. They may also give you a histamine pill to see how your body reacts.
Colonoscopy. During a colonoscopy, your doctor can check histamine and DAO levels in your colon. They can also look for signs of other conditions that might be causing your symptoms.
If you have a histamine intolerance, spinach and tomatoes, aged cheeses, processed meat, and beer may cause you to have an allergic reaction. (Photo Credit: Moment RF/Getty Images)
Some foods are naturally high in histamines. Others don't have a lot of histamine but trigger your white blood cells to make it. If you have histamine intolerance, both kinds of foods can lead to too much histamine in your body.
It's difficult to measure histamine levels in foods because they can vary greatly even in the same types of food. However, a good rule of thumb is that foods that are fermented, aged, or overly processed likely contain more histamine than fresh foods.
Highest-histamine foods
These foods and drinks are particularly high in histamine:
High-histamine fruits
Although many fruits are not high in histamine, they can trigger the release of histamine. Some may contain histamine-like substances that can aggravate symptoms. Many health care professionals recommend limiting certain fruits and juices as part of a low-histamine diet.
Consider avoiding:
High-histamine vegetables
These vegetables are high in histamine:
In addition, mushrooms and soybeans may contain histamine-like substances that can trigger symptoms.
Sauces and condiments
These ingredients can raise your histamine levels:
High-histamine seafood
Frozen, smoked, and canned seafood, as well as spoiled fish, can have high levels of histamine. Pay particular attention to:
Nuts and seeds
The following nuts don't have a lot of histamine but are high in histamine-like chemicals:
Fermented foods
The level of histamine in fermented foods (such as kimchi and kefir) can vary based on preparation techniques and the length of aging. Sauerkraut, in particular, has been shown to contain a high concentration of histamine compared with other common foods.
Alcohol
Beer and wine, especially red wine, have high levels of histamine. Because of this, some cases of alcohol intolerance are caused by histamine intolerance. Migraines are one of the main symptoms associated with a reaction to alcohol due to histamine.
Packaged meat
Opt for fresh meat over packaged, smoked, or otherwise preserved products.
This means avoiding:
Cheese
Aged, smoked, unpasteurized, pasteurized, and blue cheeses are loaded with histamine. This is because the cheese-making process, particularly ripening, raises histamine levels.
One study found that the age of cheese and the temperature at which cheese is stored can affect histamine levels. The histamine content found in cheeses stored at 22 C was higher than the histamine content found in cheese stored at 4 C.
Legumes
Legumes are a broad category of beans, lentils, and peanuts.
The following legumes don't have a lot of histamine but have high levels of histamine-like chemicals:
Other foods
Other foods that could raise your histamine levels are:
Medications
Some medications can raise your histamine levels, including:
Ask your doctor whether any of your medications could contribute to high histamine levels. They may be able to help you find an alternative medication. They also could prescribe antihistamines, DAO supplements, or medications that prevent the release of histamine. Don't change or stop taking medications without talking to your doctor.
When eating a low-histamine diet, it is important to make sure you're still eating a variety of fresh foods and taking in necessary nutrients. The following foods are low in histamine. If you're limiting the consumption of histamine, try these and other low-histamine alternatives:
Histamine tolerance can vary greatly from person to person. If your doctor thinks that certain foods may be causing your symptoms, they might recommend an elimination diet. This means cutting out all high-histamine foods from your diet and then adding them back one at a time. Pay attention to what foods you're eating when your symptoms get worse. This will give you an idea of what foods your body can tolerate and which foods result in symptoms. Keep in mind that your tolerance may change over time.
The main treatment for histamine intolerance is a change in diet. You may only need to avoid foods that trigger you, or you may need to limit all high-histamine foods. Several studies have shown that low-histamine diets can reduce symptoms in people with histamine intolerance. You can expect to see results in 3-4 weeks.
Here are some strategies for following a low-histamine diet:
Keep a food diary. This can help you track what foods trigger your symptoms.
Talk to a registered dietician. Everyone has different histamine tolerances, health needs, and food preferences. A registered dietician can help find a plan that's right for you. They'll make sure you're getting all the vitamins and minerals you need while staying away from foods that trigger you. This is especially important if you have other health conditions that affect your diet, such as diabetes.
Choose fresh, whole foods. Any type of processing, especially fermentation and curing, dramatically raises a food's histamine levels. This is partly because as food gets processed or ages, histamine-making bacteria start to grow. Avoid anything that's canned, smoked, or dried. Instead, stick with fresh foods (except for any that might trigger you, such as citrus or tomato).
Store your food safely. As foods age, they become higher in histamine. You can slow down this process by storing foods in your refrigerator or freezer. When it comes to storing cheese, the lower the temperature, the better.
Get cooking. This gives you more control over the ingredients in your food and how they are prepared and stored. Plus, cooking methods can impact histamine levels. For example, braising and steaming produce less histamine than grilling.
Take supplements. Some research suggests that copper, vitamin B6, and vitamin C can help lower histamine levels.
Talk to your doctor before changing your diet or starting supplements. They can help you choose foods, strategies, and supplements that won't interfere with other health conditions or medications. A low-histamine diet might not be a good idea for people with a history of an eating disorder.
Histamine is a natural chemical that tells the body to launch an allergic reaction. Some people have histamine intolerance, which means their bodies have a hard time breaking down the chemical. As a result, histamine builds up in the body and causes allergy-like symptoms. If you think you have histamine intolerance, talk to your doctor about a low-histamine diet. They can also help you rule out other problems with similar symptoms.
What does histamine do to a person?
Histamine is involved in many key functions, including sleep cycles and thinking capabilities. But it's most well-known for its role in triggering allergy symptoms.
What releases histamine in the body?
When you come in contact with an allergen, your body starts an immune response by telling mast cells (a type of white blood cell) to release histamine.
What are the symptoms of high histamine?
High histamine levels can cause allergy-like symptoms, including stuffy or runny nose, headaches, stomach upset, and low blood pressure.
Is soy sauce high in histamine?
Soybeans contain histamine-like substances that can worsen symptoms. In addition, the fermentation process can raise histamine levels in soy sauce.
What Is Histamine Intolerance And How To Manage It
Histamine intolerance refers to when the body cannot eliminate histamine. This can result in symptoms that mimic an allergic reaction. It can occur due to genetic factors or certain medications.
Histamine is a signaling molecule, which means it sends signals between cells. It plays a role in many bodily processes, including allergic reactions. When the body releases histamine, it can cause many of the symptoms that people associate with allergies, such as congestion and swelling.
When the body is intolerant of histamine, it is unable to eliminate histamine that a person consumes from food and drinks. This results in sensitivity and intoxication in severe cases.
This means histamine levels can accumulate in the body and cause symptoms similar to an allergic reaction. Typically, this occurs due to the reduced activity of an enzyme in the small intestine that breaks down histamine.
When the body is unable to eliminate histamine, it causes histamine levels in the blood to rise, which mimics the symptoms of an allergic reaction.
Histamine intolerance is relatively rare, affecting about 1–3% of the global population. However, a person or their doctor may not recognize it and may mistake it for a food allergy or gastrointestinal disorder.
A medical professional may have trouble defining and diagnosing histamine intolerance. This may be because the symptoms can arise in many different areas of the body and overlap with those of other conditions.
The symptoms can affect the lungs, skin, and brain, for example, but gastrointestinal symptoms, such as bloating, are most common.
Often, people with histamine intolerance experience:
Usually, an enzyme called diamine oxidase (DAO) breaks down histamine. However, different factors can inhibit the activity or expression of this enzyme.
A deficiency of DAO typically occurs due to genetic factors, meaning a person's body does not produce a sufficient amount of working DAO.
When the body does not break down histamine from foods, histamine may leak through the intestinal lining and enter the bloodstream. This can trigger an immune response.
In addition, high alcohol consumption and health conditions that damage the lining of the gut can lead to histamine intolerance.
Almost all foods and drinks contain some histamine. However, the amount of histamine is typically higher in fermented foods. Some foods and drinks also contain compounds that help release histamine in the body or block the production or effectiveness of the enzymes DAO.
Some foods and drinks that are rich in histamine may include:
Foods that may trigger the release of histamine include:
Foods that may interfere with DAO levels or actions include:
Many kinds of bacteria, including common food contaminants, can also produce histamine in the gut. In addition to producing histamine, certain bacteria can affect the health of the intestinal walls. This may lead to intestinal barrier dysfunction in people with histamine intolerance.
If they suspect an intolerance, a doctor may recommend a low histamine diet. Usually, this means limiting the intake of histamine-rich foods rather than excluding them entirely. Studies have found that trying this diet can be important in confirming a diagnosis of the intolerance. It may also improve the symptoms.
However, a person should not have a low histamine diet in the long term unless a doctor recommends it and monitors the person's health.
Anyone with a low-histamine diet should focus on variety to make sure that they have adequate nutrition.
Foods low in histamine include:
Aside from dietary changes, there is no set treatment for people with histamine intolerance.
However, one or more of the following approaches may help:
A 2020 review found that DAO supplementation yielded positive results in the majority of available studies. However, the team called for more rigorous research to establish how effective this supplementation is at treating histamine intolerance.
Many foods contain high histamine levels. If the body is unable to break down this chemical adequately, it can lead to a diverse range of symptoms, which are often gastrointestinal.
Managing a histamine intolerance tends to involve making dietary changes, taking antihistamines or enzyme supplements, and avoiding or limiting the use of medications that trigger the release of histamine.
A diet focused on fresh, minimally processed foods with few preserved or fermented products naturally contains less histamine.
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