Experiencing allergy or digestive symptoms, but you can’t figure out what’s causing your symptoms? It may be due to histamine intolerance. Read on to learn more about this condition and how a low histamine diet may help you feel good again!

Overhead photo of a variety of vegetables, including carrots and potatoes, to eat on a low histamine diet.

What is Histamine Intolerance?

Histamine intolerance is a condition in which your body cannot degrade high amounts of histamine due to inadequate levels of enzymes called diamine oxidase (DAO) (1). Histamine is produced by bacteria in foods and is also a biogenic amine found in mast cells in our body (1). The release of histamine leads to symptoms associated with allergic reactions. High-stress levels can also cause excess histamine.

Symptoms of Histamine Intolerance

Histamine intolerance typically causes various symptoms, mostly similar allergies. Common gastrointestinal symptoms include bloating, diarrhea, flatulence, abdominal pain, nausea, and vomiting. Some other symptoms are skin rashes, itchy skin, headaches, asthma, runny nose, watery eyes, low blood pressure, and irregular heartbeat. Histamine intolerance may also cause severe period pains in women.

Who Can Benefit from a Low Histamine Diet?

A low-histamine diet is beneficial to people with histamine intolerance. A diagnosis is made when an individual experiences 2 or more typical symptoms that improve with a low-histamine diet and antihistamines. The diamine oxidase activity and histamine levels can also be tested with the skin prick test. 

Because other medical conditions can cause symptoms of histamine intolerance, it is important to rule out these conditions, such as food allergies/malabsorption, celiac disease, and other food intolerances. But, it is not surprising if an individual has more than one condition.

Some conditions with similar gastrointestinal symptoms are irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and other gastrointestinal diseases. Although limited research is conducted on the relationship between histamine intolerance and IBS, one study shows that histamine may be a factor that leads to IBS symptoms. For those who haven’t done well on a low FODMAP diet, a combination of a modified low FODMAP and a low-histamine diet may help with digestive symptoms. 

To further help you decide whether you should try a low-histamine diet, below are some pros and cons of following this diet:

Pros of a Low Histamine Diet

  • A low-histamine diet can help you manage digestive and other symptoms if histamine intolerance is the cause or one of the causes.
  • It can help you identify which high histamine foods to avoid or minimize in your diet. And, conversely, you may be able to resume eating other foods, such as high FODMAP foods, you had previously been avoiding.

Cons of a Low Histamine Diet

  • Following this restrictive diet along with a low FODMAP and/or gluten-free diet without guidance can deprive your body of essential nutrients. So, it is important to see a physician and rule out other conditions before trying the diet. And then to work closely with a dietitian experienced in low histamine diets to help you plan a nutritiously sound diet.
  • As with any restrictive diet, it’s easy to get caught up in the trap of thinking all of your symptoms are related to food. This can lead to a fear of food and disordered eating. If your diet becomes too limited and you’re constantly worried about what you eat, you must work with a GI dietitian and consider an assessment with a GI psychologist. Please reach out to schedule a consultation or get a referral.

Low Histamine Diet General Tips

It has been suggested to follow a low histamine elimination diet for 3-4 weeks and then slowly reintroduce high histamine foods into your diet This can help determine your tolerance to high histamine foods.

Since each individual has various levels of histamine tolerance, keeping a food diary is essential to find out your tolerance to different foods. Some general tips include avoiding processed foods, such as canned, ready-to-eat, ripened, or fermented foods, as much as possible. Also, avoid foods that release histamine and/or block the DAO enzymes, such as citrus fruits and alcohol. In general, focus on eating fresh whole foods. The fresher they are, the better!

What foods should I avoid on a low histamine diet? List of high histamine foods

  • Certain Fish: e.g., Tuna, sardines, mackerel, herring
  • Shellfish
  • Processed meats: e.g., Sausages, ham
  • Egg white
  • Ready-to-eat meals
  • Canned, smoked, or pickled foods: e.g., canned soups
  • Fermented foods: e.g. sauerkraut, kimchi, kombucha, yogurt, kefir
  • Aged cheese: e.g., Cheddar, Swiss, Parmesan
  • Vegetables: e.g., Tomatoes, eggplant, spinach
  • Fruits: e.g., Citrus fruits, papaya, pineapples, kiwi, bananas, plums
  • Nuts: Walnuts, peanuts, all rancid or stale nuts
  • Beans and legumes: chickpeas, soybeans, etc.
  • Chocolate and cocoa
  • Vinegar: e.g., balsamic vinegar, wine vinegar
  • Alcohol and energy drinks: e.g., red wine, white wine 
  • Food additives

What foods can I eat on a low histamine diet? List of low histamine foods

  • Some fresh fish (or frozen): Hake, trout, plaice
  • Fresh meat and chicken (or frozen/cooled)
  • Egg yolk
  • Pasteurized milk and fresh dairy products
  • Fresh fruit: e.g., apple, apricot, blueberries, mango, persimmon, cherries, cranberries, peach, blueberries
  • Fresh vegetables: e.g., artichoke, arugula, beets, bell pepper, broccoli, carrots, cauliflower, kale, potatoes, romaine lettuce, zucchini
  • Grains and grain products: Quinoa, millet, oats, rice, etc.
  • Mozzarella, cream cheese, and butter (without the histamine generating rancidity)
  • Most cooking oils, leafy herbs, and herbal teas: e.g., coconut oil, basil, oregano, parsley, chamomile tea
  • Some nuts and seeds: Brazil nuts, macadamia nuts, pistachios, chia seeds, pumpkin seeds

1-Day Sample Low Histamine Diet

Bowl of oatmeal with mango slices and coconut.

Breakfast: Tropical Oatmeal. Top oats with pasteurized milk, mango, unsweetened shredded coconut, and toasted macadamia nuts.

Lunch: Salmon Quinoa Bowl with Broccoli. Place cooked quinoa in a serving bowl. Top with freshly prepared cooked salmon (or other fish) and steamed broccoli. Drizzle coconut oil on top and add minced garlic, salt, and pepper to taste.

Snack: Apple Slices with Pumpkin Seed Butter

Dinner: Chicken & Veggie Pasta. Top cooked brown rice pasta with freshly cooked chicken breast, chopped bell peppers, arugula, canola oil, garlic, basil, salt, and pepper. Add mozzarella cheese to taste.

Dessert: Chia Pudding with Blueberries + Coconut Milk. Combine 9 tablespoons of chia seeds with 1 1/2 cups coconut milk. Sweeten to taste with maple syrup and top with fresh blueberries. Makes 4 servings.

Nutrients & Supplements for Histamine Intolerance

While there’s limited research behind supplements for histamine intolerance, below is a list of commonly suggested ones.

One of these is DAO (diamine oxidase), an enzyme our bodies naturally produce that helps break down histamine. DAO supplements, formulated from porcine kidney protein extract, are available over-the-counter and may allow for a less restrictive diet. To date, three studies, albeit small, have reported symptom improvement with DAO supplementation. (1) Work with your physician or registered dietitian if you want to add a DAO supplement to your low histamine diet trial.

In addition, some micronutrients may increase the effectiveness of DAO enzymes, including vitamins C and B6. A study shows that vitamin C can raise DAO levels in the body and relieve the symptoms of seasickness, which are believed to be due to the increased histamine levels in the body (2).

Quercetin has been shown to help improve allergy symptoms. Therefore it may also help with histamine intolerance symptoms (3). A few foods high in quercetin that are also appropriate for a low histamine diet include kale, broccoli, blueberries, and apples.

In addition, probiotics help promote a healthy gut microbiome, which aids in histamine metabolism. So they MAY be beneficial for people with histamine intolerance. But, note that some gut bacteria can produce histamine; therefore, only certain strains are suitable for histamine intolerance.

The bacteria found in fermented foods like yogurt may also be why these foods are not well-tolerated on a low-histamine diet. So it may be a good idea to avoid those strains– Lactobacillus casei and Lactobacillus bulgaricus. If you have IBS and take probiotics, be sure to check the label and consult with a registered dietitian specializing in digestive health.

Strains that may decrease histamine levels are Lactobacillus rhamnosus, Lactobacillus plantarum, Bifidobacterium infantis, and Bifidobacterium longum (4). However, more research is needed to study the benefits of different strains of probiotics on histamine intolerance.

Putting it into practice: Low Histamine Recipe Book PDF & Guidebook

If you’ve decided you want to try a low histamine diet but need help putting it into practice, be sure to check out The Low Histamine Recipe Book and Guidebook!

The recipe book features 42 low histamine recipes (breakfast, entrees, side dishes, snacks, and dessert). And, the guidebook provides detailed low, moderate, and high histamine food lists for each food category, along with a one-page low/high histamine “cheat sheet.” You also get a meal planner & a food worksheet to help keep track of your symptoms. Click on the button below to learn more!

Additional References

  1. Comas-Basté, Oriol, et al. “Histamine Intolerance: The Current State of the Art.” Biomolecules, MDPI, 14 Aug. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7463562/.
  2. Jarisch, R., et al. Impact of oral vitamin C on histamine levels and seasickness.” J Vestibular Research, 17 December 2013, www.pubmed.ncbi.nlm.nih.gov/25095772/
  3. Hattori Masashi, et al. “Quercetin inhibits transcriptional up-regulation of histamine H1 receptor via suppressing protein kinase C-δ/extracellular signal-regulated kinase/poly(ADP-ribose) polymerase-1 signaling pathway in HeLa cells.” Int Immunopharmacol, 16 January 2013, www.pubmed.ncbi.nlm.nih.gov/23333628/
  4. Oksaharju, Anna, et al. “Probiotic Lactobacillus rhamnosus downregulates FCER1 and HRH4 expression in human mast cells.” World J Gastroenterol, www.pubmed.ncbi.nlm.nih.gov/21390145/

Do you have any questions about histamine intolerance or how to follow a low histamine diet? Have you tried this diet before? If so, what’s your experience with the low histamine diet? If you found this post helpful, please share. Thank you so much!

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