Histamine Intolerance

High histamine is prevalent and often undetected in most people leading to chronic inflammatory conditions.

What is Histamine?

Histamine is a chemical involved in your immune system, proper digestion, and your central nervous system. As a neurotransmitter, it communicates important messages from your body to your brain. It is also a component of stomach acid, which is what helps you break down food in your stomach.

You might be most familiar with histamine as it relates to the immune system. If you’ve suffered from seasonal allergies or food allergies, you may have noticed that antihistamine medications like Zytrec or Benedryl provide quick relief of your symptoms. This is because histamine’s role in the body is to cause an immediate inflammatory response. It serves as a red flag in your immune system, notifying your body of any potential attackers.

Histamine causes your blood vessels to swell, or dilate, so that your white blood cells can quickly find and attack the infection or problem. The histamine buildup is what gives you a headache and leaves you feeling flushed, itchy and miserable. This is part of the body’s natural immune response, but if you don’t break down histamine properly, you could develop what we call histamine intolerance.

I most often see high histamine present in skin disorders such as eczema, unexplained skin rashes, itchiness, hives, headaches or migraines, irregular periods or even in increased sweating or mood imbalance such as anxiety. Intolerance to alcohol is another clue.

The following foods are high in histamine: wine, beer, seafood, citrus fruits, berries, chocolate, canned foods, tofu, tomatoes, tempeh, eggplant and leftovers. However fermented foods such as vinegars and kombucha, aged cheeses, and sauerkraut or kimchi are among the highest. When these foods are eaten, you have to have enough DAO enzyme on board to break down the histamine levels in released from these foods, but a SNP (single nucleotide polymorphism) in your DAO gene will hinder that process and cause histamine to build up in your bloodstream.

Vegans who are prone to anxiety or other mood imbalances should consider a trial diet where they eliminate fermented foods altogether. See how you feel after a month or two, you’ll be surprised how much happier you’ll become! Keep in mind that histamine isn’t the bad guy, it’s needed to create stomach acid and to perfect your gut motility. But if you seem to have a lower intolerance to histamine in your diet, consider getting you DNA checked for DAO or “diamine oxidase” which is the enzyme that helps to break down histamine.

Histamine Food List

Low histamine level foods:

• Fresh meat (cooled, frozen or fresh)
• Freshly caught fish
• Chicken (skinned and fresh)
• Egg yolk
• Freshfruits – with the exception of strawberries, most fresh fruits are considered to have a low histamine level (also see histamine liberators below)
• Fresh vegetables – with the exception of tomatoes
• Grains – rice noodles, yeast free rye bread, rice crisp bread, oats, puffed rice crackers, millet flour, pasta (spelt and corn based)
• Fresh pasteurised milk and milk products
• Milk substitutes – coconut milk, rice milk
• Cream cheese, butter (without the histamine generating rancidity)
• Most cooking oils – check suitability before use
• Most leafy herbs – check suitability before use
• Most non-citric fruit juices
• Herbal teas – with the exception of those listed below

High histamine level foods:

• Alcohol
• Pickled or canned foods – sauerkrauts
• Matured cheeses
• Smoked meat products – salami, ham, sausages….
• Shellfish
• Beans and pulses – chickpeas, soy beans, peanuts
• Nuts – walnuts, cashew nuts
• Chocolates and other cocoa based products
• Vinegar
• Ready meals
• Salty snacks, sweets with preservatives and artificial colourings

Histamine liberators:

• Most citric fruits – kiwi, lemon, lime, pineapple, plums
• Cocoa and chocolate
• Nuts
• Papaya
• Beans and pulses
• Tomatoes
• Wheat germ
• Additives – benzoate, sulphites, nitrites, glutamate, food dyes

Diamine Oxidase (DAO) blockers:

• Alcohol
• Black tea
• Energy drinks
• Green tea
• Mate tea

Debatable:

• Yogurt – depends on the bacteria culture used
• Egg white – it is a histamine liberator only when in its raw state

Other:

• Yeast – even though it does not contain histamine as such, yeast serves as a catalyst for histamine generation during manufacture. There is no yeast in the end product.

Treating Histamine Intolerance

Remove the high histamine foods for 1-3 months. Most importantly, find the root cause for the histamine intolerance. If you’re on a medication that is causing the intolerance, working with your physician to wean off of these medications is essential. The main cause I see in my Practice that exacerbate histamine intolerance is Leaky Gut. In this case, I suggest reading my post on healing the gut and over time you should be able to stop the DAO and go back to eating histamine-containing foods.

If you’re currently suffering from histamine intolerance, you may not have to avoid these foods forever. It can be a short-term solution until your histamine or DAO levels return to their optimal ranges. Depending on your unique situation, you may find that you tolerate some foods better than others, so I encourage you to stay optimistic as you learn important information about your body!

  Sources include: NMI Portal für Nahrungsmittel Intoleranz, Histaminunverträglichkeit – Richtige Ernährung Maintz L, Novak N: Histamine and histamine intolerance, American Journal of Clinical Nutrition 2007 Jarisch, R. “Histaminunverträglichkeit”, Thieme Verlag, 2nd Edition