One day you have hives and intensely itchy skin. The next, you are doubled over with abdominal pain and cramps. And the day after, you’re out of your mind with anxiety.
If your collection of symptoms makes you and your doctor scratch your head, wondering what is going on with you, you may have histamine intolerance.
It’s a complex condition, with several possible underlying causes, that can significantly affect your quality of life. One of the best ways to manage it is through watching what you eat.
You see, some foods are high in histamine and others promote its release in the gut. So when you avoid or limit these foods you can begin to regain control of your histamine reactions.
This article explores how a well-planned diet can play a crucial role in reducing histamine-related symptoms and improving overall well-being for those with histamine intolerance.
Understanding Histamine Reactions
Histamine is a biogenic amine that plays a vital role in the body’s immune response, sounding the alarm when a potential threat is detected. It also acts as a neurotransmitter, relaying messages between nerve cells (1).
When everything is working according to plan, histamine is deactivated by the enzyme diamine oxidase (DAO) once the possible health risk has been neutralized. In this way, your body maintains a delicate balance between histamine release and breakdown (2).
This equilibrium is disrupted in people with histamine intolerance. That’s because the condition is often the result of too little DAO enzymes leading to high histamine levels and histamine sensitivity.
Elevated histamine levels can trigger a wide range of symptoms, including:
- Skin reactions - itching, hives, and flushing.
- Digestive issues - abdominal pain, diarrhea, and nausea.
- Respiratory problems - runny or stuffy nose, and sneezing.
- Cardiovascular symptoms - rapid heartbeat and low blood pressure.
- Neurological effects - headaches, dizziness, and anxiety.
The Connection Between Diet and Histamine Reactions
If you have a histamine disorder it will come as no surprise to you that diet plays a significant role in your histamine levels. What you eat can contribute to histamine overload in three ways:
First, some foods like aged cheese, fermented foods, and certain fish naturally contain high levels of histamine, often triggering a histamine attack.
Other foods are histamine liberators. In other words, although they don’t contain histamine, they trigger histamine release in the body.
Finally, certain foods are DAO blockers. That is, they inhibit the activity of DAO enzymes, making it harder for your body to break down histamine.
When these factors combine, you experience a cumulative effect. Histamine levels continue to rise, exceeding your body’s tolerance threshold, leading to a histamine reaction.
Key Dietary Strategies for Managing a Histamine Reaction
Following a low-histamine diet is the cornerstone of managing histamine intolerance (3). However, you must also ensure your meals are nutritionally balanced, your ingredients are fresh, and you prepare and store your food to minimize their histamine content.
Low-Histamine Diet
Eating a diet low in histamine is a great way to manage your symptoms, but it is also a useful tool for diagnosing histamine sensitivity (4).
The reason for this dual benefit is that the initial phase of the diet is a strict elimination of all foods known to have high histamine levels as well as those that trigger histamine release in the body.
Once your symptoms subside and your body begins healing, you then gradually reintroduce some of the offending foods. We generally recommend beginning with two to three foods you really miss, testing your histamine reaction with small amounts to determine whether you can tolerate them.
To give you an idea of what the diet looks like, here is a condensed list of foods to limit and those to include.
High-Histamine Foods to Avoid:
- Aged or fermented products like cheese, wine, and sauerkraut
- Cured meats and fish
- Shellfish
- Canned foods
- Chocolate and cocoa
- Foods containing vinegar such as pickles and mayonnaise
- Soy sauce and other fermented sauces
- Nuts, especially walnuts and cashews
- Certain fruits including strawberries, bananas, and citrus fruits
Foods You Can Still Enjoy:
- Fresh meat and fish
- Low-histamine fruits like apples, blueberries, and watermelon
- Fresh vegetables except for those with high histamine levels such as tomatoes, spinach, and eggplant.
- Gluten-free grains including rice, quinoa, and millet.
- Coconut and rice milk without additives
- Olive oil
For a more comprehensive list, download the free Low Histamine Diet Guide.
Below is a sample low-histamine meal plan to show you how to create delicious meals that help you manage your histamine response.
Low-Histamine Breakfast: Gluten-free oatmeal with coconut milk and fresh apple
Low-Histamine Lunch: Maple ginger chicken with steamed zucchini and basmati rice
Low-Histamine Snack: Carrot sticks with cauliflower low-histamine hummus
Low-Histamine Dinner: Baked salmon with sweet potato mash and asparagus
Balancing Nutrient Intake on a Low-Histamine Diet
Your body needs a balanced intake of energy and nutrients to function properly. So even during the elimination phase of the low-histamine diet it is crucial to ensure you meet your nutritional requirements.
To do so, focus on allowed nutrient-dense foods. During this time, you may also benefit from taking a multivitamin and mineral supplement to fill any nutrient gaps in your diet.
Food Quality and Preparation to Avoid Histamine Reactions
In the busyness of everyday life, it’s not always possible to stop at the store to buy fresh food. We tend to rely on the refrigerator to keep our food fresh for longer. It’s a life saver!
But in the case of histamine intolerance, this practice might be contributing to your elevated histamine levels. The reason for this is histamine develops in food over time. So the longer you store your food, the higher the amount of histamine you are consuming (5).
The solution is to either cook and eat the food you buy as soon as possible, or freeze them immediately. The same applies to leftovers. They are notorious for causing a histamine reaction, so pop them in the freezer once they are cool enough.
Also consider your cooking methods. Grilling, frying, and slow-cooking can increase histamine levels while boiling does not (6).
Beyond Diet: Complementary Approaches to Reduce Histamine Reactions
Diet is crucial for managing elevated histamine levels. However, there are other factors that can support your histamine management.
Some people experience symptom relief when they include supplements formulated specifically for histamine intolerance in their management plan. DAO enzyme supplements and natural antihistamines can help to regulate histamine levels in your body.
Also important is effective stress management, getting enough good quality sleep, and regular histamine-intolerance-friendly exercise.
Eat Right to Manage Histamine Reactions
Diet plays a pivotal role in managing histamine reactions. By understanding the connection between food and histamine levels, you can take control of your symptoms and improve your quality of life.
A low-histamine diet, combined with attention to food freshness and preparation methods, can significantly reduce your histamine-related symptoms. For a comprehensive foods list and guide to succeeding on the low histamine diet, click below to get the free Low Histamine Diet Guide.
Remember, everyone’s experience with histamine intolerance is unique. It can be helpful to work with a healthcare professional who understands the condition to develop a personalized approach that addresses your specific needs and ensures overall health and well-being.
With patience, persistence, and the right dietary strategies, it's possible to effectively manage histamine reactions and enjoy a fuller, more comfortable life.
References
- The Biogenic Amines - Neuroscience - NCBI Bookshelf [Internet]. National Center for Biotechnology Information. [cited 2024 Sep 16]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK11035/
- van Odijk J, Weisheit A, Arvidsson M, Miron N, Nwaru B, Ekerljung L. The Use of DAO as a Marker for Histamine Intolerance: Measurements and Determinants in a Large Random Population-Based Survey. Nutrients [Internet]. 2023 Jun 26 [cited 2024 Sep 16];(13):2887. Available from: http://dx.doi.org/10.3390/nu15132887
- Sánchez-Pérez S, Comas-Basté O, Veciana-Nogués MT, Latorre-Moratalla ML, Vidal-Carou MC. Low-Histamine Diets: Is the Exclusion of Foods Justified by Their Histamine Content? Nutrients [Internet]. 2021 Apr 21 [cited 2024 Sep 16];(5):1395. Available from: http://dx.doi.org/10.3390/nu13051395
- Jochum C. Histamine Intolerance: Symptoms, Diagnosis, and Beyond. Nutrients [Internet]. 2024 Apr 19 [cited 2024 Sep 16];(8):1219. Available from: http://dx.doi.org/10.3390/nu16081219
- Hrubisko M, Danis R, Huorka M, Wawruch M. Histamine Intolerance—The More We Know the Less We Know. A Review. Nutrients [Internet]. 2021 Jun 29 [cited 2024 Sep 16];(7):2228. Available from: http://dx.doi.org/10.3390/nu13072228
- Chung BY, Park SY, Byun YS, Son JH, Choi YW, Cho YS, et al. Effect of Different Cooking Methods on Histamine Levels in Selected Foods. Annals of Dermatology [Internet]. 2017 [cited 2024 Sep 16];(6):706. Available from: http://dx.doi.org/10.5021/ad.2017.29.6.706
Anita Tee
My name is Anita Tee. I'm a nutritional scientist specializing in histamine intolerance. I hold a Master of Science in Personalized Nutrition and a Bachelor of Science in Human Biology and Psychology.
For the past ten years, I have used my experience in nutritional and medical health sciences to create a scientifically backed, natural approach to healthcare that relies 100% on evidence-based research.
As I previously suffered from - and overcame - histamine intolerance, my focus is to increase recognition and expand the available resources and protocols for resolving the disorder. To date, I have helped over 4,000 individuals fully resolve or better manage their histamine intolerance symptoms.
