Histamine is an inflammatory molecule that triggers the common allergy symptoms – sneezing, itching, watery eyes, and runny nose (6). It is produced by the body in response to allergens or an immune system malfunction. It can also be ingested through certain foods, including high-histamine foods and histamine liberators. The purpose of the low histamine diet is to reduce the production of histamine in response to allergens, immune triggers, and certain foods. The low histamine diet can be beneficial for people who experience an allergy-like response to histamine in foods, otherwise known as histamine intolerance.
How Do I Know If I Have Histamine Intolerance?
There is yet no test to diagnose histamine intolerance. Because It’s not a food allergy, food allergy testing may not be helpful. The best way to determine if a person has histamine intolerance is to follow a food elimination diet and reintroduce foods containing histamine slowly.
This is especially useful if you’ve experienced histamine intolerance symptoms such as (6):
- Headache
- Asthma
- Hives
- Flushing
- Nausea
- Itching (especially of the eyes and throat)
- Dizziness/lightheadedness
- Fast heartbeat (tachycardia)
- Difficulty swallowing (dysphagia)
- Low blood pressure
The symptoms may occur a few hours or days after ingesting histamine-rich foods. These symptoms are often mistaken for a food allergy, but they can also occur without any obvious allergy triggers.
What Causes Histamine Intolerance?
Many things can cause histamine intolerance, including:
An Overactive Immune System
Mast cells in the body release histamine as a defense mechanism against inflammation and infection. If mast cells are frequently activated (for example, because of an allergy), then they may begin releasing too much histamine and cause issues for the body (6).
Certain Medications
Some medications can deplete the body of the enzyme that breaks down histamine or interfere with the way it is broken down, either of which may result in histamine intolerance (6).
Read More: The Renal Diet List Of Foods: How To Eat For Kidney Health
An Imbalance Of Gut Bacteria
Some types of bacteria can produce histamine or encourage the body to release it in response to an immune trigger. A low-histamine diet is typically very healthy for gut flora because it limits processed foods and foods that feed harmful bacteria (like sugar) while encouraging fiber-rich fruits and vegetables (9).
Eating High-histamine Foods Or Foods Containing Histamine Liberators
Histidine, which is an amino acid that forms histamine when metabolized by the body, can be found in high concentrations in certain types of fish. Other foods with very high concentrations include tuna, mackerel, herring, anchovies, and sardines (see histamine high foods) (6).
There is a theory that some foods which are low in histamine themselves contain chemical compounds that are thought to promote the release of histamine from your cells. They are called histamine liberators. Scientists aren’t sure how this works.
What Does The Low Histamine Diet Involve?
The low histamine diet restricts high-histamine foods while encouraging low-histamine foods, including many of the same fruits and vegetables that are healthy for everyone (and generally encouraged on a whole foods diet).
It may not be necessary to follow the diet perfectly every day for the rest of your life, as there is still much to be learned about the effects of food intolerance on the body. However, many people find that following this diet for a few months can reduce or eliminate allergy symptoms and improve quality of life. It is best to work with a registered dietitian while on this or any other restrictive or elimination diet to ensure that you are still getting all the nutrients your body needs. You also need to be supervised by a doctor.
Foods To Avoid
Alcoholic Beverages
Most alcoholic beverages contain histamine, but beer has such high concentrations that it has been used to create a histamine-intolerance diagnosis in scientific studies (5).
Fermented Foods
Fermentation produces high levels of histamine and possibly histamine liberators, which may trigger immune cells to pump out even more histamine (6). Some types of fermented foods can be high-histamine, including sourdough bread, vinegar, champagne/wine/beer, aged cheeses (gouda and cheddar), kombucha tea (fermented black tea), fermented tofu, and soy sauce.
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Cured Or Processed Meat
Meats that have been preserved by smoking or salting can also have high concentrations of histamine (6). These include pepperoni, salami, prosciutto, bacon, and smoked or canned fish.
Certain Fruits And Vegetables
Tomatoes and tomato products (ketchup, tomato sauces), eggplant, spinach, and avocado are high in histamines. Others like citrus fruits (oranges/grapefruit/lemons), strawberries, bananas, pineapples, kiwis, plums, can cause symptoms in some individuals (6).
Fermented Soy Products Like Tofu Or Natto
Fermentation of soy creates high concentrations of histamine and may worsen the effects in people who are sensitive to it (6). This includes tempeh (which is made using soaked/drained fermented soybeans) and fermented tofu.
Soured Foods
Foods that have gone bad because of bacteria growth (like when milk sours or bread goes moldy) can contain high concentrations of histamine and possibly histamine liberators (6). These include sourdough bread, vinegar, overripe fruit, dried fruit (histamine low fruits ), and yeast dough.
Beans That Have Not Been Properly Prepared/Soaked
A substance called lectin is found in unsoaked beans and legumes, and might trigger immune cells to pump out histamine (even though these foods are generally low histamine) (1). The lectin is deactivated by soaking the beans or grains at least overnight.
Brewer’s/Baker’s Yeast
This is a form of yeast that is used in the production of beer and bread, and it may cause immune cells to pump out histamine (7). It also occurs naturally in some foods containing gluten (like rye).
Artificial Color
These can trigger allergy symptoms even in people who are not histamine intolerant. They might also trigger immune cells to pump out histamine and slow down the body’s natural histamine breakdown process (6).
Foods To Eat (6)
Fresh Meats
Most fresh meat, chicken, seafood, and eggs are considered low histamine.
Some Fruits And Vegetables
Most fruits and vegetables can be low histamine, but some may still trigger reactions by promoting the release of histamine in the body. You may need to figure out which ones you react to through trial and error.
Some Grains
Some grains are low histamine, including oats, rice, white/brown/wild rice, buckwheat/buckwheat pasta, corn meal, corn grits, quinoa, couscous.
Most Nut And Seed Oils
Most oils are considered low histamine, including olive oil, peanut oil, sunflower seed oil , grape seed oil, safflower oil, sesame seed oil, coconut oil.
Most Nuts And Seeds
Most nuts and seeds are considered low histamine as well. They include macadamia nuts, almonds/almond butter/almonds flour, walnuts, chestnuts, brazil nuts, hazelnuts/filberts, cashews, pistachios (the green variety), pumpkin seeds , sunflower seeds, sesame seeds.
Spices And Herbs
Most spices and herbs are considered low histamine as well: Basil/oregano/tomato puree, cilantro, cinnamon, white pepper , ginger, marjoram , mint, nutmeg, parsley , rosemary, sage.
Condiments/Dressings
Most condiments and dressings are considered low histamine: apricot preserves, blackberry jam, cranberry sauce, fig spread, grape jelly (100% grape), honey, hot pepper jelly/jam/preserves/sauce. Just avoid tomato-based ones.
Does The Low Histamine Diet Work?
For people who are histamine intolerant, there is some evidence that the low histamine diet can be effective at reducing symptoms, but it isn’t the answer for everyone (4). The goal of following this diet is to eat foods that are considered “low” or “very low” in histamine (or sometimes even zero).
Research has shown that such a diet may help reduce symptoms such as atopic dermatitis (inflamed, itchy skin), flushing, hives, nasal congestion, wheezing/asthma, and others (4). On the other hand, it is very restrictive and difficult to follow. You should only do so as recommended and monitored by your healthcare team.
This diet is typically short-term and intended to either diagnose a histamine intolerance and/or to determine your individual reaction to specific foods. It isn’t a long-term treatment.
What Are The Risks Of A Low Histamine Diet?
A low histamine diet can be difficult to follow because it means saying goodbye to a lot of foods. All processed, packaged, canned, and prepared foods contain additives that are high in histamines. This means you are at higher risk for malnutrition and need to work with a registered dietitian to be sure you are meeting all your nutritional needs. Your physician should also monitor you.
It might also be expensive to follow this diet because you need to buy mostly fresh, whole foods. This might be especially true if you are following a low histamine vegan or vegetarian diet.
What Can I Do If I Can’t Follow The Low Histamine Diet?
If you have been diagnosed with histamine intolerance, you should talk to your doctor about the best approach for you. Your doctor may recommend trying a low-histamine diet temporarily to rule out or isolate specific foods that you react to.
A low-histamine diet is similar to an elimination diet , which involves removing certain foods from your diet and then slowly reintroducing those foods back into your system. It works by identifying the specific inflammatory triggers in your body so you can avoid them in the future.
Your doctor may also recommend antihistamines, certain supplements, or make changes to your medications to help your body break down histamine.
Conclusion
Studies show that low histamine diets can be effective at reducing symptoms of histamine intolerance. It can be difficult to follow this restrictive elimination diet, but it gets easier once you’ve determined which specific foods are triggers for you. If you suspect that you may be histamine intolerant, talk to your doctor about what approach is best for you.
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SOURCES:
- Dietary lectins can trigger in-vitro release of IL-4 and IL-13 from human basophils (1999, pubmed.gov)
- FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial (2016, pubmed.gov)
- Histamine and histamine intolerance (2007, oup.com)
- Histamine-free diet: treatment of choice for histamine-induced food intolerance and supporting treatments for chronic headaches (1993, pubmed.gov)
- Histamine in Beer (2009, sciencedirect.com)
- Histamine Intolerance: The Current State of The Art (2020, nih.gov)
- Immune-modulatory effects of dietary yeast beta- 1, 3/ 1, 6-D-glucan (2014, nih.gov)
- Low-Histamine Diets: Is The Exclusion of Foods Justified By Their Histamine Content? (2021, nih.gov)
- Microbial patterns in patients with histamine intolerance (2018, pubmed.gov)
