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Histamine Intolerance

What is histamine intolerance & inflammation?

Histamines are chemicals in your body produced in response to allergens. Specifically, your body produces white blood cells called mast cells to release histamines during the inflammatory-immune response to allergens. This is part of a healthy, balanced immune system. Many foods naturally contain histamine or trigger the release of histamine in the body.

Problems occur however, when there is a dysfunction or deficiency of the enzymes that break down histamine (those enzymes are called histamine N- methyltransferase (HMNT) and diamine oxidase (DAO). Without the enzymes to effectively get rid of excess histamine, you could experience a histamine overflow, which can cause many problems.

Histamine intolerance is a condition that arises when there is an imbalance between excessive histamine ingestion with food or deficient histamine breakdown in the body. Histamine intolerance displays symptoms such as headache, gastrointestinal symptoms, skin-swelling, eczema, palpitations, hives, and itching. People with histamine intolerance may also have lower gut diversity. The prevalence of histamine intolerance is estimated to be 1-4% of the population.


Histamine intolerance is basically an allergic reaction without the allergen, sometimes called a “pseudo allergy.” The typical histamine intolerance symptoms are similar to allergic reactions but also go beyond your typical sneezing, to include:

- Anxiety

- Brain fog

- Digestive problems

- Eczema

- Fatigue

- Hormone imbalances

- Irritability

- Low blood pressure

- Low sex drive

- Migraines

- Nausea

- Racing heart

What is a low histamine diet? A low histamine diet requires the restriction or elimination of any food, ingredient, or substance that contains high amounts of histamine, which triggers an allergic response. Decreasing consumption of histamine can significantly reduce allergy symptoms, and it may even increase DAO levels in the blood. After food allergies have been ruled out, a low histamine diet is often recommended, and a favorable response to it can help diagnose histamine intolerance.

Who is a low histamine diet for? An effective method for reducing the symptoms of histamine intolerance is to carefully follow a histamine-restricted diet, in combination with a DAO supplement. Every histamine-sensitive individual has a threshold of histamine or histamine-releasing foods they can tolerate before experiencing symptoms. Nutrition professionals can work with clients to implement an individualized low histamine diet and then gradually add foods back to identify how much histamine an individual can tolerate.

The amount of histamine from dietary sources can vary. Histamine is a by- product of bacterial metabolism so aged and fermented foods like cheeses, yogurt, processed meats, alcoholic beverages, kefir, kombucha, sauerkraut, and soy are typically high in histamine.

Foods to avoid if you are histamine intolerant:

High-histamine foods

- Alcohol

- Bone broth

- Canned food

- Cheese

- Chocolate

- Eggplant

- Fermented food (kefir, kimchi, yogurt, sauerkraut)

- Legumes

- Mushrooms

- Nuts

- Processed foods

- Smoked meat products (bacon, salami, salmon, ham)

- Shellfish

- Spinach

- Vinegar

Foods that release histamine:

- Avocados

- Bananas

- Citrus fruits (kiwi, lemon, lime, papayas, pineapple, plums)

- Strawberries

- Tomatoes

Foods that block the enzyme that controls histamine:

- Alcohol

- Energy drinks

- Teas (black, green)

The best way to minimize the recurrence of histamine intolerance symptoms is to maintain an individualized low histamine diet. As a long-term exclusion diet, it should be closely monitored by a nutrition professional to optimally nourish and assess for potential deficiencies. Add a DAO supplement and micronutrient supplements which may increase the effectiveness of DAO enzymes.

The low histamine diet can be implemented in a phased approach.

1. Avoidance - Histamine-containing foods should be avoided for a period of two to four weeks as a trial to assess whether symptoms improve. If a positive response is noted, you may assume that it is a histamine sensitivity, and a low histamine diet would be required long-term.

2. Reintroduction - Each individual has a personal limit of histamine tolerance and the elimination phase should be followed by up to six weeks of reintroducing foods slowly to determine histamine tolerance while taking the clients individual dietary preferences into consideration. Keep a symptom journal during this phase.

3. Maintenance - The final stage is determining what your diet might look like.

Other Sources of Histamine Intolerance

- Antidepressants

- Antibiotics

- Narcotics

- Gastrointestinal medications

- Antihypertensives

What to do if you have histamine intolerance:

1. Get a histamine blood or urine test

2. Get to the root of the problem

a. Leaky gut syndrome

b. Small intestinal bacterial overgrowth

c. Gluten intolerance

d. Nutrient deficiencies

e. Medications

f. Methylation impairments

g. Disorders like macrocytosis, which leads to too many mast cells-MCAS

3. Eliminate your problem foods

4. Focus on eating fresh foods

5. Heal your gut - microbiome imbalances can also release histamine and trigger symptoms. Problems like leaky gut syndrome, SIBO, and candida could be fueling your histamine intolerance.

6. Eat foods that help your body get rid of excess histamines

a. Vitamin B6: chicken, turkey, and potatoes

b. Copper: asparagus

c. Vitamin C: fruits and vegetables (except for those high in histamine)

d. Black cumin and quercetin are also two natural medicines that have antihistamine properties

e. Try D-hist which is a natural antihistamine and a DAO supplement of 4-12 mg daily

Keep Moving Forward 😊 Sarah

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