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What is Histamine? 

Histamine is an organic compound that is both naturally occurring in our bodies and found in many of the foods we eat. It serves us a variety of purposes, from acting as a neurotransmitter in the brain to regulating gut functioning. We require it for proper functioning. 

Above all else, histamine is well-known for its involvement in triggering a local immune response (1). When an allergen, such as dust, pollen, or pet dander is identified in the body, mast cells release histamine to boost blood flow and cause inflammation. The local inflammation is necessary for other immunity factors to join forces and help rid the body of the allergen.  

Although histamine is not detrimental to our health, problems arise when the amount released or accumulated exceeds the amount broken down. 

Histamine Intolerance 

Histamine intolerance is thought to be relatively rare, affecting only 1% of the population (2). If this value seems low, it’s because it may be an underestimation of actual cases. Oftentimes, it’s mistaken as a food allergy or gastrointestinal issue. Despite the uncertainty, some common symptoms that define an intolerance to histamine include: 

– Nasal congestion; sneezing; itchy nose

– Stomach pain; nausea

– Indigestion; heartburn

– Rashes; hives; itchiness; eczema

– Racing heart; heart palpitations

– Itchy eyes; tearing

– Irregular menstrual cycles; menstrual pain; cramping

– Headaches

– Mood swings; anxiety

– Brain fog; fatigue; insomnia

– Difficulty regulating body temperature

If you’re experiencing one or several of these symptoms, it’s possibly caused by having an imbalance of histamine production to histamine breakdown. Here’s what may be going on: 

1. your body is making too much histamine (likely due to in overactive immune response);

2. you’re consuming too much histamine in your diet; or

3. the enzyme responsible for histamine breakdown, diamine oxidase (DAO), is not functioning properly (due to genetics, medication, or possible underlying medical conditions).

Whichever the cause may be, something needs to change to enable you to better manage your symptoms. Adjusting our diet can be a beneficial strategy towards keeping histamine in check.

The Low Histamine Diet 

It’s important to be mindful that there’s no such thing as a “histamine-free diet”. Instead, the goal is to identify and limit any histamine-rich foods, foods that trigger histamine release, or foods that block DAO production (3).

Eat less of this…

1. Fermented foods: produce chemical changes to food and drinks by converting carbohydrates into alcohols using microorganisms. Some examples include: 

– Dairy products: milk, cheese, and yogurt

– Vegetables: kimchi and sauerkraut

– Meats

– Alcohol

– Kombucha

2. Ripened fruits and vegetables: histamine is formed as a deterioration bi-product in various food items. It’s best to eat sources if possible. 

3. Naturally occurring: some foods contain naturally occurring histamine regardless of any external growth conditions. Some examples include: 

– Avocados

– Spinach

– Eggplant

– Dried fruits

– Shellfish

4. Foods that trigger histamine release: these food sources cause mast cells to release histamine into our system, even if the fruits themselves don’t contain much histamine. This includes the following dietary sources: 

– Citrus fruits: oranges, lemons, grapefruits, etc.

– Bananas

– Tomatoes (including ketchup)

– Beans

– Chocolates

– Nuts

5. DAO blockers:  without proper enzyme activity, histamine can build up in the body over time. Three sources that block enzyme activity include:

– Alcohol

– Tea: black or green

– Energy drinks

Eat more of this… 

– Fresh meats and fish 

– Fresh vegetables (except for tomatoes, avocados, spinach, and eggplant)

– Non-citrus fruits: grapes, apples, pears, berries, etc.

– Eggs

– Natural peanut butter

– Gluten-free grains: quinoa, rice, and whole grains

– Dairy substitutes: almond and oat milk

– Cooking oils

If you’re uncertain about the cause of your symptoms, it may be worth adopting a low histamine diet to identify the underlying cause. Research has found that after about 4 weeks of reducing your intake of histamine-rich foods, your symptoms should resolve if it is in fact a true intolerance (4). 

Tips and Tricks 

1. Cook more meals at home –  this allows you to control the ingredients being used. You can also substitute for more lower-histamine options when necessary.

2. How you cook matters – be mindful of your methods for food preparation. Frying and grilling food increase the levels of histamine when compared to boiling (5).

3. Eat foods in their most natural form – this helps you avoid the high-histamine concentrations that occur in fermented, processed, frozen, and microbial-rich environments.  Be careful also with leftovers.

4. Limit your alcohol intake – alcohol is made through a fermentation process which influences the amount of histamine present. 

5. Consider supplementing – adhering to this diet can affect your intake of essential vitamins and minerals. Some supplements to consider include DAO enzyme, magnesium, vitamin B-6, vitamin C, copper, and zinc.

6. Speak to your doctor – there may be a concern for malnourishment. It’s best to consult with your physician about your plan to adhere to a low-histamine diet.

7. Start using a food diary – start recording your daily meals, time of meals, and any symptoms you may be experiencing. This can help you identify what food sources your body is more or less accepting of. Modify as you go. 

If you have, or suspect you may have, histamine intolerance, or for more personalized guidance on anything mentioned here, request an appointment with Dr. Gannage.

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