Who Cut the Cheese

by | Jan 31, 2023 | Articles, Blog, Histamine

Can you eat cheese if you have histamine intolerance? This is one of the most common questions I receive. If you’ve been newly diagnosed with histamine intolerance or mast cell activation syndrome, you understand the panic around your new dietary changes. 

What can I eat on a low-histamine diet? Can I eat my favorite foods? I love cheese. Can I eat cheese on a low-histamine diet?

Worry no more. In this article, I will answer all your questions regarding cheese and histamine intolerance. Spoiler: You don’t have to ditch every cheese. Certain cheeses are high in histamine. Others are safer. To learn what you can eat and what you should cut from your low-histamine diet, read on.

What Is Histamine Intolerance

Histamine is naturally made by your body to support your immune system and various mechanisms inside your body. It also supports your digestion, brain, and mental health. 

Though histamine is essential for your health, too much histamine can become a problem. Too many high-histamine foods, environmental toxins, stress, and other factors can increase the histamine load in your body. This may be for your body to handle and it won’t be able to break it all down, causing a buildup. Histamine intolerance is essentially a buildup of histamine. Histamine intolerance can affect your entire body and can lead to widespread symptoms.

Symptoms of histamine intolerance may include:

  • Headaches and migraines
  • Eczema, dermatitis, acne, and other skin issues
  • Hives
  • Fatigue and sleep issues
  • Red eyes
  • Dizziness or vertigo
  • Heart palpitation or racing heart
  • Brain fog, confusion, memory issues
  • Irritability and mood swings
  • Anxiety or panic attacks
  • Blood pressure changes
  • Allergies 
  • Asthma
  • Congestion or runny nose
  • Acid reflux, bloating, diarrhea, and other digestive symptoms
  • Abnormal menstrual cycle and premenstrual syndrome (PMS)

Histamine in Cheese

Now that you understand how too much histamine and histamine intolerance can become a problem, let’s talk about cheese. Is cheese high in histamine? Can you eat cheese with histamine intolerance? The answer is: it depends on the cheese. 

First of all, your body’s response to histamine in cheese and to a certain amount of cheese differs from person to person. Someone without histamine intolerance or mast cell activation issues may be able to tolerate cheeses with high levels of histamine. However, if you have histamine intolerance, high-histamine cheeses will likely cause a problem and you are better off avoiding them.

Aged cheeses, such as parmesan, asiago, cheddar, Swiss cheese, and gouda, are very high in histamine. This high histamine content most likely happens because they are using certain microbes that can easily convert histidine to histamine during processing. 

Histamine develops as a product of the enzymatic breakdown of an essential amino acid, histidine. There are a variety of microbes that can lead to this bacterial enzymatic activity. For example, in cheese Lactobacillus buchnerii, in wine Oenococcus oeni, and in beer, Pediococcus damnosus can lead to this reaction. 

This is not new information. According to a 1985 study published in Applied and Environmental Microbiology,  Lactobacillus buchnerii has led to a histamine poisoning outbreak from Swiss cheese (1). Certain circumstances, such as temperature, may increase this reaction and may also increase histamine levels (2, 3). 

Due to the presence of these microbes and increased histamine production, certain cheeses are higher in histamine. In cheese mongering circles, there is a phenomenon called ‘parm rash’. It refers to a reaction to high-histamine cheeses after prolonged contact, such as handling cheese or breaking down a wheel of parmesan all day long (4, 5). 

Not all cheeses are high in histamine, though. The less aged a cheese, the lower it is in histamine. Soft cheeses, such as mozzarella or ricotta, are low in histamine and are better options if you have histamine intolerance.

Factors That Increase Histamine in Cheese

There are a certain factors that may influence the histamine levels of cheese (6):

  • Bacterial starter culture
  • Salt level
  • pH level
  • Ripening time
  • Storage temperature

As you can see, certain factors, such as the bacterial starter culture used, are out of your control. Other factors, such as storage, are something you can pay attention to as well. Even if you are consuming lower-histamine soft cheeses, it’s important that you store them properly. Watch the expiration date. Keep the cheese in your fridge at all times. If you are taking a sandwich, salad, or a meal with cheese to work, take an ice pack in your lunch box and put it in the fridge right away. 

Tip: Learn more about low-histamine food prep and cooking from this article.

Low-FODMAP Diet, Your Gut, and Histamine

FODMAPs refer to fermentable oligosaccharides, disaccharides, monosaccharides and polyols. FODMAPs are short-chain carbohydrates that the small intestine doesn’t absorb well. Some people experience digestive issues consuming food high in FODMAPs. A low-FODMAP diet is commonly used to help improve irritable bowel syndrome (IBS)small intestinal bacterial overgrowth (SIBO), and other digestive issues (7, 8, 9).

Gut imbalance and gut health issues are common underlying factors behind histamine intolerance. Bacteria in your gut can produce excess endogenous histamine (10). If gut health issues are driving your histamine intolerance, it is not enough to follow a low-histamine diet. You have to address underlying gut issues, such as IBS or SIBO.

In these cases, following a low-FODMAP diet along with a low-histamine diet may help to resolve underlying gut problems. According to a 2016 study published in BMJ Journals, following a low-FODMAP diet helped to improve digestive symptoms and reduce histamine levels in IBS patients (11). You may learn more about the low-FODMAP diet for histamine intolerance here.

Since we are talking about cheese, you may wonder if you can eat cheese on a low-FODMAP diet. You guessed it right: it depends on what kind of cheese you are choosing. The low-FODMAP diet is not dairy-free or vegan. This means that you can consume some dairy on a low-FODMAP. However, you have to avoid high-lactose dairy products. Since lactose intolerance and reactions to lactose are common, choosing low-lactose or lactose-free may be a better option even if you are not on a low-FODMAP plan.

This means that you can consume low-lactose cheese and lactose-free cheeses in moderation on a low-FODMAP diet. If you are also following a low-histamine diet, you have to be careful though. Not all low-lactose and lactose-free cheeses are histamine-friendly.

Low-lactose cheeses include feta cheese and cottage cheese. Unfortunately, feta cheese is high in histamine, but cottage cheese is a great choice. Naturally, lactose-free cheeses include hard and aged cheeses, such as parmesan, cheddar, and Swiss cheese. Unfortunately, hard and aged cheeses are high in histamine. However, you can find lactose-free soft cheeses, such as lactose-free mozzarella, on the market too.

Cheeses to Avoid with Histamine Intolerance

I recommend completely avoiding aged cheeses as they are high in histamine.

Aged-cheeses include:

  • Hard cheese, such as parmesan, romano, asiago, cheddar, manchego
  • Blue cheeses aged with bacteria, such as gorgonzola, roquefort, cabrales, and stilton
  • Moldy cheeses, such as camembert and brie
  • Stinky cheeses that were ripened with bacteria, such as Limburger and raclette
  • Cheese made from unpasteurized ‘raw’ milk

Cheeses You May Try with Histamine Intolerance

Each cheese has different amounts of histamine. Aged cheeses generally have higher histamine content than less-aged, soft cheeses, and fresh cheeses. The less aged the cheese is, the safer it is. If you are eating cheese, choose soft cheeses, such as mozzarella, ricotta, mascarpone, cottage cheese, and cream cheese. Opt for low-lactose or lactose-free dairy if you can to avoid lactose sensitivities. 

Keep your cheese intake low. Focus on low-histamine, nutrient-dense, anti-inflammatory foods, such as greens, vegetables, herbs, spices, fruits, grass-fed meat, pasture-raised poultry and eggs, wild-caught fresh fish and seafood, and wild game. Lower-histamine, soft cheeses should only be a small portion of your diet. If you find that your body is reacting to soft cheeses too, remove them.

Going Plant-Based Instead?

What about plant-based ‘cheese’? Great question. Aside from the fact that most plant-based ‘cheeses’ just don’t taste like cheese from dairy and often have a disappointing texture, plant-based ‘cheeses’ are not necessarily healthy or histamine intolerance-friendly.

Most plant-based cheeses on the market are made from soy. Soy is a common food sensitivity and may increase estrogen dominance in higher quantities. Since estrogen dominance can drive histamine intolerance and histamine intolerance can drive estrogen dominance, you have to be careful keeping your estrogen levels at bay. They are also overly processed with lots of added ingredients that may not be the best for your health. 

There are also plant-based ‘cheeses’ made from cashews or other nuts. While some of these nut cheeses are also overly processed, you can find some simple recipes online using only cashews, nutritional yeast, and some spices. These are usually ‘cheese’ spreads instead of hard, sliceable ‘cheese’.

These homemade recipes sound healthy. But there is a major problem: cashews are high in histamine. Homemade plant-based ‘cheese’ recipes with macadamia nuts or almonds may be a better option to try occasionally. Also remember, for some, yeast can trigger mast cell release of histamine and other mediators.

If you opt for plant-based ‘cheese’, it is important that you read the ingredient list carefully. Ideally, opt for a homemade option with low-histamine ingredients. Since most plant-based ‘cheeses’ are even higher in calories than dairy cheese, keep your intake in moderation.

Next Steps

If you have histamine intolerance or mast cell activation issues, I recommend that you follow my recommendations when it comes to cheese. If you are learning more about how to improve histamine intolerance or mast cell activation syndrome and how to implement a low-histamine diet, you may benefit from working with a doctor. I invite you to schedule a consultation with me here to see if you can benefit from a low-histamine diet.

If you are dealing with any chronic health issues, for advice on how to improve your nutrition and health, I welcome you to start a functional medicine consultation with me for further personalized guidance. You may book your consultation here

Check out my Histamine Intolerance Course here. Learn on your own time, from anywhere. Get an inside look at the most helpful functional medicine tests for pinpointing imbalances, ways to identify and manage the most common (and sometimes surprising) mast cell triggers, and learn what to eat, what to avoid, and why.

Learn more about working with Dr. Gannage