Constantly experiencing problems like allergies, headaches, fatigue, itchy skin and rashes, or runny nose even though you are eating a healthy, real foods diet? The problem might be histamine intolerance, a condition which affects about 1% of Americans. (source) It is possible that even more people are suffering from histamine intolerance since the problem is so under-reported.
Here we will go over what is histamine, why the body might develop a histamine intolerance, symptoms, of histamine intolerance, foods which contain histamine, and histamine intolerance treatments.
What is Histamine?
We normally think of histamine as the chemical our bodies release during allergic reactions. Yes, this is one of the roles of histamines. But histamines also play many other important roles in our bodies:
- Fighting off foreign invaders (even when they are really harmless invaders like with mild allergic reactions)
- Acting as a neurotransmitter
- Regulating stomach acid production, muscle contractions, brain function, sleep, and more. Histamine even helps produce orgasms!
Histamine is mostly found in the skin, eyes, and stomach, hence why histamine is associated with problems like rash, watery eyes, and indigestion. Histamine is also found throughout the rest of the body too though, so it can cause a wide array of symptoms.
The body produces histamine from basophils (a type of white blood cell) and mast cells (a connective tissue cell). Histamine is then stored in white blood cells which circulate through the body and are activated if needed.
Histamine is found in many foods as well. The body also produces some histamine to digest food. “Normal” levels of histamine are about 0.3 to 1.0 nanograms per milliliter in blood plasma. Everyone has different tolerances for histamine though.
Symptoms of Histamine Intolerance
Diagnosing histamine intolerance based on symptoms alone is really difficult. Almost all of the symptoms which are associated with histamine intolerance could also be associated with some other condition as well.
In fact, if you go to a doctor with these symptoms, you will probably end up getting treatment for the symptoms or some other common ailment and not the underlying problem.
For example, if histamine intolerance is causing acid reflux, you might get proton pump inhibitors. (Learn why proton pump inhibitors are NOT the best way to treat reflux in The 30 Day Heartburn Solution) This is only compounded by the fact that few doctors and nutritionists are even aware that histamine intolerance exists.
The most common symptoms associated with histamine intolerance are:
- Skin problems like itchiness, rashes, and hives
- Swelling and inflammation
- Low blood pressure
- Fast heart rate
- Anxiety and panic-like symptoms
- Runny nose and congestion (which can lead to decongestant addiction like yours truly used to suffer with)
- Watery, red eyes
- Headaches and migraines
- Fatigue and lethargy, bad mood
- Digestive problems like upset stomach and reflux
UPDATE: Good news! There is now a histamine test that you can order directly without a doctor’s order! While I’m a HUGE fan of having a doctor’s guidance, I understand the need to know whether you have SIBO or not before you invest in a practitioner. You can order the test directly here.
What Causes Histamine Intolerance?
Histamine intolerance is caused when the body has more histamine than it can break down. Normally, the body is able to break down histamine using amine oxidases enzymes. Diamine oxidase (DAO) is the main enzyme in charge of breaking down histamine from food.
There are two main reasons your body might not be able to handle histamine:
- You are consuming too much histamine from food and/or
- Your amine DAO enzymes aren’t functioning properly
1. Food As a Cause of Histamine Intolerance
There are many foods which contain histamine. Consuming too many histamine foods can cause histamine intolerance. Note that histamine intolerance is very different from a food allergy though. With food allergies, there is a sudden release of histamine. With histamine intolerance, there is a gradual buildup of histamine in the body.
I like how Chris Kresser compares histamine intolerance to a glass of water overflowing.
When the cup is very full (high amounts of histamine in the diet), even a drop of additional water will cause the cup to overflow (symptoms activated). But when the cup is less full, it would take more water (histamine) to cause a response.
This is what makes histamine intolerance so difficult to diagnose. One day, you might be fine eating a certain food even though the histamine is gradually filling up your cup. But the next day, that food is the “additional drop of water” which overflows the cup, causing anabolic shock that sends you to the emergency room.
2. Amine DAO Enzymes as a Cause of Histamine Intolerance
If your amine DAO enzymes aren’t functioning properly, then you might not be able to handle even a little bit of histamine from food. (source)
What causes your amine oxidase enzymes to become impaired? Researchers still aren’t exactly sure but many believe that the problem lies in the gut.
If your digestive system isn’t functioning properly, you will have a lot of undigested food in the gut. Bacteria then work on this food, producing histamine. (source)
Certain antidepressant drugs called monoamine inhibitors (MAOS) are also to blame because they block amine oxidase enzymes and prevent histamine breakdown. People taking these drugs had all sorts of allergy-like symptoms. This is partly how researchers finally caught on to the problem of histamine intolerance.
Foods which Cause Histamine Intolerance
Before I give you a list of histamine foods, you must understand that food can cause histamine intolerance in various ways.
- There are foods which contain histamine
- There are foods which don’t contain histamine, but they get histamine from bacteria which feed on them (an example of this is meat which has been stored improperly). Note that even healthy bacteria (such as from fermented sauerkraut, pickles and kombucha) produce histamine.
- There are foods which trigger the body to release histamine
- There are foods which can block DAO, thus causing histamine intolerance.
The list of foods which contain histamine is really long. Quite frankly, it can be downright overwhelming. To make matters worse, good luck finding two lists of histamine foods which actually match! For example, some lists will say that citrus fruits are a no-go, whereas others say they are okay.
The reason for this discrepancy in histamine food lists is because everyone reacts to histamine in foods differently. Some people don’t have problems with citrus fruits but fermented foods might cause serious problems. (source) Unfortunately, customizing your list of histamine foods will require some trial and error as well as time and patience.
High Histamine Foods
- Alcohol (red wine is the worst offender)
- Other fermented beverages (this includes healthy beverages like kombucha too)
- Fermented vegetables (pickles, sauerkraut, etc)
- Seafood
- Most cheese
- Vinegar (although Apple Cider Vinegar seems to be less problematic)
- Processed meats like bologna and salami and, sadly, bacon
- Nuts
- Nightshade vegetables (tomatoes, eggplants, etc)
- Spinach
- Avocado
- Some spices (cinnamon, anise, chili, nutmeg, curry, cayenne, cloves)
- Leftover meat (because bacteria growing on it produces histamine; eat your meat as fresh as possible and store it carefully!)
- Fermented foods
Foods which Trigger Histamine Release
- Alcohol and other fermented beverages like kombucha
- Eggs
- Citrus fruits
- Strawberries
- Tomatoes
- Banana
- Dairy products
- Chocolate
- Wheat germ
- Shellfish
- Artificial dyes and preservatives
Foods which Block DAO
- Alcohol and other fermented beverages
- Tea (mainly green and black tea)
- Sugary soft drinks
(Source 1)
How to Treat Histamine Intolerance
The good news is that you don’t have to suffer from histamine intolerance symptoms forever! The bad news is that it can be a bit tricky to diagnose histamine intolerance and you will have to be very careful about your diet for a period of time if you want to keep symptoms at bay.
Low Histamine Diet
The easiest method for diagnosing and treating histamine intolerance is to put yourself on a rigid low-histamine diet. You will need to avoid ALL foods which contain histamine, cause histamine to be released, or inhibit DAO. If your symptoms go away while on this strict diet, then you likely have histamine intolerance.
You don’t have to be on the low histamine diet forever. Remember, histamine builds up in the body over time. After a while of being on the low histamine diet, you’ll have hopefully purged some of the excess histamine from your body. You can start gradually reintroducing histamine foods back into your diet and see how you feel.
DAO Supplements
Remember that the body uses an enzyme called DAO to break down histamine. If your DAO enzymes are impaired, then you won’t be able to break down histamine and can develop symptoms.
There are some natural DAO supplements which can help improve DAO activity.
- Nigella Sativa Oil: This oil comes from black cumin seeds. It’s especially helpful if you’re dealing with congestion. The recommended dosage is 1tsp of the oil before eating in the morning.
- DAO enzymes: These are extracted from porcine kidneys. Take two capsules no more than 15 minutes before eating histamine-rich foods.
- Bromelain: This is a natural enzyme found in pineapple. Take one capsule daily.
- Quercitin with Bromelain: Quercitin is an antioxidant found in many plant foods. When combined with bromelain, it becomes an even more potent DAO-booster. Take two capsules daily.
- Ubiquinol CoQ10: Coenzyme Q10 is used for energy production in all of your cells and is important for many processes, including DAO activity. Ubiquinol is a reduced version of the coenzyme. Take one capsule daily.
The SIBO link
As with all complex health situations, histamine intolerance has several other components is closely linked to SIBO (small intestine bacterial overgrowth). Since gut bacteria producing histamine might be one of the causes of histamine intolerance, curing SIBO could cure your histamine intolerance. (source) You can take a breath test for SIBO thru Commonwealth Labs thru your health care practitioner. This is the test I took which confirmed my case of SIBO.
You can learn more about SIBO here.
Heal Your Gut
Why wouldn’t your body be producing enough DAO naturally? Researchers believe that a damaged gut might be to blame.
Foods like bone broth and gelatin are great for healing a damaged gut. You can find a recipe for how to make bone broth here.
As for gelatin, I recommend the Great Lakes brand of gelatin. Do not use those chemically-made and flavored packs of gelatin you find in supermarkets! They do not provide the same gut-healing benefits of real gelatin. You can buy Great Lakes gelatin here.
For more advice on how to use gelatin to heal your gut (along with lots of great recipes), I recommend you read The Gelatin Secret.
Eat Meals which Are Easy to Digest
Frustratingly, digestion itself causes the release of histamine. If you have a lot of histamine built up in your body, then the act of eating could cause problems – regardless of what you eat.
To prevent this, The Low Histamine Chef recommends eating a diet which is easy on digestion. She recommends that you get your nutrients from juicing, smoothies, and soups. These liquid meals require less gastric juices to digest and thus less histamine. I’m not normally a fan of juicing (read why), but this is one case when juice can help. Just go easy on the fruit so you don’t mess up your blood sugar regulation in the process! If juicing and other easy-to-digest meals are all you can handle for a while, don’t fret, it’s just the first step in your healing journey.
Probiotics
Probiotics can also help heal the gut and improve digestion. Unfortunately, most probiotics can also trigger histamine intolerance problems (remember, even healthy bacteria can produce histamine!). The exception to this is a probiotic called Prescript Assist. It is made from a soil-based organism and does not cause histamine to be released.
What About Antihistamines for Treating Histamine Intolerance?
Antihistamines might be able to temporarily get rid of your symptoms and they’ve saved me of additional trips to the emergency room on more than one occasion but, in the long term, they are a bad choice for people with histamine intolerance. For more on this, read Why Antihistamines Aren’t a Good Treatment for Histamine Intolerance
Be Patient!
Yes, I know that it is frustrating and adhering to the ultra-strict low-histamine diet is annoying. But be patient! Healing takes time. Once you remove the histamine buildup from your body and get your gut healthy, you will probably be able to start consuming some small amounts of histamine foods again.
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Sylvie,
What about sourdough bread? Although it has wheat it’s broken down due to the fermentation. Yes fermented foods is normally bad but for somereason my body handles this very well. Also, I don’t have the SIBO issues when digesting food at night which is another issue as many carb high foods ferment in the gut which causes more of a histamine release. I’m vegan so this made my food choices next to nothing for a short term period. I literally concumed hemp seeds, oats,sourough bread and olive oil for about 2 weeks to fully recover from severe histamine intolerance issues. I read that olive oil increases DAO by 500%.
HI THERE
YOU MENTION LEAKY GUT OR INFECTIONS MIGHT BE A CAUSE OF HISTAMINE ISSUES AND SUGGEST HAVING BONE BROTH AND GELATINE ARENT THESE BOTH HIGH HISTAMINE FOODS THOUGH???
Was just going to say the same thing! Please let us know your thoughts!
Yes, they are high in histamine, unless they’re cooked for a short time. You would have to make your own to control cooking time.
I just read that ubiquinol, which you recommend, is fermented. Fermented foods are off limits for those with histamine intolerance. Your thoughts? Thank you.
I just read that gelatin is the cause of histamine problems as it promotes histamine. Now, I read that I should try plenty of broth and GELATIN… WHAT? Which is true, it’s anti-histamine or it promotes it?
Ma’m I have been facing erectile dysfunction issues. I am taking cetrizine since 8 years. Can you please mail me regarding the same. Please
Hi everyone. I stumble across this article when searching on if antihistamine is bad and taking histamine is better. I have never had allergies when i was a kid. Over the last 20 years I will say. I have had problems with being allergic to stuff. Almost 60 had my first anaphylactic shock. Then second one was just a few weeks back due from testing for fire ants. I am allergic to about 12 prescriptions. Some foods like pizza but the sauces. Msg. Nuts. Pecan Trees. Other kinds of trees.Pecans will put me in hospital. Cats dogs which i have. Detergents. Shampoos. Chemicals lots of just the smellcause problems. Fabrezze will swell me up to where my face is twice or more eyes completely swollen shut takes weeks to heal. Perfumes.Just had several months ago reaction to cutter mosquitoe spray. Angioadema. Etc. Doctor said best i stay inside. That wonnt happen i work. Its just getting worse. I have taken natural histamine i do feel better. The 2 meds doctor has me on make me drowsy brain fog.even by cutting in half they still do. Right now my allergies with stuff nose watery eyes etc headahe are on so ill take something. But what. I agree everthing is only a bandaide i dont like to do pills so i dont do mine much. I think meds a lot bad for you so i like to do natural stuff. My doctor said he thinks my ammune symptom is out of wack. I also agree with enviroment has a lot because once heard that smog will cause people to have allergies and can inhance the ones you have. I live in Houston. I dont understand this histamine stuff you’re all talking about. By what I’ve said can someone tell me if this could be with me also. Sorry so long. Thankyou.
Anabolic shock? You meant anaphylaxis right? Or anaphylactic.
About probiotics, you mentioned Prescript Assist but if you read researches and Low histamine chef blog you probably know, some species like bifidobacterium infantis or lactobacillus rhamnosus are actually reducing histamine! How long did you treat HIT and SIBO until you got better? I am on low histamine diet for over a year and treating SIBO until last days/weeks right now.
What is the link to aspirin? I have been dealing with true Allergic reactions to some things and then what the docs are calling adrenaline surges. Usually have extremely low blood pressure but it’s been running severely high when these attacks hit. Benadryl seems to be the only thing that stops them.
I had genetic testing done, and had a double negative on the gene that processes histamine.
Have been on a sugar and gluten free diet, so had been eating lots of nuts for the protein, and lots of strawberries, pineapple, spinach etc (all foods with high histamine levels). Thought I had allergies, could hardly breath, itchy watering eyes. It will be hard to give up these foods, or limit quantities, but am glad I know the cause of my symptoms. It’s tough when u eat foods that you thought were good for u and they end up being bad for u!!!!
Sylvia:
I have no idea how long you have been in Abu Dhabi, but as someone with an14-year old who is exhibiting histamine intolerance (which has taken us years to pin down) and who lived in Abu Dhabi for four years of my son’s life, it would have been great to be able to see you there! We now live in Beverly Hills and I have been cobbling together UCLA and Cedar SINAI docs of all persuasions to try and figure out why my son– who has been a star athlete despite on and off stomach and gut issues that were never completely understood or sorted out– all of the sudden has been too ill to attend classes for over half of the past three months. We started temporary home schooling yesterday and I am now going to start him on a strict low histamine diet. My problem is they gave him amitriptyline for migraines (abdominal and head migraines– that I am pretty sure come from the underlying gut problems). I have read amatryptline is a DAo inhibitor and thus would be working against the low histidine diagnosis. My question for you: do you know anyone here in LA you would recommend to see to get my son seen, and to give advice? I feel all of the neurologists, gastroenterologist a and allergists are working at cross purposes and this may be harming, not helping, my son.
Unfortunately I don’t have anyone to recommend there Michelle that is specifically experienced with HIT. A good place to start your search would be primaldocs.com and paleophysiciansnetwork.com I would call up and specifically ask them what their HIT experience is. I think a naturopath might be your best bet. Your son is lucky to have you. Hope he feels better soon! – Sylvie
Thank you for this post. I agree with Allison – it was very straightforward and comprehensive. It’s encouraging to hear your positive improvements. Hard to find practitioners who are familiar with HIT and who can help. Do you have sources you can share? Thank you!
This is so intersting because I started making saurkraut, eating pickles, I made peanut butter and strawberry cookies I knew immediately with Kamachu andoh yes bananas which were fine for a bit and then all of the sudden I couln’t tolerate them. Never putting this together
I live in North Carolina and spring is aweful for me the pollen puts me down and it seems like since pollen season has hit I can’t eat any of these foods. I tried your pumkin smoothy with gelatin and cinnamon and Ifelt badafterwards dont know if its the cinnamon of the gelatin
I am so frustrated I lost 30 lbs and still have only put 5 of that back in weighing a whopping 94lbs. I cant eat gluten because of SIBO and I struggle with Candida as well. The hardest part of all of this is trying to figure out what to eat that wont make you feel bad, and when you dont have any energy it makes it even rougher. I know you can’t give a diagnosis, but can you share what you ate. I realizethat it may not all work for me but at least its a pllaceto start
Do you consider pregnancy hormones, estrogen, or post pardom? I have been having reactions CONSTANTLY since I was about 2 weeks post pardom. Unfortunately I am so new to my journey that I have resorted to taking a Claritin each morning or before I eat. I have needed Benadryl several times. So miserable. The bacteria thing makes sense. I was seen by an iridologist a few years ago and she suggested food enzymes (proactazyme by natures sunshine) because I apparently had undigested matter in my tract. Can’t remember where. Thoughts?
A very interesting post. I have never heard of histamine intolerance before but it does make sense medically. I have coeliac and a damaged gut as a result. I also carry antihistamines with me in case my throat swells when I eat but we have never worked out what I react to. I do improve with juicing and i prefer veggies to juice with ginger and turmeric. I’ll bare this in mind. Thanks x
You’re welcome Cath 🙂
I am having prostate enlargement BPH problem. Doctor adviced me to take medicines like sildosin and dutasteride. BPH is under control. But when I am under the fan for sleeping the symptoms become aggressive and if I avoid direct fan air I am safe. does the fan air induces my histamine level?
Hi – before I figured out the problem of what level of histamine intolerance I was, I new I needed some probiotics for some amoxicillin I took. In taking different products, including Prescript Assist, I noticed an allergic breakout thats not much fun. Learned from a 30 year alternative Pharmacist that his probiotics didn’t have milk derived strains and Dave Asprey, the bulletproof guy also had a blog on sticking with probiotics that didn’t have the milk based strains, as they are high in histamines. So just a FYI on some very high histamines in probiotics.
Thanks for sharing that Jerry! It takes some detective work, doesn’t it? 🙂
That’s so interesting Patty! Thanks for sharing!
Thanks for adding that Leslie. Good points!
I did not know that such a condition existed until today. Was being tested at my allergy lady, she does muscle testing. Foods that I felt were an issue were not showing up. So as we talked she was trying to figure me out.. she added a vial of histamine with the carrot and boom I was weak as a noodle. My nose actually started running and plugging up. For YEARS I have had days where my nose runs like a faucet, copious amounts of drainage, seriously like nothing anyone has ever seen, exhausting and 24 hours its over, I can go a week, month, whatever and boom it hits again. I just started calling it my clean out day and have said its like my body gets to a point and its has to clean out. So this article was great to see the description, it was spot on. I am seriously looking into this.
That’s so interesting Patty! Thanks for sharing!
Impressive explanation of histamine intolerance and I would add that an additional factor in the accumulation of a histamine burden may be environmental. If one is getting frustrated with poor results after doing all the right stuff managing foods, look to personal care & cleaning/laundry products, recent changes in work, home, etc. Maybe coworkers’ colognes, chemicals at work? If there’s an improvement when you’re away from home? better on a long weekend or vacation? Another factor is stress–meditation, walking and other stress relievers may help.
Thanks for adding that Leslie. Good points!
Thanks Mary! I’m knee deep in SIBO research at the moment 😉 Hope to have more posts up about it soon!
very well researched article, and i didn’t know about the link with SIBO!
Thanks Mary! I’m knee deep in SIBO research at the moment 😉 Hope to have more posts up about it soon!
Karen, other than the 2 you mentioned, I would also avoid citrus (or avoid for a while and then test to see how you do with it).
I can’t seem to find any information on fruits to drink, as in which ones are safe? And to eat? I know bananas, and strawberries are out.
Karen, other than the 2 you mentioned, I would also avoid citrus (or avoid for a while and then test to see how you do with it).
adele, I too had the reaction with Liver! Was down for a couple of weeks, thought I was going to die, and wanted too! Like you I have to take aspirin almost nightly, now I wonder if that triggered it!
Hi,
Yes, very nice exposition on this. But where do we get the Gelatin?? Just an ordinary box of Knox in the grocery (no sugar dyes or flavors obviously)? Or is the kind a whole other matter and important?
This is the most comprehensive but straightforward post as an introduction to histamine intolerance that I have found. Thank you!
Thank you Allison!
Hollywood Homestead Oh yes, I’ve seen that and the Facebook groups, too. Thanks.
Adele you might enjoy The Low Histamine Chef’s blog. She also was eating very few foods. (Note, her recipes are not paleo). I must say this is the first time I hear of the aspirin connection but Yasmina (the LHC) might know something about that. You’re welcome to join the Paleo Histamine Intolerance Facebook group if you haven’t already and ask there. I wish you all the best!
Until I started taking daily aspirin at the direction of my cardiologist in December 2013, I never had a histamine reaction (except adult-onset shellfish intolerance, inherited from my father). I ate everything! One month after starting the aspirin, I had a massive reaction to liver. Since then, more and more reactions until early July, when I finally realized I had histamine intolerance. Stopped the aspirin, went on low-histamine diet. Have you heard of people like me recovering? How long does it take? I can eat very few foods now.
Adele you might enjoy The Low Histamine Chef’s blog. She also was eating very few foods. (Note, her recipes are not paleo). I must say this is the first time I hear of the aspirin connection but Yasmina (the LHC) might know something about that. You’re welcome to join the Paleo Histamine Intolerance Facebook group if you haven’t already and ask there. I wish you all the best!
Hollywood Homestead Oh yes, I’ve seen that and the Facebook groups, too. Thanks.
adele, I too had the reaction with Liver! Was down for a couple of weeks, thought I was going to die, and wanted too! Like you I have to take aspirin almost nightly, now I wonder if that triggered it!
Interesting Barney! Both strawberries and avocados are high in histamine. I would suggest doing a low histamine diet for a while and then try re-introducing one at a time to see if any of them are instant triggers. It may just be that your histamine levels are through the roof and your system just needs to calm down a bit. Let us know how it goes!
For several years now I have received what i perceive to be an allergic reaction from food. I have not been able to pin point what it is. The symptom is my esophagus tightens up so much saliva backs up. It is extremely painful, and I have a pretty high threshold for pain. The other night strawberries triggered it. Other times its been avocado. But I eat avocado often and get no reaction. It does seem to happen when I eat an under ripe avocado. Anyway, I cant pin point any one food. Any ideas???
For several years now I have received what i perceive to be an allergic reaction from food. I have not been able to pin point what it is. The symptom is my esophagus tightens up so much saliva backs up. It is extremely painful, and I have a pretty high threshold for pain. The other night strawberries triggered it. Other times its been avocado. But I eat avocado often and get no reaction. It does seem to happen when I eat an under ripe avocado. Anyway, I cant pin point any one food. Any ideas???
Interesting Barney! Both strawberries and avocados are high in histamine. I would suggest doing a low histamine diet for a while and then try re-introducing one at a time to see if any of them are instant triggers. It may just be that your histamine levels are through the roof and your system just needs to calm down a bit. Let us know how it goes!
Sometimes after I eat my nose will get really itchy right around my nostrils. I’ve looked into a little and found that it could be linked to a histamine intolerance (although much more mild than what it sounds like you’re referring to here because I’ve never had any other symptoms associated with it except for maybe digestive issues which I pretty much always struggle with). I’ve yet to figure out which foods specifically trigger it but I have noticed the itchy nose pretty much every time I drink red wine. Do you think this could be a mild histamine intolerance? I’m working on healing on my gut so if it is, hopefully it will resolve itself eventually 🙂
Hi Kiersten,
Red wine is probably the highest histamine thing you can consume. If you think it’s the only thing you react to, I wouldn’t unnecessarily restrict your diet further. Gut healing will definitely help. If you can, try to include plenty of broth and gelatin in your diet.
Hope that helps!
Sylvie