Low-Histamine

Clusters of seemingly unrelated symptoms such as headaches, insomnia and sleep disturbances, intermittent loose stools, pain all over the body, chronic abdominal pain (visceral hypersensitivity), low blood pressure, hives, nausea, wheezing, and itching may be related to a condition called histamine intolerance. Histamine is an inflammatory chemical that is found in certain foods and that is produced by certain immune cells in the body called mast cells. The intestines release an enzyme called Diamine Oxidase (DAO) that breaks down histamine in the gut. Some individuals don’t produce enough DAO due to genetics or gut damage. This can lead to a build-up of histamine in the gut, which then gets absorbed into circulation throughout the body. Histamine intolerance is, therefore, a build-up of too much histamine in the body and not enough DAO to break it down. Each person will have a different tolerance to histamine levels before symptoms begin to appear. One of the major drivers of increased histamine levels in the body is from gut imbalances. In individuals with IBS, high-FODMAP foods can trigger mast cells in the gut to release too many inflammatory chemicals like histamine and tryptase. When working on healing histamine intolerance, there needs to be a focus on both decreasing levels of histamine from food and healing the gut, such as a gluten-free diet, reduction in high-FODMAP foods (for some individuals), digestive enzymes, stress reduction, specific probiotics designed for histamine-intolerance, and anti-inflammatory foods that help stabilize mast cells such as ginger, turmeric, and quercetin-rich foods or a quercetin supplement. 

What is the Low-Histamine Diet?

The Low-Histamine diet greatly reduces histamine coming from the diet, and supports the gut in breaking down histamine by removing foods that inhibit DAO production (the enzyme that breaks down histamine). Some diets take time to see an effect, however, with the Low-Histamine Diet, you will often start feeling better within just a few days if excess histamine is what is behind your symptoms. The most important aspect of the Low-Histamine diet is that it is a fresh foods diet. As food ages, the amino acid L-histidine in food is metabolized by bacterial decarboxylases into histamine, therefore, food that begins to spoil becomes very high in histamine. Fermented foods like lacto-fermented vegetables, vinegars, beer, wine, cured meats, and hard cheeses are also all high in histamine.

If you are experiencing the following conditions or symptoms, then a Low-Histamine Diet may be right for you:

  • Cluster headaches
  • Migraines
  • Insomnia
  • Inability to fall asleep or lack of quality sleep (histamine promotes wakefulness)
  • Night Sweats
  • Restless Leg Syndrome
  • Brain Fog
  • Anxiety
  • Hives
  • Skin rashes
  • Chronic itching
  • Intermittent loose stools
  • Nausea and vomiting
  • Chronic abdominal pain
  • Low blood pressure
  • Skin flushing
  • Wheezing
  • Tongue or throat swelling
  • Constant runny nose

What can I eat on a Low-Histamine Diet?

The Low-Histamine diet can be a tricky diet to follow. There are three components to remember: Avoiding high-histamine foods, avoiding DAO inhibitors (foods that inhibit the enzyme that breaks down histamine in the gut), and reducing histamine-liberators (foods that trigger mast cells to release histamine in the gut). Additionally, lifestyle and food choices that increase intestinal permeability (leaky gut) can increase the uptake of histamine from the gut into systemic circulation. Stress, alcohol intake, very spicy foods, gluten, and gut microbial imbalances all contribute to intestinal permeability.

The Low-Histamine Diet is highly individualized and dose-dependent, meaning that some people will be able to tolerate higher levels of histamine in foods than others. Another important aspect in reducing histamine release in the gut is to focus on ways in which to stabilize mast cells. Certain foods that are high in flavonoids like quercetin can be very helpful in stabilizing mast cells and reducing histamine release. Think about brightly colored fruits and vegetables that are on the Low-Histamine safe list.

Note: Please check the temperature of your refrigerator to make sure it is cold enough. Higher protein foods will spoil quickly at the wrong temperature and subsequently increase in histamine levels. Newer refrigerators have meat drawers that can be set to 32 degrees F to keep meat from spoiling. This is a very important aspect to reducing histamine levels in food.

Foods to Avoid

High-Histamine Foods:

  • All food additives, preservatives, and food dyes
  • All alcoholic beverages (wine, beer, hard liquor)
  • Kombucha (unfortunately!)
  • All vinegar (except raw apple cider and raw coconut vinegars)
  • All types of fermented condiments (fish sauce, tamari, coconut aminos, Worcestershire sauce)
  • Fermented vegetables (sauerkraut and other lacto-fermented veggies)
  • Flavor enhancers (yeast extract, bouillon, glutamate, MSG)
  • Store-bought broths and stocks (make your own only)
  • Olives (unfermented olives may be ok)
  • All canned meats and fish (tuna, sardines, etc.)
  • Smoked meat and fish
  • Pickled fish and seafood
  • Cured meats (bacon, sausages, salami)
  • Dried meats (jerky)
  • Deli meats (sliced turkey, ham, etc.)
  • Organ meats (liver)
  • Certain types of fish: tuna, mackerel, herring, sardines, anchovies, mahi mahi
  • Aged and hard cheeses (parmesan, cheddar, blue cheese, gouda, etc.)
  • Sourdough bread and yeast breasts, baker's yeast
  • Certain vegetables (spinach, mushrooms, tomatoes and all tomato products, eggplant, avocado)

Histamine-Liberators:

  • Alcohol
  • All shellfish (crab, shrimp, prawns, lobster, mussels)
  • Certain nuts (walnuts and cashews)
  • Chocolate (cacao powder, chocolate chips, hot cocoa)
  • Strawberries
  • Citrus fruits (lemons, limes, oranges, grapefruit)
  • Tomatoes and tomato products

DAO Inhibitors:

  • Alcohol
  • Mate Tea
  • Theobromine (energy drinks, green and black tea, chocolate)
  • Biogenic amines that use the DAO pathway (banana, plantains, pineapple, pears, peanuts/peanut butter, raspberries, kiwi, grapefruit, oranges, legumes)

Food you can Eat

Low-Histamine Foods:

  • All fresh meats (chicken, turkey, beef, lamb, pork)
  • Eggs (preferably organic & pastured)
  • Frozen meats and fish (thaw quickly and use)
  • VERY fresh fish (wild salmon, halibut, cod, black cod, pollock, trout)
  • Fresh dairy products (milk, heavy cream, butter)
  • **Lightly fermented dairy products (cottage cheese, sour cream, crème fraiche, buttermilk, cream cheese, mozzarella, mascarpone, ricotta, soft goat cheese, and possibly feta cheese)
  • Whole grains and pasta and flours (quinoa, rice, corn, millet, etc.)
  • Grain-free starches (potatoes, sweet potatoes, winter squash, cassava)
  • Coconut products (canned coconut milk, shredded coconut, coconut water, coconut oil, etc.)
  • Fresh and dried herbs
  • Mild spices (turmeric, paprika, cumin, coriander, cardamom, ginger, etc.)
  • All oils and animal fats
  • All fresh and frozen fruits (except those listed above)
  • All fresh and frozen vegetables (except those listed above)
  • Certain nuts and seeds (almond milk, macadamia nuts, chestnuts and chestnut flour, flaxseeds, pumpkin seeds, sunflower seeds)
  • Sweeteners such as pure maple syrup, honey, coconut sugar, cane sugar, agave nectar, stevia
  • Juice from acceptable fruits and herbal teas (except nettle)

**Lightly fermented dairy products may also trigger a histamine reaction in some individuals. It is best to test your tolerance to these by first eliminating them and then reintroducing after symptoms have calmed down. 

What can I cook and bake on a Low-Histamine Diet?

Remember, this diet is focused on the freshest foods you can find. Leftovers should be frozen or used within a day as histamine content in foods starts to increase from bacterial activity. For breakfast, start with a simple bowl of Oatmeal topped with frozen blueberries and ground flaxseeds. These Cottage Cheese Pancakes make a great low-histamine breakfast too! You can make homemade Breakfast Sausages and Apple Muffins for a nourishing weekend breakfast. Low-histamine lunches can be a batch of freshly made Turkey Meatball Soup or a salad with Instant Pot Shredded Chicken, salad greens, and this Pomegranate Juice Dressing. For dinner, this Herb Roasted Salmon is simple and quick to prepare. Serve it with Roasted Sweet Potato Rounds, Rice Pilaf, and some steamed vegetables for a balanced, nourishing meal. 

Low-histamine desserts and snacks can be done too! Try these Oatmeal Heart Cut-Out Cookies (use different shapes for different holidays, and don't add the chocolate topping). This Mango Coconut Pudding is easy to make and is a delicious, antioxidant-rich sweet treat! This low-histamine Berry Antioxidant Smoothie can be served for breakfast or a snack anytime of the day. This Coconut Strawberry Mousse can be easily modified for the Low-Histamine Diet to use low-histamine fruits in place of the strawberries. Check the Modifications section at the bottom of the recipe! 

How do I start a Low-Histamine Diet?

  1. Become a member on this site.
  2. When setting up your user profile, choose Low-Histamine Diet. Then add any other food allergens you may have. You may want to include Dairy-Free and Gluten-Free along with Low-Histamine as these foods can contribute to intestinal permeability and gut inflammation for many individuals (consuming lactose if you have a lactose intolerance can increase histamine release in the gut for example). Lightly fermented and fresh unfermented dairy products are included in the Low-Histamine Diet, which may or may not work for you. 
  3. Go to the Search page and start adding recipes to your meal plans and calendar! Many of the recipes on this site can be modified to be safe for the Low-Histamine Diet; check the modifications section at the bottom of this page for more recipes that may not show up in your search.
  4. It is best to follow a low-histamine diet for 6 weeks and then begin reintroducing foods to see how your body responds. Some individuals may only need to keep out very high-histamine foods in order to keep symptoms eliminated, and are ok with some foods like legumes, citrus, pineapple, green tea, nuts, bananas, pears, etc. 
  5. Remember! Leftovers can become high in histamines as they sit in your refrigerator. It is very important to eat foods they day they are made or within the first 24 hours. Freezing leftovers in small portion-sized containers immediately after cooking is your best bet to keeping histamine levels low in your meals. 
  6. New low-histamine recipes are added weekly to keep your meal plans tasty and exciting, so stay tuned! Join our Nourishing Meals Community Facebook Group to get notified with new recipes and more! Everyone is welcome.