Low-Histamine Diet

Table of ContentsView AllTable of ContentsBenefitsDiagnosisHow It WorksConsiderationsOther Diets

Table of ContentsView All

View All

Table of Contents

Benefits

Diagnosis

How It Works

Considerations

Other Diets

Ingesting a large quantity of foods high in histamine can trigger this response, but figuring out which foods triggered the response can be complicated.

Oncefood allergieshave been ruled out, people can try a low-histamine diet. Foods to avoid on a low-histamine diet include aged cheeses, processed meats, dairy products, alcohol, and certain fruits and vegetables. Eating whole, unprocessed foods is also important.

Benefits of a Low-Histamine Diet

There aren’t many studies examining the benefits of a low-histamine diet, likely due to the difficulty of following a low-histamine diet and the complexity of diagnosing histamine intolerance.

A small study conducted in Italy in 2016 found that, when people restricted their intake of histamine-provoking foods, their symptoms improved. These people did not have food allergies or other gastrointestinal diseases.

There are many limitations in examining the role of histamine in the diet, and most of the time, individual cases need to be examined to determine the actual source of the intolerance. Part of the reason for this is because it’s not possible to avoid histamine altogether—exposure to histamine goes beyond diet.

Additionally, because some people are more sensitive to histamine, a dose-dependent response is plausible (meaning that the response may only occur after certain exposure threshold).

This makes following anelimination diet(where certain foods are avoided and then added back in at specific times) especially important. Keeping a food journal for a few weeks to track symptoms is also important in discovering the trigger foods.

Histamine Intolerance vs. Histamine Toxicity

Diagnosing Histamine Intolerance

If food allergies and other gastrointestinal diseases such asceliac diseasehave been ruled out, your healthcare provider may try to determine if you are histamine intolerant.

To do so, they may ask you to take askin prick test(which can be unreliable) or measure your blood to test your diamine oxidase activity (DOA), the main enzyme involved in the metabolism of histamine. Oftentimes, people with histamine intolerance have an imbalance of histamine due to a combination of too much histamine and lack of DOA.

How a Low-Histamine Diet Works

If you are histamine intolerant, you may be told to follow a low-histamine diet. Because everyone responds to histamine differently, an individualized meal plan should be created.

There is no specific scientific protocol for elimination diets, therefore, it will be important to work with a registered dietitian to make sure you are receiving adequate nutrition and are getting all your vitamins and minerals.

A 2018 study in theJournal of Dermatologyreported that people with severe histamine intolerance with urticaria (hives) can benefit significantly from a histamine-free diet. According to the researchers, after just four weeks, the diet helped reduce the severity of urticaria and, in some cases, led to the complete resolution of symptoms.

What To Eat and Avoid on a Low-Histamine Diet

Eating a diet rich in whole, non-processed foods will be important. Foods that are very ripe, aged, fermented, or soured should also be avoided. Certain fruits and vegetables can induce a histamine response, too.

Foods to EatFresh meat: Including beef, pork, and poultryCooked ham: Only uncured ham with no preservatives or yeast extractEggs: Including chicken, quail, and duckFresh or frozen fish: Including pollock, cod, trout, whitefish, and perchFresh dairy: Including milk, butter, and creamNon-matured cheese: Including cream cheese, mascarpone, mozzarella curd, and young GoudaVegetables: All, with the exception of those on the excluded listFruits: All, with the exception of those on the excluded listBeverages: Herbal teas, rooibos nature, fresh juices, almond milk, coconut milk, coconut waterCondiments: Distilled white vinegar, apple cider vinegar, garlic, mild spicesSweets: Honey, agave, jams made from acceptable fruitsGrains: Including breakfast cereals, oats, cream of wheat, and pastaNuts: Macadamia, chestnutsFoods to AvoidExcluded meat: Bone-matured or dry aged meat (particularly beef)Processed meats: Including sausage, cured meats, dried cured hams, bacon, canned meats, meat spreads, and cold cutsExcluded fish: Tuna, mackerel, herring, sardines, anchovies, and mahi mahiShellfish: Mussels, lobsters, crabs, shrimps, prawnsProcessed fish and seafood: Including canned, marinated, salted, dried, smoked, or pickled fish or seafoodExcluded dairy: Buttermilk, yogurt sour creamMatured cheese: Including hard, semi-soft, blue, and soft ripened cheesesExcluded vegetables: Spinach, tomatoes, eggplant, mushroomsLegumes: Lentils, beansExcluded fruits: Citrus fruits, papaya, strawberries, pineapple, banana, raspberries, kiwi, pears, guavarExcluded beverages: Sodas, sweetened juice drinks, energy drinks, tomato juiceAlcohol: Including spirits, aperitifs, brandy, wine, and beerExcluded condiments: Wine vinegar, balsamic vinegar, fish sauce, ketchup, soy sauce, hot spices, yeast extractExcluded sweets: Cocoa, chocolate, carob, licoriceNuts: All with the exception of macadamia and chestnutFermented foods: Including sauerkraut, pickles, kimchi, kefir, and kombuchaSoy: Including edamame, tofu soymilk, tempeh, soy protein, and natto

Fresh meat: Including beef, pork, and poultry

Cooked ham: Only uncured ham with no preservatives or yeast extract

Eggs: Including chicken, quail, and duck

Fresh or frozen fish: Including pollock, cod, trout, whitefish, and perch

Fresh dairy: Including milk, butter, and cream

Non-matured cheese: Including cream cheese, mascarpone, mozzarella curd, and young Gouda

Vegetables: All, with the exception of those on the excluded list

Fruits: All, with the exception of those on the excluded list

Beverages: Herbal teas, rooibos nature, fresh juices, almond milk, coconut milk, coconut water

Condiments: Distilled white vinegar, apple cider vinegar, garlic, mild spices

Sweets: Honey, agave, jams made from acceptable fruits

Grains: Including breakfast cereals, oats, cream of wheat, and pasta

Nuts: Macadamia, chestnuts

Foods to AvoidExcluded meat: Bone-matured or dry aged meat (particularly beef)Processed meats: Including sausage, cured meats, dried cured hams, bacon, canned meats, meat spreads, and cold cutsExcluded fish: Tuna, mackerel, herring, sardines, anchovies, and mahi mahiShellfish: Mussels, lobsters, crabs, shrimps, prawnsProcessed fish and seafood: Including canned, marinated, salted, dried, smoked, or pickled fish or seafoodExcluded dairy: Buttermilk, yogurt sour creamMatured cheese: Including hard, semi-soft, blue, and soft ripened cheesesExcluded vegetables: Spinach, tomatoes, eggplant, mushroomsLegumes: Lentils, beansExcluded fruits: Citrus fruits, papaya, strawberries, pineapple, banana, raspberries, kiwi, pears, guavarExcluded beverages: Sodas, sweetened juice drinks, energy drinks, tomato juiceAlcohol: Including spirits, aperitifs, brandy, wine, and beerExcluded condiments: Wine vinegar, balsamic vinegar, fish sauce, ketchup, soy sauce, hot spices, yeast extractExcluded sweets: Cocoa, chocolate, carob, licoriceNuts: All with the exception of macadamia and chestnutFermented foods: Including sauerkraut, pickles, kimchi, kefir, and kombuchaSoy: Including edamame, tofu soymilk, tempeh, soy protein, and natto

Excluded meat: Bone-matured or dry aged meat (particularly beef)

Processed meats: Including sausage, cured meats, dried cured hams, bacon, canned meats, meat spreads, and cold cuts

Excluded fish: Tuna, mackerel, herring, sardines, anchovies, and mahi mahi

Shellfish: Mussels, lobsters, crabs, shrimps, prawns

Processed fish and seafood: Including canned, marinated, salted, dried, smoked, or pickled fish or seafood

Excluded dairy: Buttermilk, yogurt sour cream

Matured cheese: Including hard, semi-soft, blue, and soft ripened cheeses

Excluded vegetables: Spinach, tomatoes, eggplant, mushrooms

Legumes: Lentils, beans

Excluded fruits: Citrus fruits, papaya, strawberries, pineapple, banana, raspberries, kiwi, pears, guavar

Excluded beverages: Sodas, sweetened juice drinks, energy drinks, tomato juice

Alcohol: Including spirits, aperitifs, brandy, wine, and beer

Excluded condiments: Wine vinegar, balsamic vinegar, fish sauce, ketchup, soy sauce, hot spices, yeast extract

Excluded sweets: Cocoa, chocolate, carob, licorice

Nuts: All with the exception of macadamia and chestnut

Fermented foods: Including sauerkraut, pickles, kimchi, kefir, and kombucha

Soy: Including edamame, tofu soymilk, tempeh, soy protein, and natto

Strawberries Are Incredibly Good for You: Here’s Why

In addition to your choice of foods, the way that you cook your food can increase or decrease your risk of histamine intolerance. For instance, the longer a food is left out, the more histamine will be produced. Plan to cook your meat or fish right away. Moreover, steaming or braising meat or seafood produces far less histamine than grilling.

Some people may also be advised to supplement with B vitamins, calcium, copper, zinc, and other micronutrients. Research suggests that a low intake of key micronutrients is linked to an increased risk of histamine intolerance.

Keeping a food journal can help because you may be able to determinehow muchof a food you can reasonably eat. For example, some people may be able to eat a strawberry or two without incident. Others may have a reaction with just one bite.

While limited data have suggested that following a low-histamine diet can reduce the symptoms of histamine intolerance, more research needs to be done in this area. Keep in mind that because this diet is somewhat restrictive, it is not meant for everyone.

General Nutrition

Overall, if done right, this diet can be a healthy one. But it important to ensure that you are eating a variety of fruit, vegetables, healthy fats, and protein.

Because one of the main focuses of the diet is the elimination of foods, people can fall into the trap of eating too much of one type of food and not enough of another. To avoid this, meet with a registered dietitian who can help you select a healthy variety of foods.

Practicality

The diet is hard to sustain as you really cannot eat anything processed, packaged, canned, or pre-prepared. Many people rely on the convenience of these foods, particularly when they have a busy job or are managing a family. Whole foods can also be expensive.

Keep in mind that, most of the time, the diet is used temporarily until your symptoms are better managed. To reduce costs, buy local and seasonal foods whenever possible.

FODMAP—which stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols—are short-chain carbohydrates that resist digestion, including certain fruits that high in fructose, dairy products that are high in lactose, and cereal grains that are high in fructans.

A low-FODMAP diet is frequently used to treat irritable bowel syndrome (IBS) but may help some people with histamine intolerance, particularly if they experience severe diarrhea.

A Word From Verywell

A low-histamine diet has been shown to help improve symptoms of histamine intolerance, which can produce allergy-related symptoms such as sneezing, headaches, and itchy skin.

As much as you may want to self-treat your symptoms with diet, it is still wise to speak with your healthcare provider before starting. While you may assume that you have histamine intolerance, there may be other causes for your condition, such asceliac disease,lactose intolerance,gallbladder problems, and others.

8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kohn JB.Is there a diet for histamine intolerance?J Am Diet Assoc. 2014 Nov;114(11):1860. doi:10.1016/j.jand.2014.09.009Manzotti G, Breda D, Di Gioacchino M, Burastero SE.Serum diamine oxidase activity in patients with histamine intolerance.Int J Immunopathol Pharmacol. 2016 Mar;29(1):105-11. doi:10.1177/0394632015617170American Academy of Allergy, Asthma & Immunology.Histamine toxicity (scombroid poisoning).Manzotti G, Breda D, di Gioacchino M, Burastero SE.Serum diamine oxidase activity in patients with histamine intolerance.Int J Immunopathol Pharmacol. 2016 Mar; 29(1): 105-11. doi:10.1177/0394632015617170Swiss Interest Group Histamine Intolerance.SIGHI leaflet: histamine elimination diet.Chung BY, Park SY, Byun YS, et al.Effect of different cooking methods on histamine levels in selected foods.Ann Dermatol.2017 Dec;29(6):706-14. doi:10.5021/ad.2017.29.6.706Vassilpoulou E, Konstantinou GN, Dimitriou A, Manios Y, Koumbi L, Papadopoulos NG.The impact of food histamine intake on asthma activity: a pilot study.Nutrients. 2020 Nov;12(11):3402. doi:10.3390/nu12113402Harvie R, Chanyi RM, Burton JP, Schultz M.Using the human gastrointestinal microbiome to personalize nutrition advice: are registered dietitian nutritionists ready for the opportunities and challenges?J Acad Nutr Diet. 2017;117(12):1865-9. doi:10.1016/j.jand.2016.10.02Additional ReadingReese I.Nutrition therapy for adverse reactions to histamine in food and beverages.Allergol Select. 2018;2(1):56-61. doi:10.5414/ALX386

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kohn JB.Is there a diet for histamine intolerance?J Am Diet Assoc. 2014 Nov;114(11):1860. doi:10.1016/j.jand.2014.09.009Manzotti G, Breda D, Di Gioacchino M, Burastero SE.Serum diamine oxidase activity in patients with histamine intolerance.Int J Immunopathol Pharmacol. 2016 Mar;29(1):105-11. doi:10.1177/0394632015617170American Academy of Allergy, Asthma & Immunology.Histamine toxicity (scombroid poisoning).Manzotti G, Breda D, di Gioacchino M, Burastero SE.Serum diamine oxidase activity in patients with histamine intolerance.Int J Immunopathol Pharmacol. 2016 Mar; 29(1): 105-11. doi:10.1177/0394632015617170Swiss Interest Group Histamine Intolerance.SIGHI leaflet: histamine elimination diet.Chung BY, Park SY, Byun YS, et al.Effect of different cooking methods on histamine levels in selected foods.Ann Dermatol.2017 Dec;29(6):706-14. doi:10.5021/ad.2017.29.6.706Vassilpoulou E, Konstantinou GN, Dimitriou A, Manios Y, Koumbi L, Papadopoulos NG.The impact of food histamine intake on asthma activity: a pilot study.Nutrients. 2020 Nov;12(11):3402. doi:10.3390/nu12113402Harvie R, Chanyi RM, Burton JP, Schultz M.Using the human gastrointestinal microbiome to personalize nutrition advice: are registered dietitian nutritionists ready for the opportunities and challenges?J Acad Nutr Diet. 2017;117(12):1865-9. doi:10.1016/j.jand.2016.10.02Additional ReadingReese I.Nutrition therapy for adverse reactions to histamine in food and beverages.Allergol Select. 2018;2(1):56-61. doi:10.5414/ALX386

Kohn JB.Is there a diet for histamine intolerance?J Am Diet Assoc. 2014 Nov;114(11):1860. doi:10.1016/j.jand.2014.09.009Manzotti G, Breda D, Di Gioacchino M, Burastero SE.Serum diamine oxidase activity in patients with histamine intolerance.Int J Immunopathol Pharmacol. 2016 Mar;29(1):105-11. doi:10.1177/0394632015617170American Academy of Allergy, Asthma & Immunology.Histamine toxicity (scombroid poisoning).Manzotti G, Breda D, di Gioacchino M, Burastero SE.Serum diamine oxidase activity in patients with histamine intolerance.Int J Immunopathol Pharmacol. 2016 Mar; 29(1): 105-11. doi:10.1177/0394632015617170Swiss Interest Group Histamine Intolerance.SIGHI leaflet: histamine elimination diet.Chung BY, Park SY, Byun YS, et al.Effect of different cooking methods on histamine levels in selected foods.Ann Dermatol.2017 Dec;29(6):706-14. doi:10.5021/ad.2017.29.6.706Vassilpoulou E, Konstantinou GN, Dimitriou A, Manios Y, Koumbi L, Papadopoulos NG.The impact of food histamine intake on asthma activity: a pilot study.Nutrients. 2020 Nov;12(11):3402. doi:10.3390/nu12113402Harvie R, Chanyi RM, Burton JP, Schultz M.Using the human gastrointestinal microbiome to personalize nutrition advice: are registered dietitian nutritionists ready for the opportunities and challenges?J Acad Nutr Diet. 2017;117(12):1865-9. doi:10.1016/j.jand.2016.10.02

Kohn JB.Is there a diet for histamine intolerance?J Am Diet Assoc. 2014 Nov;114(11):1860. doi:10.1016/j.jand.2014.09.009

Manzotti G, Breda D, Di Gioacchino M, Burastero SE.Serum diamine oxidase activity in patients with histamine intolerance.Int J Immunopathol Pharmacol. 2016 Mar;29(1):105-11. doi:10.1177/0394632015617170

American Academy of Allergy, Asthma & Immunology.Histamine toxicity (scombroid poisoning).

Manzotti G, Breda D, di Gioacchino M, Burastero SE.Serum diamine oxidase activity in patients with histamine intolerance.Int J Immunopathol Pharmacol. 2016 Mar; 29(1): 105-11. doi:10.1177/0394632015617170

Swiss Interest Group Histamine Intolerance.SIGHI leaflet: histamine elimination diet.

Chung BY, Park SY, Byun YS, et al.Effect of different cooking methods on histamine levels in selected foods.Ann Dermatol.2017 Dec;29(6):706-14. doi:10.5021/ad.2017.29.6.706

Vassilpoulou E, Konstantinou GN, Dimitriou A, Manios Y, Koumbi L, Papadopoulos NG.The impact of food histamine intake on asthma activity: a pilot study.Nutrients. 2020 Nov;12(11):3402. doi:10.3390/nu12113402

Harvie R, Chanyi RM, Burton JP, Schultz M.Using the human gastrointestinal microbiome to personalize nutrition advice: are registered dietitian nutritionists ready for the opportunities and challenges?J Acad Nutr Diet. 2017;117(12):1865-9. doi:10.1016/j.jand.2016.10.02

Reese I.Nutrition therapy for adverse reactions to histamine in food and beverages.Allergol Select. 2018;2(1):56-61. doi:10.5414/ALX386

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Benefits of a Low-Histamine Diet#

Histamine Intolerance vs. Histamine Toxicity#

Diagnosing Histamine Intolerance#

How a Low-Histamine Diet Works#

What To Eat and Avoid on a Low-Histamine Diet#

General Nutrition#

Practicality#

A Word From Verywell#