What Is the Low-Histamine Diet?

hard boiled eggs

Verywell / Alexandra Shytsman 

At Verywell, we believe there is no one-size-fits-all approach to a healthy lifestyle. Successful eating plans need to be individualized and take the whole person into consideration. Prior to starting a new diet plan, consult with your healthcare provider or a registered dietitian, especially if you have an underlying health condition.

Stringing the words "diet" and "histamine" together may read like an odd pairing—one refers to the food options that you consume or restrict yourself to, while the other is responsible for the sneezing, itching, and puffy eyes that usually usher in the start of allergy season.

Histamines, which are produced by your immune system, are an important part of your body’s digestive, neurological and immunological activities—they are necessary for the defense of the body.

In digestion, histamines help in the secretion of gastric acid. Without this acid, you probably wouldn't be able to break down and digest today's lunch. And histamines may affect feeding behavior by causing a decrease in the desire for food.

Histamines promote neurological function by regulating transmitters within the brain. These transmitters are like little messengers that share information between brain cells. You also really need your histamines to promote wakefulness in your body.

Additionally, histamines are a key modulator in the body’s fight against harmful outsiders. This compound is released to trigger inflammation. This is an immune response by the body.

Histamines are also found in the food you eat. With a marked presence in fruits, vegetables, beef, and certain seafood, a significant portion of your diet is made up of histamines. Unfortunately, this isn't always a good thing as your body can sometimes build up a resistance to it.

Just as histamines can cause your body to react negatively to food, there are instances where your body responds poorly to food due to its high histamine content. This is usually referred to as histamine intolerance.

If you experience symptoms like headaches, sneezing, itching, hives, abdominal pain, flatulence, diarrhea, vomiting, constipation, runny nose, watery eyes, or cough after eating certain foods that are high in histamines, you may have histamine intolerance.

These symptoms usually require a significant reduction in the amount of histamines you consume, which is why a low-histamine diet becomes necessary for some people. If you suspect histamine intolerance, consult with a healthcare provider for advice before trying an elimination diet.

Causes of Histamine Intolerance

Histamine intolerance, which is also known as enteral histamines, is a very rare condition. Because its symptoms share similarities with other conditions, it’s not unusual for people to first assume that they are having a mere food allergy, or perhaps a gastrointestinal disease.

Should you experience the listed symptoms after eating certain foods, there's a chance your body is producing low amounts of the enzymes diamine oxidase (DAO) and histamine-N-methyltransferase, which are necessary for the breakdown and processing of histamine. DAO is the main enzyme for processing histamine-derived from food.

Your body could be experiencing reduced levels of DAO due to an acquired condition like an interaction with drugs that blocks its functioning. DAO deficiency may also be linked to gastrointestinal disorders like gastroenteritis, irritable bowel syndrome, short bowel syndrome, and gastrointestinal surgery. There is also a chance that reduced DAO activity is caused by gluten sensitivity.

Without these enzymes, you may experience a gradual build-up of histamines, which can cause these negative reactions throughout your body.

Histamine Intolerance Diagnosis

A number of factors make it difficult to diagnose histamine intolerance. First, its symptoms are similar to other conditions. This typically requires that illnesses such as Celiac disease, lactose intolerance, irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD) are first ruled out before settling on histamine intolerance.

If histamine intolerance is suspected, you'll be required to keep a food diary for about two to four weeks. During this time, it is expected that you eliminate foods that are high in histamines, and then re-introduce them to watch for triggers. This will allow your healthcare provider to recognize diet patterns and foods that trigger your symptoms.

Another factor could make it difficult to determine histamine intolerance is the requirement of a build-up before symptoms are noticed. Therefore, an individual could have an intolerance, but unless foods that can cause high amounts of histamines to accumulate are consumed, the condition could go undetected when testing for histamine levels in the blood on certain days.

Histamine intolerance may also be diagnosed by carrying out a blood test on DAO and enzyme activity levels on the body. A skin prick test may also be used when diagnosing histamine intolerance. However, its effectiveness is yet to receive wide acceptance.

What Can You Eat?

The purpose of the low-histamine diet is to weed out foods that are high in histamines. This involves cutting out high-histamine foods from the diet and reintroducing them to have an idea of how well you tolerate these foods. Since this diet is so restrictive, it is not ideal as a long-term diet plan.

What You Need To Know

Because fermented foods are high in histamines, these are easy options to cut out of your diet. Fresh, unprocessed foods have a lower histamine content and may be safe.

What to Eat
  • Boiled meat

  • Boiled fish

  • Eggs

  • Legumes (e.g., chickpeas and lentils)

What Not to Eat
  • Grilled chicken

  • Grilled meat

  • Cheese

  • Wine

  • Sausages

  • Sauerkraut

  • Vegetables

  • Citrus fruit

Low-Histamine Foods

Here's a look at some of the foods that are safe to consume on a low-histamine diet.

Boiled Meat

Cooking meat to a boil helps to regulate the amount of histamines it produces. Lower amounts of histamines are produced when meat is boiled.

Boiled Fish

While fried and grilled fish aren't advisable for a low-histamine diet, boiled fish produces lower amounts of histamine, making it safe for a low-histamine diet.

Eggs

Boiled, fried, or poached eggs aren't affected by cooking methods when it comes to histamine content. Eggs are low in histamines, this makes them ideal for the low-histamine diet.

Legumes

Chickpeas, peanuts, and lentils have been found to have low concentrations of histamines and may be safely consumed in a low-histamine diet.

High-Histamine Foods

Let's take a look at some of the foods that are high in histamines.

Altered Meat

Processed meat, as well as meats that have been cooked through methods like grilling, have been shown to have a higher histamine content. This treatment process increases the histamine levels of meat, which can be dangerous when consumed by people with histamine intolerance.

These meats include grilled pork, grilled chicken, as well as processed meats such as sausages and ham which may be preserved in conditions that increase histamine levels.

Altered Fish

Like beef, when fish is grilled or fried, this can increase its histamine levels. This means fish like fried anchovies and smoked mackerel will have to be excluded when following a low-histamine diet.

Vegetables

Histamines are naturally found in vegetables such as spinach, eggplant, and tomato. While their histamine content varies, these vegetables are high enough in the compound to require their removal when selecting options for a low-histamine diet.

Fruit

Citrus fruit such as oranges, lemons, and tangerines are known to release histamines when consumed. The same goes for bananas, grapes, and strawberries.

Fermented Foods

Wines, cheeses, sauerkraut, and beer undergo a fermentation process regulated by bacteria. These bacteria release histamines during the fermentation process, leaving these foods with high amounts of the compound.

Pros and Cons

A low histamine diet is an easy option if you're looking to get your food allergies under control. However, in addition to other benefits, this eating model may also have some disadvantages.

Pros
  • Diagnosis of histamine intolerance

  • Migraine relief

  • Management of chronic urticaria

Cons
  • May lead to malnourishment

  • Impractical as a long-term plan

Pros

  • Diagnosis of histamine intolerance: Diligently following a low-histamine diet can help with identifying and avoiding foods high in histamine that may cause an allergic reaction.
  • Migraine relief: Because histamines contribute to the inflammation that triggers migraines, a low-histamine diet can be useful in managing this condition.
  • Management of chronic urticaria (hives): When there is a high level of histamines in the body, it's common to develop hives. A low-histamine diet can help rectify this.

Cons

  • May lead to malnourishment: This diet is very restrictive and may lead to malnutrition.
  • Impractical as a long-term plan: This diet may not be sustainable for a long period of time.

Is Low-Histamine the Right Diet For You?

Before proceeding with a low-histamine diet, it's important to consider if you are exhibiting symptoms of histamine intolerance. These include headaches, hives, itchy skin, redness, red eyes, runny nose, nasal congestion, etc.

When you tick these boxes, then a low-histamine diet may be beneficial as a method of elimination. This is to help you identify foods that may trigger or worsen your symptoms.

However, low-histamine diets should be viewed less as a lifestyle overhaul, and more as a diagnostic tool to single out foods that cause adverse reactions. This is because too many foods will be avoided, leading to an overly regulated diet that may not be sustainable long-term.

Health Benefits

A low histamine diet may be useful in treating urticaria and, although limited studies exist, this diet has been shown to treat the inflammatory skin condition atopic dermatitis.

Eating foods low in histamines can help with the diagnosis of a histamine allergy. This diet helps to identify foods that produce the most negative reactions when eaten.

A low-histamine diet may also help to improve the symptoms of a histamine allergy and improve migraine symptoms in patients.

Health Risks

While the low-histamine diet helps to minimize the chances of reacting to high levels of histamine, it does so at the risk of undernourishment. The number of foods prohibited under this diet leaves very few options to get the balanced diet necessary for overall well-being.

A Word From Verywell

A low-histamine diet is necessary to weed out the causes of negative reactions to food. These reactions may be headaches, diarrhea, vomiting, constipation, etc. These reactions may be due to the high histamine content found in certain foods like tuna, wine, eggplant, cheese, etc.

A low-histamine diet will help to identify these foods to enable their reduction in your diet. In the process, this diet may also help in managing skin conditions such as atopic dermatitis and spontaneous urticaria.

However, despite being effective, its restrictiveness makes a low histamine diet an unsuitable option as a daily meal plan over a long period of time.

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