What Foods to Eat and Avoid on a Low Histamine Diet

All about histamine intolerance: symptoms & low histamine diet. Explore foods to eat & avoid, plus a low-histamine meal plan.

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Science-based and reviewed

Published:
February 29, 2024
August 10, 2023
— Updated:

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Histamine is a hormone and neurotransmitter in the body that plays a significant role in the body. Involved in regulating the immune system, digestive function, and neurotransmission, it is produced by the body's cells and found naturally in some foods. 

While histamine is a necessary chemical in the body, some individuals may experience adverse reactions when histamine levels become imbalanced. This condition is known as histamine intolerance, which can lead to various unpleasant symptoms. 

In this article, we’ll delve into the role of histamine in the body and explore how a low histamine diet can help manage histamine intolerance; plus, we’ll look at which foods to eat and which ones to avoid to support your overall health and well-being.

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Histamine Intolerance

Histamine is a chemical responsible for a few important functions, including1:

  • transmitting messages to your brain
  • triggering the release of stomach acid to aid in digestion
  • releasing after injury or allergic reaction as part of your immune response

Your body naturally produces histamine and the enzyme diamine oxidase (DAO). The DAO enzyme is responsible for metabolizing histamine that you consume from food.

A histamine intolerance does not mean that you are intolerant to histamine but that your body cannot process histamine efficiently. 

You could develop histamine intolerance if your body develops a DAO enzyme deficiency and can‘t break down histamine.2

Some medical conditions may increase your chances of developing a histamine intolerance. These conditions can prevent the body from managing histamine levels normally, potentially triggering symptoms like headaches, hives, digestive issues, etc. 

Some of the health problems that may increase the risk of histamine intolerance include:

  • Liver Conditions - The liver plays a crucial role in metabolizing histamine. Impaired liver function may cause inefficient histamine metabolism, increasing its accumulation in the body.
  • Crohn’s Disease - Inflammatory bowel diseases like Crohn’s disease can disrupt the integrity of the intestinal lining, affecting histamine regulation and absorption.
  • Chronic Stress - Prolonged stress may impact various bodily processes, including histamine metabolism. Stress hormones can influence histamine release and contribute to intolerance symptoms.
  • Gastrointestinal Disorders - Conditions like irritable bowel syndrome (IBS) and leaky gut syndrome can disrupt the gut barrier, allowing histamine-rich foods to be absorbed more readily and worsening intolerance. Food allergies may also cause histamine intolerance.
  • Gastroesophageal Reflux Disease (GERD) - GERD can increase histamine levels due to stomach acid impacting histamine-containing foods, leading to symptoms in susceptible individuals.

Some medications, both prescription and over-the-counter, can affect your MAO levels and cause histamine intolerance. These medications include:

  • Heart medications
  • Antibiotics 
  • Antidepressants
  • Pain medications
  • Gastrointestinal medications

Histamine Intolerance Symptoms

Histamine receptors are present in many different systems within the body, so histamine intolerance can cause various symptoms.3

These symptoms are not specific to histamine intolerance and can often occur in many other health conditions, such as food intolerances. Because of this, your doctor may have difficulty diagnosing histamine intolerance.

The most commonly experienced symptoms involve the gastrointestinal (GI) system and include:3

  • Abdominal pain
  • Bloating
  • Diarrhea
  • Constipation
  • Gas
  • Nausea
  • Vomiting

Other reactions associated with this intolerance include:3

  • Headaches or migraine
  • Nasal congestion, sinus issues, or sneezing
  • Fatigue
  • Itchy skin
  • Hives
  • Irregular menstrual cycle

Although uncommon, some people with severe cases of histamine intolerance may experience:3

  • Abdominal cramping
  • Swelling
  • Hypertension (high blood pressure)
  • Irregular heart rate
  • Anxiety
  • Difficulty regulating body temperature
  • Dizziness

What is a Low Histamine Diet?

A low histamine diet is an elimination diet that aims to manage histamine intolerance. The purpose of this diet is to reduce the amount of histamine you consume from food, which can help ease symptoms of histamine intolerance, including headaches, rashes, and GI symptoms.

Following a low histamine diet means avoiding foods with high levels of histamine or foods that might trigger the chemical release in your body. 

Foods with lower levels of histamine typically include fresh, unprocessed produce. Fermented foods tend to have high levels.

Does it Have Any Benefits or Drawbacks?

Benefits

A low histamine diet can serve as a diagnostic tool and confirm whether you have histamine intolerance or other health conditions. 

Another benefit of a low histamine diet is symptom relief in individuals with histamine intolerance. When histamine intake is reduced, many people experience a decrease in symptoms such as headaches, skin rashes, digestive discomfort, and more. Alleviating these symptoms often leads to a better quality of life. 

The low histamine diet can be tailored to individual needs and preferences. It allows people to identify specific trigger foods that worsen their symptoms and make dietary adjustments accordingly.

Drawbacks

Some possible drawbacks of a low histamine diet include extremely limited food choices and potential nutrient deficiencies. 

The low histamine diet is very restrictive. Many high-histamine foods are nutritious and provide essential nutrients. Cutting out a wide range of foods may lead to nutritional gaps if not carefully planned.

Following a low histamine diet may also limit food variety and dining options, making it challenging to enjoy meals in social settings or while traveling.

Successfully adhering to a low histamine diet requires knowledge of histamine-containing foods, food preparation methods, and label reading. This complexity can be overwhelming for some people.

Following a low histamine diet long-term can increase the risk of certain nutrient deficiencies if not carefully managed. 

How to Follow a Low Histamine Diet: Tips and Food List

Understanding the distinction between a high histamine diet and a low histamine diet is important for your success, as following the correct diet can significantly affect your outcomes.

A high histamine diet involves consuming foods rich in histamine or promoting the release of histamine in the body. When the body cannot properly process histamine, levels become too elevated.

On the other hand, a low histamine diet focuses on reducing histamine intake from foods and minimizing triggers that contribute to histamine release. Following a low histamine diet can help prevent histamine accumulation and alleviate symptoms associated with histamine intolerance.

Low Histamine Diet Tips

  1. Educate Yourself

Familiarize yourself with high-histamine foods, low-histamine foods, and foods that trigger histamine release. 

  1. Read Labels

When grocery shopping, carefully read food labels to identify potential histamine-containing ingredients or additives.

  1. Plan Meals

Plan your meals ahead of time to ensure you have access to suitable options that adhere to the low histamine guidelines.

  1. Cook Fresh

Opt for fresh, unprocessed foods whenever possible. Cooking from scratch gives you better control over ingredients and preparation methods.

  1. Rotate Foods

Incorporate various low-histamine foods into your diet to avoid food burnout and nutrient deficiencies.

  1. Keep a Food Diary

Track your meals and any symptoms you experience. This can help you identify patterns and pinpoint specific trigger foods.

High Histamine Foods to Avoid

Although it’s difficult to quantify histamine levels in food, there are some generally agreed-upon foods to avoid when following a low histamine diet.2 

  • Fermented dairy products, such as cheese (especially aged), yogurt, sour cream, buttermilk, and kefir
  • Fermented vegetables, such as sauerkraut and kimchi
  • Pickles or pickled veggies
  • Kombucha
  • Cured, fermented, or processed meats (sausages, salami, and fermented ham)
  • Wine, beer, alcohol, and champagne
  • Fermented soy products such as tempeh, miso, soy sauce, and natto
  • Fermented grains, such as sourdough bread
  • Tomatoes
  • Eggplant
  • Spinach
  • Frozen, salted, or canned fish, such as sardines and tuna
  • Vinegar
  • Tomato ketchup
  • Citrus fruits 

List of Low Histamine Foods to Eat

  • Fresh meat and freshly caught fish
  • Fresh fruits (non-citrus; blueberries, apples, mango)
  • Eggs
  • Gluten-free grains (oatmeal, quinoa, and rice)
  • Dairy substitutes (coconut milk and almond milk)
  • Fresh vegetables (except for tomatoes, avocados, spinach, and eggplant)
  • Olive oil

Remember, individual responses to histamine-containing foods can vary. If you suspect histamine intolerance, consult a healthcare professional or registered dietitian before making significant dietary changes. They can guide you in following a proper low-histamine diet tailored to your needs and help you achieve the best possible outcomes in managing your symptoms.

Low Histamine Diet Meal Plan Example 

Breakfast

Option 1: Scrambled Eggs with Spinach and Rice

  • Scrambled eggs (freshly cooked)
  • Sautéed spinach (cooked freshly)
  • Steamed white rice
  • Herbal tea (e.g., chamomile)

Option 2: Oatmeal with Fresh Berries

  • Oatmeal (cooked from scratch)
  • Fresh blueberries or strawberries
  • Almond milk (low histamine dairy substitute)
  • Chopped almonds (lightly toasted)
  • Herbal tea or water

Option 3: Smoothie Bowl

  • Fresh banana
  • Fresh kiwi
  • Unsweetened coconut yogurt (low histamine dairy substitute)
  • Ground flaxseeds
  • Honey (use in moderation)
  • Fresh mint leaves for garnish

Lunch

Option 1: Grilled Chicken Salad

  • Grilled chicken breast (freshly cooked)
  • Mixed greens (lettuce, arugula)
  • Cucumber slices
  • Carrot sticks
  • Olive oil and lemon juice dressing
  • Freshly ground black pepper

Option 2: Quinoa and Vegetable Stir-Fry

  • Quinoa (cooked from scratch)
  • Broccoli florets (lightly steamed)
  • Bell peppers (sautéed)
  • Snow peas (lightly cooked)
  • Sesame oil (use in moderation)
  • Fresh cilantro for garnish

Option 3: Lentil Soup

  • Homemade lentil soup (prepared with fresh ingredients)
  • Gluten-free bread (toasted)
  • Sliced avocado (use freshly)
  • Water with lemon

Dinner

Option 1: Baked Salmon with Roasted Potatoes and Asparagus

  • Baked salmon fillet (freshly cooked)
  • Roasted baby potatoes (cooked with olive oil and herbs)
  • Roasted asparagus spears
  • Herbal tea or water

Option 2: Grilled Turkey Burgers with Quinoa Salad

  • Grilled turkey burger (freshly cooked)
  • Quinoa salad with chopped cucumbers, tomatoes, and fresh herbs
  • Lemon vinaigrette (made with fresh lemon juice and olive oil)

Option 3: Stuffed Bell Peppers

  • Bell peppers (stuffed with a mixture of cooked ground turkey, cooked quinoa, and fresh herbs)
  • Served with a side salad of mixed greens and a light vinaigrette

Snacks

Option 1: Veggies and hummus

  • Carrots and cucumbers
  • Homemade hummus

Option 2: Trail Mix

  • Raw sunflower seeds
  • Pumpkin seeds
  • Dried apricots (use in moderation)
  • Dark chocolate chips (low histamine variety, if tolerated)

Option 3: Nut Butter and Banana Rice Cakes

  • Rice cakes
  • Nut butter (almond or sunflower seed butter, if tolerated)
  • Sliced banana (fresh)
  • Cinnamon powder (sprinkle lightly for flavor)

Remember that individual sensitivities to histamine can vary, so pay attention to how your body responds to different foods. Additionally, always consult with a healthcare professional or registered dietitian nutritionist before making significant dietary changes, especially if you suspect histamine intolerance. They can help you create a personalized meal plan that suits your needs and supports your overall well-being.

How To Lower Histamine Levels in Your Body

Managing histamine levels naturally can be beneficial for individuals dealing with histamine intolerance. 

  • Follow a low histamine diet and avoid known food allergens. Choose fresh, unprocessed foods whenever possible. Freshly prepared foods will likely have a lower histamine content than aged or processed foods. 
  • Cooking foods and freezing them immediately after preparation can help preserve their freshness and reduce histamine formation.
  • Limit the high histamine foods you consume, like tomatoes, spinach, eggplant, avocados, and citrus fruits. Avoid fermented foods like aged cheeses, sauerkraut, and fermented sauces. 
  • A healthy gut can aid in histamine breakdown. Consume fiber-rich foods, probiotics, and prebiotics to promote gut health. Drink plenty of water to help flush out excess histamine from your system. 
  • Chronic stress can worsen symptoms of histamine intolerance. Practice stress-management techniques such as yoga, meditation, or deep breathing exercises.

Additionally, antihistamines may temporarily relieve symptoms. 

Remember, managing histamine levels requires a well-rounded approach. While these natural tips may offer relief, it's important to remember that everyone's body is different. Before making any significant changes to your diet or lifestyle, it's highly recommended to consult with your doctor or a dietitian for personalized guidance.

Learn How To Eat Healthier and Keep Good Habits with Signos’ Expert Advice 

Signos is a great resource for expert advice on nutrition and healthy eating. Signos has a team of registered dietitians who compile evidence-based nutrition information to help you improve your health and wellness. Check out the resources here.

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References

  1. Patel RH, Mohiuddin SS. Biochemistry, Histamine. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557790/
  2. Zhao, Y., Zhang, X., Jin, H., Chen, L., Ji, J., & Zhang, Z. (2022). Histamine Intolerance-A Kind of Pseudoallergic Reaction. Biomolecules, 12(3), 454. https://doi.org/10.3390/biom12030454
  3. Schnedl, W. J., Lackner, S., Enko, D., Schenk, M., Holasek, S. J., & Mangge, H. (2019). Evaluation of symptoms and symptom combinations in histamine intolerance. Intestinal research, 17(3), 427–433. https://doi.org/10.5217/ir.2018.00152

About the author

Victoria Whittington earned her Bachelor of Science in Food and Nutrition from the University of Alabama and has over 10 years of experience in the health and fitness industry.

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