Histamine is a chemical the immune system releases in response to allergens, triggering an allergic reaction. Many foods also contain histamine, which is broken down by an enzyme in the gut. Some people don’t have enough of this enzyme. As a result, blood histamine levels can increase and cause symptoms such as rashes, itching, diarrhea, and headaches.
A low-histamine diet includes foods that have low histamine levels, while excluding high-histamine foods.
Design by Health
You can get histamine from many foods. However, some people have a histamine intolerance, meaning their bodies have trouble breaking down the chemical in the gut. When this happens, it can cause symptoms such as bloating, diarrhea, stomach pain, hives, itching, fatigue, and difficulty breathing.
Some people temporarily experience high histamine levels due to medications. This is because some medications can reduce the activity of the enzyme that breaks down histamine.
A low-histamine diet can help by eliminating foods high in histamine. This could decrease histamine exposure and symptoms.
One 2018 study showed that following a low-histamine diet for a month decreased blood histamine levels in adults.
Another study in 2022 found that a low-histamine diet can change gut microbiota (microorganisms like bacteria and fungi that live in the digestive tract). Nine months of a low-histamine diet decreased histamine-producing gut bacteria in women.
Guidelines
The degree of histamine intolerance can greatly vary among people. For this reason, a low-histamine diet may look slightly different for each individual.
A food’s histamine content can also vary. This is based on factors such as freshness, pH (acidity), saltiness, nutrient composition, processing, and how it is stored.
These variables make it challenging to define what a low-histamine diet includes. A histamine-free diet is not possible. In general, the goal is to limit high-histamine foods.
In a low histamine diet, you can consume grains, dairy, oils, cooked eggs, fresh meat, some fish (mostly non-fatty fish), and some vegetables and fruit. Here is a list of foods considered suitable on a low-histamine diet:
- Grains and starches: Bread, pastry, potatoes, rice, pasta, cereals, millet, buckwheat, corn
- Dairy: Yogurt, fresh soft cheese, butter, and margarine
- Vegetables: Lettuce, cauliflower, broccoli, chicory, carrot, garlic, onion, cucumber, pumpkin, zucchini, pepper, radish, artichoke, rhubarb, and asparagus
- Fruits: Apple, pear, cherry, amarelle, peach, apricot, watermelon, and blueberries
- Oils and condiments: Vegetable oils, vinegar, honey, and jam made from allowed fruits
- Meat: Poultry, veal, beef, lamb, and pork
- Fish: Cod, trout, zander, and halibut
- Eggs
- Spices and herbs
What To Drink
Here are some drinks low in histamine:
- Water
- Herbal teas
- Homemade juices from allowed fruits and vegetables
Fermented foods, fatty fish, some seafoods, nuts, chocolate, and some fruits and vegetables are among high-histamine foods. Here are some foods high in histamine that should be avoided on a low-histamine diet:
- Canned and fermented fish: Canned tuna and sardines in oil
- Fatty fish: Salmon, tuna, herring, and mackerel
- Seafood: Oysters, shrimp, and clams
- Aged or ripened cheeses: Parmesan, gouda, cheddar, and feta
- Fermented foods: Sauerkraut, soy, miso, tempeh, and dry fermented sausages
- Certain fruits: Avocado, banana, kiwi, plum, pineapple, citrus fruits, and strawberry
- Certain vegetables: Tomato, spinach, and aubergine (eggplant)
- Nuts: Cashews, pistachios, almonds, and walnuts
- Chocolate
- Peanuts
Drinks Not in the Diet
Fermented drinks also contain high levels of histamine, such as:
You have plenty of low-histamine food options. A sample day on a low-histamine diet may look like this:
- Breakfast: Breakfast burrito filled with scrambled eggs, cottage cheese, and chopped lettuce, pepper, carrots, and cucumber.
- Lunch: A grain bowl consisting of buckwheat, grilled white fish, and steamed broccoli, drizzled with a sauce made from yogurt, vinegar, and spices.
- Snack: Homemade oatmeal cookies served with a cup of milk.
- Dinner: Beef stew cooked with lamb, potatoes, carrots, onions, and fresh parsley.
Histamine intolerance can cause a wide range of symptoms, such as gastrointestinal symptoms (like bloating, diarrhea, stomach pain, and nausea), skin conditions (including hives, itching, flushing, and eczema), headaches or migraines, dizziness, runny nose, fatigue, rapid heartbeat, and difficulty breathing.
A low-histamine diet can help lower the amount of histamine in the blood. This may ease symptoms in people with histamine intolerance.
It may improve urticaria, also known as hives. Urticaria happens when certain immune cells release histamine. This causes symptoms such as swelling, redness, and itchy skin. So, reducing histamine in the diet may help lessen symptoms of chronic urticaria.
A 2017 study showed that following a low-histamine diet for three weeks helped improve symptoms and severity of chronic urticaria without a known cause.
However, other health conditions can cause symptoms similar to those of histamine intolerance. You should consult your doctor before starting a low-histamine diet.
Limited evidence shows that a low-histamine diet can improve symptoms of histamine intolerance and other conditions linked to histamine release, such as chronic urticaria.
There are no studies showing adverse effects of a low-histamine diet.
Drawbacks
A low-histamine diet can help some people, but may have some drawbacks:
- The diet excludes some nutritious foods. Low-histamine diets exclude foods that are beneficial to health, such as fermented foods, nuts, fatty fish, and some vegetables and fruits. This can cause some nutrient gaps in the diet. Some of these foods may also contain nutrients that are important for the function of histamine-digesting enzymes.
- It’s impossible to determine a food’s exact histamine content. Histamine levels can vary depending on factors such as freshness, pH, salt levels, nutrient composition, processing methods, and storage conditions.
- Some low-histamine foods can still trigger histamine release. More studies are needed to identify and confirm which foods cause this.
- Each person’s histamine tolerance is different. The effects of a low-histamine diet are highly personal since how much histamine a person reacts to can vary. You may need to spend some time experimenting to determine which foods you can and cannot tolerate.
- The diet takes time to get right. For similar reasons to the above, it takes time to find the best version of the diet that improves symptoms while limiting foods as little as possible.
- It may be hard to follow. The restrictive nature of the diet can make it challenging to adhere to.
- There is no standard low-histamine diet protocol. More studies are needed to find the best way to plan the diet, decide how long it should last, and create a clear list of foods to avoid.
