Low Histamine 101

If you’ve tried the conventional route and have even searched for natural remedies to help alleviate allergies but are still experiencing nagging symptoms, it’s possible that a histamine intolerance is at play. A low histamine eating plan could provide some relief! Here is what you need to know:

What are Histamines?
Histamines are biogenic amines released by our cells in response to injury, inflammation, and allergic reactions. They are also naturally occurring in many foods.

In healthy individuals, histamine is rapidly removed by DAO (diamine oxidase) and HNMT (histamine n-methyltransferase) enzymes. The main enzyme, DAO is stored in epithelial cells and secreted into the circulation on stimulation.

Histamine intolerance results when the body is unable to breakdown histamine sufficiently, leading to a histamine excess. This can lead to a host of symptoms which usually mimic those of an allergic response. The main cause of histamine intolerance seems to be the impairment of DAO activity caused by gastrointestinal diseases or through the inhibition of DAO. There is also evidence for a genetic predisposition for histamine intolerance in some people.

Histamine Intolerance Symptoms?

Histamine intolerance can be difficult to diagnose because many of the symptoms are similar to those seen with allergies, as well as symptoms of sulfite intolerance or intolerance to other amines. The signs and symptoms of histamine intolerance include:

• Diarrhea
• Headache
• Hives
• Asthma
• Hypotension (low blood pressure)
• Tachycardia (rapid heartbeat)
• Pruritus (severe itching of the skin)
• Nasal congestion and runny nose
• Tissue swelling (usually of the face or oral tissue and sometimes throat)
• Chest pain
• Conjunctivitis (pink eye)
• Fatigue/confusion/irritability
• Flushing

Additionally, excess histamine in individuals with histamine intolerance can exacerbate some existing conditions such as eczema, digestive issues, and anaphylaxis.

Low Histamine Eating Plan
Histamine intolerance will vary from person to person. What sets off symptoms for one person, might not do the same for someone else. This is due to the many different factors leading to a histamine intolerance and any other medical conditions present that may be contributing to the amount of histamine in the body. Therefore, the guidelines for foods to avoid are to be used as tools to help each person determine what their threshold level is.

There is no such thing as a histamine-free diet so keeping histamine intake as low as possible is key. When considering a low histamine plan, it’s best to avoid all foods known to contain high and moderate amounts of histamine, foods known as histamine liberators, and those that are DAO inhibitors.

Improvements in symptoms are usually noticed after 4 weeks of following a low histamine plan. Once symptoms are alleviated, one can determine the individual threshold levels by introducing foods back one at a time into the diet. A food diary can be very helpful in keeping track of foods and symptoms, and will facilitate creating a customized list of foods to avoid for each individual.


Aside from histamine-rich foods, some foods, like alcohol, are also DAO inhibitors and should be avoided for that reason. Other guidelines are as follows:
• Avoid canned or ready-made meals
• Avoid ripened, fermented, or aged foods (aged cheeses, alcoholic beverages, yeast containing products, stale fish)
• Purchase and consume only fresh products
• Avoid leaving food out of the refrigerator (especially meat products)
• Consume only fresh wild caught fish (ideally cooked within 30 minutes of catching)
• Avoid smoked products such as ham, salami, and sausages
• Avoid foods that contain preservatives and artificial colors. Focus on consuming fresh whole foods.
• Avoid histamine liberators. (Some of these are citrus, cocoa, nuts, papaya, beans, tomatoes, and spinach.)
• Avoid DAO blockers. (alcohol, black/green/mate tea, energy drinks)

Histamine intolerances often go undiagnosed or misdiagnosed due to the number of different symptoms that may result and their similarity with those symptoms of allergies and other intolerances. All histamine sensitivities are not created equally and efforts should be made to determine the mechanism of the histamine intolerance and individual threshold level, therefore it’s best to implement with help and guidance from a qualified nutrition expert like our experts at PreviMedica. If you are interested in scheduling a nutrition consultation or enrolling in our monthly membership, give us a call at 855-773-8463. You can also schedule a complimentary discovery call by completing this quick questionnaire. 

Maintz, Laura, and Natalija Novak. “Histamine and Histamine Intolerance.” The American Journal of Clinical Nutrition 85 (2007): 1185-196. Web. 26 Feb. 2016. http://ajcn.nutrition.org/content/85/5/1185.long

“About HIT.” Histamine Intolerance. N.p., n.d. Web. 20 Sept. 2016. http://www.histamineintolerance.org.uk/about/

Joneja, Janice. “Histamine Intolerance Investigated by Dr Janice Joneja.” Histamine Intolerance Investigated by Dr Janice Joneja. N.p., n.d. Web. 27 Sept. 2016. http://www.foodsmatter.com/allergy_intolerance/histamine/articles/histamine_joneja.html

Joneja, Janice M. Vickerstaff, and Cabrini Carmona-Silva. “Outcome of a Histamine-restricted Diet Based on Chart Audit.” Journal of Nutritional & Environmental Medicine 11.4 (2001): 249-62. Web. http://www.encognitive.com/files/Outcome%20of%20a%20Histamine-restricted%20Diet%20Based%20on%20Chart%20Audit_0.pdf

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