Histamine Intolerance: Everything You Need To Know Explained in Plain English


[Last updated 9th November, 2018]

Histamine intolerance is poorly understood in the medical world.

Most health professionals are not knowledgeable on the topic; diagnosis is flaky at best; and the condition itself is difficult to treat.

That’s why I’ve created this guide. It’s a comprehensive, research-driven review of histamine intolerance, with a particular emphasis on diet and treatment.

What is histamine? A simple definition

HistamineWhat is histamine? A simple definition is a chemical that is both made by the body and found naturally in certain foods.

In the body it’s produced by mast cells (a type of white blood cell) and has a crucial role in our immune system. It’s actually the key mediator in causing the symptoms of allergy, which is why we take antihistamines for allergy relief.

Histamine also occurs in our food as a by-product of the fermentation of Histidine, which is a form of protein. In this context it’s part of a family of chemicals known as Biogenic Amines, which are produced by bacteria during fermentation, storage or decay (1, 2).

While high levels of biogenic amines (such as histamine) can make you feel unwell, the majority of people tolerate the amounts found in a regular diet.

Summary: Histamine is a chemical that has a crucial role in our immune system. It’s produced by the body and also found in certain foods.

What is histamine intolerance?

What is histamine intolerance?Approximately 1% of the population experiences adverse reactions to what is considered a “normal” level of histamine in food (3).

This increased sensitivity is called a Histamine Intolerance.

It develops through both increased availability of histamine in the body, and decreased activity of the enzymes that break down histamine and remove it from your system. This “defect” is primarily thought to be caused by previous gastrointestinal disease and/or genetics.

The main histamine enzyme in the gut is Diamine Oxidase (DAO), while areas like the skin, spinal cord, lungs and other organs rely on an enzyme called Histamine N-Methyltransferase (HNMT) (3).

So, an individual with a histamine intolerance will have low levels of DAO or HNMT (or both), which can lead to a build-up of excess histamine in their blood plasma.

It’s not unlike those with a FODMAPs intolerance, or those intolerant to caffeine or lactose. These conditions are also the result of enzyme problems.

What can cause high histamine levels?

Some reasons why you may have lower levels of DAO and higher levels of histamine include:

  • Certain medications that block DAO production, including several antibiotics
  • Gastrointestinal disorders like leaky gut syndrome and inflammatory bowel disease
  • High histamine foods and foods that trigger histamine release (see list below)
  • Bacterial overgrowth, like that found in SIBO

Histamine levels and testing

Normal levels of plasma histamine range from 0.3–1.0 ng/mL, but anything above this causes problems.

For example, a level of 1–2 ng/mL can increase stomach acid secretion and heart rate, while levels of 3–5 ng/mL can cause flushing and headaches (4).

A histamine-sensitive individual who consumes a high histamine meal is likely to get high plasma histamine levels. Unfortunately, there are no common tests to diagnose this, and the skin prick test is fairly new (5).

Therefore, it’s important that an experienced clinician rules out food allergies before tweaking your diet for histamine intolerance.

Summary: An increased sensitivity to histamine is called a histamine intolerance. It develops through both increased availability of histamine in the body, and decreased activity of the DAO enzymes that break it down. This can be caused by certain medications, gastrointestinal disorders and/or high-histamine foods. There are no common tests to diagnose this condition.

Signs and symptoms of histamine intolerance

Signs and symptoms of histamine intoleranceWhile symptoms appear allergy-like, they do not involve an IgE-mediated response and therefore are not allergic reactions (hence the term intolerance).

Of course, there is no way to know this until you have ruled out allergy through tests.

The onset and severity of histamine intolerance symptoms vary greatly between individuals, but common complaints are:

  • Flushing and headaches
  • Respiratory problems including asthma, runny or blocked nose
  • Skin conditions likes rashes, dermatitis, hives or eczema
  • Gastro problems such as nausea, reflux, vomiting, abdominal pain, diarrhea
  • Dizziness, low blood pressure and irregular heartbeat

Also note that antihistamines may help to relieve symptoms, but only if you do not already follow a low-histamine diet (3).

Summary: Symptoms appear allergy-like, but they do not involve IgE antibodies. The only way to be sure is to get tested for allergies.

High-histamine foods to limit or avoid

If you are histamine intolerant, it makes sense to reduce the amount of histamine you consume.

Unfortunately, it’s difficult to quantify the amount of histamine found in different foods. It varies greatly according to the type of bacteria, food composition, length of time unrefrigerated and conditions for fermentation (6).

As a general rule, high concentrations of histamine are typically found in fermented foods such as bread (effects of yeast), sauerkraut, wine, beer, processed meat and aged cheese.

In addition to histamine-rich food, there is an untested theory that several foods have the capacity to release histamine directly from our white blood cells (7).

This means they could contribute to increased histamine levels, even if that food itself is low histamine.

High histamine foods

There is a lot of conflicting information online and I found many authoritative sites did not provide very comprehensive lists.

Here, I’ve summed up the foods that most experts recommend you avoid:

  • Fermented dairy products such as aged cheese, yogurt and quark
  • Fermented or pickled vegetables
  • Soured foods such as sour cream and buttermilk
  • Tinned/canned, cured and processed meats
  • Fermented soy products including miso, tempeh and soy sauce
  • Green tea, matcha tea, coffee, cocoa, chocolate
  • All legumes (including peanuts) and tree nuts (regular nuts)
  • Citrus fruits, raspberries, strawberries, bananas, pineapple, grapes, pears and fruit juice
  • Avocado, eggplant, spinach, olives, tomato and tomato products (ketchup, tomato juice)
  • Vinegar, bouillon and broth
  • Smoked fish
  • Any alcohol
  • Junk foods or drinks that contain artificial colours or flavors.

I strongly recommend you also check out this Histamine Compatibility list (PDF) by the Swiss Interest Group Histamine Intolerance (SIGHI).

It ranks the likelihood of foods to cause symptoms on a scale of 0 to 3 as well as other important tips.

Summary: Foods to look out for are either high in histamine or have the capacity to release histamine from our white blood cells. As a general rule, fermented foods are the most histamine-rich and should be avoided.

How much histamine is safe for those who are sensitive?

Defining a safe threshold level for those with a histamine intolerance is incredibly difficult (8).

Firstly, sensitivity to bioactive amines varies greatly between individuals. Unlike food allergies, which are triggered at first exposure, it’s the cumulative amount of histamine that causes symptoms. What may trigger headaches in one person may have no effect on the other.

Secondly, as mentioned above, certain pharmaceutical drugs inhibit the enzyme DAO from breaking down histamine in the body. This can lead to increased histamine levels over time, especially if they are long-term medications (9).

Some of the more common drugs include alprenolol (for blood pressure) and many forms of antibiotics.

These factors must be accounted for when deciding on individualized dietary changes and how strict they should be.

As a general guideline, a limit of 100 mg histamine per kg in foods and of 2 mg histamine per liter in alcoholic beverages has been suggested, although these are likely too generous (10).

Summary: Individual sensitivity to histamine, as well as the impact of certain pharmaceutical drugs can seriously affect plasma histamine levels. Therefore, defining a safe threshold is very difficult.

A low-histamine diet

A low histamine diet planA low-histamine diet is a structured program that’s best done under the supervision of a dietitian specializing in food intolerance.

Once food allergy has been ruled out, the elimination phase involves strictly limiting the amount of histamine you consume for 2-4 weeks. Diet and symptoms must be recorded in your own food diary, which is proven useful in tracking significant improvements and relapses.

The reintroduction phase is next, where you gradually reintroduce histamine-containing foods to determine your tolerance and threshold. It doesn’t need to be done in a particular order, and I generally advise that you reintroduce the foods you miss the most first.

Some pointers to keep in mind:

  • Try to cook most of your own meals during the elimination phase
  • Avoid or limit eating canned foods and ready meals
  • Avoid junk foods; food dyes/artificial colors can be major triggers
  • Keep your kitchen clean
  • Refrigerate vigilantly as histamine forms on food as it spoils.

A low-histamine diet plan

Here’s an idea of what a realistic low-histamine day would look like:

Breakfast: Cereal + milk

Lunch: Fresh Spring (Rice-Paper) Rolls. Avoid using meat or veggies on the high-histamine list.

Dinner: Pan-seared chicken breast (fresh or thawed rapidly) + roast potato and vegetables (not those on high histamine list)

Snacks: 1 apple or peach; cucumber or carrot sticks + cottage cheese

Drinks: Water, herbal tea

Summary: A low-histamine diet requires you to follow a 2-4 week elimination period, followed by a reintroduction phase to determine your histamine threshold. A diet and symptom diary is necessary, and it’s strongly recommended that you see a specialist dietitian during this entire plan.

Important considerations before you trial a low-histamine diet

Significant dietary restrictions can affect nutritional status at any age (11).

Therefore, the risk–benefit ratio must be considered first when contemplating any form of elimination diet. Much like a low FODMAP diet, a low-histamine diet excludes multiple nutrient-dense foods that provide health benefits.

This is why it’s recommended that you follow a low-histamine diet under the supervision of a dietitian specialized in food intolerance.

Not appropriate for young children

Low chemical diets are becoming increasingly popular for young children despite the lack of evidence that they help.

A 2013 case-study review of 74 children placed on an elimination diet (for salicylates) found that almost half experienced harmful side-effects, including nutritional deficiencies, food aversion and eating disorders (12).

Growth rate is highest within the first years of life and a failure to meet this potential can have a long-lasting impact on development and later health (13).

Therefore, chemical elimination diets are only warranted for young children if there is clear-cut evidence it’s helping with symptoms.

Summary: A low-histamine diet can be quite restrictive even though it’s temporary, so consider your nutrition status before you start. It’s not appropriate for young children.

Supplements for histamine intolerance

Supplements for histamine intoleranceThere is basically one supplement available marketed specifically for histamine intolerance.

It contains DAO isolated from pig kidneys and is designed to supplement the sub-optimal DAO levels of patients with histamine intolerance.

There was one clinical trial that found DAO supplementation helped to reduce the duration of histamine-induced migraines by 30%, but not the intensity nor how often they occur (14). It was reportedly a small study though, and ideally it would be nice to see if the results can be replicated.

The reviews of this particular supplement are interesting, and you can give it a try. Note that the capsules are labelled vegetarian (as you would expect), but the DAO inside is sourced from pork. Highly misleading labelling.

And as always, please consult with your personal doctor before you decide to try any new supplements.

Vitamin C and vitamin B6

Some researchers believe both vitamin C and vitamin B6 supplementation can be beneficial.

Both nutrients are required (cofactors) for DAO activity, so in theory they act as antihistamines by supporting the breakdown of histamine (15, 16).

One trial found that 5 mg of vitamin B6 supplementation daily significantly increased DAO activity in pregnant teenagers, but only those deficient in vitamin B6. It didn’t benefit anyone else (17).

That’s the only scientific proof I could find, and study after study shows that vitamin supplements are basically useless unless you have a clinical deficiency. Your money is better spent on foods naturally rich in vitamin B6 and vitamin C.

Note that if you want to try vitamin C supplements, it’s best to avoid the form called ascorbic acid. It’s typically derived from fermented corn and/or citrus, both not appropriate for histamine intolerance.

Summary: DAO supplementation was shown in one clinical trial to reduce the duration of migraines, but had no effect on frequency or severity of symptoms. In theory, a vitamin C and/or vitamin B6 supplement may help too, but this is not supported by any strong evidence.

Probiotics for histamine intolerance

Probiotics for histamine intoleranceProbiotics are microscopic bacteria that we get from fermented foods.

They help to restore and maintain the balance of bacteria in the gut, which is linked to varying aspects of well-being including digestive health and even weight loss.

Fermented foods are not an option for someone with a histamine intolerance, which leaves us with probiotic supplementation. Unfortunately the research is thin.

One study found oral intake of two Bifidobacterium strains supressed factors involved in histamine signalling and production, at least in rats (18).

Another study looked at the effects of several probiotic strains on human mast cells in a laboratory setting. Researchers were able to “turn down the dial” on the immune response and minimize histamine release, especially with two strains of Lactobacillus rhamnosus (19).

It seems that if probiotics were to help, they would be most useful in preventing allergic reactions rather than treating symptoms of histamine intolerance. Nevertheless, if you want to try some just be careful about what strains you use. Some strains of Lactobacillus have been shown to increase histamine content, while other strains decrease it (20, 21).

I suggest this probiotic (Lactobacillus rhamnosus) or this probiotic (Bifidobacterium strains) (full disclosure: these are Amazon affiliate links).

Just note that we don’t know the optimal dosage for this condition, nor the long-term side effects (if any), so always consult with your doctor first.

Summary: Early studies on rodents and in test-tubes have shown that certain probiotic strains may help minimize histamine release. The most effective strains are likely to be Lactobacillus rhamnosus or several Bifidobacterium strains, but there is no guarantee they will help.

This is only a guide…

There are a lot of aspects to consider when treating histamine intolerance, particularly when it comes to diet and nutrition.

While I’m a qualified dietitian, this general advice is no substitute for your personal medical professional that knows your medical history.

That being said, if food allergy has been ruled out, avoiding histamine-rich foods as part of a low-histamine diet is the next logical step. Some supplements and probiotics may help, but I would not expect any miracles.

There’s also the possibility of a food intolerance, which you can learn more about here.

About Joe Leech, Dietitian (MSc Nutrition & Dietetics)

Joe Leech is a university-qualified dietitian from Australia.

He graduated with a Bachelor's degree in exercise science, followed by a Master's degree in Nutrition and Dietetics in 2011.

Learn more about him on the About page

59 responses to “Histamine Intolerance: Everything You Need To Know Explained in Plain English”

  1. Hi Joe,

    Do you have any doctors in the NYC area that your recommend for Histamine Intolerance/Mast Cell Disease? I have been searching for many years to find an allergist/doctor who has knowledge/experience in the subject.

    Thanks so much!

    • Dr, Anne Maitland! long waiting list. I am waiting to get in. Dr. Afrin recommended her via email (I am reading his book!. It is awesome.

    • Gerard Butler, The experts for Mast Cell decease and Histamine issues are at Mayo Clinic in Rochester, Minnesota or at Harvard University’s Medical Center. also, Dr. Afrin, also in Minnesota, about 60 miles away from Mayo Clinic. Many insurance plans cover Mayo Clinic treatments too. Good luck!

    • Dr. Joseph Butterfield is an allergist-immunologist in Rochester, Minnesota and is affiliated with Mayo Clinic. He received his medical degree from University of Chicago Pritzker School of Medicine and has been in practice for more than 20 years. He is one of 19 doctors at Mayo Clinic who specialize in Allergy & Immunology. Butterfield at the MAYO clinic in Rochester Minnesota if this isn’t too far.

  2. Just to share my first hand experience with histamine intolerance. I had eczema and psoriasis for over a year and was informed that stress could have been the initial trigger. Fortunately I was referred to a dietitian who gave me a Salicylate food guide. I started going on an elimination diet cutting out salt, sauces of any kind and just started eating plain food such as fish soup to start with just a speckle of pepper and small potatoes. I noticed at that time, whenever I added tomato or chilli, my eczema will flare up. I realised then I had to be strict with my diet to let my body recover. I was also taking some zinc tablets as well as antihistamine tablets; but I was taking these even before the elimination diet. I also found a shower cream and moisturiser cream that worked for me. These creams are organic. After a month, my psoriasis and eczema started to clear up; I was able to sleep better which helped me recover further. A doctor who had seen me before I started my diet was unable to give me any further advise and I saw 3 different doctors who gave me the same steroid creams which I found did not do much and which I believe could also thin the skin (not good for when I go out in the sun) so I was quite reluctant to use them and so made my own oatmeal solution; this was before I discovered the creams mentioned above. Anyhow I have fully recovered from my eczema and psoriasis. I get the odd flareups on my hand when I eat some fermented food and some foods like shrimps or overindulge in tomatoes.

  3. Thanks for the article. My naturopath suggested D-Hist, which is also available on Amazon. It has been very helpful with my symptoms.

  4. Ingesting a probiotic species without knowing the strain can be a hazardous undertaking. I would suggest sticking to the specific strains that have research behind them to back their efficacy. If you suspect you are HIT…do your homework.

  5. I became aware of Histamine Intolerance about a year after having two severe allergic reactions to food and a subsequent diagnosis of Oral Allergy Syndrome. At that point, my system became to reactive that I had broken out in hives almost every time I had eaten for a year, and I was desperate to find something that helped.

    I an severely allergic and avoid the foods I know cause problems but doing so had not helped. I figured I had nothing to lose by trying a low histamine diet. Rather than just following the elimination diet for a few weeks, I followed it for several months until I was certain that I was no longer reacting to any foods. My diet was extremely restricted as I also could not eat fresh fruits and vegetables due to the OAS, but I stuck with it. Eventually, I was able to add some foods that I had been unable to tolerate and also learned to avoid the canned and processed foods that I had favored after my OAS diagnosis.

    Adding probiotics last winter also addressed a long term problem with IBS which my GI had unsuccessfully treated for years. I am very careful about the probiotics and change strains periodically which seems to help. I am bookmarking your article so that I can return to it. It is clear, succinct, and puts together information that I have gathered from various sources over the course of the past 2 years. Thanks.

  6. Coffee according to this site is on the high histamine list and on the low histamine list too – it seems every time i research something on the internet the information i find says one thing then it says the complete opposite in the same article on the same web page written by the same author.

    • Hi Chris, I concur. I specifically searched for coffee and histamine intolerance, saw the first section of the article thought “aha!” then “oh” b/c it states to drink coffee/tea. So, unfortunately, I love coffee but am following an AIP diet so I’ve been weening myself off anyway. I would say if you drink lots of coffee, or even a cup a day, do 1/2 a cup for a week, then a 1/4 and finally just a swallow (I went cold turkey and slept at lunch and 4 hours after work before I went to bed for another 10 hours, it was insane!).

      All you can do is take it out of the diet for a month, note changes, reintroduce and see what happens (or don’t if you’re feeling great and it’s the only change you made). There just isn’t enough concrete information out there, like SIBO which is just now unraveling, histamine intolerance will have more info as studies allow, but my guess is it’s decades away.

      Sorry for the rant, hope that helps!

  7. I’ve been dealing with histamine intolerance for several years now. Mostly I handle it OK but every so often it clobbers me. I am allergic to soy, so I’m on the paleo diet. A lot of people on the paleo diet run into this problem. I suppose it doesn’t help any that our bodies are already used to making histamine due to soy. I should add I am incredibly sensitive to soy; I react to contact – including the brightly colored ink on some boxes that contain soy protein. It makes me itchy.

    I didn’t know about the ascorbic acid being high histamine. It explains why I always ended up reacting after taking it in powder form for a few days. I had always thought it was cross contaminated with soy. Now I know.

    Mainly I find if I avoid the high histamine foods for awhile, my system will reset and then I can eat them again..but carefully. For example, if I would eat cheese, spinach, canned pineapple (pineapple, pineapple juice), homemade chocolate (from cocoa powder…it’s more like hot chocolate drink really), mushrooms, etc..I would get clobbered. I think mushrooms are high histamine…? The most recent one gave me a red flushed face from eating tomato, spinach, cinnamon (also high histamine) and pineapple plus beef. So don’t eat the stuff day after day. I think the cinnamon bugs me more than the other stuff, probably due to age.

    I can eat most meats (beef,chicken, duck, pork, fish) OK as long as it’s not soaked in anything. A lot of meats these days are soaked in a solution of “natural flavors”, which I am allergic to. I make a lot of homemade soups and stir-fries. To expand my diet, I added a lot of the Asian veggies to my meals like daikon (giant radish), gobo (burdock root), bitter melon, bok choy….the bok choy yellows quickly so need to eat it while dark green.

    Examine greens when you buy them to make certain they are fresh. Look at broccoli for browning or discoloration. It helps alot.

    I drink tea every day. Tea doesn’t bother me, as long as there are no additives like ” flavors”. I also eat a small amount of beef five days a week to get iron. Doesn’t bother the histamine… But then I do watch what I eat. I really don’t eat any preprocessed food.

    I can eat raisens, yogurt, cheese,nuts, etc….BUT only if I avoid other high histamine food at that time. It’s when I forget that I get clobbered with reactions.

    So what I do eat: carrots, celery, gobo, onions,ginger root, bitter melon, squash, daikon, zuchinni, bananas, bok choy, lettuce, spinach (eat it far apart), winter melon, mushrooms, shatake, asparagus, eggs, fish (fresh or frozen fillets… Look at eyes on whole fresh fish to see how fresh they are), chicken, duck, beef, fresh pork….. I may be forgetting some veggies… Eat bananas daily but other fruit less often .

    Hope this helps.

  8. I came across your blog here and found it very informative, thank you. My son suffers from allergies to foods and other for many years. We have done the diet elimination and been to dermatologists and allergists and never seem to get anywhere. Skin issues(very bad on scalp) that have been diagnosed as eczema/dermatitis/psoriasis. Also, have made my own homemade cleansers, shampoos and natural products purchased none of which work. He also suffers from Ulcerative Colitis and we are trying hard to find ways to battle this for a more norm life. Any suggestions would be gladly welcomed.

    • Please look up ‘fast track diet’, it has helped many with digestive issues.
      I found it helped me but also giving up gluten and grains and dairy stopped itchy skin.

  9. I think i have histamine intolerence because my face flashes when i eat fermented food, meat, banana, drink coffein ect. But it does not flush when i eat avokado? does that mean i don’t have histamin intolerence or is it possible that you tolerate some types of foods and not others ? I hope someone can help me

    • Please look up ‘fast track diet’, it has helped many with digestive issues.
      I found it helped me but also giving up gluten and grains and dairy stopped itchy skin.

      • I have had histamine intolerance since May 2016. My symptoms have increased. I was wondering if anyone has experienced joint pain and muscle weakness. I have also list 37 lbs and wondering when the weight loss will stop. Thanks

        • You may have SIBO, or Small Intestine Bacterial Overgrowth syndrome. You should probably see a university setting GI specialist to have a breath test to check for this condition.
          I have had SIBO at least 3 times with terrible diarrhea and 30 -40 pound weight loss. Very debilitating.

  10. I am 71 and have varying degrees of seasonal type symptoms and after a virus that lasted through xmas 2014 to Feb 2015 I went on to have a reaction on my BD in August 2015 when I went for a swim I came out of lake covered in hives I have what is known as cold urticaria and csnmot stand any temperature below 20 cel and if exposed to cold I get hives.In my determined effort to beat this thing that has a grip on me even when I sweat as sweat turns cold and I get hives I have learned that olive oil taken before eating increases DAO enzyme 500 % ,so a tablespoon 3x a day plus magnesium before each meal and a B6 vitamin I am so excited about this and would gladly share with anyone my ecperience with histamine intolerance.

    • Sheila,

      This is all new to me. I am 56 and had 2 viruses a year ago and have been different ever since. I am not gluten free, soy free and msg free but recently have had many migraines and continued brain fog. Waiting for next appointment with Functional Medicine Doctor but have seen acupuncturist a few times and she was shocked at my high histamine reaction. Just started researching and finding out I need to change more with food but I like your idea about the fish oil at meal time and increasing DAO! This is very helpful as well as the magnesium and B6. Is it Magnesium Citrate? There are several kinds. Thanks so much for sharing!!!

      • I’d like to kbiw,uf nagnesium citrate is safe as well being that is with citric acid and citris fruit is a,no no.

        • Soorry for all the misspelled words. Was on cell phone and tried to edit post, vut sure if it’s possible. Just needing to know if using magnesium citrate is safe to use being it is made from citric acid. Thanks

          • Be careful with magnesium citrate, unless I miss my guess, this form is a laxative, so you may want to check with your local pharmacist.

    • Sheila,
      I am from India. I have been suffering with cold urticaria fir last 6 years..if i exposed to even fan breeze, hives appeared. I would like to follow your idea to take olive oil for 3 times per day. Pkease advice about magnesium and B6 whether these are available in local pharmacy.

  11. San Francisco Bay Area Recommendations??? I am seeking a doctor or nutritionist who can support me with histamine/mast cell.

    I am going insane with insomnia waking up with itching skin, itching nostrils and ears, racing heart. I am now severely underweight. I get extremely fresh meat and eat only above ground veggies. I take prescript-assist, seeking health’s bifido strains. My g.i. Doctor is focused on my leaky gut/sibo which I know will heal the histamine intolerance but my symptoms have gotten worse. I am 5’5″ and currently 103lbs. Also taking holy basil to survive during the day. Too many rabbit holes on the internet. Please help me.

    • Hi Kris,

      Have you tried elimination diet? I know what you are going through as have been though it myself. No steroid cream etc seemed to work for me although steroid tablets did help. I went on this elimination diet because I was thinking the reactions I was getting must be due to certain foods messing up my my body’s Eco system. Anyway I went to basic with food just having fish seamed etc , no other meat, no spices etc or anything like and veges low in Salycilate. I had obtained a checklist showing the salicylate content in food and used this as a guide to the foods I consumed for a month and then slowly introducing the ones that I had avoided. My plan was to help return some balance to my body and I felt it helped and know the food that triggers bad reactions. Also I found this amazing cream in Australia which was organic and created by someone who suffered bad eczema too. I used their shower cream and after shower cream. The first time I used their shower cream I Had my first good sleep! It’s called Caroline cream but it’s only sold in Australia. I am still using their product.

      • Also, cheapest itch reliever I found is water from ground oats. I just buy a big bag of cooking oats and grind then when I need them. Add water to make the paste and just rub it over your itch..helps but remeber to moisturise as it does dry up your skin. So cheap as you make it yourself and easily available at supermarkets

  12. Please help. There are so many healthy, good foods that I cannot eat and I do not know why. Today ate ate some bell peppers in my sandwich and know I am in so much pain down in the pelvic area of my gut. This happens to me so often with avocado, bell pepper, banana, grapes, broccoli, cauliflower, asparagus, so many delicious healthy things that I simply can’t eat. The pain can be so instense that it throws my body into shock, sweating, nearly passing out, throwing up. The only way I can explain it is it’s like a gas ball is stuck and is getting bigger with no where to go.

    • Hi Miquel,

      I would recommend speaking to your doctor about this as it sounds quite complex, and it’s best to get advice from someone who knows your medical history. Good luck.

  13. To Miquel – a lot of those things can be high in histamines, salayclic acid and other naturally occuring food chemical – which gives food bright colours and yummy taste – but can upset some people. Run a low sensitivity food diet. Google ‘RPAH elimination diet’ . Basically, have a bland diet for 2-4 weeks and see how you feel. If you feel better, great, you can let your body recover a bit – and then try to slowly reintroduce foods. Then you need to look for the root cause. A functional medicine practitioner might help

  14. Thank you Joe, this is the best article I have read on histamine intolerance. I drink organic chicken BONE broth twice daily as I need the collagen for my autoimmune condition to prevent greater hair loss. Am I better off drinking organic chicken MEAT broth ?

  15. Hi,

    Please let me know- is there someone in the Atlanta are you can refer me to to be tested? And a dietician too? Testing is most important for Histamine intolerance?

    I’m thinking I’ve suffered for years now with a histamine intolerance. Your article was extremely informative. Everything from 2 glasses of red wine to processed deli meat, especially salami, etc. I get extreme migraines and what I thought were hangovers for such little levels of alcohol- from vomiting non stop, sweating, in bed all day…yet I knew I just had some casual drinks at dinner. I figured I was a light-weight. Strangely, years ago too when I breast fed my children years ago u would break out in rashes all over my body and doctors never could diagnose why or what it was. We just determined it was some type of histamine reaction…so now I feel like I have a high-tendacy or an inability to break down histamines? It may all be adding up years later as I suffer. I have toe fungus, can’t ever lose the last 15lbs (I’m about 135 lbs) and eat well, don’t snack and never lay around! I try to avoid bread-eat lettuce wraps instead and eat tofu noodles instead of pasta which now I read could release histamines in me…???

    Thank you,

  16. Hello, I have recently been diagnosed with a number of allergies.
    I received my allergy diagnosis of: fish (halibut), Lima beans, apricot, avocado, cauliflower, coconut, through a skin prick test last summer. I was also supposed to get my blood tested for nut (I have reactions to them, but I didn’t test positive) and additional fish allergies, but it was too expensive for me to afford.
    Many of my new allergies are on the list of high histamine foods, and I also have many of the other systems of histamine intolerance (heart,lung, bowel,blood pressure, fatigue, etc). Is it possible that I have histamine intolerance instead of, or in addition to true food allergies?

  17. The practitioner’s guide to simple, drugless and safe asthma healing.
    Step one: massage of the patient’s face between upper lip and nose (philtrum) to feel the relaxation of lung airways by reflex arc.
    Step two: the patient does this himself or herself to coordinate easing of lung airways with massaging or just stroking this area of the face.
    Step three: determined and slow sniffing to get the same relaxed feeling owing to pressing of lips.
    Step four: breathing retraining on this basis.

  18. Hi
    A year ago I started with cold urticaria. I get when outside, but have had it two or three times in the house.
    My Immunologist did scratch skin tests which showed I am allergic to cats, dog, grass pollen and dust mites. The strange thing was they also did a scratch test for histamine and I was told it would itch like mad, it did not. When I asked the Immunologist why it did not he just looked puzzled. the ice cube test was showed positive the first time but when repeated was negative. Immunologist kept doing the Dermography (sorry not sure of real name) test until he thought it was positive.
    Does this mean I do not have Histamine Intolerance or is there another reason why the histamine test did not itch.
    I also have hypothyroidism but not sure if it is hashimotos as antibody level are in range although near the top of the range.

  19. Hello,

    my dad has a number of food intolernaces which are suspiciously overlapping with high histamine foods. Are there places in the UK who do histamine intolerance testing please?

  20. This post would be easier to take seriously (I have found “professionals” to be USELESS.) if it didn’t suggest cereal for breakfast. Come on! Any cereal with gluten will represent a sky-high histamine presentation, and that’s assuming the individual knows NO DAIRY, never, ever, nada, none! Plus, cereal will trigger glucose swings, very inflammatory! I do an egg (just one) on sweet potato with a vegetable thrown in. Or shredded vegetable “pancakes,” but overall anyone with European ancestry, especially Western European ancestry, has no business eating ANY grains, because our guts can’t handle them, part of what may have gotten you into a histamine problem to begin with.

    And where no recommendation of taking DAO plus a host of other enzymes to augment digestion, with DAO critical for people like me. I almost DIED from histamine overload as everyone sat and looked stupid, not for example, asking, “Why does a glass of alcohol send this woman to the hospital in an ambulance?”

    • Sad too, almost everything has histamine, especially super foods. One article warned iff meats, veggies and fruits. That covers all the fresh stuff. Also everything fermented, like things we should be taking FOR the good gut bacteria they contain. And cheese. That about covers it.

  21. I suffered perforated colon along with sepsis and multiple organ failure that went along with it. I’m still in the hospital healing a fistula in my belly. My body miraculously healed from most of the serious effects of the sepsis, thanks in large part the power if prayer supports from at least 100 people. I was on TPN ( synthetic milk administered through a vein), but in my 5th month, they began to allow me solid food. Immediately, I had full body hives. I looked it up and discovered DAO abd that ut was mostly nade in the ileum. The cut off to my new ostomy. So my ileum now being compromised cannot efficiently produce DAO. The article suggested turmeric, which worked dabulously but I had to take 2.5 grams at each mealtime. Which was ok at first but lately has been causing diarrhea. Not fun coming out my skin. Blowing off the appliance.
    So I’m game to try kidney. There us a grass fed beef one getting great reviews. Normally I could butcher my own chickens and rabbits and use theirs, but I’m not home and my hubby isnt up to butchering. Until I can get my health and energy back I won’t be butchering at home. It takes some strength and agility.

    • See my most recent post. A bit calmer about dairy, but you are in crisis and you need a healing PROGRAM and quickly. Sadly, you’re likely the only one who can do that, but start with LIVER RESCUE but never, ever due a “liver detox,” it’ll rip you apart. Dandelion and nettle teas and tincture are what you need. Hugs, and believe me, I’ve been there. But read everything you can on how to naturally heal your gut, as that’s the source of your illness, and where ALL the research on degenerative disease is headed!

  22. Stop worrying about histamine, except short term. Address CAUSE. Research everything about digestion and it requires an aggressive rebuilding of herbs to heal the gut (true source, not stomach), digestive enzymes, perhaps hydrocholoric acid and NEVER, EVER, EVER acid-fighters like Tums or Nexium, B vitamins, L-glutamine to heal the gut along with vitamin A and minerals. Also, Anthony William’s LIVER RESCUE essential to read. Might also do nettle and dandelion tea to nourish the liver, another cause. And, yes, cautious of dairy, GRAINS (all grains, not just wheat) although rice, especially white rice is okay, and short-term eggs and perhaps other particular trigger foods. BUT DON’T MAKE THE MISTAKE I DID OF ENDLESSLY GIVING UP NOURISHING FOODS AS I GOT SICKER AND SICKER. Educate yourself, because many healers, including alternative types, are 20 years behind reality. Also, never, ever fight candida unless thrush or whatever. As LIVER RESCUE explains, it’s part of healing. Oh, and caution on caffeine and over-the-counter painkillers (not to mention opiates), they BURN the gut!

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