LOW-HISTAMINE DIET
After ruling out any food allergies and sensitivities, following a low-histamine diet is the most crucial treatment to lower your body's histamine levels. Although removing high-histamine foods, histamine-liberating foods, and DAO enzyme-blocking foods and drinks may seem overwhelming at first, with time and guidance, it becomes easier to identify better food choices and create a well-balanced eating plan that resonates with you.
Please always work with a healthcare practitioner to help you with any changes in your diet. You must never remove food without replacing it with another food similar in nutritional value!
Many high-histamine and low-histamine food lists are online, with a particular disparity in the list of excluded foods. As they summarized in this study, carried out by Dr. Sonia Sánchez et al.in 2021, while the evidence supporting the clinical efficacy of low-histamine diets is progressively growing, there is still a lack of consensus on the foods that must be avoided in the dietary management of histamine intolerance. The presence of other biogenic amines could partly help explain the relationship that some patients have established between consuming certain histamine foods and the onset of symptoms. For example, putrescine in foods can interfere with histamine degradation by competing with the DAO enzyme at the intestinal level. This mechanism could explain why certain foods, such as citrus fruits and bananas not high in histamine, are also often kept out of stricter low-histamine diets.
For all these reasons, it is worth highlighting that low-histamine diets continue to require the attention of researchers to clarify the specific interaction with other amines in histamine metabolism and elucidate the potential mechanisms of foods that release endogenous histamine.
Also, let's consider that everyone is different. You may be able to tolerate some foods that another histamine-intolerant person cannot. Or a food someone else does fine with might set you off. So, finding foods you can eat without a problem is always a personal exploration.
That said, let's concentrate on the high-histamine foods, histamine-liberating foods, and DAO enzyme-blocking foods and drinks that are more unanimously excluded in most of the lists and could affect histamine levels in the body.
High-Histamine Food List
In general, avoiding histamine means avoiding old or aged food. This includes vinegar, alcohol, cured meats, smoked meats, fermented foods, canned foods, and leftovers. However, this is a general rule of thumb; other foods contain histamine. Processed foods are high in histamine; avoid ultra-processed and packaged foods as much as possible
• Aged Cheeses
• Alcohol
• Bone Broth
• Cured, Smoked, or Processed Meats
Bacon
Smoked Fish
Salami
Pepperoni
Luncheon Meats
Hot Dogs
Canned Fish (sardines, anchovies, tuna, etc.)
• Dried Fruits
Apricots
Prunes
Dates
Figs
Raisins
• Fermented Alcoholic Beverages
Wine
Champagne
Beer
Whiskey
Brandy
• Fermented Dairy and Soured Foods
Sour Cream
Sour Milk
Buttermilk
Soured Bread
Cottage Cheese
Yogurt
Kefir
• Fermented Foods
Sauerkraut
Vinegar
Soy Sauce
Kimchi
Kombucha
Miso
Tempeh
• Leftovers in Fridge**
• Shellfish
• Over-Riped Fruit or Vegetables
• Spoiled Foods
• Vinegar Foods
Pickles
Mayonnaise
Olives
Ketchup
Balsamic Vinegar
Mustard
• Yeast Products
Bread
Most Baked Products
Vinegar
Cereal
Stock, Stock Cubes, and Gravy
Prepackaged Fruit Juices
Barley Malt
High-Histamine Fruits, Vegetables, and Nuts
• Avocado
• Cashews
• Eggplant
• Mushrooms
• Pineapple
• Peanuts
• Raspberries*
• Spinach
• Strawberries*
• Tomato
• Walnuts
Histamine Releasers
This group consists of those foods that release endogenous histamine, i.e., histamine located in mast cells.
• Alcohol
• Algae, Kelp, Seaweed
• Bananas
• Chocolate and cocoa
• Citrus fruits (Lemon, Lime, Oranges)
• Egg Whites (in excess can be problematic)
• Food Additives (Dyes, Preservatives, Stabilizers, Flavorings)
Calcium Chloride
Carrageenan
Citric Acid
Food Colorings
Lecithin
Maltodextrin
MSG
Smoke Flavoring
Sodium Benzoate
Sodium Nitrite
Sodium Triphosphate
Potassium Sorbate
Potassium Triphosphate
Xanthan Gum
Yeast Extract
• Grapefruit
• Kiwi
• Papaya
• Peanuts
• Pineapple
• Pulses (soy, beans, peas, lentils)
• Tomatoes
• Soy Sauce
• Spices
Allspice
Anise
Cayenne
Chili powder
Cinnamon
Cloves
Cumin
Curry
Mustard
Nutmeg
Paprika (Hot)
Pepper (Black, White)
Yeast Extract
• Strawberries
• Sunflower Seeds
• Walnuts
• Wheat Germ
DAO-Blockers
This group consists of those foods and drinks that block the function of the DAO enzyme.
• Alcohol
• Black Tea
• Energy Drinks
• Green Tea
• Yerba Mate
Note: Alcohol is one of the most harmful products for people with Histamine Intolerance and DAO deficiency. It contains histamine, cadaverine, and other amines; it releases endogenous histamine and has the property of blocking DAO.
*Foods can have opposing properties. For example, raspberries are considered high in histamine but have quercetin, an antihistamine. This accounts for some confusion, as a person googling antihistamine foods might come across raspberries because of the quercetin content. At the same time, a person googling high-histamine foods would also find raspberries on the list.
Also, I'd like to point out that berries and some spices are high in benzoate. Benzoates release histamine. Certain berries, such as strawberries, raspberries, and cranberries, are higher in benzoates and release more histamine. Cinnamon has a very high level of benzoates, so again, we’ve got this factor where histamine is released due to the benzoates in these foods.
WHAT FOODS CAN I EAT IN A LOW-HISTAMINE DIET?
As produce ages, it loses nutrition and increases histamine levels. The fresher your foods are, the more vitamins, minerals, and antioxidants they have. Foods that show signs of age, like wrinkled skin, loss of firmness, wilting leaves, or browning, will have higher histamine levels.
Since histamine and other amines can continue to form during refrigerated storage, it is essential to emphasize the maximum freshness in foods. Also, I'd like to point out that the method used for cooking is important. The study by Chung et al. observed that frying and grilling foods increased the histamine level while boiling had little influence or even decreased it. Slow cooking also raises histamine levels in food.
**LEFTOVERS - If you have food leftovers, it is essential to freeze them; don't refrigerate them, as they will raise histamine levels. When you finish cooking, place the leftovers in a bowl or dish safe for the oven and put them in the freezer. When it is time to eat, place the frozen leftovers directly into the oven at a high temperature to thaw and warm them so histamine levels don't rise.
Low-Histamine Foods That You May Be Able To Eat
• Any Meats and Poultry that are fresh, not dried, cured, smoked, or aged
• Butter that is not aged or fermented
• Coffee
• Cream
• Eggs (hen) fully cooked, if you can tolerate them
• Eggs (quail)
• Fish that are gutted and flash frozen immediately after catch
• Fresh Cheeses. Mascarpone, Mozzarella, Burrata, Paneer, Ricotta, Cream Cheese
• Fresh Fruits that are not on the high-histamine list and are not overly ripe
• Fresh Herbs and Spices that are not on the high-histamine list
• Ghee
• Herbal Teas
• Ice Cream and Popsicles (not made with high-histamine ingredients or artificial additives)
• Milk
• Most Fresh Vegetables are safe on a low histamine diet. Any vegetable except tomatoes, eggplants, spinach, mushrooms, squash, pumpkin, canned, pickled or fermented vegetables
• Most Nuts, except cashews, peanuts, walnuts
• Whole Gluten-Free Grain Products
Supplements that Can Help Lower the Levels of Histamine in the Body
• DAO Enzyme. DAO breaks down histamine in the gut. DAO enzymes help break down histamine from food.
• DAO Co-Factors. Including vitamin B-6, Copper, and Zinc.
• Flavonoids - Luteolin and Quercetin. These two flavonoids have been studied more for stabilizing mast cells. They are potent anti-oxidant and anti-inflammatory compounds with mast cell inhibitory actions. Remember that histamine is one of the mediators mast cells release to neutralize offenders. Some people don't do well with Quercetin but do great with Luteolin, like I do.
• Vitamin C. Known for its antihistamine properties, vitamin C can support the body’s response to histamine.
• Zeolite. It is a natural clay-like substance. Some studies confirmed the excellent histamine-binding capacity of Zeolite.
