Histamine is a natural chemical that helps your cells communicate. It plays a few important roles in your body, including managing your sleep cycle and supporting your brain function. But it is best known for its role in allergies.
Allergies happen when your immune system overreacts to things such as pollen and mold. Your immune system might mistakenly think that these things, which are usually harmless, could be threats to your body. To defend against the so-called threats, your mast cells (a type of white blood cell) release histamine. The histamine tells your body to launch an allergic reaction.
Seasonal allergies are often the cause of histamine production in the body, but foods can also contain this chemical.
Most people can tolerate foods high in histamines, but approximately 1% of the population has a histamine intolerance. It tends to be more common in middle age. When you have this condition, you can’t break down histamine correctly, causing it to build up in your body. Although it can lead to allergy-like symptoms, it’s not considered a food allergy.
It’s not clear why some people develop histamine intolerance. Some medications and gut conditions can make it harder for your body to break down histamines. Or you might not have enough diamine oxidase (DAO), the protein that is mainly responsible for breaking down histamine. Low levels of DAO can be caused by genetics (meaning it's passed down through your family), kidney disease, or liver disease.
Histamine intolerance symptoms
Too much histamine triggers an immune response. This can cause symptoms such as:
- Runny or stuffy nose
- Shortness of breath
- Swollen lips, tongue, or throat
- Headaches or migraines
- Fatigue
- Diarrhea
- Bloating
- Nausea or vomiting
- Flushing (redness in the face)
- Itching, rash, or hives
- Irregular or fast heart rate
- Low blood pressure
- Irregular or painful periods
In severe cases, histamine intolerance could lead to a dangerous condition called anaphylaxis. Call 911 if you have:
- Swollen lips, tongue, or throat
- Shortness of breath
- Sudden drop in blood pressure (this could look like dizziness, confusion, or fainting)
How to know if you have histamine intolerance
If you have symptoms of allergies or histamine intolerance, talk to your doctor. They might recommend keeping a food diary. This involves writing down the foods you eat and symptoms you have each day. A food diary can help you find patterns and figure out if a certain food (or combination of foods) is causing your symptoms.
Your doctor also might suggest avoiding all foods high in histamines for a few weeks. If this helps you feel better, you may have a histamine intolerance. To find out if there’s a particular food that triggers your histamine intolerance, slowly add foods back into your diet, one at a time. If you start getting symptoms again, the recently added food might be a trigger.
They may also prescribe:
Allergy testing. This can help show whether your symptoms are being caused by allergies. You might get a skin prick test, where the doctor pricks your skin with tiny drops of allergens to see if they cause a reaction. Or you might get a blood test.
Blood testing. Some blood tests can show whether you have high levels of histamine, low levels of DAO, or other irregularities.
Histamine testing. During a histamine skin prick test, a doctor pricks your skin with a tiny drop of histamine. This will probably cause a reaction. But if the reaction doesn’t go away after 50 minutes, your body might have a hard time breaking down histamine. They may also give you a histamine pill to see how your body reacts.
Colonoscopy. During a colonoscopy, your doctor can check histamine and DAO levels in your colon. They can also look for signs of other conditions that might be causing your symptoms.
Some foods are naturally high in histamines. Others don’t have a lot of histamine but trigger your white blood cells to make it. If you have histamine intolerance, both kinds of foods can lead to too much histamine in your body.
It’s difficult to measure histamine levels in foods because they can vary greatly even in the same types of food. However, a good rule of thumb is that foods that are fermented, aged, or overly processed likely contain more histamine than fresh foods.
Highest-histamine foods
These foods and drinks are particularly high in histamine:
- Alcoholic beverages
- Canned and semi-preserved fish
- Cured meat
- Dry-fermented sausages
- Cheese
High-histamine fruits
Although many fruits are not high in histamine, they can trigger the release of histamine. Some may contain histamine-like substances that can aggravate symptoms. Many health care professionals recommend limiting certain fruits and juices as part of a low-histamine diet.
Consider avoiding:
- Banana
- Pineapple
- Papaya
- Citrus fruits (such as lemons, limes, and oranges)
- Strawberries
- Cherries
High-histamine vegetables
These vegetables are high in histamine:
- Tomatoes
- Eggplant
- Spinach
In addition, mushrooms and soybeans may contain histamine-like substances that can trigger symptoms.
Sauces and condiments
These ingredients can raise your histamine levels:
- Sauerkraut
- Soy sauce
- Vinegar
- Chili powder
- Cinnamon
- Cloves
High-histamine seafood
Frozen, smoked, and canned seafood, as well as spoiled fish, can have high levels of histamine. Pay particular attention to:
- Mackerel
- Sardines
- Tuna
- Herring
- Shellfish
Nuts and seeds
The following nuts don’t have a lot of histamine but are high in histamine-like chemicals:
- Almonds
- Chestnuts
- Hazelnuts
- Pistachios
Fermented foods
The level of histamine in fermented foods (such as kimchi and kefir) can vary based on preparation techniques and the length of aging. Sauerkraut, in particular, has been shown to contain a high concentration of histamine compared with other common foods.
Alcohol
Beer and wine, especially red wine, have high levels of histamine. Because of this, some cases of alcohol intolerance are caused by histamine intolerance. Migraines are one of the main symptoms associated with a reaction to alcohol due to histamine.
Packaged meat
Opt for fresh meat over packaged, smoked, or otherwise preserved products.
This means avoiding:
- Sausage
- Deli meats
- Bacon
Cheese
Aged, smoked, unpasteurized, pasteurized, and blue cheeses are loaded with histamine. This is because the cheese-making process, particularly ripening, raises histamine levels.
One study found that the age of cheese and the temperature at which cheese is stored can affect histamine levels. The histamine content found in cheeses stored at 22 C was higher than the histamine content found in cheese stored at 4 C.
Legumes
Legumes are a broad category of beans, lentils, and peanuts.
The following legumes don’t have a lot of histamine but have high levels of histamine-like chemicals:
- Chickpeas
- Lentils
- Peas
- Peanuts
- Soybeans
Other foods
Other foods that could raise your histamine levels are:
- Tea
- Licorice
- Chocolate
- Pork
- Egg whites
- Additives (such as colorings and preservatives)
Medications
Some medications can raise your histamine levels, including:
- Antidepressants
- Diuretics
- Blood pressure medications
- Opioids
- Muscle relaxants
- Anti-inflammatory medications
- Antibiotics
Ask your doctor whether any of your medications could contribute to high histamine levels. They may be able to help you find an alternative medication. They also could prescribe antihistamines, DAO supplements, or medications that prevent the release of histamine. Don’t change or stop taking medications without talking to your doctor.
When eating a low-histamine diet, it is important to make sure you’re still eating a variety of fresh foods and taking in necessary nutrients. The following foods are low in histamine. If you’re limiting the consumption of histamine, try these and other low-histamine alternatives:
- Fresh meat and chicken
- Eggs
- Some fish, including trout and hake
- Fresh fruits and fruit juices (but not citrus)
- Fresh vegetables (but not tomato, eggplant, or spinach)
- Herbal tea
- Grains and grain products, such as rice and bread
- Honey
- Fresh pasteurized milk and milk products
- Milk substitutes, such as goat milk, sheep milk
- Cooking oils
Histamine tolerance can vary greatly from person to person. If your doctor thinks that certain foods may be causing your symptoms, they might recommend an elimination diet. This means cutting out all high-histamine foods from your diet and then adding them back one at a time. Pay attention to what foods you’re eating when your symptoms get worse. This will give you an idea of what foods your body can tolerate and which foods result in symptoms. Keep in mind that your tolerance may change over time.
The main treatment for histamine intolerance is a change in diet. You may only need to avoid foods that trigger you, or you may need to limit all high-histamine foods. Several studies have shown that low-histamine diets can reduce symptoms in people with histamine intolerance. You can expect to see results in 3-4 weeks.
Here are some strategies for following a low-histamine diet:
Keep a food diary. This can help you track what foods trigger your symptoms.
Talk to a registered dietician. Everyone has different histamine tolerances, health needs, and food preferences. A registered dietician can help find a plan that’s right for you. They’ll make sure you’re getting all the vitamins and minerals you need while staying away from foods that trigger you. This is especially important if you have other health conditions that affect your diet, such as diabetes.
Choose fresh, whole foods. Any type of processing, especially fermentation and curing, dramatically raises a food’s histamine levels. This is partly because as food gets processed or ages, histamine-making bacteria start to grow. Avoid anything that’s canned, smoked, or dried. Instead, stick with fresh foods (except for any that might trigger you, such as citrus or tomato).
Store your food safely. As foods age, they become higher in histamine. You can slow down this process by storing foods in your refrigerator or freezer. When it comes to storing cheese, the lower the temperature, the better.
Get cooking. This gives you more control over the ingredients in your food and how they are prepared and stored. Plus, cooking methods can impact histamine levels. For example, braising and steaming produce less histamine than grilling.
Take supplements. Some research suggests that copper, vitamin B6, and vitamin C can help lower histamine levels.
Talk to your doctor before changing your diet or starting supplements. They can help you choose foods, strategies, and supplements that won’t interfere with other health conditions or medications. A low-histamine diet might not be a good idea for people with a history of an eating disorder.
Histamine is a natural chemical that tells the body to launch an allergic reaction. Some people have histamine intolerance, which means their bodies have a hard time breaking down the chemical. As a result, histamine builds up in the body and causes allergy-like symptoms. If you think you have histamine intolerance, talk to your doctor about a low-histamine diet. They can also help you rule out other problems with similar symptoms.
What does histamine do to a person?
Histamine is involved in many key functions, including sleep cycles and thinking capabilities. But it’s most well-known for its role in triggering allergy symptoms.
What releases histamine in the body?
When you come in contact with an allergen, your body starts an immune response by telling mast cells (a type of white blood cell) to release histamine.
What are the symptoms of high histamine?
High histamine levels can cause allergy-like symptoms, including stuffy or runny nose, headaches, stomach upset, and low blood pressure.
Is soy sauce high in histamine?
Soybeans contain histamine-like substances that can worsen symptoms. In addition, the fermentation process can raise histamine levels in soy sauce.