❖
❖
optimise.mfm.au/wp-content/uploads/documents/Eat-Low-Histamine-Guide.pdf
❖
Low histamine food guide
See the PDF.
❖
This guide is designed to help you better understand the histamine response
in the body and ways your food choices can ease the histamine burden.
❖
optimise.mfm.au/wp-content/uploads/documents/Eat-Low-Histamine-Guide.pdf
❖
Low histamine food guide
See the PDF.
❖
This guide is designed to help you better understand the histamine response
in the body and ways your food choices can ease the histamine burden.
❖
| Low Histamine Guide.pdf |
| 1.-Food Table |
From Switzerland
❖
https://www.histaminintoleranz.ch/en/introduction_outline.html
❖
What is histamine intolerance?
❖
❖
https://www.histaminintoleranz.ch/en/introduction_outline.html
❖
What is histamine intolerance?
❖
Histamine intolerance (abbreviation: HIT, also referred to as histaminosis) is a food intolerance, which affects at least 1% of the population.
An imbalance between intake/release and degradation of histamine results in an increased level of histamine in the body. The disease is mostly acquired; the congenital (genetically determined) type is rarer.
Four out of five sufferers are women from the age of 40 years. HIT is not an allergy
but a metabolic disorder (impaired degradation of histamine) without involvement of the immune system.
Normal histamine metabolism ... Histamine is a substance, which is naturally produced in the body and regulates various functions (mediator, messenger, transmitter). In case of infections and allergic reactions, histamine puts the body's defense mechanisms on the alert.
Histamine is also an inflammation mediator, a tissue hormone and neurotransmitter; it plays a role in the circadian rhythm, the bowel movements and many other processes.
The body may produce histamine, store it in certain cell types and if necessary release it all at once.
Pathological mechanism in people suffering from histamine
intolerance ...
Influenced by a wide range of factors, histamine may on the one hand be released from the body's own reservoirs and on the other be ingested.
The body of a healthy subject is able to quickly degrade this histamine, so that it will normally not lead to any problems. If the amount of histamine in the body is - for whatever reason - too high for the body to eliminate, the histamine level increases too much.
Food is usually the main source of histamine, and insufficient enzyme activity of diamine oxidase (DAO) and/or histamine-N-methyltransferase (HNMT) are the causes of an imbalance between the histamine intake/release and degradation.
Symptoms
The symptoms of histamine intolerance are similar to those of an allergy, food poisoning or the common cold. They usually occur in connection with food intake, either occasionally or chronically, so that it may be difficult for the people concerned to tie the symptoms to the foods ingested.
There is a wide range of partly unspecific symptoms, which vary between individuals. Typical guiding symptoms are:
Unlike with allergies, where even traces of a substance may trigger a violent reaction, the intensity of HIT symptoms depends on the dose.
DiagnosisIt is not possible to diagnose or exclude histamine intolerance based on symptoms.
There is also no laboratory test that can diagnose HIT. The analytical determination of the enzyme level (DAO, HNMT) or the concentration of histamine and its metabolites in blood or urine may be included in the diagnosis, but do not constitute reliable indicators if they are considered out of context.
Usually, the diagnosis at a consultation with a general practitioner is inconspicuous without any pathological findings, so that doctors often cannot relate to the suffering of their patients and do not see any need for further examinations.
Many research findings are still new and not always known to the physicians. Often doctors would look for allergens as trigger when presented with histamine-related symptoms.
They often simply do not consider the option, that there may be no trigger at all, but that an impaired degradation of histamine may be the cause of the histamine symptoms.
That is the reasons why many cases remain undiscovered or are misdiagnosed or only identified months or years later. Typically, people suffering from HIT have spent a lot of time and energy, going from one doctor to the next, always undergoing costly examinations just to be eventually - out of a lack of understanding - declared perfectly healthy or labelled mentally ill (psychosomatic, hypochondriac, pathological attention seeker).
The only reliable method to diagnose HIT is an elimination diet lasting several weeks, where you consistently pass on all foods with histamine potential.
The thoroughly instructed patients meticulously record all the symptoms and foods ingested. If the suspicion of histamine intolerance is confirmed, the symptoms will decline and conditions improve already within the first days. In case of doubt, a placebo-controlled provocation with encapsulated histamine may provide additional certainty.
Subsequently, the patient determines his or her individual tolerance threshold by introducing the avoided foods one by one and by observing the reactions.
Therapy
Histamine intolerance must be treated with a low-histamine diet. In addition, the therapy may be complemented with medicines and food supplements.A stress-free way of life has a positive effect. It is important for allergy sufferers to avoid allergens.
Diet
Histamine is a product of fermentation, maturation and putrefaction, which may be found in most foods in varying concentrations. Particularly products, which are easily perishable, are almost free of histamine when they are fresh, but may turn into veritable "histamine bombs" with increasing duration of storage.
Particularly high concentrations of histamine may be measured in putrid fish and canned fish, sausage products and dried meat, mature cheeses, wine, champagne, beer and vinegar as well as in other fermented products.
As histamine is heat and cold resistant, it cannot be removed from the foods by cooking or other methods.
Some foods do not contain histamine directly but certain substances called histamine liberators, which non-specifically release histamine, produced and stored by the body, and thus may also result in histamine-related symptoms.
Other foods have the characteristic to block the enzymes that break down histamine or that facilitate the absorption of histamine in the intestines.
That is why sufferers should avoid
sauerkraut,
spinach,
tomatoes,
aubergines,
avocado,
pulses (lentils, beans, soya),
strawberries,
raspberries,
citrus fruits,
bananas,
pineapple,
kiwi,
pears,
papaya,
nuts,
many sauces,
condiments and spices,
but also certain food additives.
In principal, people affected by HIT should prepare their meals with fresh and preferably unprocessed products and consume them quickly or freeze them immediately
An imbalance between intake/release and degradation of histamine results in an increased level of histamine in the body. The disease is mostly acquired; the congenital (genetically determined) type is rarer.
Four out of five sufferers are women from the age of 40 years. HIT is not an allergy
but a metabolic disorder (impaired degradation of histamine) without involvement of the immune system.
Normal histamine metabolism ... Histamine is a substance, which is naturally produced in the body and regulates various functions (mediator, messenger, transmitter). In case of infections and allergic reactions, histamine puts the body's defense mechanisms on the alert.
Histamine is also an inflammation mediator, a tissue hormone and neurotransmitter; it plays a role in the circadian rhythm, the bowel movements and many other processes.
The body may produce histamine, store it in certain cell types and if necessary release it all at once.
Pathological mechanism in people suffering from histamine
intolerance ...
Influenced by a wide range of factors, histamine may on the one hand be released from the body's own reservoirs and on the other be ingested.
The body of a healthy subject is able to quickly degrade this histamine, so that it will normally not lead to any problems. If the amount of histamine in the body is - for whatever reason - too high for the body to eliminate, the histamine level increases too much.
Food is usually the main source of histamine, and insufficient enzyme activity of diamine oxidase (DAO) and/or histamine-N-methyltransferase (HNMT) are the causes of an imbalance between the histamine intake/release and degradation.
Symptoms
The symptoms of histamine intolerance are similar to those of an allergy, food poisoning or the common cold. They usually occur in connection with food intake, either occasionally or chronically, so that it may be difficult for the people concerned to tie the symptoms to the foods ingested.
There is a wide range of partly unspecific symptoms, which vary between individuals. Typical guiding symptoms are:
- Swelling of the nasal mucous membrane, runny nose, sneezing, expectoration, irritation of the throat, breathing troubles
- Digestive problems: diarrhea, abdominal pain, flatulence, heartburn
- Itching, rash, flush (particular in the face)
- Hot flashes, attack of sweating, impaired temperature sensation
- Tachycardia, allodromy, palpitation, drop in blood pressure
- Headache, migraine, dizziness
- Sleep disturbance, fatigue
- Nausea, vomiting
- Menstrual molimina
- Oedema (Swelling, water retention, i.e. swollen eyelids)
Unlike with allergies, where even traces of a substance may trigger a violent reaction, the intensity of HIT symptoms depends on the dose.
DiagnosisIt is not possible to diagnose or exclude histamine intolerance based on symptoms.
There is also no laboratory test that can diagnose HIT. The analytical determination of the enzyme level (DAO, HNMT) or the concentration of histamine and its metabolites in blood or urine may be included in the diagnosis, but do not constitute reliable indicators if they are considered out of context.
Usually, the diagnosis at a consultation with a general practitioner is inconspicuous without any pathological findings, so that doctors often cannot relate to the suffering of their patients and do not see any need for further examinations.
Many research findings are still new and not always known to the physicians. Often doctors would look for allergens as trigger when presented with histamine-related symptoms.
They often simply do not consider the option, that there may be no trigger at all, but that an impaired degradation of histamine may be the cause of the histamine symptoms.
That is the reasons why many cases remain undiscovered or are misdiagnosed or only identified months or years later. Typically, people suffering from HIT have spent a lot of time and energy, going from one doctor to the next, always undergoing costly examinations just to be eventually - out of a lack of understanding - declared perfectly healthy or labelled mentally ill (psychosomatic, hypochondriac, pathological attention seeker).
The only reliable method to diagnose HIT is an elimination diet lasting several weeks, where you consistently pass on all foods with histamine potential.
The thoroughly instructed patients meticulously record all the symptoms and foods ingested. If the suspicion of histamine intolerance is confirmed, the symptoms will decline and conditions improve already within the first days. In case of doubt, a placebo-controlled provocation with encapsulated histamine may provide additional certainty.
Subsequently, the patient determines his or her individual tolerance threshold by introducing the avoided foods one by one and by observing the reactions.
Therapy
Histamine intolerance must be treated with a low-histamine diet. In addition, the therapy may be complemented with medicines and food supplements.A stress-free way of life has a positive effect. It is important for allergy sufferers to avoid allergens.
Diet
Histamine is a product of fermentation, maturation and putrefaction, which may be found in most foods in varying concentrations. Particularly products, which are easily perishable, are almost free of histamine when they are fresh, but may turn into veritable "histamine bombs" with increasing duration of storage.
Particularly high concentrations of histamine may be measured in putrid fish and canned fish, sausage products and dried meat, mature cheeses, wine, champagne, beer and vinegar as well as in other fermented products.
As histamine is heat and cold resistant, it cannot be removed from the foods by cooking or other methods.
Some foods do not contain histamine directly but certain substances called histamine liberators, which non-specifically release histamine, produced and stored by the body, and thus may also result in histamine-related symptoms.
Other foods have the characteristic to block the enzymes that break down histamine or that facilitate the absorption of histamine in the intestines.
That is why sufferers should avoid
sauerkraut,
spinach,
tomatoes,
aubergines,
avocado,
pulses (lentils, beans, soya),
strawberries,
raspberries,
citrus fruits,
bananas,
pineapple,
kiwi,
pears,
papaya,
nuts,
many sauces,
condiments and spices,
but also certain food additives.
In principal, people affected by HIT should prepare their meals with fresh and preferably unprocessed products and consume them quickly or freeze them immediately
❖
A Website from Switzerland
❖
https://www.mastzellaktivierung.info/de/downloads.html#foodlist
❖
ENGLISH (Englisch)
Food compatibility list EN. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN. Histamine; Sorting: alphabetical, without categories
Food compatibility list EN. Histamine; Sorting: by compatibility, with categories
Food compatibility list EN. Histamine; Sorting: by compatibility, without categories
Food compatibility list EN. Histamine; Lactose; Gluten; Sorting: alphabetical, with categories
Food compatibility list EN. Histamine; Lactose; Gluten; Sorting: alphabetical, without categories
Food compatibility list EN>DE. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>FR. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>IT. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>CS. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>SK. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>SV. Histamine; Sorting: alphabetical, with categories
A Website from Switzerland
❖
https://www.mastzellaktivierung.info/de/downloads.html#foodlist
❖
ENGLISH (Englisch)
Food compatibility list EN. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN. Histamine; Sorting: alphabetical, without categories
Food compatibility list EN. Histamine; Sorting: by compatibility, with categories
Food compatibility list EN. Histamine; Sorting: by compatibility, without categories
Food compatibility list EN. Histamine; Lactose; Gluten; Sorting: alphabetical, with categories
Food compatibility list EN. Histamine; Lactose; Gluten; Sorting: alphabetical, without categories
Food compatibility list EN>DE. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>FR. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>IT. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>CS. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>SK. Histamine; Sorting: alphabetical, with categories
Food compatibility list EN>SV. Histamine; Sorting: alphabetical, with categories
| The Best Histamine Chart .... |
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❖
Green Peas
themselves are naturally low in histamine. However, they are classified as histamine liberators, meaning they can trigger the release of histamine already stored in your body, and contain other biogenic amines that compete with histamine for breakdown. [1, 2, 3]
Histamine Ratings and Compatibility
Because they can provoke histamine release in sensitive individuals, green peas are generally not recommended for strict low-histamine elimination diets: [1, 2, 3, 4]
Resources and Diet Guides
If you are managing your diet, it is helpful to reference trusted compatibility charts to track how different foods affect your system:
Green Peas
themselves are naturally low in histamine. However, they are classified as histamine liberators, meaning they can trigger the release of histamine already stored in your body, and contain other biogenic amines that compete with histamine for breakdown. [1, 2, 3]
Histamine Ratings and Compatibility
Because they can provoke histamine release in sensitive individuals, green peas are generally not recommended for strict low-histamine elimination diets: [1, 2, 3, 4]
- SIGHI Rating: Moderately incompatible. While they don't have high intrinsic histamine levels, they often cause minor to distinct symptoms for those with histamine intolerance or Mast Cell Activation Syndrome (MCAS). [1, 2, 3, 4, 5]
- Freshness Matters: Histamine builds up as legumes decay; fresh or immediately frozen green peas contain lower levels, while canned or overripe peas are more likely to cause reactions. [1, 2, 3, 4]
Resources and Diet Guides
If you are managing your diet, it is helpful to reference trusted compatibility charts to track how different foods affect your system:
- Consult the Swiss Interest Group Histamine Intolerance (SIGHI) guidelines available in the comprehensive SIGHI Food Compatibility List to check other vegetables and legumes.
- Review the Mast Cell 360 Low Histamine Foods List for additional insights into which foods trigger histamine release.
- Learn about the complete elimination process via the SIGHI-Leaflet Histamine Elimination Diet. [1, 2]
| Histamine Chart.pdf |
❖
❖
Patricia D Stotler
Histamine Intolerance Food List:
A Comprehensive Guide and Chart For Low-Histamine Diet
including Food to Eat & Avoid ...
❖
Histamine Intolerance Food List:
A Comprehensive Guide and Chart For Low-Histamine Diet
including Food to Eat & Avoid ...
❖
❖
What is an insufficient enzyme activity
of diamine oxidase (DAO) ?
https://www.adrianaduelo.com/en/deficit-dao/
❖
What is an insufficient enzyme activity
of diamine oxidase (DAO) ?
https://www.adrianaduelo.com/en/deficit-dao/
❖
Insufficient enzyme activity of diamine oxidase (DAO) is a condition where the body cannot effectively break down ingested histamine in the small intestine, leading to histamine accumulation in the blood and a broad range of allergy-like symptoms. It is considered the primary cause of histamine intolerance (HIT), or food histaminosis. [1, 2]
Core Aspects of DAO Deficiency
Diagnosis and Management
Core Aspects of DAO Deficiency
- Definition: A state where DAO functional activity is low, resulting in a failure to metabolize food-derived histamine, which triggers adverse health effects, according to the Official Scientific Society (deficitdao.org). [1]
- Symptoms: When DAO is insufficient, excess histamine triggers non-specific symptoms similar to an allergic reaction, including:
- Cause: It is often an acquired (secondary) condition resulting from intestinal mucosal damage, such as irritable bowel syndrome (IBS), Crohn’s disease, or celiac disease. Other causes include pharmacological inhibition by medication or genetic predispositions, such as polymorphisms in the AOC1 gene. [1, 2, 3]
- Prevalence: Studies suggest it affects 1-3% of the population, often misdiagnosed and more common in middle-aged individuals. [1, 2]
Diagnosis and Management
- Diagnosis: Serum DAO concentration/activity tests are used, with values below 10 IU/mL confirming deficiency (serum levels below 3–10 U/mL are often used for high probability of histamine intolerance). [1, 2]
- Management:
- Low-Histamine Diet: Reducing consumption of aged cheese, fermented foods, alcohol, and processed meats.
- DAO Supplementation: Using oral DAO enzymes to assist in breaking down food histamine at the gut level.
- Nutrient Support: Ensuring sufficient intake of copper, Vitamin B6, and iron, which are cofactors for DAO function. [1, 2]
❖
What is DAO Deficiency?
❖
❖
DAO deficiency is the functional lack of the main digestive enzyme responsible for the histamine elimination, a molecule found in food.Diamine oxidase enzyme or DAO is located in the intestinal mucosa mainly, thus acts during the digestion of food.
When there is an alteration in the metabolism of histamine and there is not enough DAO activity, the imbalance between ingested histamine and histamine released from the storage cells leads to histamine accumulation in plasma and the occurrence of adverse effects on health.
The main cause of the enzymatic dysfunction has a genetic origin. Some people have or produce few Diamine Oxidase, this is the reason why until recently, migraine was believed to be hereditary, when in fact; the hereditary factor is the deficiency of DAO. Moreover, drugs or some inflammatory bowel diseases represent another factor that enables histamine decrease.
DAO deficiency symptomsUnlike food allergy, the occurrence of symptoms or adverse effects is not linked to the intake of specific food; by contrast it can be related to a wide variety of food with different histamine contents. Symptoms can also occur even after the ingestion of products with low histamine levels. This imposed considerable difficulty when establishing a maximum tolerable dose; in fact, there is no clear consensus on this value.
Values that range from 50μg of histamine to 60-75mg have been listed as triggers of DAO deficiency symptoms. When there is an accumulation of histamine many body systems can be altered, but symptoms don’t necessarily have to appear in all patients. The most typical are:
Due to the wide variety of symptoms derived from DAO deficiency, which represent chronic pathologies with a high prevalence in population, immediate research and advances on its origin and possible treatments are required.
It has been observed that most patients with low functional DAO activity present other related symptoms, being migraine the prevalent one. 20% of patients experience 1 or 2 of these associated symptoms, 41.3% of patients experience 3 or 4 of these symptoms and 33.8% present more than 5. Migraine is always de most highlighted syndrome when interviewing the patients due to its disabling character.
Histamine and DAO DeficiencyHistamine is a molecule derived from an essential amino acid, histidine, with many physiological and patho-physiological functions: It takes part in the regulation of local blood circulation, in capillary permeability, contraction and relaxation of smooth muscles and blood vessels, secretion of hydrochloric acid in stomach, immediate hypersensitivity responses,
allergic processes, inflammatory ones as part of the immune response to external pathogens, tissue healing, and its action has also been observed as neurotransmitter in the nervous system.
Therefore, and taking into consideration its multiple roles, indispensable for the efficient functioning of many metabolic processes, it is not surprising that histamine appears to a higher or lower quantity in a great variety of food, both of animal and plant origin. However, it has no function, unlike endogenous histamine.
Histamine we get through food is the most difficult to control because its regulation depends on the organism of each person. If some alteration in its metabolism occurs and normal histamine concentrations in blood do not remain (50-70 mg/l), free circulation of this amine in high concentrations triggers undesirable effects, such as migraine. In the metabolism of histamine,
it should be degraded by DAO enzyme in order to become N-acetyl aldehyde imidazole; an accumulation of the amine is produced due to the lack of enzyme in the intestinal mucosa cells. Low enzyme activity causes the concentration of food histamine, which cannot be metabolized and a transepithelial permeation of exogenous histamine occurs.
This way, histamine enters the bloodstream increasing its plasma concentration and once located in blood it spreads throughout the body and to the superficial arteries. Histamine acts in this area causing inflammation followed by one of the most common effects, vasodilatation, and migraine process starts. The vasodilatation caused by histamine is linked to the side effects suffered in the Nervous and Cardiovascular Systems mainly, but also in the epithelium.
How do we treat DAO Deficiency?First of all, a special blood test is carried out to detect the enzymatic deficiency. Once confirmed, the treatment consists in a diet low in histamine and other amines that enhance its accumulation.
In the first visit, we normally recommend starting with a stage one diet, this means a stricter diet, which is completely tailor-made and delivered to the patient after the visit.
We study each case individually, since there are no two identical individuals, nor are there two identical diets. We take into account patient’s clinical history, habits, schedule, lifestyle, physical activity, preferences and economy.
In case specific dietary requirements are needed, we try to fill them through food, although this is not always possible and we resort to nutritional supplements. For example, in most cases we recommend adding omega-3 pearls, since it is difficult to find food with low content of histamine and rich in fatty acid. We also recommend to take DAO enzyme pills before each meal. Patients improve faster when combining diet and supplementation.
As the weeks go by, patients tent to observe changes and improvements and we schedule another visit. Second phase is a good sign, and means that histamine accumulation is lowering and we can broaden the diet.
When the third and final phase is reached, diet becomes freer and the patient start controlling the amount and frequency of consumption of high-histamine food.
Food and low histamine dietSome food provokes histamine accumulation in the organism, but not all are necessarily rich in this amine.
Until now, the cause had been searched for in food as during years patients have linked several foods to migraine. Considering all the information disclosed until now, it can be concluded that the origin of this syndrome is in the individual itself, being food the access road of the component that leads to this accumulation.
There are discrepancies on the criteria that help to consider a food rich in histamine or not.
Some authors suggest eliminating from diet those foods with concentrations higher than 20 mg/kg, while other authors are more demanding and consider low histamine foods those with quantities below 1mg/kg. However, to do it correctly, the amount of histamine in food should be in the nutrition labels, and it is not.
On the other hand, in addition to the foods rich in histamine, we should take into account other factors that cause the accumulation of the amine in the body such as the amount of other amines, the ability to release endogenous histamine or DAO enzyme blocking factors such as alcoholic beverages.
The following table lists the DAO deficit histamine accumulation food precursors (due to high concentration, containing other amines that compete with DAO or endogenous histamine release), but it does not replace a balanced low histamine diet, which should be advised by a professional: a registered dietitian and nutritionist.
When there is an alteration in the metabolism of histamine and there is not enough DAO activity, the imbalance between ingested histamine and histamine released from the storage cells leads to histamine accumulation in plasma and the occurrence of adverse effects on health.
The main cause of the enzymatic dysfunction has a genetic origin. Some people have or produce few Diamine Oxidase, this is the reason why until recently, migraine was believed to be hereditary, when in fact; the hereditary factor is the deficiency of DAO. Moreover, drugs or some inflammatory bowel diseases represent another factor that enables histamine decrease.
DAO deficiency symptomsUnlike food allergy, the occurrence of symptoms or adverse effects is not linked to the intake of specific food; by contrast it can be related to a wide variety of food with different histamine contents. Symptoms can also occur even after the ingestion of products with low histamine levels. This imposed considerable difficulty when establishing a maximum tolerable dose; in fact, there is no clear consensus on this value.
Values that range from 50μg of histamine to 60-75mg have been listed as triggers of DAO deficiency symptoms. When there is an accumulation of histamine many body systems can be altered, but symptoms don’t necessarily have to appear in all patients. The most typical are:
- Nervous System: Migraine, headaches, vertigo and/or ADHD.
- Digestive System: intestinal irregularities (diarrhoea, constipation), abdominal pain and distension, reflux, nausea and/or vomiting.
- Cardiovascular System: hypotension and/or arrhythmia.
- Dermatologic System: itching, redness, edema, atopic skin and/or eczema.
- Respiratory System: nose congestion, rhinitis, asthma and/or sneezing.
- Locomotor System: muscle pain, joint pain, fibromyalgia and/or fatigue.
Due to the wide variety of symptoms derived from DAO deficiency, which represent chronic pathologies with a high prevalence in population, immediate research and advances on its origin and possible treatments are required.
It has been observed that most patients with low functional DAO activity present other related symptoms, being migraine the prevalent one. 20% of patients experience 1 or 2 of these associated symptoms, 41.3% of patients experience 3 or 4 of these symptoms and 33.8% present more than 5. Migraine is always de most highlighted syndrome when interviewing the patients due to its disabling character.
Histamine and DAO DeficiencyHistamine is a molecule derived from an essential amino acid, histidine, with many physiological and patho-physiological functions: It takes part in the regulation of local blood circulation, in capillary permeability, contraction and relaxation of smooth muscles and blood vessels, secretion of hydrochloric acid in stomach, immediate hypersensitivity responses,
allergic processes, inflammatory ones as part of the immune response to external pathogens, tissue healing, and its action has also been observed as neurotransmitter in the nervous system.
Therefore, and taking into consideration its multiple roles, indispensable for the efficient functioning of many metabolic processes, it is not surprising that histamine appears to a higher or lower quantity in a great variety of food, both of animal and plant origin. However, it has no function, unlike endogenous histamine.
Histamine we get through food is the most difficult to control because its regulation depends on the organism of each person. If some alteration in its metabolism occurs and normal histamine concentrations in blood do not remain (50-70 mg/l), free circulation of this amine in high concentrations triggers undesirable effects, such as migraine. In the metabolism of histamine,
it should be degraded by DAO enzyme in order to become N-acetyl aldehyde imidazole; an accumulation of the amine is produced due to the lack of enzyme in the intestinal mucosa cells. Low enzyme activity causes the concentration of food histamine, which cannot be metabolized and a transepithelial permeation of exogenous histamine occurs.
This way, histamine enters the bloodstream increasing its plasma concentration and once located in blood it spreads throughout the body and to the superficial arteries. Histamine acts in this area causing inflammation followed by one of the most common effects, vasodilatation, and migraine process starts. The vasodilatation caused by histamine is linked to the side effects suffered in the Nervous and Cardiovascular Systems mainly, but also in the epithelium.
How do we treat DAO Deficiency?First of all, a special blood test is carried out to detect the enzymatic deficiency. Once confirmed, the treatment consists in a diet low in histamine and other amines that enhance its accumulation.
In the first visit, we normally recommend starting with a stage one diet, this means a stricter diet, which is completely tailor-made and delivered to the patient after the visit.
We study each case individually, since there are no two identical individuals, nor are there two identical diets. We take into account patient’s clinical history, habits, schedule, lifestyle, physical activity, preferences and economy.
In case specific dietary requirements are needed, we try to fill them through food, although this is not always possible and we resort to nutritional supplements. For example, in most cases we recommend adding omega-3 pearls, since it is difficult to find food with low content of histamine and rich in fatty acid. We also recommend to take DAO enzyme pills before each meal. Patients improve faster when combining diet and supplementation.
As the weeks go by, patients tent to observe changes and improvements and we schedule another visit. Second phase is a good sign, and means that histamine accumulation is lowering and we can broaden the diet.
When the third and final phase is reached, diet becomes freer and the patient start controlling the amount and frequency of consumption of high-histamine food.
Food and low histamine dietSome food provokes histamine accumulation in the organism, but not all are necessarily rich in this amine.
Until now, the cause had been searched for in food as during years patients have linked several foods to migraine. Considering all the information disclosed until now, it can be concluded that the origin of this syndrome is in the individual itself, being food the access road of the component that leads to this accumulation.
There are discrepancies on the criteria that help to consider a food rich in histamine or not.
Some authors suggest eliminating from diet those foods with concentrations higher than 20 mg/kg, while other authors are more demanding and consider low histamine foods those with quantities below 1mg/kg. However, to do it correctly, the amount of histamine in food should be in the nutrition labels, and it is not.
On the other hand, in addition to the foods rich in histamine, we should take into account other factors that cause the accumulation of the amine in the body such as the amount of other amines, the ability to release endogenous histamine or DAO enzyme blocking factors such as alcoholic beverages.
The following table lists the DAO deficit histamine accumulation food precursors (due to high concentration, containing other amines that compete with DAO or endogenous histamine release), but it does not replace a balanced low histamine diet, which should be advised by a professional: a registered dietitian and nutritionist.
❖
Foods High in Histamine
Written by Deanna Altomara
Medically Reviewed by Kathleen M. Zelman, RD, LD, MPH on May 11, 2026
What Is Histamine?
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.
Histamine Intolerance
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:
In severe cases, histamine intolerance could lead to a dangerous condition called anaphylaxis.
Call 911 if you have:
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.
High-Histamine FoodsIf you have a histamine intolerance, spinach and tomatoes, aged cheeses, processed meat, and beer may cause you to have an allergic reaction. (Photo Credit: Moment RF/Getty Images)
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:
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:
High-histamine vegetables
These vegetables are high in histamine:
In addition, mushrooms and soybeans may contain histamine-like substances that can trigger symptoms.
Sauces and condiments
These ingredients can raise your histamine levels:
High-histamine seafood
Frozen, smoked, and canned seafood, as well as spoiled fish, can have high levels of histamine. Pay particular attention to:
Nuts and seeds
The following nuts don’t have a lot of histamine but are high in histamine-like chemicals:
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:
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:
Other foods
Other foods that could raise your histamine levels are:
Medications
Some medications can raise your histamine levels, including:
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.
Low-Histamine Foods
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:
How to Stay Away From High-Histamine Foods
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.
Takeaways
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.
High-Histamine Foods FAQs
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.
Written by Deanna Altomara
Medically Reviewed by Kathleen M. Zelman, RD, LD, MPH on May 11, 2026
What Is Histamine?
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.
Histamine Intolerance
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.
High-Histamine FoodsIf you have a histamine intolerance, spinach and tomatoes, aged cheeses, processed meat, and beer may cause you to have an allergic reaction. (Photo Credit: Moment RF/Getty Images)
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:
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.
Low-Histamine Foods
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
How to Stay Away From High-Histamine Foods
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.
Takeaways
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.
- Related:Why We Eat When We’re Not Hungry
High-Histamine Foods FAQs
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.
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