The low histamine diet may help people who develop symptoms, such as sneezing, itching, or hives, in response to foods that contain histamine. Histamine is a chemical that occurs naturally in the body and some foods.

The low histamine diet can help a person find out which foods cause their symptoms. By avoiding those foods, they may see an improvement. A nutrition professional can guide someone through this process.

This article looks at how histamine affects the body, what histamine intolerance is, and the foods people may wish to avoid. It also provides an example meal plan and tips for grocery shopping and food preparation.

A woman chops kale as part of her low histamine diet for dinner.Share on Pinterest
A low histamine diet can help people with histamine intolerance avoid symptoms.

Histamine is a chemical that regulates the body’s response to foreign substances and injury.

When the body reacts to a substance it perceives as harmful, it releases histamine. This causes inflammation and dilates a person’s blood vessels, leading to symptoms such as:

Despite the discomfort these symptoms can cause, histamine plays an important and complex role in the body’s defenses.

A 2018 review describes histamine as having a ‘paradoxical nature’, as it can both increase and decrease inflammation levels.

Laboratory experiments the authors quote also show that histamine may help with wound healing and inhibit tumor growth. However, researchers have not yet replicated these results in humans.

Some people develop symptoms in response to foods that contain or release histamine. Doctors call this condition histamine intolerance.

The symptoms of histamine intolerance are similar to that of an allergic reaction and can affect multiple systems in the body.

Symptoms include:

Diamine oxidase (DAO) is the enzyme responsible for breaking down histamine in the body.

People with lower levels of DAO have higher levels of histamine, and therefore may be more likely to develop allergies.

A small study showed that 10 out of 14 people who visited an allergy clinic had lower DAO activity. Also, 13 reported an improvement in at least one of their symptoms following DAO supplementation.

Another study found that DAO activity was lower in 316 participants with suspected histamine intolerance than others without histamine intolerance. When 20 of those subjects tried a low histamine diet for 6–12 months, their symptoms improved or disappeared.

The impact of histamine varies depending on age, sex, and genetics. The gut lining and gut flora also seem to play a role in histamine intolerance.

A 2018 study compared people with histamine intolerance to those with food intolerances, and others with no intolerances at all. The group with histamine intolerance had lower bacterial diversity in their gut and an impaired gut lining.

Several bacterial species occurring naturally in some foods and probiotic supplements produce histamine, which may make symptoms of histamine intolerance worse.

The low histamine diet aims to reduce the symptoms of histamine intolerance and allergies. There is limited evidence to suggest the diet may be helpful for some people.

A small 2018 study showed that a 4-week low-histamine diet helped reduce symptoms in adults with hives.

Research has also shown that low histamine diets may help reduce symptoms in people with atopic dermatitis in those with suspected histamine intolerance.

Scientists now need more high-quality studies on histamine intolerance to better understand the condition and the best treatments.

An article in the Journal of the Academy of Nutrition and Dietetics suggests an individualized approach to nutrition is best for people with histamine intolerance.

Factors such as medication, stress levels, and a person’s overall health all affect what works for them.

Research in 2017 recommended a phased approach to the diet. This entails 10–14 days of avoiding histamine foods, followed by up to 6 weeks of reintroducing foods. This allows someone to determine their histamine tolerance.

Before trying any type of restrictive diet, people should seek expert nutritional counseling to ensure they are getting adequate nutrients, and to avoid an unnecessary reduction in their quality of life.

The following foods contain higher levels of histamine:

  • some types of fish
  • aged cheeses
  • processed meats
  • wine and beer
  • sauerkraut
  • fermented products
  • spinach
  • eggplant
  • tomato
  • avocado

Studies indicate that some foods can “release” histamine in the body, even if they do not contain it. Scientists do not fully understand how this works, but some people may react to specific foods, including:

  • milk
  • shellfish
  • eggs
  • kiwi
  • strawberry
  • pineapple
  • plum

Foods that contain chemicals called amines that are similar to histamine can also compete for DAO. This means that if someone eats lots of these foods, histamine will not break down as quickly and may cause symptoms.

Foods that contain other amines include:

  • citrus fruits
  • mushrooms
  • soybeans
  • bananas
  • nuts

Other sources also report that the following foods are either high in histamine or histamine releasing or they block the DAO enzyme:

  • pickled and canned foods
  • chocolate and cocoa products
  • vinegars
  • wheatgerm
  • yeast extract
  • black tea
  • Mate tea
  • energy drinks

The following is an example of a low histamine diet plan that someone could follow while monitoring their symptoms.

Breakfast options

  • oatmeal made with water or coconut milk
  • puffed rice with coconut milk
  • apple, melon, and pear fruit salad with chopped pistachios
  • smoothie made with mango, coconut milk, chia seeds, and kale

Lunch options

  • chicken and kale salad with chopped grapes
  • chicken, lettuce, and grated carrot sandwich
  • cottage cheese and cucumber on toast
  • quinoa and herb salad

Dinner options

  • Low histamine fish, such as trout or cod, freshly caught and served with zucchini and roasted carrots.
  • Chicken with new potatoes, broccoli, and green beans.
  • Pasta with olive oil, garlic, herbs, and chicken or borlotti beans.
  • Homemade turkey burger with sweet potato wedges.

Snacks

  • blueberries
  • pistachios
  • carrot sticks
  • cottage cheese
  • grapes
  • celery sticks
  • apple slices and natural peanut butter

Freshness has an impact on how much histamine a food contains. It is a good idea to learn how different methods of production and storage impact histamine levels in food.

How a person shops for and prepares food is also important.

A person with histamine intolerance can monitor and potentially reduce their symptoms by:

  • planning meals in advance
  • buying fresh food, shopping more often if necessary
  • eating foods as soon as possible after purchase
  • asking restaurants about their ingredients when eating out
  • keeping a food journal to record symptoms and triggers

Some medications and supplements also influence histamine levels. If a person suspects something they are taking is exacerbating their symptoms, they should speak to their doctor.

A low histamine diet may benefit someone with histamine intolerance. Planning varied meals, avoiding high histamine foods, and allocating time to prepare fresh foods may help a person manage their symptoms.

If someone suspects they may have histamine intolerance, it is essential that they consult their doctor for advice.

People need to ensure that they do not miss out on essential nutrients when following a limited diet. People should not follow long-term exclusion diets without seeking advice from a registered dietitian or nutritionist.