Freshness Counts: Histamine Intolerance

wine and cheese (histamine) licensed

When it comes to food, age discrimination is a very good thing.

 

 

 

 

 

 

I am grateful to Dr. Judy Tsafrir for calling my attention to this important aspect of food sensitivities.  I recently wrote a series of blog posts documenting in (some would say horrifying) detail my personal attempt at an extreme ketogenic diet. Given that I have an extraordinary number of food sensitivities, that experiment was even more challenging than it would have been for a normal person…

You see, for the past few years I have gravitated towards a mostly-meat diet–usually fresh or frozen poultry and fish supplemented with small amounts of the plant foods that bother me least–cucumbers, lettuce, etc.  However, the ketogenic diet put strict limits on how much protein I could eat, so I found myself turning to some foods that are unusual for me, such as pork and beef, which tend to have more fat and less protein than poultry and fish.  While travelling, I sometimes had to resort to smoked, cured, or other processed meats.  I have known for a long time that these do not agree with me, which is why I prefer to eat fresh meats whenever possible.  So there I was, having all kinds of difficulty tolerating these foods, and driving my readers crazy.

Then one day, Dr. Tsafrir commented beneath one of my posts that I might have histamine intolerance.  She had removed foods high in histamine from her own diet and written on her own site about the many benefits she’d experienced.  So, I decided to learn more about the science behind this topic in hopes of better understanding my own bizarre food reactions, as well as helping those of you out there who may be struggling with similar issues.

Histamine is found lurking primarily in aged, cured, fermented, cultured, and spoiled foods. Reactions to histamine described in the literature vary from subjective reports of a wide variety of variable symptoms to full-blown toxicity.  We will dive in to the details soon enough, but first:  what is histamine?

Say Hello to Histamine

Histamine is a tiny messaging molecule that some cells use to communicate with each other.  It is naturally found in all kinds of plants and animals.  Histamine is best known for its role in the body’s allergic response.  If you are allergic to peanuts and you sink your chompers into a yummy peanut butter cup, your immune cells will flood your system with histamine, wreaking all kinds of havoc–from hives to low blood pressure to difficulty breathing.  But this is histamine in crisis mode.  Under normal circumstances, tiny amounts of histamine are quietly conducting the daily business of the body.  It is not typically cruising recklessly through your bloodstream in large quantities, the way it is during an allergic emergency (anaphylactic shock).

Histamine is versatile–it helps to regulate body functions as diverse as digestion, sleep, sexual function, blood pressure, and brain function.  How does this one molecule do so many different things?  The secret to histamine’s multi-faceted nature lies in which type of cell and which type of receptor it binds to.  For example, when histamine binds to special cells in the stomach called parietal cells, they respond by producing stomach acid.  When histamine binds to receptors on the surface of blood vessel cells, blood vessels dilate, dropping blood pressure. Small vessels called capillaries become leaky and fluids ooze out of them, which can lead to runny nose, watery eyes, and puffy skin/fluid retention.  In the brain, histamine acts as a neurotransmitter, carrying chemical messages between nerve cells.

Histamine is promiscuous, lives fast and dies young.  As soon as it delivers its special chemical message to its target cell it is then instantly destroyed to keep it under control.  No respect–but that’s what it gets for being the cad that it is. So, if histamine doesn’t hang around in plants and animals, why should we worry?

We all get old…but we do not rot. As long as oxygen and blood are flowing, we stay fresh as a daisy.  Meat used to be alive, but it’s not anymore.  As soon as it stops being alive, bacteria start eating it–decomposing it—fermenting it–breaking its proteins down into ever-smaller, stranger, and often smellier compounds.  Many of these by-products are biogenic amines. Histamine is just one example of a biogenic amine.  Unlike in living tissues, the histamine that is produced during meat fermentation is not instantly destroyed—so it accumulates.  The longer meat is left out, the higher the biogenic amine content.  Histamine itself has no flavor and is odorless, so you can’t use the smell test to detect its presence.

What are Biogenic Amines?

A biogenic amine is a potent signaling molecule made from an amino acid.  Histamine, for example, is made from the common amino acid histidine (amino acids are what proteins are made of).  Meat and fish are rich in protein, so they are chock full of amino acids.  [For more information about amino acids, see my protein page].

Here is a list of the most common biogenic amines and the amino acids they are made from.  You’ll notice that a couple of them have ghastly names, worthy of a Vincent Price voiceover:  putrescine and the perfectly ghoulish cadaverine—mwaaah ah ah…

Parent amino acids are in green and their biogenic amine products are in red:

  • ArginineAgmatine, Putrescine, Spermine, Spermidine
  • HistidineHistamine
  • LysineCadaverine
  • OrnithinePutrescine, Spermine, Spermidine
  • PhenylalaninePhenylethylamine
  • TryptophanTryptamine, Serotonin
  • Tyrosine–Tyramine

To turn a garden variety amino acid into a powerful biogenic amine, you need to remove its carboxyl group. To accomplish this you need a special enzyme called a decarboxylase (fancy word for “enzyme that chops off carboxyl groups”).

Many species of bacteria and yeast contain the enzyme histidine decarboxylase (HDC), which turns histidine into histamine. So, when meat (or fish) is not immediately consumed or frozen, bacteria get straight to work breaking down the amino acids within it, and one of the by-products is histamine.

So, take-home lesson:  eat your meat/fish either very fresh or confirm that it was frozen quickly.  Seems simple enough, right?  But wait, there’s more.  We silly humans actually go out of our way to ferment foods on purpose.  People like to play with food—we add bacteria to milk to make cheese and yogurt.  We add yeast to grapes to make wine. We add bacteria to meat to make salami.  In the process, these fresh foods—milk, grapes, and meat—which in their fresh forms are essentially histamine-free, become very high in histamine and other biogenic amines.

Foods High in Histamine

The lists below are not meant to be complete, just representative of what I found in the literature. Levels exceeding 2 mg/L in beverages and 100 mg/kg in foods are considered risky:

Alcoholic Beverages

Red wine         up to 24 mg/Liter

Plant Foods

Most (fresh) vegetables are very low in histamine, with levels ranging from 0 to 16 mg/kg.  The notable exceptions are tomatoes, eggplant, and spinach:

Ketchup           22 mg/kg

Eggplant          26 mg/kg

Spinach           30 to 60 mg/kg

Sauerkraut (fermented cabbage)       up to 229 mg/kg

Dairy Products

Uncultured dairy products such as milk and cream tend to be very low in histamine, with levels of less than 1 mg/kg.  The same is true for fresh, unripened cheeses with short shelf-lives, such as fresh mozzarella and ricotta.

Sour cream                 up to 7 mg/kg

Yogurt                          up to 13 mg/kg

Ripened cheeses        2.21 – 2500 mg/kg (whoa…)

Meat

Most fresh meats are very low in histamine, with the exception of ground/chopped beef products:

Raw ground beef stored in refrigerator for 12 days              31.8 mg/kg

Cooked ground beef stored in refrigerator for 12 days          85.4 mg/kg

Dry sausages such as salami, pepperoni, and chorizo, are the meat products highest in histamine content.

Dry fermented sausages        up to 357.7 mg/kg

Fish

Like other animal foods, fresh fish is very low in histamine, whereas levels in canned tuna range from zero to as high as 40.5 mg/kg.

However, improperly handled fish is notorious for causing “scombroid poisoning”—an extreme reaction to spoiled fish:

“The onset of scombroid poisoning is typically from 10 min to 1 h following consumption of poisonous fish. The symptoms are variable and include peppery or metallic taste, oral numbness, headache, dizziness, palpitations, rapid and weak pulse (low blood pressure), difficulty in swallowing, and thirst. Noteworthy as allergy-like are symptoms such as hives, rash, flushing and facial swelling. Symptoms involving the central nervous system (CNS) such as anxiety are less frequently observed. Less specific symptoms such as nausea, vomiting, abdominal cramps and diarrhea are also experienced. Recovery is usually complete within 24 h.” [Hungerford 2010]

Fish samples that have caused scombroid poisoning tend to be very high in histamine, typically with levels of greater than 100 mg/kg.  However, the relationship between histamine levels and degree of toxicity is not straightforward; it seems that two other biogenic amines may also play a role in these severe reactions:  putrescine and cadaverine.  It figures. Leave it to Smelly and Spooky.

Certain species of fish are more likely to be associated with scombroid poisoning, and the majority of them are dark-fleshed fish which are especially rich in the parent amino acid histidine:

  • Amberjack
  • Anchovies
  • Bluefish
  • Cape yellowtail
  • Herring
  • Mackerel
  • Mahi-Mahi
  • Marlin
  • Pilchards
  • Sardines
  • Tuna

[*Salmon and Swordfish are also more commonly associated with “scombroid poisoning” despite not having particularly high levels of histidine in their tissues.]

Some foods are suspected of triggering histamine release within some people’s bodies, even though they may not contain any histamine of their own:

  • Citrus fruit
  • Fish
  • Additives
  • Papaya
  • Crustaceans
  • Licorice
  • Strawberries
  • Pork
  • Spices
  • Pineapple
  • Egg white
  • Nuts
  • Peanuts
  • Tomatoes
  • Spinach
  • Chocolate

However, there isn’t much evidence to support the theory that these foods can trigger histamine reactions:

We could not find any study on histamine-releasing effects of most of the foods suggested of having histamine-releasing capacities…there are no DBPCFC (double-blind placebo-controlled food challenge) studies in human beings supporting the widely held belief that foods should have histamine-releasing capacity. The hypothesis that foods may have a histamine-releasing capacity is based on several older in vitro studies, animal studies in other diseases demonstrating histamine-releasing effects of foods, and on studies in which pharmacological substances were incubated directly with digestive tract mucosal tissues. Thus, the normal digestive influences on foods are eliminated and the significance of these findings is doubtful.” [Vlieg-Boerstra 2005]

What is Histamine Intolerance?

“The term “histamine intolerance” was introduced as common denominator for symptoms such as abdominal pain, flatulence, diarrhoea, headache, pruritus (itching), blepharedemas (puffy eyes), urticaria (hives), rhinorrhea (runny nose), dysmenorrhea (menstrual cycle problems), respiratory obstruction (difficulty breathing), tachycardia (racing heart), extrasystoles (palpitations) and hypotension (low blood pressure) occurring after the consumption of histamine-rich foods.” [Komericki 2010]

According to a 2007 review article [Maintz and Novak], histamine intolerance affects at least 1% of the population, and 80% of those affected are (ahem)…middle-aged.

Women seem to comprise the majority of people who complain of histamine intolerance.  This may be because estrogen and histamine reinforce each other—histamine can increase estrogen levels and vice versa, which may explain why histamine intolerance is associated with pre-menstrual cramps and menstrual migraine.  Even more fascinating is that pregnant women may experience relief from food sensitivities during pregnancy because the placenta secretes very high amounts of diamine oxidase, or DAO, the enzyme that destroys histamine.

Histamine intolerance may be caused by abnormally low levels of DAO.  DAO is found, among other places, in the membranes of cells lining the small intestine and the upper portion of the colon, therefore people with damaged gastrointestinal systems seem to be at higher risk for histamine intolerance.

Is Histamine Intolerance Real?

There is considerable controversy around this diagnosis, and many scientists think of histamine intolerance as only weakly grounded in scientific evidence or perhaps even psychosomatic in nature.

A 2003 analysis of biogenic amines and food intolerances, which included two studies of histamine and red wine reactions, concluded:

“Of the studies performed on the adverse effects of biogenic amines, only a few are methodologically acceptable. Although this limits the conclusions that may be reached, the current scientific literature does not show a relation between the oral ingestion of biogenic amines and food intolerance reactions. There is therefore no scientific basis for dietary recommendations concerning biogenic amines in such patients.” [Jansen 2003]

A more recent consideration of the evidence suggested:

“The concept of histamine intolerance as a metabolic disease is in need of more experimental and clinical evidence and affected patients will benefit from a clear, evidence-based, diagnostic and therapeutic regime.” [Schwelberger 2010].

The way I tend to think about these things is this:  if you notice that foods high in histamine and other biogenic amines bother you, you do not need a scientist or a doctor to prove you right or wrong.

How is Histamine Intolerance Diagnosed?

You may have histamine intolerance (HI) if you have at least 2 typical symptoms of HI and they go away either with a histamine-free diet or with the use of antihistamine medications.  As with any food intolerance issue, keeping a careful food & symptom diary is very important in noticing patterns.  People who suspect they may have HI should first be tested for food allergies to rule those out before undergoing more specialized testing.

Levels of DAO–the enzyme that destroys histamine–can be measured:

“Histamine intolerance is presumably highly likely in patients with DAO activity <3 U/mL, likely (but less likely) in patients with DAO activity <10 U/mL, and improbable in patients with DAO activity >10 U/mL.” [Maintz and Novak 2007]

The gold standard for diagnosis of histamine intolerance involves following a strict “histamine-free” diet for 4 weeks, and then undergoing a “histamine capsule challenge” in which you are given capsules filled with histamine and a clinician monitors your medical reaction.

Treatment of Histamine Intolerance

If you suspect you have HI, here are some options which may help you to feel better:

  1. Eat a low-histamine diet.  Avoid cultured, processed, cured, fermented and aged foods.  Choose fresh foods whenever possible.  Ask your grocer what the “pack date” is of the meat or fish being sold.  “FAS” (frozen-at-sea) fish may be your best bet. Unfortunately, grass-fed and pastured meats are often shipped from farther away, and may not be the best choice when it comes to histamine content.
  2. If you are someone who can tolerate small amounts of histamine-containing foods, pay attention to how often you eat them, because histamine can accumulate in the body over time.
  3. Occasional use of antihistamines or medicines called “mast cell stabilizers” may be helpful–if they don’t bother you.
  4. Vitamin C, vitamin B6 and copper can all increase DAO activity
  5. DAO supplements (isolated from pig kidney) are available
  6. Some people, especially those with prominent gastrointestinal symptoms of HI may benefit from pancreatic enzymes.
  7. Avoid alcohol—alcohol reduces DAO activity
  8. Be aware of medications that interfere with DAO activity.  If you take any of the following medicines, discuss with your clinician how they may be affecting your HI symptoms, to see if alternatives are available:
    • Acetylcysteine
    • Alcuronium
    • Alprenolol
    • Ambroxol
    • Amiloride
    • Aminophylline
    • Amitriptyline
    • Aspirin
    • Cefotiam
    • Cefuroxime
    • Chloroquine
    • Cimetidine
    • Clavulanic acid
    • Cyclophosphamide
    • Dihydralazine
    • Dobutamine
    • D-tubocurarine
    • Isoniazid
    • Metamizole
    • Metoclopramide
    • Morphine
    • NSAIDs (Ibuprofen/Advil, etc.)
    • Pancuronium
    • Pentamidin
    • Pethidine
    • Prilocaine
    • Propafenone
    • Thiopental
    • Verapamil

Prevention of Histamine Intolerance

Of course, simple, natural, preventive measures are usually the wisest course of action.  Understanding how histamine forms in foods can help you to minimize your exposure not just to histamine, but to all potentially irritating and/or toxic biogenic amines.

  • Immediate storage of meats and fish on ice dramatically reduces the rate of histamine formation but does not stop it completely.
  • HDC, the enzyme that turns histidine into histamine, can remain in foods even after the bacteria (or yeast) that produced that enzyme have died. Therefore, HDC can remain active, turning proteins into histamine, long after the micro-organisms are dead and gone, leading to continued accumulation of histamine. However, HDC can be inactivated by freezing for 1-2 weeks, and is destroyed by cooking.
  • Histamine itself is NOT destroyed by cooking, freezing, hot smoking, or canning. Therefore, once it has been produced, you are stuck with it.

Tune in next Thursday, March 28th, when I’ll be posting about my first week’s experience with plain ol’ nutritional ketosis–no fasting jump-start, no extremely high ketones, no extremely low protein intake–should be a piece of cake. Mmmmm…cake…

Also coming soon to Diagnosis:Diet–

  • The history of mostly-meat/all-meat diets around the world
  • Homocysteine
  • Hypothyroidism
  • Apolipoprotein B
  • Nutritional Ketosis according to various experts, including Dr. Rosedale’s advice to me, and why he does not recommend measuring ketones at all
  • A review of the scientific literature on ketogenic diets

To be notified of new blog posts as they become available, click here↓

REFERENCES

Al Bulushi I, et al.  Biogenic amines in fish: roles in intoxication, spoilage, and nitrosamine formation—a review.  Crit Rev Food Sci Nutr 2009; 49(4): 369-377.

Ancin-Azpilicueta C et al.  Current knowledge about the presence of amines in wine.  Critical Reviews in Food Science and Nutrition 2008; 48(3): 257-275.

Bodmer S et al.  Biogenic amines in foods: histamine and food processing. Inflamm Res 1999; 48: 296–300.

Hungerford JM.  Scombroid poisoning:  a review. Toxicon 2010; 56: 231–243.

Jansen SC et al. Intolerance to dietary biogenic amines:  a review.  Ann Allergy Asthma Immunol 2003; 91:233–241.

Komericki P et al.  Histamine intolerance: lack of reproducibility of single symptoms by oral provocation with histamine: a randomised, double-blind, placebo-controlled cross-over study. Wien Klin Wochenschr 2011; 123: 15–20.

Maintz L and Novak N.  Histamine and histamine intolerance.  Am J Clin Nutr 2007; 85:1185–96.

Ruiz-Capillas C and Jimenez-Colmenero F. Biogenic amines in meat and meat products. Critical Reviews in Food Science and Nutrition 2004; 44:489–499.

Schwelberger HG. Histamine intolerance: a metabolic disease? Inflamm Res 2010; 59 (Suppl 2): S219–S221

Vlieg-Boerstra BJ et al. Mastocytosis and adverse reactions to food. The Netherlands Journal of Medicine 2005; 63(7): 244-249.

Wöhrl S et al.  Histamine intolerance-like symptoms in healthy volunteers after oral provocation with liquid histamine. Allergy Asthma Proc 2004; 25(5): 305-311.

  • Someone, Somewhere

    Hi Dr. Ede,

    Thanks for another fascinating, useful post.

    I myself started minimizing histamine in my diet ever since I saw Dr. Tsafrir’s discussion of histamine intolerance in her comments on your ketosis blog posts a couple of weeks ago. For as long as I can remember, I’ve noticed myself experiencing tachycardia, anxiety, and swelling of my ear canals (is there a name for that, before it reaches the point of tinnitus?) almost immediately after eating certain foods—and now (apparently) I know why. Fortunately, ever since eliminating histamine-rich foods from my diet, those symptoms have abated.

    Question:Could you please expand on this statement: “Some foods are suspected of triggering histamine release within some people’s bodies, even though they may not contain any histamine of their own.” I assume you’re referring to “histamine liberators,” yes? Would you mind explaining the science behind the idea of histamine liberators, including how confident we are that the foods in this list really do cause histamine spikes in gut-impaired individuals?

    I absolutely love citrus, pineapple, papaya, strawberries, and crustaceans, so I’m hesitant to reduce my intake thereof. I could be wrong, but it does seem like all of those foods spoil relatively easily, and a lot of people seem to eat overripe/borderline-rotten instances of these foods without really thinking about it quite often. I wonder if problems with these foods can be avoided if one is careful to eat them only when they’re very fresh and not at all overripe. Thoughts? Science?

    • L. Amber Wilcox-O’Hearn

      Someone, I’m curious. When you say ear canal swelling, does that result in a visible reddening of the outer ears, or is it just something you feel from the inside?

      • Someone, Somewhere

        Just something I feel from the inside.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi SS
      I will see what I can find out about the “histamine liberators” and get back to you asap…but my general way of thinking about these things is that if those foods don’t bother you, then you probably don’t need to worry…the review articles I read only mentioned these foods in passing, and skeptically so, but I came across the concept so often that I felt I had to include it…

      • Someone, Somewhere

        Thanks, Dr. Ede. The problem is that I find it difficult to figure out exactly which foods bother me. My system is so complex and variable, that I’ve found that I can’t just rely on my subjective response for self-diagnosis. Plus, I’m biased, because I really want to think that these foods don’t bother me, because my diet is restrictive enough as it is and these are some of my favorites! So I don’t ignore my symptoms, but I couple them with science, whenever possible, to get a clearer picture.

        I have seen the term “histamine liberator” in various places online—and Google reveals a panoply of results—but I have yet to see and understand the science (or lack thereof) behind the idea. I look forward to reading what you find once you look into it.

        Thanks so much for your personal attention and your attention to detail! :)

    • http://diagnosisdiet.com/ Dr. Ede

      Hi SS
      I updated the article above to include what I could find about histamine-liberating foods. The quote I included is from 2005 and so far I haven’t been able to find anything more recent…

      • Someone, Somewhere

        Hi Dr. Ede,

        Very helpful. Thank you. That’s very reassuring.

        In response to reading that, I’m not going to be eliminating any so-called “histamine liberators” from my diet, until and unless I read a stronger scientific indictment thereof.

        By the way, I too searched for something more recent than 2005 on the matter, but couldn’t find anything.

  • Maleia

    Hi Dr Edes, love your posts, very informative – especially the cancer series. One small note and just my “two cents” – as you embark on your next ketosis adventure – be sure to get plenty of salt. My hubby and I have been grain free, sugar free, healthy high fat (Wheat Belly/Paleo) for one year. He is a GP. There were days in the first few months I would feel light headed and weak with low blood pressure too – felt similar to low blood sugar in the old days, but was actually due to low salt. Kidneys are a lot more efficient with this lifestyle and flush salt out quickly. A bit of broth and Himalayan pink sea salt on everything did the trick every time. Be sure your thyroid and hormones are in check too. We also had our food allergies done – came back allergic to yeast with 13 other intolerances – gave up all for six months along with giving up grains and sugars – took probiotic 50 billion and let gut heal. As you know, watch sauces and seasonings for hidden wheat/grain and sugars. We drink only gin or tequila (grain free) in moderation and surprisingly don’t miss our beloved red wine. Gradually adding back in some intolerances with no negative symptoms (organic hard cheese, garlic, etc). Key is also to heal your gut and then be sure to eat correctly. Now interested in the ketogenic aspect as we are pretty much there already. Enjoy your posts as although we all agree low carb is the right direction, there are many variables on this journey and plenty to learn! All the best!

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Maleia
      Thank you kindly for writing and I’m so glad you are enjoying the posts. Thanks also for the helpful tips! I didn’t measure salt in February, but I will definitely be keeping track of salt intake this time around to make sure I’m getting enough. Sounds like both of you are doing splendidly!

  • L. Amber Wilcox-O’Hearn

    Thank you, Dr. Ede, this is very helpful. I’ve been wondering about whether amines are contributing to my rosacea. Most of the time I eat only meat, and only fresh meat at that, but I do eat cheeses, salami, and shrimp, (and occasionally red wine) in party situations. Other than wine, those don’t seem to cause symptoms acutely, but they could be delaying remission.

    I’m also curious about those foods you listed as triggering histamine release, since they look to have high overlap with reported rosacea triggers, and since many, but not all, are also high in phenols. Phenol sensitivity is another rosacea hypothesis, and I wonder if, insofar as it is may be relevant, the phenols themselves are involved in the histamine release.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Amber
      Glad you found this post helpful. The more I read about histamine, the more curious I became about all of the other biogenic amines–I’m sure one could write dozens of posts about all of the strange chemicals that accumulate in various foods:) I hope to write a post about rosacea itself…it’s (still) on the (long) list of everything I want to get to the bottom of…so many topics…all fascinating…all complicated…and all fun to research:)

  • VK

    Just yesterday, I was hoping you’d write about this. Wow.

    I’ve suspected for a while that I have HI. I developed chronic night-time nasal congestion at around 35 – middle age! I had turbinate reduction surgery but that only helped for less than a year. Also went paleo w/dairy about 4 years ago – helped with a bunch of other stuff (skin issues, RLS etc.) but not this. As a test, I recently had a big glass of red wine with dinner – oh boy! Won’t do that again! The DAO inhibition + built in histamine felt like my kid shoved baby carrots up my nose!

    I’ve quit yogurt, cheese, wine and fermented veggies. No improvement. I am going to try Vit C, B6 and Copper rich foods and may be the DAO supplement. Will also drop my N-acetylcysteine supplement.

    I rely quite a bit on grass-fed beef and lamb. Going low-HI on paleo will be a challenge. Do you know histamine content of eggs? I’m assuming eggs are OK.

    Again, thanks for the great blog.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi VK
      Too funny! I am not aware of any scientific evidence to support or refute the existence of pediatrically-powered intranasal carrot delivery systems, so you are on your own there…
      As I understand it, eggs are naturally low in histamine but they are on the list of potential “histamine liberators”, which is a topic I’m trying to get to the bottom of today for another reader, SS, below. I’ll post a comment asap…

    • rita

      I’m not sure but I think that I read somewhere that with regards to histamine egg yolk is ok but egg white is not good.

  • culturedsf

    A couple of things related and unrelated. I have been fermenting foods for a couple of years now in an attempt to get good gut bacteria via food rather than probiotic supplements. My research over time has indicated that sauerkraut goes through several stages including one where the histamines are very high and vitamin c is low. After they ferment past that stage vitamin c becomes prominent again and histamines lower. This takes as long as 30 days, which is why it’s best to do ferments in a completely anaerobic environment. Those open vessels with the food just pushed under the salt water may not cut it for folks sensitive to histamines. I find I have no reaction to long fermented sauerkraut but cannot stomach shorter ferments at all. Hmmm

    Was also curious if one can be allergic or have a histamine reaction to a particular vitamin. A recent experiment with fairly low doses of niacin (300 mg and under) caused a range of visible symptoms (like broken capillaries on the body) but mainly seemingly histamine like reactions like hives, swelling of the lower legs and itching. Needless to say I haven’t taken any more Niacin but it was a bizarre reaction.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi culturedsf

      I hope to learn more about the risks and benefits of cultured foods and probiotics in the near future and write about them; as things stand right now I am certain you know so much more about them than I do…and I fear it’s going to be a giant and unwieldy topic to get to the bottom of!

      As for vitamins, I can attest to severe reactions to vitamins, as I’ve had them myself, but I am not you…I have never taken Niacin myself but Niacin is notorious for causing the reaction you described. In its milder form it is referred to as “niacin flush” but some people get full-blown allergic reactions to Niacin.

      • JimE

        I do not feel so much like the “Lone Ranger” hearing that others have trouble with supplemental niacin. It disregulates my glucose control and makes me fly into a rage (sudden anger) with slightest provocation. Very dangerous for me, and one of the reason that I read health blogs. I haven’t found any explanation for the reaction, but first became aware of the problem after reading an advertising tract for Niaspan in the doctors office.

      • neverending

        Thank you for your social contribution to the problems that countless thousands of people worldwide are dealing with daily because I believe that many diagnosed with the “catch all” diagnosis’ are falling in the cracks of lack of information. Please continue to keep us informed of new information to address histamine reactions or mast cell reactions. Do you see DAO as a possible optimistic supplement?

        • http://diagnosisdiet.com/ Dr. Ede

          Dear neverending,
          I have never tried DAO myself and choose to simply try to avoid foods that bother me, but that is my own choice and not always easy, of course. If you try it and would like to share your experience, here, please do!

    • Gingerone

      I react badly to B vitamins. I have rosacea (which originates in the gut) and am histamine intolerant now after having no food sensitivities prior.

      Your post was very useful to me as I am just starting to make my own sauerkraut

  • http://www.facebook.com/people/Donavan-Taylor/100000182775258 Donavan Taylor

    I almost shed a tear when I heard about this tragic sensitivity. Dry aged steak, sharp cheese, wine, … bacon!?! Sad so sad.

    • http://diagnosisdiet.com/ Dr. Ede

      LOL–yes, I imagine depression rates across the country are skyrocketing…I should have mentioned this as a potential downside of a low-histamine diet:)

  • http://twitter.com/JudyTsafrirMD Judy Tsafrir, MD

    Hi Dr. Ede.

    I am so delighted that you have turned your expert researching skills to this topic and that you recognized it as a potentially significant issue personally. I understand histamine better now because of your clear, readable and even humorous discussion of this complicated mysterious subject. I uniformly find this true about every area of research that you take on. I also really enjoyed and learned a lot reading the fascinating comments from your readers.

    I never heard of some of those evocative biogenic amines. The names are incredible, putrescine, cadaverine. Poetry. I imagine that histamine is to the biogenic amines as candida is to the microflora. People think that they have “candida” but it is really almost a generic designation for so many different unclassified or isolated microflora that may be impacting us. I intuit that this must also be true of the biogenic amines.

    You wrote about the gold standard for diagnosing histamine intolerance, and suggested maintaining a “histamine-free diet” for 4 weeks before initiating a challenge with histamine capsules. My understanding is that it is not possible to maintain a histamine free diet. Histamine is in so many things, that it cannot be avoided like gluten. I think that is sufficient to target particular symptoms that are characteristic, like autonomic dysregulation, anxiety, insomnia, hypotension, or whatever your particular symptom picture is, and then to try and avoid foods that are typically considered to be high in histamine, and to see what you notice about how your symptoms are affected.

    It also seems clear that each person has a unique reaction to particular foods and that one size does not fit all. A friend of mine has a crazily intense reaction to avocados with unbearable restless leg syndrome and a feeling of a “zooming mind” when she eats avocado. One of my readers also reported something similar. Avocado does not seem to bother me particularly. Important also is the fact that histamine intolerance reactions appear to be often based upon cumulative exposure. In other words, if you are maintaining a relatively low histamine diet, then you may tolerate a higher histamine food in isolation, because the overall quantity of histamine in the body has not reached your personal tipping point to create symptoms.

    There is a woman who has a blog called The Low Histamine Chef. (http://thelowhistaminechef.com)
    She emphasizes the role that stress plays in histamine reactions, and that an individual will be more histamine tolerant if they get their psychological stress levels under control. She also focuses on the healing potential of anti-histaminic and anti-inflammatory foods, such as thai basil and thyme. She believes that healing is as much about eating anti-histaminic anti-inflammatory foods, as it is about avoiding high histamine foods. This is interesting to me and I plan to investigate this further.

    Anyhow, thanks so much for this post, and I look forward your future installments and discoveries.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Dr. T

      Thanks so much for your generous and thoughtful feedback. I edited the “histamine-free” phrase above (which was the phrase used in the journal article), because I completely agree that it is probably impossible to eat a histamine-free diet.

      I had forgotten about the avocado question–I didn’t come across any mention of avocado in the research, so I just looked for it specifically and still can’t find any references about it…all I know is avocado does not agree with me personally. Given how many compounds there are in plants that have potential to be irritating, whether it is histamine or something else, I feel best when I avoid them or eat only very small amounts.

      I could not agree with you more about individual idiosyncrasies and tipping points when it comes to food reactions. I would not wish my food sensitivities on my worst enemy!

  • Lee

    Wonderful work thank you, just discovered your site and looking forward to digging
    through it. I have recently been diagnosed as an “undermethylator” which is connected with high histamines somehow, haven’t quite got it all sorted out. But you may be interested in the work of Dr. William Walsh of the Pfeiffer Treatment Center, if you don’t already know it.

    Also a lack of b6 and zinc can be caused by pyrrole disorder (diagnosed with that too!). My hunch (more research ahead) is that damaged gut is the root trigger for these problems in me.

    I have a question about self experimenting, what time frame do you use to decide if some food/drink is a problem for you? Maybe this is elsewhere on your site, I will continue to look.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Lee
      Thanks for reading; I’m glad you are finding the site useful so far!
      I did not go into the details of another enzyme that breaks down histamine in our bodies–that enzyme is called HMNT. DAO is the enzyme thought to be most important in suspected cases of histamine intolerance, and it lives in cell membranes, esp in the cells lining the gut. HMNT lives inside our cells–in the cells’ cytoplasm. HMNT uses demethylation to break down histamine.

      As for time frames, that’s a great question, because it varies from food to food and even from person to person. Some foods can cause delayed symptoms that may not begin until the following day, and then affect people for many days, such as gluten, whereas other foods may cause problems within a half hour and only last for a few hours. This is why keeping a food and symptom journal is so helpful–it can help you see patterns between foods and symptoms you might not otherwise notice. The more slowly-digested a food is, the more likely it is to cause delayed and prolonged symptoms–this means grains, beans, nuts, casein, and very slowly-digested vegetables such as crucifers, There is a little more information about this on the food sensitivity diets page.

      • Sarah

        I wonder if the delay is due to the fact that the histamine is not from the food but from an overgrowth of histamine forming bacteria in the gut, thus the histamine builds up as the bacteria digest protein. I think this is my problem at the moment, as my histamine sensitivity went through the roof and I cannot tolerate protein at all without fatigue, postural hypotension, brain fog and a really annoying sharp headache around my left eye. It occurred within a week of me having a weird infection that caused sores all through my mouth and throat, that looked a bit like Hand, foot and mouth, with no sores on my hands and feet.

        I have noticed that high histamine foods give me an immediate response, but low histamine high protein foods give me a delayed response. I have had issues with gut dysbiosis that I had been treating with the GAPS diet protocol, and I think I may have low stomach acid, which is possibly how a histamine producing bacteria could get established. Just theories, I have some testing to do. REALLY over eating nothing but fruit and low carb veggies, and some nuts.

        Thank you for your information it is simply put and well explained.

  • Angela

    Hi,

    Do you know where coconut products would fit in this topic? Would they be considered a nut and therefore be considered high and/or a trigger for histamine release?

    Also would you think that animal fat not be high in histamine, since the histamine is a product of the protein metabolism? or would fat carry the histamine too? I don’t see anything specifying animal fat like lard as distinct from pork.

    Or have you heard anecdotally if anyone has trouble with meats but not the animal fat?

    I really appreciate this article. Thanks for all your efforts.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Angela

      Thanks for your questions.

      Since it seems the science behind the concept of “histamine-triggering” foods (as opposed to foods which actually contain histamine) is weak, it may not matter…however, I’m not aware of any information suggesting that coconut is a problem when it comes to histamine content or histamine “liberation.” As with just about everything about nutrition, the proof is in your own body—you’d have to test these foods out to know whether or not they bother you.

      Fat, theoretically, should be very low in histamine. Fat is not protein-free, but it is extremely low in protein, therefore should be extremely low in histamine.

  • Liz Fraser

    Hi Dr Ede, I am a GP (family physician) in Australia and I have a story a bit similar to yours – became interested in nutritional medicine because of my own health issues, particularly salicylate and amine intolerance. I have been doing the strict Elimination Diet (as per the Royal Prince Alfred Allergy Unit, Sydney, Dr Loblay and his team) for almost 3 years and what a bore it is. And if I don’t, my QoL is c***.
    Am now a year into exploring nutritional medicine and bringing the benefits of searching original literature back to my patients, but still don’t have an answer for me. Nor did the the RPAH immunologist when I consulted with him 2 or so yrs ago. What causes amine intolerance? “We don’t know. Stick with the diet.” Very disappointing.

    I now have a hypothsesis – which is that I have a dysbioisis with gut bacteria which overproduce biogenic amines. It means that I live very close to the symptom threshold; it doesn’t take many amine foods to give me symptoms eg itch without rash, short lived localised burning sensations like someone sticking voodoo needles into my skin relieved by counterirritation, jumpy legs, insomnia, typically at night after lights out ie neuromuscular irritability. Very distressing. Am very motivated to do tedious low amine diet because it has worked, even ‘tho the likes of Jansen et al (2003) says there is no scientific evidence that diets low in BAs help.

    Where’s the evidence for my hypothesis? A stool test showing excess clostridia and bifidos, both of which are capable of producing amines. According to microbiological literature, many gut bacteria have decarboxylase enzymes. Clostridia produce amines maximally under certain conditions, especially the absence of a fermentable source of glucose. This is consistent with my experience that the amine intolerance got worse when I tried cutting out carbs.
    It begs the question: why? Why the overgrowth of amine producing bacteria? Why do undigested protein or unabsorbed amino acids get into my colon to feed the clostridia?
    I am pursuing several threads including amalgam removal – had 12 amalgams, 35 surfaces, many for decades. Mercury amalgam is known to induce changes in primate gut bacteria as well as impair detox pathways eg methylation. It is possible that my amine producing bacteria might also be Hg resistant. The fact that the amine intolerance got worse despite the strict Elim diet the week after the first amalgam removal is consistent with this hypothesis; amalgam removal is known to increase the Hg resistant gut flora in primates. (Can provide refs if you like…)

    So I’m anticipating a few years of low dose chelation as per Cutler protocol. And pursuing the methylation question as this might help heal my gut. And continuing to explore what else might be contributing eg liver detox and other enzyme impairment. The extreme afternoon fatigue improved the day after the root canal tooth was removed – also the last amalgam removal. That’s another interesting observation, although it is still only Day 4 post this last removal.

    So what I am trying to say – your article on histamine intolerance is interesting; and I suspect that the gut dysbiosis plays a big part in histamine/biogenic amine intolerance phenomenon. I’ve yet to find any medical/scientific literature that makes these connections; if I recover, then I better write up my own case!
    Sorry about the big rant – it’s a function of almost 3 years of dietary frustration. Basically, I would love to be able to eat normally, and eat out, and not have my ife revolve around the next meal. I’d like to eat yummy thai curries with lashings of coconut and lime and the flavours that I love. And nuts. And fruits other than pears. And more than the 8 or 9 vegies that don’t give me itch, needles and jumpy legs.
    Oh yes, and I am a middle aged female…

    • http://diagnosisdiet.com/ Dr. Ede

      Dear Dr. Fraser

      Thank you for sharing your story here with us. I wish I had answers for you regarding the etiology of food sensitivities, and better yet, a solution. Unfortunately all I know is that my extremely boring diet has been the key to my own well-being, regardless of what the underlying cause was. When I eat a nearly 100-% fresh (unprocessed) meat diet, I have no symptoms at all Whether my original constellation of symptoms was triggered by 40 years of processed foods, antibiotic exposure, environmental toxins, unrecognized gluten intolerance, or some other factor, I am not sure I will ever know. It is wonderful to hear that you are incorporating unconventional dietary principles into your practice and I hope you continue to discover new insights along the way!

    • Natalya

      Hi Dr. Fraser, Scroll down to item #19 in the 1st link, the 2nd link is the detailed post. An account concerning gut dysbiosis, Clostridia, and food sensitivities.
      I have gut issues too and am trying the Body Biotics myself, but have not yet been able to increase my dose above 1/day, w/out diarrhea.- From another middle aged woman trying to find her way! :)

      http://grayson-youarewhatyoueat.blogspot.com/p/our-treatment-choices.html

      http://grayson-youarewhatyoueat.blogspot.com/2012/02/low-downand-dirty.html

    • Meg Bignell

      Hi Dr Fraser, I am very interested to hear what you have found since this post. I suffer terribly from symptoms like yours (itch, needles etc, lately increasing in severity and including angioedema). Is there any chance we can chat? Email or phone. I am in Tasmania. No doctors have been able to help me. I suspect histamine intolerance and have just started a low histamine diet (God what a bore) so will know more in coming weeks but I just want to talk to some one. I am miserable (but optimistic after finding this page and others like it). I am 38 and my symptoms began 8 years ago when pregnant with my twins. Anyway, just hoping we can talk an interested to hear any recent findings you have made. Cheers, Meg

    • http://ahuman.tumblr.com Joshua Becker

      Hey Dr. Fraser,

      I’m here exploring a possible histamine intolerance (HIT) as the cause of chronic congestion. For me, chronic congestion is a huge issue — it prevents me from sleeping and makes me rather “heavy headed” during the day to boot. I had a septoplasty that provided very short-term relief.

      I recently came across the possibility of HIT and found some relief by changing my diet; however, its very difficult, and of course avoiding alcohol is no fun, but I am extremely motivated. As a grad student, being tired all the time is simply not an option. Since becoming aware of the possibility of HIT, I have noticed an immediate reaction to certain foods — and I know its not a placebo, because I’ve always had and vocalized a weird sensation in my cheeks when I ate canned tuna. Now I know why.

      I am curious to know if you have tried or explored the idea of DAO enzyme supplement? I have not. My next step, after sticking to the diet for a while, is to see a medical professional with this possibility in mind.

  • Hilary JS

    A wonderfully helpful post! Thank you. In an attempt to heal my gut and address a myriad of GI and allergic problems, my doctor put me on the GAPS diet 6 months ago. The whole point is to eat enough cultured foods and take in high enough doses of probiotics that one’s gut flora is transformed and becomes healthy. I’ve been more sick since I started the diet than ever before, and each time I attempt to take probiotic supplements I get dreadfully ill about 3 or 4 weeks in. Abdominal pain, bloating, diarrhea. Once it starts, It intensifies each time I eat and only goes away after I stop probiotic supplements and fast for several days.

    From your article, I assume that it would make sense that someone with HI would not be able to tolerate probiotics. Is this correct? And, if so, do you know if it would make a difference to take probiotics by enema rather than orally? My doctor and I are wondering whether a fecal transplant might be helpful for me.

    Also, have you observed HI presenting without skin symptoms? I have a chronically stuffy nose, but my worst symptoms are all digestive.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Hilary

      I’m so glad you found the post useful. I have not yet researched probiotics myself, so I can’t say anything intelligent yet about their potential effects on health. All I can say is that I was able to eliminate all of my gastrointestinal issues without the use of probiotics by making dietary changes alone. I believe that HI can present in a variety of ways, as can any food or chemical sensitivity, because we are each unique, so how we respond to various substances can vary from person to person. The only way to know what may be causing the stuffy nose is to experiment with dietary changes to see what works best for you. Stuffy nose is most commonly associated with dairy products, so if you have never tried a dairy-free diet, that would be worth a shot.

    • Natalya

      Hi Hilary,

      As far as probiotics and HI is concerned, perhaps it depends on WHICH probiotic. This post lists probiotics that are ‘good’, and those that should be avoided.
      http://salicylatesensitivity.com/forum/comments.php?DiscussionID=2683

      Perhaps it needs to be taken w a grain of salt, and depend on how you personally feel. All the best.

  • JamieAnne Sant

    My goodness. I have been on a ridiculous journey for years now. And have been able to track my symptoms to childhood.

    I went gluten free about 5 years ago. My symptoms became much less. About 9 months ago I felt like my world came crashing down. I am an ER RN, obviously a stressful job. I suddenly could not eat ANYTHING without severe abdominal pain. I was scoped, HIDA scan, CT scan, ultrasound, lab work, etc … All normal. And then the doctors and nurses looked at me like a crazy person and I was diagnosed with IBS (which I happen to think is a BS diagnosis.)

    I then saw a naturopath hoping he could help me, I was at my wits end. He diagnosed me with fructose malabsorption. He also advised me to stop eat corn, soy, and all utter milk and products, in addition to my already gluten free diet. Oh yeah, and the low fructose/fructan diet. So much fun.

    I have been doing the above mentioned diet. Some days I feel great. Others I feel downright awful. I have very low energy despite a very healthy diet and vitamin supplementation. And I still have GI symptoms, migraines, and terrible dysmenorrhea. The naturopath wanted to diagnose me with chronic fatigue or fibromyalgia. No f-ing way, pardon my french. Being an ER RN, I know the type of person who has these diagnoses. That is not me. (Side note though – I think people are diagnosed with IBS, chronic fatigue, or fibro BECAUSE of crazy allergies and intolerances that the medical community has been unable to help them with.)

    I found out about HIT yesterday. Every single symptom hits a chord with me. Even the symptoms I have never told any one about. So today I start my gluten free, low fructose/fructan, low histamine diet. I really hope this is my missing link. I really hope that I can start to feel better.

    Wish me luck!

    • http://diagnosisdiet.com/ Dr. Ede

      Hi JamieAnn

      I do wish you luck! Please feel free to share the results of your new diet with us if you would feel comfortable doing so, as I would be curious to hear how it goes for you. I agree with you that many of the diagnoses I like to call “mystery syndromes” such as IBS, FM, CFS, etc, are best managed with dietary adjustments. What causes some of us to develop these syndromes in the first place is anybody’s guess.

    • Terry

      I have chronic fatigue and I’m trying to understand what you meant by, “Being an ER RN, I know the type of person who has these diagnoses. That is not me.”

      I am a former social worker with a university education – who may seem a little crazy at times due to the fact that almost every doctor I have seen is incredibly dismissive. I hope your comment wasn’t trying to stereotype or stigmatize people with this horrible condition.

      This is the problem with modern health care, if your symptoms don’t fit a list you are immediately labeled as a hypochondriac. Healing is about compassion and research – if there were more of these two we would be healing these conditions as the come up, not stagnating.

      • Sharyn Hanover

        What she was say “I think” is really… the fact is… that there is NO SUCH thing as chronic fatigue, fibromyalsia..etc.. Doctors created this NAME because of a group of symptoms people are carrying. It’s just a name because they do not know what is causing it. You HAVE heard I’m sure that doctors do not know what causes fybromyalisia and chronic fatigue and the other illness.. This actually goes for every illness out there that the medical doctors TRY and treat with medications. Nothing is cureable because the do not know the cause. Most causes are so simple scientists miss it.. Like this histamine. I’ve been having a lot of these crazy symptoms of chronic fatigue and what they CALL fybromyalsia and I”m no going to label myself (this is what she was trying to say (the RN).. Don’t let doctors label you with a specific disease. Find out the true, deep cause and you can fix it yourself. No doctor is going to dive deep within your body to find out the true cause. You have no choice but to do your own research and find it yourself. Luckily we have this godsent internet. Doctors will label you and give you a drug for the symptoms.. Meanwhile your body will get worse and worse and retaliate by creating a whole host of other symptoms..

        don’t comment on my mispellings please.. I just type fast and don’t care if I mispell….l0l

    • Teddy

      Well judgemental Jamie just what type of person has CFS and FM you bloody ignoramus whoopy do RN! Seriously you didn’t just say that!

    • neverending

      I would really like to hear how things are going for you now and what you have learned. I too have been diagnosed with your diagnosis’ along with severe atopic dermatitis through childhood (mild now), MVP, dysautonomia. I agree that IBS, Chronic Fatigue, Fibromyalgia are “catch all” terms to save the docs time in research. I was a licensed Respiratory Therapy until a long and severe bout with illness many years ago. Have allergists or internal medicine docs gained any ground in real knowledge here? I am starting DAO this week and I wonder if you have tried the same?

    • Carolyn Scott

      Can you tell me if that has helped you. My husband is going through it all too and has had a clean bill of health other than the fructose intolerance, IBS, gall bladder removed (didn’t help) but gluten free didn’t help either so am thinking the histamine free might.

    • John

      Hi JamieAnne, My 6 yr old son seems to be suffering from HIT (after observing symptoms). He gets red hot ears, stomach cramps certain days… We are trying to get him on a low histamine diet but we’re confused about which fruits and vegetables to give. Are you able to pls give us a guide as to what fruits & veges worked for you ? Thanks
      John

    • AnnP

      I have suffered with Hives for 2 years, covered my body, what hell was that…
      To cut a long story from IBS to tiredness I realize my problems have been foods that are fermented, stay way from them and take the odd anti histamine and I am fine. Trouble is my GP doesn’t understand why my Blood Pressure goes high now and again. I try to explain it is the histamines! For some years I thought I had a dairy allergy, but recently found that is not the case, just eating cheese and other fermented foods are my problem. My GP says taking antihistamines can make one tired too.

    • Karla

      Hi Jamieann,

      I had also been diagnosed with ibs, chronic fatigue, fibromyalgia and that was from my doctor, I finally went to a natural path doctor and what he found was my histamine was really high and my body was lacking iodine which I now take in my water, I couldn’t believe the difference I started taking it two years ago, I don’t have to take it all the time but I do know when I need it but food diet is important I know I have problems with bacon and ice cream now in saying that be very choose y on your natural path doctor my natural path doctor does not believe in ibs, chronic fatigue etc he said it’s all in our cells in we just have to find out what we are lacking or getting too much of. My sister in law was also diagnosed with high histamine and she was lacking copper she also had different symptoms then me

    • http://www.low-histamine.com/ Vikki

      GOOD LUCK JAMIEANNE!!!

  • Natalya

    Hi Dr. Ede,

    Sometimes the most benign and lovely things can be a catalyst for change. Like the arrival of summer, and therefore new available vegetables. Part of my dietary adventure, which began Nov 2010, just after turning 50, involves mostly eating local, seasonal products. I live in the sub-tropics, our main vegetable growing season is the winter. In the summer we grow hardier crops, including a super mucilaginous local spinach. So, I started eating this spinach, lots. I’ve been on the GAPS diet for 1 year now. My digestion has improved enormously, but suddenly it took a turn for the worse. A girl friend sent me your post about vegetables. (I’ve already embraced ‘good’ salt as good, smiled at cholesterol, realized fat is my friend, learned to love the sun in moderation, walked away from sugar, alcohol, all starchy foods and all processed food, OK – except for the recent addition of 100% cocoa, that does come in a wrapper.) But frankly, I felt confused about vegetables. Despite the fact that last summer for 2 months I ate not a scrap of any plant food. Which was the start of my very much needed 20 lb weight gain. Then she stopped by this past Sunday and read me this post.

    Of course I know about the potential issue w histamines. Everyone involved in the Gapshelp group knows, but it doesn’t affect me, right? But this post, on the heels of the veg post, started to clarify things. I recalled that about 7 years ago my red wine tolerance went to 0. When I started GAPS the food I could not eat at all, even though I had been making it for a year, was kraut. And I have symptoms that come and go w/out apparent reason: Brain fog, fatigue, waking up feeling slightly hung over, pink spots on my face, facial puffiness, diarrhea, and, worst of all, heart ‘noise’ (for lack of a better term since the cardiologist says my heart is fine). It may look like I mention this last casually, but it is wretched, and I am willing to take any measure to have a quiet heart (but not too quiet!).

    So, I figure it is worth it to take a few more steps and try omitting histamine rich foods. I confess to a depressed half day while I wrestled w the idea of giving up my beloved ferments: kefir, kefired coconut water, kombucha, kraut and other fermented veg. And the bone broth, I eat it all the time. I do not yet know exactly what I’ll be eating. But I know that it has the potential to be so worth it! I’m obviously enjoying optimistic moments! :)

    Btw…I started this fun-ness almost 3 years ago when my ability to digest carbs just stopped. Although my digestion had been ‘weak’ for 20 years, or maybe forever! Having been a scrawny, asthmatic, psoriasis covered kid.

    Thanks for being a catalyst to helping me put things together. I really appreciate it.

    • Sarah Jodoin

      I appreciate all of the information you have given on here, especially being one of these crazy hypochondriacs for years starting in my late teens. Was diagnosed with fibromyalgia, chronic fatigue, IBS, positive ANA, and the list goes on.. I used to run marathons and now I can barely walk. I keep listening to my body, and it’s telling me there’s just something else going on… I feel that your post involving these histamine foods and enzymes are helpful and headed in a better direction than the VA treatment (take Tylonol and exercise.) How long does it take to notice a difference after switching diet and following new routine??

      • Natalya

        Hi Sarah,
        Personally, I saw changes begin quite quickly, like in a few days. But it was not a complete change, from being a wreck to being 100% better:) It is a process, and not necessarily a straight line w continuous improvement. I’ve learnt to tweak my diet and do what works for me. In the early days I went to a nutritionist, she told me to eat lots of carbs, to fatten me up. That might be conventional wisdom, but it just made me feel sick, plus I continued to loose weight. I had to do a lot of reading and figure it out for myself.
        The effort has been oh so worth it. I think the speed of improvement is very individual, but I feel there is a lot we can do to help ourselves!
        All the best!

  • Natalya

    Dear RW Dr. Ede :)

    It’s been 2 wks since I was read this post about histamines. I just realized the last couple days I’ve been concentrating on general misery. Rather than my initial delight that the diarrhea stopped right away, as soon as I stopped the spinach. Like a switch. I can’t believe I didn’t figure that out for myself. It took an additional 2 days to stop the long cooked bone broths. My guts slowed down even more. 5 days to cut out all the ferments. My guts came to all but a halt. About the same time I got a low grade headache that lasted 3 days. It felt a lot like caffeine withdrawal (caffeine being the only ‘drug’ from which I’ve felt withdrawal). I have not had a headache since Christmas Day (When I thought it might be nice to have a couple glasses of red wine w Christmas lunch, it wasn’t nice at all).

    We had a family lunch out last Sunday. Restaurants are tricky. That evening my face was bright pink and the following day the diarrhea was back. Yesterday I foolishly added not one but 3 new things to my diet. At least one of them bothered me. I could tell in the night ’cause my gut gets sore. Obviously it is better to just add one thing in at a time.

    In my mild current diet confusion I feel hungry! It seems that I have loved most foods high in histamine. I also kinda feel like my histamine ‘bucket’ was large. But now that I’ve reduced histamines considerably my body has decided to pitch out that big bucket and get a little one, just to keep me on a short reign, now that I finally figured it out! With lots of help.

    I know it is early days yet. But this has been a good thing, although the road is a little bumpy! Thanks again for your help.

    • Georgia Ede, MD

      Dear RWN

      Thanks for sharing your progress with us and keep up the excellent detective work!

  • Rusty

    This is very interesting. I just had my first ‘aged’ steak last week coupled with spinach and potatoes. My digestive system exploded and I felt down for two days. I am highly sensitive to histamine and never looked at it from this angle before. Very timely for me! Thank you!

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Rusty
      I’m so glad you found the information helpful; it made a huge difference in my own health when I was introduced to the possibility by Dr. Tsafrir:)

  • Leslie de Villiers

    Your post is well thought and well presented for the most part. I had to piece together this information for numerous sources when I was searching for answers to my sudden food intolerances years ago.

    You are, however, missing a list of high histamine containing foods. These are usually acompanied by a list of high tyramine foods, which some people react to, and there is some overlap. Also, pointing out that alcohol has histamine in varying amounts, but also blocks DAO like the medications listed will help some of your readers. If they have red wine with cheese, the double whammy can affect even those not normally subject to symptoms.

    Your dismissal of histamine liberators is a bit cavalier. I can’t recall the exact sources this many years later, but I was able to pinpoint my problems being with histamine liberating foods only, not histamine containing. My triggers include squashes, avocados, tomatoes, protein powder of any type, and raw egg white (it’s only the raw generally listed, I recall a paper that investigated and the effect was observed, but can could not be explained). I do know that lots of my investigating was on chronic urticaria sites, as the triggers tend to overlap but their symptoms are a different expression.

    • http://diagnosisdiet.com/ Dr. Ede

      Hello, Leslie
      Thank you for sharing your experience and perspective here. I did not mean to dismiss histamine liberators, which is why I went to the trouble of listing as many as I could find–I only meant to point out that the evidence is weak. There is weak or nonexistent evidence for all kinds of true phenomena, so just because there isn’t strong evidence doesn’t mean it’s not true.

  • Leslie de Villiers

    … Continuation

    Histamine intolerance as a specific condition is a.bit muddled in its definition in many discussions. My current understanding is that Histamine Intolerance is generally a condition of inadequate DAO, and that even normal DAO can be overcome by blocking substances or medications or excessive histamine intake as in scromboid poisoning.

    There is another fairly recently coined condition that a subset of people with histamine intolerance symptoms may be suffering from called Mast Cell Activation Syndrome or MCAS. It is related in symptoms and triggers to the rare and serious condition Mastocytosis which involves excessive numbers of mast cells, but is much more widely present and relates to mast cells improperly releasing mediators (including histamine). Triggers include not only foods, but also medications (appers to be much crossover in the DAO blocking list), environmental factors like heat or storms, emotional stress, insect venom, and even scents. The reactions are considered pseudo allergic or called intolerances, but the symptoms range from hives, to swelling, to headaches, to high/low blood pressure with POTS, to anaphylactoid events. They are not IgE mediated allergic reactions, but cen be severe nonetheless.

    I thought I simply had histamine intolerance for years, and treated it with avoidance of trigger foods. I recently found out that my other issues that I once considered distinct like migraines with numbness on face, extreme swelling from insect bites, skin reactions to many medications, and severe intolerance to alcohol and opioids all stemmed from the source of mast cells being triggered.

    Research is being done by a handful of doctors, with 2 of the leaders in the field at Brigham And Young Women’s Hospital in Boston.

    • http://diagnosisdiet.com/ Dr. Ede

      Very interesting Leslie, thank you!

    • neverending

      Thank you for your time gathered information. One of the most incapacitating symptoms that I deal with, among many, is the head/brain numbness sometimes with migraines. You describe a face numbness which usually accompanies my head/brain numbness. I have been diagnosed with most of the diagnosis’ mentioned in these posts plus, but I believe there is an allergenic or mast cell connection since when I don’t eat at all, which is only when I am very ill, I feel better. Have you tried taking DAO with any benefit? Since I am already so dietarilly inhibited due to allergy to milk, corn, onion and requiring low carbs, DAO might be my only hope.

    • Leslie de Villiers

      Sorry, that’s Brigham and Women’s Hospital

  • Gingerone

    “There is considerable controversy around this diagnosis, and many scientists think of histamine intolerance as only weakly grounded in scientific evidence or perhaps even psychosomatic in nature.”

    Many scientists need a slap it seems. Much like menstrual pain was all in our heads…Attitudes like that are why research is slow and people stay in pain. Great article.

    • http://diagnosisdiet.com/ Dr. Ede

      Hello, Gingerone
      The menstrual pain analogy is a very interesting one! Glad you liked the article~

  • Julie

    I found this post extremely helpful! Thank you for sharing your expertise online! –JRCH, Greenwich, CT

  • Stephanie

    Thank you so much for this article, for about 12 years now i have been dealing with docs that tell me they are not quite sure whats wrong with me. I have been diagnosed with FM, CFS, and IBS amongst other things. I have been having heart palpitations for the 12 years. They told me it was because i have bad anxiety. I have been on at least 8 different anxiety meds and not a one totally helped 100%. After reading this article i put some thought into just the last few days cause i have been feeling really bad lately and having a lot of heart palpitations and i am freaking out wondering why. I have been trying to eat more fresh veggies and spinach is one of them. Just tonight i had a chicken salad with spinach and just a few mins after eating i starting to feel hot, my face felt flush, i had this weird feeling of something rush over me and i started having hart palps and getting dizzy. I have been trying to be on a GF diet and it wasn’t fully working. I am at a total loss of what to do. But after reading this article i feel that this is my problem. I am going to try this out for a week or so and see if it makes a difference in how i feel. Again thank you for this article…

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Stephanie–I hope you are able to get to the bottom of your symptoms. If you have not already started keeping a food & symptom log, that may be helpful in noticing connections between specific foods and bodily reactions. Best of luck!

    • Victoria

      Stephanie, I can totally empathize… after my son was born I started suffering from severe anxiety (specifically panic disorder). It got so bad that I was afraid to drive a car for fear of passing out and crashing. My life was in crisis. I also started suffering from severe heart palpitations and tachycardia, debilitating menstrual cramps, vertigo, and a host of other symptoms. I would sometimes get violently ill from a few glasses of wine. I asked my doctor if I could be allergic to red wine or if he knew what could be causing these other problems. He said no and was no help. Tried to put me on Paxil for the anxiety, which I refused (thank god). I had CT scans for the vertigo and a battery of tests. All negative. Finally, I started keeping a food diary and realized that the heart palpitations, anxiety, and other symptoms were linked to what I was eating. I started taking 400mg magnesium supplements and the palpitations and panic disappeared. I also cut out caffeine and artificial sweeteners as coffe and soda were huge triggers. I also realized that I likely had histamine intolerance. Cut back on red wine and alcohol with great improvement. I no longer woke up at 2am with my heart racing. After a bout of angioedema (food allergy tests all negative) I went on a low histamine diet and the rest of my health problems went away, including some things I never expected. No more cramps, headaches, or blemishes. I realized that several episodes from my childhood and teen years were no doubt histamine reactions (went to the emergency room thinking I was having a heart attack after eating a bowl of mixed nuts, collapsed in Balducci’s after eating aged cheeses, etc.) Hopefully others will be able to make their own diagnosis faster with the great information here and elsewhere. Doctors will not help.

    • Victoria

      Just to clarify, I have experienced the same exact reactions you describe above… heart racing, flushing, palpitations after eating certain foods. The mag helps to balance the nervous system. I would highly recommend you try Mg supplements (I take 400mg capsules from Oxide, Citrate, Aspartate… some types aren’t absorbed as well as these). I no longer eat processed or fast food, food with additives, preservatives, or seasonings, avoid all foods high in histamine and known triggers, and try to consume the freshest meats I can (local, air chilled chicken and green beef… won’t eat seafood unless I can see a boat or am 100% sure it is high quality and fresh). As time goes on, I have reintroduced some things in moderation and found that I can tolerate.

      Hope this helps!

    • David Harrell

      Hi Steph, just so you know, FM, CFS are frequent misdiagnoses given to people suffering with borreliosis (aka Lyme disease). IBS symptoms can be caused by co-infection also from ticks, called bartonella. Heart palps and anxiety are classic chronic borrelia symptoms. Finally, the bacteria can upset the immune system in a way that worsens old allergies and triggers new ones. You might want to get checked by a doc who is “Lyme literate.” i myself suspect I’ve had this for 10+ years, and food allergies have recently worsened.

  • gatasiam

    Regarding the tomatoes – they do create a histamine reaction in my body. They increased the effects of estrogen, causing severe menstrual cramps (even when cross contamination or just a hint of a tomato product had been introduced to my body during the month) & coughing.
    I know that’s just me, but seeing how tomatoes can have that affect on me, I’m wondering if the other histamine inducing foods have an effect on me too, and I just don’t know it.

  • Neil

    Have you come across a product called Daosin?It only works on a temporary basis ( for a single meal) but rep;laces the Dao enzyme in the digestive system

  • Kaylyn

    Hi there! So my acupuncturist has asked me to start researching histamine intolerance because I have been having freak allergic reactions where my tongue and throat swell with no apparent reason. I also have interstitial cystitis, acid reflux and bowel issues. I want to try this diet. My question is would an allergist be able to test for this. I have went to an allergist and been tested with no allergies. Do they also perform test to check for histamine intolerance? Have you heard of any correlation to interstitial cystttis?

    • Tam

      My allergist found that though I have reactions on my skin test- my rashes and anaphylactic reaction didn’t match. He then tested my trypase which was high. He suspects I have Mastocytosis. The next step will be bone biopsy which I will hold off on. So even if you are not testing with allergies- it may be your mast cells. I can eat things high in histamines when my mast cell numbers are lower.

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Kaylyn

      I have not come across any correlation between interstitial cystitis and histamine intolerance. I do not know how difficult it might be to find an allergist who can test for histamine intolerance, but I do think that avoiding histamine-containing and histamine-producing foods for a while is the best way for you to figure out whether histamine is the culprit in your particular case. Good luck!

      • loraleena

        Yes ic is consdiered to be a mast cell disorder in some. IT is listed in the 58 possible symptoms.

    • Amy

      Consider oxalate sensitivity, Kaylyn!

    • loraleena

      Yes IC is one of the related conditions. I also have ic and am reacting nasaly to everything . All foods. I am already very low histamine because the ic diet is very low histamine and i am stricter than typical ic diet. Reacting with nasal congestion to all foods just happened in last month. It waxes and wanes depnding on day but doesn’t matter if i eat a piece of broccoli or a bowl of rice its all the same. Running nose and congestion while eating which stops shortly after. I am left with constant swellign in right nostril. My nd has also suggested mcas or histamine intolerance. HE said we can react to histamines secreted in gut for digestion so that just eating at all can cause reaction so then how the heck will low histamine diet matter? Doesn’t make a difference for me. My nose just goes nuts as soon as i move my mouth – even with teeth brushig! BTW IC is considerd a mast cell disease. They have found toomany mast cells in some of our bladders. My ic went into remission with quercitin ( a natural anthistamine)

  • Jenfro

    I believe avocado should be on this list somewhere, but I could be wrong.

    • http://www.low-histamine.com/ Vikki

      You’re right Jenfro, avocado SHOULD be on the list!

  • Karla

    I had also been diagnosed with ibs, chronic fatigue, fibromyalgia and that was from my doctor, I finally went to a natural path doctor and what he found was my histamine was really high and my body was lacking iodine which I now take in my water, I couldn’t believe the difference I started taking it two years ago, I don’t have to take it all the time but I do know when I need it but food diet is important I know I have problems with bacon and ice cream now in saying that be very choose y on your natural path doctor my natural path doctor does not believe in ibs, chronic fatigue etc he said it’s all in our cells in we just have to find out what we are lacking or getting too much of. My sister in law was also diagnosed with high histamine and she was lacking copper she also had different symptoms then me
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  • JessiKat

    Wow! THANK YOU SO MUCH FOR THIS INFO! I have been suffering 37 years with allergies/intolerance and symptoms that have evolved since childhood. I am 100% sure I have extreme HI plus several other related allergy/intolerance issues. It started as a child with chronic runny and stuffy nose/watery eyes all day everyday. I felt allergic to everything with no relief using allergy shots, medication & vitamins. (grew up & first 2 pregnancies amazingly no allergy symptoms the whole time even through summer!!) After 2nd child was born, sinuses became painful and I got chronic headaches so I went through sinus surgery to clean out all the junk and it was a mess according to my ENT. After 3rd pregnancy I was still ok and didn’t have many awful allergies until I was pregnant with my 4th baby (7 years ago) and they came back in full force and never left! Currently, they are not so much in my sinuses as they are in my GI tract. This is now affecting my esophagus and causing swallowing problems. My allergies can feel moderate to low regarding my skin, nasal eyes,sinuses etc but on a daily basis I can not swallow certain bites of food without it being a 10 minute circus act. My most recent allergist said it could be anything even something I breathe that causes my oral allergy syndrome. He talked really fast and pushed me on to see a GI doc. My GI labeled it Eosonophillic Esophagitis and GERD and told me to go back to my allergist to see what I am allergic to. HA! I have eliminated as much as I can without starvation but it is impossible to cut out all foods when I am sensitive to so many plus allergic to so much in the environment and in nature. This has been an exhausting journey because I feel I will never be able to eliminate everything that is causing my histamine flare ups. My doctors are just running me in circles back and forth and collecting the cash each time while giving me no more answers and running no further tests. I really want to take this into my own hands but do not know enough medical jargon to know what tests and blood work to ask for. Perhaps I am low on a mineral or copper, iodine or DAO? I would LOVE to find out but who and how do I seek these tests?? I live in Iowa, USA Thanks you so much for this helpful information. I know my hormones play a huge role in my histamine…or vice versa.

    • http://diagnosisdiet.com/ Dr. Ede

      Hello, JessiKat

      Often the simplest (but not necessarily the easiest) way to figure these things out is to eat a very simple diet based on fresh meats for a week to see if your symptoms go away, and then add back one new food every few days.

  • http://www.low-histamine.com/ Vikki

    JessiKat I really feel for you. As a child, for years I always had streaming eyes and nose, especially in the mornings (turned out to be dust mite sensitivity as there were dust mites living in the feather duvet), but I also had hives on my legs, and when any insect bit me the site would swell up like a red golf ball and I’d just want to scratch off my skin. As I grew up I became ‘allergic’ to Elastoplast, wool, and a lot of other thigs, and I developed acid reflux and then I started getting severe stomach pains. Thank goodness for search engines. After desperately trying to find out some clue to what was wrong I fond out about histamine intolerance and it rang a few bells in my mind (thanks Dr Ede!) I ended up getting a book called Is Food Making You Sick, the Strictly low histamine diet. Followed the diet for a few weeks and the first thing that happened, the stomach pains vanished and have never been back. Everything else is improving too and I’m keeping fingers crossed that at last I’ve found a solution. It’s really important to stick to it and not even have a squeeze of lemon juice on your food, the book tells you some good substitutes. But its worth taking a bit of trouble to find ingredients when you feel so much better.

  • Rachelle Ashford

    I dont agree with the theory that estrogen levels and histamine levels mimic each other, reason being is this, estrogen levels mimic copper levels, copper increase dao/ histaminase……this lowers histamine, i have experienced this myself when supplementing copper, decreased stomach acid and decreased reaction to niacin which signifies low histamine……

    • Gisele Lamarche

      I tried niacin a few times & always got very very nauseous with it as well as intense flushing—perhaps this was actually a histamine reaction?? Interesting…

  • Sofia

    I came across this site, because i triggered histamine intolerance symptoms by taking for some days 5-htp (Griffonia). It sneaked gradually in, and it took me some days to REALLY realize. Now i have awful urticaria, itching. I did not have this since i was a kid, means 30 years ago. Back in the days it was diagnosed as “allergy”. I will put my poor organism on a low histamine diet for some time now. And i swore myself to be more careful – in general – with supplements.

  • Gina Boman Costa

    Thank you very much for all this info. I have been extremely sick for 3 months now, and my alternative dr just mentioned histamine intolerance and told me to check it out. I am convinced this is at least part of my problem. After two days on a low HI diet, my symptoms have already improved dramatically. My question is this – I have been trying to find healing through a Paleo diet, and have ordered a very large amount of grass-fed beef from a nearby farmer. He ages the beef 21 days before butchering. Is aged beef high in histamines? Should I ask him to butcher my steer earlier than the 21 day period? I am so new to all of this that any guidance would be appreciated. Thank you.

    • dawterofliberty

      Yes aged beef is high in histimines.

  • Kaitheetheeya

    I have a fish poison like reaction every time I have pizza or barbecued meals, I eat most of the ingredients of these foods if cooked differently. What could be the cause

    • klk9100

      sulfites?

  • Kaitheetheeya

    I am totally allergic to eggplant

  • Jackie

    You know what’s funny – it sounds like histamine reactions are much more common in little kids than adults – facial rashes after spaghetti sauce, wheezing after cheese, etc. But I can’t find a darn thing on that! I took my toddler off milk proteins because of a persistent perioral rash, but in the last year, it seems to have almost eliminated her asthma symptoms too. But it is hard to feed a toddler a low histamine diet (seems like all that’s left after you eliminate the high-histamine foods is red gummy bears). I would love to find out more about juvenile histamine sensitivity and diet.

    • mw

      We have/had a multitude of food allergies with our kids. We went to a restaurant, and presented a variety of items from a salad bar to their plate, and said “These will not make you sick like (fill in the blank). Eat all you want.” This was after a long period of “No, you can’t have that, you will throw up” (because that’s what we were dealing with). Just being able to eat freely was enough to cause our children to enjoy vegetables.

  • Rudita

    Hi can somebody advice which hospitals in the world has Histamine Provocation Test services? I badly needed this test for my allergy. Itchiness, skin swell like hives when itchiness attacks…. Recently something grow on my hands like a chicken skin and are so itchy. No such hIstamine provocation tests here in dubai. I appreciate if someone can share to me, which part of the world a hospital offers this test…. Thanks in advance.

    • Kellyboat

      I first read about HI in an article written by German scientists in a nutrition journal. Germany is known for using integrative health care for all patients inside a hospital or not. I don’t know if the UAR has integrative care or not, but I can guess that India, Malaysia and Japan probably do based on the types of research articles I find in PubMed. Good luck with your test, but like the Dr. Ede said, there’s no need to have a scientist give you permission to do something you know is helpful. If you eliminate these foods for a while and then re-introduce them and they make you react, then you can make your own decision.

  • Evelyn Onst

    It is very interesting to read this. I suffered for most of a decade with out of control histamine levels that manifested in asthma, chronic sinus headaches, fevers, joint inflammation and digestive problems. Allergies really wrecked my productivity during my late 30s. I got so depressed with the endless, useless doctors I saw that I strarted to do elimination diets and note-taking. I went through about five years of this on and off. I improved my exercise, also. I went on this extreme anti-gout diet, because my friend had gout — and I read about it. At the time a doctor told me it was absurd to think I had gout, due to my lifestyle, diet and weight. But while I was on this diet I became a vegetarian. My symptoms got much better. That was about eight years ago, Today I have improved by 80 percent. I have a social life even. I gave up all meat and fish and all foods with high purine content, all wheat, all corn, all dairy except the occasional egg (and very limited yogurt intake on a special occasion… I miss yogurt). I limit sugar significantly sometimes because I start to get symptoms with it. I eat tons of fresh vegetables and fruits both cooked and raw. I have a little organic brown rice and organic soy. But mainly I eat LOTS of fruit and vegetables — and a lot of bitter greens like dandelions, nettle, kale, chard, etc, on a daily basis. Also, cucumbers, radishes, quercetin foods such as onions (no broccoli however…), squash, zucchini. Tomatoes are fine. Avocado is no good. I got used to it and now have my favorite recipes that fit my needs. And I just wake up with a feeling of joy that I do not have a sinus headache or pain anymore. It is awesome.

    • mw

      Beware of the greens and almonds, or at least drink a lot of water with them. They are high oxalate foods. But that may not be an issue for you anyway.

  • Kellyboat

    OMG for the first time I understand why 25% of the time I can drink a glass of alcohol, and be fine, and the other 75% of the time it makes me sick to have just one drink. Wine and beer are even worse for triggering the reaction, so I have the least risk with gin/tonic. I used to tell doctors about that, and always got a blank look like they were deciding if I was a lush or something and only lying about how much I drank. You know how they routinely ask how much you drink and I would say, “Alcohol makes me sick so I avoid it, I might have one at my anniversary or new years, but it’s not worth it otherwise.” They’d always look at me funny. But now I can see that it’s a symptom of HI based on how much accumulated histamine I’ve had lately.
    My period also sets this off. I can be fine, and then whammo, when PMS time comes, I can literally feel my entire colon from end to end, inflamed. The estrogen connection is very strong for me. I’m considering using a progesterone cream throughout my period too… I already use it the rest of the time. I’m going to go looking for a list of things that deactivates too much estrogen. Doesn’t soy do that? Unfermented of course. This also explains why most Midol type PMS medicines have antihistamines in them. That always made me wonder.

  • Crabpaws

    Dr. Ede, I used to eat everything with no problem. No lifelong IBS, no skin rashes, no environmental sensitivities, except shellfish allergy and manageable pollen nasal allergies. I seemed to have developed histamine food intolerance after 6 months of daily 325mg aspirin directed by my cardiologist. (Stopped the aspirin in early July.) Went on low histamine diet, symptoms went away. My DAO must be normal, but the histamine food intolerance continues. Can this be reversed? What would it take to do this?

    • Jacquie

      Since your symptoms began while taking aspirin, salicylate sensitivity is something else you may want to look into, if you haven’t already. Many foods high in histamine are also high in salicylates.
      Best of luck to you as you try to understand and manage your illness.

      • Crabpaws

        No, I did not react at all to the aspirin per se or to salicylate foods, only to high-histamine foods.

  • David Harrell

    I’ve apparently become allergic to ground beef — at least, the cheapo kind from the cheapo store. Or maybe it was the bit of mustard (containing beer) or the ketchup. I’m not feeing up to retesting it since whatever it was, sent me to ER with anaphylactoid reaction.
    One twist in my case is, I’ve also had every symptom of chronic Lyme disease for years — i’m trying to wend my way through that medical maze as well. And Lyme apparently is notorious for worsening existing food allergies, or triggering new ones. one variant of the bacteria appears to cause red meat allergy!

  • Lisabee

    I lover your site I find it very helpful and informative. Just wanted to share that
    I found the RPAH Allergy Unit Friendly Food Diet (low in amines, glutamine and salicylates) very good particularly when combined with Paleo type principals. Dr Robert Loblay director of the RPAH Allergy Unit has done a lot of good work around diet and Chronic Fatigue Syndrome

  • Alex_Buck

    Does anyone got expierence with Daosin? I’m wondering if someone can recommend it and if there are really no side effects. By looking for some different dietary supplements against HI I saw Daosin and it is cheaper then the other ones. Well, I’m looking forward to hear sth about it!

  • sam

    Google quercetin. Natural anti histimine supplement.

  • Janet J

    I have known (and have been diagnosed by an allergist) that I have HI for some time now. I continue to try to find ways to prepare food so that I keep the levels of histamines as low as possible. I also find that I have a real problems with salicylates – and in some cases, when a food is high in both, it’s really a problem. (I know that alot of HI folks also suffer with salicylate intolerance… and salicylates are in EVERYTHING!) However, I have recently begun canning, including trying to “dry can” meat (mostly chicken for use in soups, casseroles and chicken salad). I understand that canning will not kill histamines that have already developed – but does canning stop the growth of histamines? For example, if I were to cook a chicken and then immediately put it through the process of canning it, would the histamines still remain as low as they are after being cooked and then immediately consumed?

  • Milan

    Very useful article. ;)