Freshness Counts: Histamine Intolerance

freshness counts: try a low-histamine diet


Could a Low-Histamine Diet Be the Solution to Your Health Problems?

Do you suffer from any of the following?

  • Headaches/Migraines
  • Asthma
  • Itching
  • Puffy eyes
  • Facial flushing
  • Hives
  • Pre-menstrual cramps
  • Cough
  • Palpitations or racing heart
  • Swelling of ankles/feet
  • Low blood pressure
  • High blood pressure
  • Insomnia
  • Abdominal pain, gas, bloating, diarrhea

If so, you’re not alone. MANY people have at least one of the problems listed above but might never suspect that the culprit could be right in front of their noses—on their dinner plates! These symptoms can all be caused by a tiny but powerful natural substance called histamine.1)Komericki 2011 Wien Klin Wochenschr 123: 15–20 2)Kovacova-Hanuskova 2015 Allergol Immunopathol (Madr) 43(5):498-506

Anybody can have Histamine Intolerance, but you are at higher risk if you eat a GAPS diet, low-carb diet, enjoy gourmet foods, or have been swept up in the current fermented foods fad, because histamine is found lurking primarily in aged, fermented, cured, cultured, and smoked foods. Foods like aged beef, ripe cheeses, salami, sauerkraut, red wine, and natto can all be quite high in histamine.

Histamine Intolerance symptoms tend to appear very soon after eating a high-histamine food, typically within less than two hours. Symptoms typically disappear in a matter of hours and rarely last longer than 24 hours.3)Kovacova-Hanuskova 2015 Allergol Immunopathol (Madr) 43(5):498-506 These symptoms aren’t proof positive of a histamine problem; it is also possible that you have other food sensitivities or health problems, which we’ll discuss later in this article.

This post is dedicated to the practical aspects of Histamine Intolerance, such as diagnosis, prevention, treatment, food choices, food handling/storage, and medications to avoid. To learn about the biology and chemistry behind this diagnosis—what histamine is, how it forms, how it behaves in our bodies and why some people are more sensitive to it than others, please see my companion post: Histamine Intolerance: Understanding the Science.

If you already know you have Histamine Intolerance and just want to know what to do about it, you can skip ahead by choosing a heading from the menu below:

Ready? Onward!

Histamine Intolerance in a Nutshell

Histamine is an important molecule used to regulate body functions, so it’s found naturally in our bodies in tiny amounts for good reason. The problem is that it is also found in aged foods. If you have healthy gut defenses, you can handle reasonable quantities of histamine in foods. However, more and more of us have compromised gastrointestinal systems and so have difficulty with even small quantities of natural food toxins like histamine. If too much histamine makes its way from foods into your bloodstream, it can cause a wide variety of unpleasant symptoms.

If you eat too much histamine or are sensitive to histamine, you can experience all kinds of annoying symptoms that most people wouldn’t think of as related to diet, including asthma, panic attacks, pre-menstrual cramps, and sleep disturbances.

My Story

Histamine Intolerance is much more common than most people realize. Most people who have it don’t realize it—I was one of them!

Years ago when I first turned my diet upside-down and started eating a low-carbohydrate, high-fat, mostly-meat diet, my health improved tremendously in every way. Yet there were still some frustrating symptoms that would crop up every once in a while: IBS, fatigue, insomnia, ankle swelling, itchy skin, dry cough, and environmental allergies. I couldn’t tell which foods were the culprits. Sometimes fish or beef or pork would bother me and other times it wouldn’t. Some processed meats agreed with me while others didn’t. In 2013 I started a blog series about a new ketogenic diet I was experimenting with, describing how I felt along the way. It was then that Dr. Judy Tsafrir wrote in and suggested I might have Histamine Intolerance. And by gum, she was right! This eureka moment was what inspired me to write these articles for you.

Who is at Risk for Histamine Intolerance?

Histamine Intolerance affects at LEAST 1% of us, but the majority of people with Histamine Intolerance go undiagnosed, so the actual prevalence is surely much higher.4)Maintz 2007 Am J Clin Nutr 85:1185–96

80% of Histamine Intolerance sufferers are middle-aged, and the vast majority are female.5)Maintz 2007 Am J Clin Nutr 85:1185–96

Other risk factors for Histamine Intolerance include:6)Kovacova-Hanuskova 2015 Allergol Immunopathol (Madr) 43(5):498-506

  • Gastrointestinal damage (Crohn’s, Celiac, intestinal surgery, chemotherapy)
  • Deficiencies in vitamin B6, vitamin C, zinc, or copper
  • Genetic abnormalities in DAO (diamine oxidase), the primary enzyme responsible for protecting us from histamine in foods
  • Taking a medication that interferes with histamine metabolism

How Much Histamine Can You Tolerate?

Levels exceeding 2 mg/L in beverages and 50 mg/kg in foods are considered risky7)Byun and Mah 2012 Journal of Food Science 77(12) even for healthy individuals without Histamine Intolerance, because the human body has a limited capacity to handle histamine in foods. People with Histamine Intolerance tend to react to even lower levels because they are especially sensitive.

Foods High in Histamine

Nearly all foods contain at least a small amount of histamine, so it’s impossible to completely avoid it. However, some foods are MUCH higher in histamine than others. Unfortunately, histamine levels in foods vary WIDELY. For example, like other animal foods, fresh tuna is very low in histamine, whereas levels in canned tuna can range anywhere from zero to as high as 40.5 mg/kg. So as you’ll notice, most histamine levels in the tables below are listed as ranges rather than absolute values.

Unless you have your own personal chemistry lab, it is simply impossible to know how much histamine is in any given food. However, there are general guidelines that can help you guess whether a food is likely to be lower or higher in histamine.

  • Any high-protein food (meat, poultry, seafood) that isn’t absolutely fresh will contain rising levels of histamine. The less fresh it is, the more histamine it will contain. Examples include aged beef, leftover chicken salad stored for too long in the refrigerator, and fish that takes a long time to travel from the boat to the grocery store
  • Most aged, cultured, fermented, smoked, and cured foods and even some cultured beverages
  • A handful of fresh plant foods that are naturally high in histamine

Note: the lists below are not meant to be complete, just representative of what I found in the literature.

Champagne670 mg/L
Red Wineup to 24 mg/L
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:
Ketchup22 mg/kg
Eggplant26 mg/kg
Spinach30 to 60 mg/kg
Sauerkraut (fermented cabbage) up to 229 mg/kg
Miso (fermented soybeans)3 to 6 mg/kg
Natto (fermented soybeans)can reach over 50mg/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
Yogurtup to 13 mg/kg
Ripened cheeses2.21 – 2500 mg/kg (whoa…)
Most fresh meats are very low in histamine. Dry sausages such as salami, pepperoni, and chorizo, are the meat products highest in histamine content.
Dry aged sausagesup to 357 mg/kg
Certain kinds of fish are more likely to contain high amounts of histamine unless they are very fresh, because they are naturally higher in the amino acid histidine, which bacteria can turn into histamine.
BluefishMahi MahiSardines
Cape YellowtailMarlin
Trigger Foods
Some foods are suspected of triggering histamine release within some people’s bodies, even though they may not contain much histamine of their own.
Citrus fruitsCrustaceansSpicesPeanuts
AdditivesStrawberriesEgg WhiteSpinach

How is Histamine Intolerance Diagnosed?

If you have at least two typical symptoms (listed at the top of this article) and they go away either with a low-histamine diet or with the use of antihistamine medications, then you probably have Histamine Intolerance. As with any food sensitivity issue, keeping a careful food-symptom diary is very important in noticing patterns. There are many possible food culprits in the world that have nothing to do with Histamine Intolerance, so you may discover some surprising food reactions if you pay close attention.

low-histamine diet food diary

Keeping an accurate food diary— food and drink consumed, symptoms, sleep, exercise, and medications—can reveal patterns and identify problem foods in your diet. This is a powerful tool in reclaiming your good health.

People who suspect they may have Histamine Intolerance should first be tested for true food allergies to rule those out before undergoing more specialized testing. Food allergies can cause a lot of the same symptoms that Histamine Intolerance can.

Other possible conditions that can mimic Histamine Intolerance Include:

  • Non-histamine food intolerances
  • Mast Cell Activation Syndrome, a condition in which histamine-producing mast cells in the immune system are too reactive 8)Frieri M 2015 Clin Rev Allergy Immunol
  • Mastocytosis, a rare genetic excess of mast cells

There is a variety of methods you and your doctor can use to figure out whether you might have Histamine Intolerance, but most available tests are imperfect. This means that even if you “test negative” for Histamine Intolerance, you could still have it. That’s why I believe the best approach is to eat a low-histamine diet for a few weeks to see if your symptoms go away. If they do, you’ve solved your own problem and you may decide you don’t need further proof or validation!

Serum DAO Level

Activity levels of DAO—the enzyme that destroys histamine–can be measured using a blood test:

“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]

However, this method is considered fairly unreliable, because blood levels of DAO are so unstable. Even if your DAO blood test comes back normal, there is still a 50% chance that you have Histamine Intolerance (false-negative). If your DAO blood test comes back abnormal, there is a 17% chance that you DON’T have Histamine Intolerance (false-positive).

Oral Histamine Challenge

Many physicians consider this test to be the gold standard for diagnosis of Histamine Intolerance. It involves following a strict low-histamine diet for four weeks, and then undergoing a “histamine challenge” in which you are asked to swallow capsules filled with pure histamine (typically a 75 mg dose) while a clinician monitors your medical reaction for signs and symptoms of Histamine Intolerance. Unfortunately, this test can also be misleading, because there are many people with Histamine Intolerance who do not react to pure histamine and pass this test with flying colors. They look and feel perfectly fine.

Why would that be? If you are sensitive to histamine, and someone gives you pure histamine, shouldn’t you have a bad reaction?

Here’s the thing: pure histamine does not exist in nature. In real life, histamine exists in foods, some of which can affect the way we respond to histamine. To make matters more complicated, histamine is always accompanied by related substances (other biogenic amines) in aged foods that magnify our reaction to histamine. There are also many other factors that can influence how you respond to histamine from one day to the next [see section below entitled confounding factors].

In addition, oral challenge tests are expensive and time-consuming, so they may not be offered by your doctor’s office and/or may not be covered by your medical insurance plan.

Intestinal Biopsy

DAO levels in the cells lining the gut can be measured directly if you undergo an endoscopy and have small samples of your intestinal cells biopsied for laboratory testing. This test is the real gold standard, because most cases of Histamine Intolerance are thought to be due to reduced levels of DAO in the cells lining the gastrointestinal tract.9)Jarisch (ed) 2014 Histamine Intolerance: Histamine and Seasickness Berlin: Springer Naturally, the biopsy test is rarely performed, because:

  • it is an invasive surgical procedure
  • it is expensive
  • it is highly unlikely that your insurance would cover it

Histamine Skin-Prick Test

This is probably the best test available because it’s inexpensive, simpler, and more accurate than other readily available office tests.

In this test, your skin is punctured with histamine. If you develop a “wheal” (bump) on your skin that is still visible 50 minutes later, it is likely that you have Histamine Intolerance. Whether you test positive or negative for Histamine Intolerance by skin testing, there is about a 20% chance that the test result is wrong.10)Kofler 2011 ISRN Allergy vol 2011 Article ID 353045 11)Kovacova-Hanuskova 2015 Allergol Immunopathol (Madr) 43(5):498-506

Beyond Histamine

Unfortunately, symptoms of Histamine Intolerance are not simply about how much histamine is in the foods we eat. There are many other things that influence how we respond to histamine in foods, which can make things quite confusing for patients and doctors alike. Below are common reasons why we might have different reactions to the same food on different days.

  • Some medications interfere with DAO activity, including NSAIDS such as Ibuprofen12)Maintz 2007 Am J Clin Nutr 85:1185–96 13)Kovacova-Hanuskova 2015 Allergol Immunopathol (Madr) 43(5):498-506
  • Estrogen stimulates histamine production14)Maintz 2007 Am J Clin Nutr 85:1185–96
  • Stress and physical injury trigger immune cells to release histamine and other pro-inflammatory substances15)Kovacova-Hanuskova 2015 Allergol Immunopathol (Madr) 43(5):498-506
  • Alcohol interferes with DAO activity,16)Wackes 2006 Inflamm Res 55(Suppl 1):S67-S68 which can increase our exposure to histamine
  • Histamine is always accompanied by a posse of other “biogenic amines” which can worsen our response to histamine depending on which ones are present and how high the levels of each of them are.17)Bodmer S et al 1999 Inflamm Res 48:296–300

Is Histamine Intolerance Real?

Although the concept of Histamine Intolerance is gaining ground, there is considerable controversy around this diagnosis, and many scientists and physicians still think of Histamine Intolerance as only weakly grounded in scientific evidence or perhaps even psychosomatic in nature. It is easy for doctors to be skeptical:

  • Tests for Histamine Intolerance are often inaccurate
  • A person’s reaction to high-histamine foods can vary from day to day
  • Some doctors may not understand the complexity of the science behind Histamine Intolerance

My philosophy is this: if you notice that foods high in histamine bother you, you don’t need a scientist or a doctor to prove you right.

Food Handling and Storage Tips to Minimize Histamine Exposure

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.

Histamine is indestructible

Once histamine is in a food, there’s no getting rid of it; it is not destroyed by cooking, freezing, hot smoking, or canning.

Histamine is Indestructible. Once histamine develops in a food, there’s no getting rid of it. And if bacteria or yeast are still present in the food, histamine levels will only continue to rise. So here’s what you need to know:18)Hungerford 2010 Toxicon 56:231–243

  • Immediate storage of meats and fish on ice dramatically reduces the rate of histamine formation (but does not stop it completely). If you can bring a cooler with some ice in it to your grocery store, you can keep histamine levels from rising in your warm car on the way home.
  • HDC (histidine decarboxylase) is the enzyme that bacteria and yeast use to create histamine from proteins in our foods. HDC can remain in foods even after the bacteria (or yeast) that produced that enzyme have died off. Therefore, HDC can remain active, turning proteins into histamine, long after the micro-organisms are dead and gone, leading to continued accumulation of histamine. Fortunately, 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.
  • Histamine itself has no flavor and is odorless, so you can’t use the “smell test” to detect its presence.

Treatment of Histamine Intolerance

If you suspect you have Histamine Intolerance, 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. Look for the “packed on” date of the meat or fish being sold. “FAS” (frozen-at-sea) fish may be your best bet. Grass-fed and pastured meats are not necessarily better choices—it depends on how far they had to travel to get to your store. Also, it is important to know that nearly all beef sold in the U.S. “hangs” for at least two weeks before it is packaged, even if it comes from a local family farm that pastures their animals. Therefore virtually all beef is aged to some extent.

Yasmina Ykelenstam’s website contains a wealth of information about low-histamine diets:

  1. Occasional use of antihistamines such as Diphenhydramine (Benadryl) and Cetirizine (Zyrtec), or “mast cell stabilizers” such as Cromolyn Sodium (Gastrocrom) may be helpful if they don’t bother you.
  2. Vitamin C, vitamin B6, zinc, and copper are all required for DAO to work properly. Addressing potential deficiencies in these may be helpful in resolving Histamine Intolerance.
  3. Umbrellux DAO supplementDAO supplements are available and have been proven effective.19)Komericki 2011 Wien Klin Wochenschr 123: 15–20 The one I use is called UmbrellexDAO. This supplement contains DAO enzymes isolated from pig kidney. It also contain a small amount of vitamin C, which helps DAO to work better. While I generally try to avoid high-histamine foods, life happens. When I’m traveling, eating at someone else’s home, or not sure about the histamine content of a food, I use this supplement to help minimize symptoms of Histamine Intolerance from foods I suspect may bother me. It needs to be taken right before you eat—no longer than 15 minutes– so that it will be in the right place at the right time—in your small intestine when the suspicious food arrives. By purchasing through this link you save $5 over the Amazon price and help support this website.
  4. Some people, especially those with prominent gastrointestinal symptoms of Histamine Intolerance may benefit from pancreatic enzymes.20)Maintz 2007 Am J Clin Nutr 85:1185–96
  5. Avoid alcohol—alcohol reduces DAO activity
  6. 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 Histamine Intolerance symptoms, to see if alternatives are available.21)Maintz 2007 Am J Clin Nutr 85:1185–9622)Kovacova-Hanuskova 2015 Allergol Immunopathol (Madr) 43(5):498-506
AmilorideClavulanic acidMorphineVerapamil
AminophyllineCyclophosphamideNSAIDs (Ibuprofen/Advil, etc.)

Bottom Line? EAT FRESH (and I don’t mean at Subway…)

Hungry for more histamine knowledge?

Please see my companion post: Histamine Intolerance: Understanding the Science, which explores the fascinating world of biogenic amines, how histamine forms inside and outside of our bodies, how and why histamine affects our physical and mental health, why some people, especially women, are more sensitive to histamine than others, and why reactions to high-histamine foods can be so unpredictable and confusing.

To learn about the connection between food sensitivities and anxiety or insomnia, including the possibility that histamine is keeping you up at night or causing panic attacks, I recommend reading my Psychology Today article 5 Foods Proven to Cause Anxiety and Insomnia.

You can also listen to my new podcast interview with Yasmina Ykelenstam, the Low Histamine Chef, about the connection between Histamine Intolerance and mental health.

Update: Recommended Resource

I have received numerous inquiries from people wanting to learn more about Histamine Intolerance. One resource that I found particularly helpful was a textbook entitled: Histamine Intolerance: Histamine and Seasickness by Reinhart Jarisch. Since it is a textbook, it is written in an academic voice and is expensive (although available to rent on Kindle), but goes into depth about many of the topics discussed in my two-part histamine series and includes many helpful food tables.

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References   [ + ]

  • 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.

    • 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! 🙂

    • 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!

    • 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.

    • 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.

    • 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.

    • 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?

        • 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

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

    • 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:)

    • gorgegirl999


  • 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. (
    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.

    • 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.

    • 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


    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.

    • 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…

    • 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! 🙂

    • 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

    • 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.

    • 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.

      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!

    • 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.

      • Jessie Swan

        Lyme disease mimics many diseases and conditions. Anyone with mystery symptoms should be tested at Igenex labs in California. The test your general practitioner will.give you is only 50% accurate.

    • 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

        • Swampmom

          No, she was being a typical judgmental medical person. I was in the field, and most become the most judgmental/dismissive people of them all.

          • Annie

            Yes. She is doing the very thing she is complaining about for herself,. Dismissing people who have symptoms and conditions that are not part of the mainstream medical education. Also conditions that medical people can not just medicate to cover the symptoms. I am extremely offended by her writing this-. “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.” bcs she obviously means “crazy” people. It’s a disgusting attitude and I’m guessing she works in the States tho I’m not certain. It is exactly this attitude of making assumptions, judging, dismissing, and acting something like a schoolyard bully rather that an medical person that illustrates what a huge disconnect there is between the growing demand for real care and answers and the close minded attitudes of “health” workers.

          • The Tranya

            “I’m guessing she works in the States tho I’m not certain.”

            Pot, meet kettle.

          • RC

            ER RN = Emergency Room Registered Nurse

        • andrew

          SIN, Systemic, Indemic, Nomnoculture. Sick of, [pun intended] professionals labeling & the public misinterpreting Symptoms as Diseases.

    • 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

    • 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.

      • Laura Aulenbacher

        Not glad that you have this issue, but glad that I am not the only one where blood pressure goes high with this. I am tired of fighting with drs. as they try to put you on their meds. I can’t do BP meds but I can’t make Drs. see this. So here I am. I will say that for me, this is definitely a bucket overflow type of issue. Although, this last flare has cinched it in my mind that this is a histamine intolerance. I have numerous food intolerances and I have had IBS since I was in my teens about 30 years now. Recently added Kombucha and trying to eat goat cheeses has made be realize that this is histamine. Also I recently started having issues with nuts and haven’t in the past. GRRR………. So now as I try to last out this flare, I am living on meat only until the flare lessens. Then I will try to add in some more veggies (the ones not high in histamine) and then I will get back to AIP. The trouble is learning to cook, with a 10 hour day, and commuting into town and back home. Three years to retirement and then I can take all day to cook if I need to.

    • 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


      • stacy

        says Jamieanne… lol

    • Laurie Avenell Olson

      Organic is best as well. I think the reason we are seeing so many getting this is that the food is contaminated with Glyphosate. Thinking that it is safe, farmers have been using it as a drying agent in 160 crops, this is in addition to the RoundUp Ready crops like corn, soy, canola… Glyphosate has been found in kids urine, mothers’ breast milk, water samples, and rain. People need to stop using RoundUp. There are new studies coming out all the time. The World Health Organization just came out with a statement that it could be carcinogenic and Monsanto is all over them to take it back. What I do know from personal experience is that it is very dangerous stuff. My neighbor who sprayed it on his weeds got Diabetes, then lost his leg and then got Parkinson’s Disease. He passed away in 2012. My kids and I who were in the house next door (very close) had our own symptoms from exposure. On April 1st I found the article Everything You Need to know about Histamine Intolerance, by Dr Amy Myers and that food list was everything I’ve learned to stay away from because my face would redden and I’d feel brain fogged and sleepy… Now I’m reading everything I can and making these changes to my diet and I’ve been feeling better and better everyday. Sometimes I can tolerate peanut butter and sometimes I can’t. I’m thinking now that it may be I can when it it really fresh and I can’t when the jar has been opened for awhile.

    • Susan Pyne

      JamieAnn, did it ever occur to you that “those kind of people” with CFS, Fibromyalgia, IBS might really be sick and it is simply “those kind of doctors”…..and apparently ER RNs” who don’t know what they are talking about? How insulting!!

    • Gina

      I do wish you luck!! Your comment is almost mine situation exactly! I curious how you are doing for food selection / variation? I was great for first several days of rediscovering hit. But then started having major cravings for more tastes and textures. I eat greens and meat and tons of olive oil at least twice a day. I drink homemade bone broth at least one 12 oz s per day. I eat creamed coconut with shredded coconut.. And variety of seeds chia. Flax , hemp. Mixed up. But that’s preety much it!! I am still drinking a little bit of coffee!! And an occasional alcoholic beverage ( clear rum on ice) . I was feeling way better but then I got so desperate that I cheated with peanut butter and a little jam!! I have sick since. I need more food options. I have been Keto for seven months but eating a ton of histamine rich foods and suffering mysterious ailments: skin rashes, hair falling out, wounds not healing, extreme weakness, rapid heart rates, anxious, irritable, pms, and skin rashes ( extreme) around eyes, on back , finger, oh yea, and how could I forgot … Four yeast infections in 6 months and daily diareah. My western meds doc did lots of tests l neg! He now says these symptoms are in my head! Thanks! But I am going to new naturalopath soon.. Can you do Keto and low histamine diet at same time? Do you even need to? Ps when starting Keto I lost 4 -5 lbs and just recently ( two weeks) I lost 4 lbs again while starting low histamine. But I am starting to feel deprived!! How can I maintain both together?? Or should I but back some carbs to help me?

      • Hi Gina

        For whatever it’s worth, I follow a low-histamine ketogenic diet, so it can be done, although it does limit food choices quite a bit. If variety became an issue, perhaps just a simple low-carb high-fat diet (without having to limit protein), along with histamine restriction, would do the trick. The major body irritants other than histamines I notice in your menu are the nuts/seeds–flax, hemp, chia–these are untrustworthy characters and are very good at provoking our immune system, so if you’ve never tried removing them, that would be the first recommendation. Even coconut bothers some people (including me), so you never know…to read more about how nuts/seeds affect health:

        • dotslady

          Dr. Ede, I wonder if you find value in butyrate production, which might not be produced with such a diet (low-carb, high fat). Do you believe producing butyrate helps prevent colon cancer? I’ve been low-histamine for years, and have since been diagnosed with and treated h pylori, and am currently working on SIBO and liver/gallbladder health from LPS. I likely have some type of yeast imbalance and can’t detox acetylaldehyde/endotoxins well. I’ve yet to find a practitioner to help with my complications. Anyway, I have low butyrate and am wanting to increase fiber for fermentable carbs and butyrate production but can’t tolerate it just yet. Your thoughts on this would be appreciated. Thanks.

          • Dear dotslady (another fun name!)

            I haven’t personally researched butyrates and the claims that high-fiber and prebiotic diets are good for our digestive health yet, but I’m very suspicious of this theory. It doesn’t make sense to me that our guts would require fiber to be healthy: I was able to cure every digestive problem I’d ever had by eating a high-animal, low-fiber diet. Not that this means it would be true for everyone, of course, but it gives me pause. Not to mention the fact that many cultures ate low-fiber diets and were healthier than most Americans are: My gut instinct tells me that eating a low-carbohydrate diet could deprive “bad” gut bacteria from their favorite food source (fermentable carbohydrates) and avoiding foods that are difficult to digest improves gut health as well: As for colon cancer, there is no evidence that fiber is helpful: And lots of evidence that cancers are promoted by high-sugar/high-refined carb diets:

          • Phillipa Joy

            I’m an Ayurvedic practitioner & recommend you introduce ghee into your diet. It’s high in butyrate acid (which is needed on intestinal walls for digestion/assimilation/elimination) & also has the ability to draw toxins from your system. This also can fit into your high fat model of nutrition you are following.

      • Amy

        I know this thread is over two years old, but hopefully some will see it and research MCAS- Mast Cell Activation Syndrome. States with asking your doctor for a blood test called Serum Tryptase and then if elected a bone marrow biopsy for a definitive diagnosis. If your Tryptase levels are over 20 as mine was, it is VERY likely you are either In Anaphylactic shock ( unlikely) or you have a Mast Cell disorder, Mastocytosis. I had many if not all of the symptoms described here, mostly GI though. There is a disorder in the Mastcytosis family called Mastocytitic Enterocolitis, often mistaken for Crohn’s. This syndrome is treated with a low histamine diet, H1 and H2 antihistamines and a leukotriene in hibitor like Singulair or Aflapin which is a Boswellia extract, very effective. Also more prescription and natural mast cell stabilizers, chromolyn a prescription, or natural quercetin. Please do your research, you may find the key to your symptoms.

        • AmandaSun

          Thank you Amy, I have just been diagnosed with Mastocytosis, after years of being told I had IBS and following many restrictive diets that did absolutely nothing. Many of my family have Coeliac disease (I have the gene) so I’ve also been subjected to endoscopy and colonoscopy to rule out Crohn’s and Coeliac. Now I am waiting for full blood tests to see just how invasive the Mastocytosis is – I am hoping and praying it is not systemic. I am very very scared – especially as so little is known about this syndrome. Wishing you good health!

      • Jessie Swan

        Isn’t bone broth high histamine?

        • Ruth Karulas

          Yes bone broth is high in histamine

        • Theoretically, it depends on how it is made. The cooking process destroys the enzyme that generates histamine. If you use very fresh (or freshly-frozen) bones, prepare the broth right away, and then freeze or use the broth immediately, it should be fine. However, some people are in the habit of collecting bones over the course of a number of days in the refrigerator, then preparing broth from those older bones. Cooking will not destroy the histamine that was formed while the bones were sitting in the fridge. And some people store their broth in the fridge, where more histamine can form.

          • Jessie Swan

            Great information, thank you!

        • Emily

          Yes. Very high. The longer you cook the broth the most histamine ..

        • Yogaguerilla

          Yes… home made like I do, for many many hours is super high in histamines! In. Fact many of the paleo foods are high. Gelatine as used in paleo food and drinks is extremely reactive for me. Perhaps that’s why so many of us healthy eaters are suffering WHILE trying to heal our leaky guts.

    • Mrs Hemming

      Hello after reading your many problems, i so relate to all of the above i to have suffered for many years I have had so many allergy tests done and only one seems to show up which is histamine, doctors are not helpful at all? i to was told i have ibs, how are you getting on with your gluten free,low fructose,low histamine diet do you know the foods in which you can eat ? i dont know where to start many thanks.

  • 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!

    • 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.

    • 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.

    • 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

    • Swampmom

      This is also a common comorbidity to Hereditary Connective Tissue Disease, specifically Ehlers-Danlos. That is NOT one of those mystery diagnoses, it is a genetic mutation of the collagen genes. MCAD/S is seen in over 80% of patients, along with POTS and Dysautonomia (affects the nerves that cause the motility issues in the gut). Just thought I would pass it on.

      • Ellen Nutter

        Do you have a source for the 80%? I was finally diagnosed with EDS hypermobility in January after struggling with constant injuries and pain my entire life, I was diagnosed with IST (similar to POTS) 6 years ago, and have suffered from ‘allergies’ and asthma since I was a child. My list of foods and other triggers continues to grow, and my reactions now include severe joint and bone pain when I am subject to specific environments. My rheumatologist is baffled and sending me to an allergist to try and figure out what is going on. I’m going to bring up MCAS, but have not found any sources other than blog posts stating the strong connection between EDS and MCAS. While I believe the blogs and my fellow sufferers, I was hoping to be able to take in something that scientifically supports this co-morbidity in case he isn’t familiar with the subject.

      • Amy

        Not always related to ED, there is a mutation called C- KIT that many people with mastocytosis have.

        • Swampmom

          Not saying it is. However, it is seen in a large population of EDSers now a days. While they can be a separate diagnosis, it is being seen as a more common comorbidity. Just like POTS, cervical myelopathy, etc.

    • Alisa Harding-Stein

      Can you please post the names of the docs at the Brigham?

    • Susan Pyne

      What is DAO and how can we increase it?
      How can we test for it?

    • Amy

      Oh I see someone addressed MCAS! I should’ve read the entire thread!

  • 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.

    • 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…

    • 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.

      • gorgegirl999

        David Harrell, Thank you, I was wondering when someone would mention Borellia b. sp. (Lyme) and other tick borne diseases. However, after reading this I am certain that this is a huge factor that aggravates lyme symptoms for many.

  • 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.

    • 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.

    • 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.

    • 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.

    • dkaj

      Hi Jessie Kat, Once you eliminate for a couple weeks you can then add some foods back in and test for those that give the worst symptoms. But, also look at the spices you are using too. This part is a big component of it. And, remember it’s all about your histamine load. Go down to salt and fresh herbs that are good for both inflamation and those that help with reflux. Test the herbs one at a time. Basil is good for reflux and anti-inflamatory. The Low Histamine Chef is an excellent site to go to also. Be careful with Tumeric though. It is a great herb as it has anti-inflamatory properties, but can definitely add to reflux because it stimulates bile acid production. So, if you have reflux, be careful with it. I learned the hard way on that one. You most likely won’t find a doctor to test for this, so you could always try taking an anti-histamine med like zyrtek prior to eating a trigger food, and see if it helps once you know your worst triggers. If it helps, you have your information there. But, from what I’ve read on the Low Histamine chef site, she did say that antihistamines reduce DOA enzyme levels.

  • 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


  • 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. 😉

  • shelie

    There’s a lot to this article when meat lemons icannot breath have trouble with strawberries and I think pineaple also my doctor has no clue why….

  • Valerie Ruscher

    I’m using Daosin for almost 2 month. It controls my histamine level and makes it even possible to eat histamine rich food! No more allergic reactions and no more pain! Happy!

    • Chuck

      Sensitive to HI as well and using Daosin since janurary and now I can go out without thinking what I can or can not eat! perfect.

  • Iris

    I had a severe histamine reaction to Braggs apple cider vinegar, I tried it for high blood pressure, 1 teaspoon in 20 ounces of warm water and I sipped it thru a straw. Awhile later I developed a severe sinus headache, runny nose, nausea, dizziness and my body had heatwaves similar to hot flashes but more concentrated in my abdomen. Went to my doctor the next day and he said it was a severe sulfite allergy to the apple cider vinegar which caused a bad histamine reaction. I was sick for about a week and needless to say no more Braggs acv for me.

  • Swampmom

    I have MCAD along with a HCTD, and even with a low histamine diet, I deal with a lot of these symptoms. However, I went for so long with no one having a clue as to what in the world was going on (over a decade), that I now have to take cromolyn sodium in addition to the diet, and the OTC meds. Personally, I hate it as there are so few things you wind up being able to eat.

  • Swampmom

    I know this is an older post, but you post that spinach contains up to 60mg of histamine, but then you post it under the list of foods that do not actually contain histamines. Can you clarify?

  • ImNobodyWhoRU

    Hello, this is a good overview; Janice Jonega, PhD is considered a world expert in this subject. She has several books from the professional to the consumer level. Anyone with histamine intolerance should carefully consider asking to be tested for carcinoid cancer and/or mast cell disease. These rare diseases are often missed by clinicians and can manifest as “histamine intolerance,” which is a symptom, not a diagnosis. I know. I have mastocytosis that went undiagnosed for 40 years until I believe I almost died from a rare form of heart anaphylaxis.

  • Xzigalia

    Strange little reactions to foods have just added up. Why my tongue swells up if I have red wine. Why I get upset stomachs if I drink hot cocoa instead of tea. Why I had an allergic reaction to raw peanuts last year, but never a problem with roasted. And why the last two days with my breadmaker, I’ve noticed inflammation of the tongue. It’s a histamine intolerance. I once tried to wash my face with milk instead of a commercial cleanser, but it felt red and irritated. I was baffled – it was just milk! Now at least I can stop blaming imaginary pollen.

  • Bonnie

    You state that histamine can accumulate in the body over time from various high histamine ingestions. Isn’t histamine broken down fairly quickly?

    • Hi Bonnie

      Good question! Yes it can be broken down very quickly by the DAO enzyme but that enzyme can be deficient in some people or overwhelmed by a high histamine diet.

  • FallenLegacy

    What about grass fed beef? How would you get farms to hang them for less time? They usually hang them for 28 days then when you order them it’s delivered in a box with ice packs to keep it pretty chill.. Is that okay?

    • Dear FallenLegacy

      I have asked my local meat CSA’s how long they hang beef for and I haven’t found any farm that hangs it for less than 2 weeks. I personally have found I do better with grass-fed beef that’s been hung for 2 weeks and then frozen because that cuts down on the time spent aging. Everyone’s sensitivity is different–you’d have to see if the beef hung for 4 weeks agrees with you. I notice that older beef tends to look purplish instead of red, so that can be a clue.

  • Hildegard Fuchs

    Wines, especially red wines, are often blamed to contain much histamine. This is not necessarily correct. The content of histamine of wines rather depends on the quality and healthiness of the grapes and on their further processing in the cellars.
    Careful and elaborate work makes it possible to produce wines containing less than 0.1 mg/l histamines:

    • Dear Hildegard

      What a wonderful resource–thank you so much for sharing this information with readers here. Vielen Dank und alles Gute!

  • Chris Wiseman

    For the long term sufferers, and that includes me, I have done my own research for more than 15 years and am still in production of my own programme for myself. We know that histidine is present in a mass of foods and, to a lesser degree, though still extensive gluten content. Then by my own determination it is alk also related to a ggreat imbalance, of sometimes almost non existant omega 3 content, itself being dwarfed by omega 6, the ratio which is hugely the wrong way round from what be. The point is all of these amines, acids etc are essential to life itself, albeit in better proportions than is presently typically consumed because attempting to severely limit or to attempt to ban them all and rely at all on supplements is tantamount to dangerous and certainly will not bring about any possibility of cutting the majority of symptoms unless the whole picture is viewed rather than going down one “narrow road“. For me, I am quite confident I am on the right track though impossible to put a time on it but suffice to say, ongoing. Many people evefy day feel unwell from time to time, which carry these symptoms but put it down to a “cold“ or even “flu“ when it is a case of food intake.
    What I can definitive about and simple tvough it is, is those who have had the chronic condition over years, one day realky high, the next day very mow or perhaps one week/month seemingly on tlp of the world, the next poorly,but, over many years then please don’t first step past looking at your overall intake of food! In my case I have firmly established that over severall trial runs, some for a hundred days at a time and consistently xound all my symptoms fall away. The reliability of this I cannot emphasize. This may not in itself solve the actual underlying problem but will, let me repeat will reduce and even remove some or all of the symptoms. I have been involved in high and very high physically active jobs my entire life and still now and even now at 67 putting up steel scaffold alone and able to climb the pole to each lift if I fancy, walk easily 3 to 4 miles every day, more on weekends. I used to eat when I first took an interest in nutrition, easily 1900 to 2100 and guess more than that during my construxction years. I have always weighed around 9 – 9.5 stones at 5ft 7“ and still do. Yet my calorie intake now is never more than 1550 calories +/- 1.5lbs. The common symptoms suffered my whole life, are rhinisitis, joints, particularly ankles suddenly giving out, bloating. In middle age headaches, later to be diagnosex as migraines often days,or a week long at a time and definitely IBS symptoms added to the afre-mentioned. In more recent years, indeed while my nutrition studies were under way I have all the listed, with greater frequency plus some more of the other common symptoms. Yet, apart from when these conditions reduced me to semi-infirm, the rest of the time I am working on the scaffold, fixing and repairing, walking, hell, running too and peffectly fine. In the last two years I have eliminated the IBS type of symptoms but know I need to take control. So, please be honest with yourself and bear in mind just for indication, one slice of regular bread, without anything on it, around 80-110 calories would supply enough energy to walk five miles if not overweight. Using that as a broad guide, you can see that no one unless they ard 8 feet tall or cmimb mountains every single day should beon anyway near the,commonly accepted limit of 2000 calories. Study this and reduce take if your bmi is 22 or higher. The body will only lose weight to a certain limit which if not suffering any pre diagnosed illnesses etc, willbe your correct and normal weight. During which neddless to say eat better natural food and you will see a reduction, often dramatic and in many cases a cessation to some of your reactions. Its not so much a case of too much histidine/histamine or gluten and the like which are part of the natural make up of foodbut an overload of food in total. Too much fuel forced through to an engine and it will run badly, still run but no way efficiently, or pile too much wood at once on a bonfire and it will smoke and choke some and painfully work through the excess fuel slowly and end up blazing away. In both these analogies the,same applies to us and like the,engine or the fire constant over feeding will ultimatelead to the engine or fire dying out! If you are eating too much, it will be impossible to correct the remaining problems.

  • Jasmine

    If histamine sabotaging your digestive health there is other way around to treat the allergy without affecting your digestion. Histamine free diet could be the best option to consider. A natural way of healing may able to help preventing or treating various allergies with the used of detoxification program such as allergy free diet, Matrix detoxification, Chelation / Heavy metal detoxification, Liver detoxification program and a lot more. Dr. Sundardas also specializes with naturopathy wants to share a hand with you Dr. Georgia and talk about clientele as well as a natural way of healing. Please have time to visit our website at or email us at

  • Jenny Alvis

    DR. Ede, I have many symptoms of histamine intolerance, such as chronic swollen ears and throat, itching, etc. I have tried too many things to count. I was on the Gaps diet to heal my gut, as I had severe celiac disease. My stomach feels better, but these other symptoms haven’t abated at all. I have found that I may do better on an all meat diet, but I can’t seem to eat fish, and I am not sure how to get adequate nutrition. What meats and organs are the best to eat?

    • Dear Jenny

      You may eat any animal you wish–it doesn’t have to be fish. It doesn’t even have to be a variety of animal foods. As long as you’re eating meat, poultry, and/or seafood, and being sure to eat plenty of animal fat (choosing fattiest cuts of meat, including fatty skin, etc), it doesn’t matter which animal(s) you eat. Most would say it’s important to include occasional liver as well, but there are some people who seem to do fine without it. If you haven’t read it already, you may want to read my article about high-meat diets, including the comments section, which contains many helpful ideas, stories, and website resources:

  • Carolivia Herron

    I am grateful for this information about histamine intolerance. I feel that I’m finally getting an answer for my throat problems.

  • D. A. Rudi

    I have environmental, food, major inhaled allergies, Chemical sensitivity, Lichen Planus, Cold Urticaria (allergic to cold), too many medicine reactions/intolerances/allergies and many others…guess I should not rule out histamine intolerance either.

    • Hi D.A. Rudi

      Sadly, those of us who have food and chemical sensitivities tend to have lots of them, not just one. You are not alone–I know how frustrating this is! Simply prepared fresh/frozen animal foods (meat, poultry, seafood) are your best option. In addition you may be able to tolerate some of the safer vegetables (avoid bitter veggies in particular) and most fruits, unless you have allergies to specific fruits or need to be careful with your carbohydrate intake. The most common food culprits are listed in this brief article:

  • Linda

    Hi there

    I came to your website through a search for Low Histamine foods, my daughter 14 year old, has had very odd symptoms that the Dr and naturalist can not figure out. She has Adrenal fatigue caused by something unknown. So after doing the 21 day elimination diet we are trying the Low Histamine diet. That is where i was hoping to get info from you. I am trying to figure out what to feed her that is simple foods- not elaborate recipes- we are very simple clean eaters and already don’t eat much if any processed foods. So if you have any recipes or meal ideas that are simple I would love to hear them

    I’m thinking – oatmeal in the morning, lunch- no idea yet- maybe a rice tortilla with nut butter and an apple- and dinner being pear, veggie and meat of some sort or maybe a rice veggie meat dish . Simple but not so simple. Any advice would be greatly appreciated.

    • Hi Linda

      I’m sorry to hear about your daughter’s struggles. Let’s see if we can try to help you out here!

      First of all, what are her symptoms of adrenal fatigue, and how was it diagnosed? What kind of elimination diet did she try already?

      Second of all, the menu that you are considering is high in carbohydrate and grains (rice, oats). It would be better in my opinion for her overall health and her adrenal system in particular if she tried eating a diet based on animal proteins and fats and steered away from carbs in general and grains in particular. Of all the carby foods out there, grains, beans, and sugars are the worst for our health:

      A healthy low-histamine elimination diet for a couple of weeks could be very illuminating:

      fresh/frozen poultry, meats and seafood (not lean cuts–include their natural fat/skin!)

      eggs (unless she’s allergic or sensitive)



      nuts (unless allergic or sensitive)

      healthy fats: animal fats like lard and duck fat, olive oil, coconut oil, avocado oil, palm fruit oil, and butter (if she can tolerate dairy)

      If she has blood sugar/insulin resistance issues or is overweight, leave out the fruit and starchy veggies:

      Happy to hear more about the situation, including additional questions!

      • Linda

        Thank you for getting back to me. My daughter had a saliva test that indicated stage 3 Adrenal Fatigue . symptoms are headaches, tired all the time body stiffness and ache, mind fog, stuffy nose, ear wax, some wheezing occasionally, sometimes has itching from inside out, rash on face and arms.
        we are seeing a naturapath who put her on a 21 day elimination diet on Dec 1. found that in addition to being sensitive to Gluten which we took out of her diet two years ago, she is allergic to Eggs and Cows Milk though a blood test. No problems with Thyroid. Still waiting for stool sample to come back and a few more blood tests. So far what looks like it might fit is a histamine problem. Just started a Low Histamine diet with DAO pills to complement it (those should come in the mail tomorrow)
        She has no blood sugar problems. She is an athletic, smart and driven girl who recently had to stop her sport of swimming and hasn’t been to school in weeks because she is too tired to endure it.
        The diet suggested, Low histamine, is what we are now trying. This is a difficult diet because all foods must be the freshest possible. We are having trouble figuring out meals for her with this obstacle and not including eggs or milk or gluten. What is your experience with this diet? Do you have meal suggestions? I will be running to the store every day I assume- as I am now but having a hard time figuring out how to make food tasty with this limited diet.
        Any suggestions are greatly appreciated. Also any ideas we have not explored… I am open to anything.

        • Hi Linda

          At least in the first stages of trying to figure out what the culprits are, it’s very difficult to make meals interesting and tasty. She may need to put up with a few weeks of pretty simple foods. Then food groups can be added back one a time to see what she can tolerate. I personally eat a low-histamine, mostly-meat diet, and it’s not very exciting, but I have numerous food sensitivities that I’m hoping your daughter doesn’t have. If it’s only histamine that’s her issue, she should be able to tolerate not just fresh/frozen meat/fish/poultry, but also quite a few herbs and spices, most vegetables, and most fruits.

          The best way to ensure that your’e getting the freshest meat/poultry/fish is, ironically, to buy it frozen. That also cuts down on trips to the grocery store. Just make sure she eats enough fat and calories to fuel her body. I am not a great cook so I’m not the best resource for helpful recipes, plus my diet is very limited, so not very inspiring! If you haven’t come across it already, there is a low-histamine website that includes some recipes:

  • Linda Simon

    The reaction I’ve been getting for the last few months is a flushing to the face that can feel like my skin is being scraped by a razor and or a dry feeling to the skin across my forehead and cheeks, as well as the sensation that something is crawling under my skin or there are hairs in my eyes or on my nose. My eyes usually feel sore and gluey. Unless my face is flushing, when i look in the mirror it doesn’t look any different from normal. It often occurs in the morning after taking my supplements which I take to help my liver to detoxify chemicals that i am sensitive to. I also get the reaction if I am exposed to certain fragrances such as those found in personal care products, laundry detergents, fabric softeners, household cleaning products, perfume and after shave. It has been suggested that I could have an intolerance to histamine and that I take a test. In the past I always reacted when I drank alcohol but not when I ate meat, fish, cheese and yogurt which I no longer have and I don’t drink alcohol anymore either.

    • Hi Linda

      I wonder what liver supplements you are taking, as it sounds like they may be triggering some symptoms for you in the morning? Have the liver supplements been doing anything helpful?

      • Linda Simon

        I take the following which seem to be helping my liver problems and the issues I was having with fragrances

      • Linda Simon

        I take the following:

        * Opti GHI which contains: Cycteine, Taurine, Glutamine, Gllcine, Vitaminc A, C, B6, B12, Thiamin, Riboflavin, Niacin, Folate, Biotin, Panthenic acid, Iodine, Magnesium, Zinc, Selenium, Chromium, Flax seed, Pomegranate concentrate, Lemon concentrate, Ginger root powder, Watercress powder, Choline, Green tea extract, Brocoli seed concentrate.
        * VegeNAC (N-Acetyl-Cysteine)
        * Activated B complex

        I also take:

        *Opti3 omega 3 EPA and DHA (micro algae)
        * Glucosamine (from corn)
        * Bio activated calcium
        * C Max vitamin C
        * S.Bifido biotic

        Since taking the supplements to help my liver I am less sensitive to fragrances and do not get the same symptoms e.g. brain fog, irritability, the feeling that I can’t breath when I can, tingling sensation on my face, ears and neck and when over exposed the feeling that my face is numb or frozen. None of this was apparent to look at me. However now my face flushes/goes red especially around my nose, cheeks, forehead and eyes and sometimes my chin and neck. It feels like my skin is being scraped by a razor blade and my ear are being stung. It’s not itchy but my eyes are sore and feel gluey. My skin across my face feels tight and like something is crawling under my skin or that there are hairs on my face. Sometimes I get a slight runny nose.

        With the reaction to fragrances, if I removed myself from the source I would usually recover after 10 minutes or so and if exposed for longer I would feel slightly unwell for the rest of the day. I only got the symptoms out in public and never at home. The reaction i get now can happen at any time and often when I’m at home. The first flushing attack was at home in the morning after breakfast and I felt quite ill. Now it’s not so bad.

        Sometimes I get the flushing and then the sensations on the skin, other times I just get the sensations and the flushing on their own. I’ve noticed that it can be worse on hot days but not always. It comes and goes so i have days when its ok and then it flares up again.

        It’s annoying more than anything else.

        Any insight into this would be much appreciated.


        • Hello, Linda

          Sorry for the delay; busy preparing for a conference. Anyway, the liver supplements you are taking, particularly the GHI, contain a staggering number of ingredients! It is impossible to say for sure which of them may be irritating to your skin, unfortunately, but the prime suspects are the plant extracts, such as ginger, watercress, flax, and broccoli seed.

      • Dan

        Dr. Ede, while organ foods are rich in nutrients I tend to steer those with chronic illness away from these as with the pathogens now in our foods and GMO’s in our foods these “organ” foods are the only fire break we have ! thus many toxins to be avoided in vegan style diets could be consumed in concentration in organ supplemented diets, for wife and myself we have switched to avoidance of sugar based diets (vegan) and anything GMO’d – and I see no point in grain’s or bulk they supply nothing ! shredded wheat with powdered sugar – don’t sound nutritious to me !!!

  • Kimberly White

    This is quite interesting, out of the blue, I have noticed a dramatic increase in the symptoms I’ve been experiencing for years! What caught my attentions was I’d over the past week, I’ve been eating strawberries, aged cheese and tomatoes, chocolate, dried fruit and NUTS! All of them in the same week and my “allergy” symptoms have been driving me nuts! Well I am 99.99% sure it’s the histamine in the foods as the food allergy tests that I had a number of years didn’t show me as allergic to these foods, but it now is making sense why I am constantly struggling with allergy like symptoms, it’s because these foods have a higher histamine content which is keeping me in that chronic reactive state!! The foods I mentioned above are ones that I don’t normally eat on a weekly basis, but this week was an exception for whatever reason and, wow it all makes sense now! I am going to avoid the higher histamine foods and see if my symptoms improve, I am sure they will! Thank you for this site!!

    • Hi Kimberly

      I’m so glad you find the site helpful and congratulations on finding your culprit!

  • Laurie

    I wonder about blueberries & sesame.
    Also, do some parts of meat hold more histamine than other parts, e.g. Liver, skin, bones, fat?
    What about oils that come from nuts & seeds & coconut? Would these promote histamine release?
    Has anyone tried a Chinese supplement that contains DAO?

    • Hi Laurie

      Thanks for these excellent questions!

      Blueberries and sesame are thought to be low-histamine foods.

      As for various animal foods and nuts, the protein-containing portions of those foods are the portions that can generate histamine. This means that in meat, the muscles, organs, and marrow would be highest, followed by skin (higher in fat) and finally by fat, which should theoretically be lowest in histamine. The oils from nuts would be very low in histamine because there is little to no protein remaining in the oil. Histamine dissolves very poorly in fat, so the fats and oils of animal foods, nuts, and seeds, should be very low in histamine.

      I haven’t tried any Chinese supplements myself.

      Hope this helps, and thanks for writing in!

      • Laurie

        Hi Dr. Ede,

        Thank you so much for answering my questions! It is so helpful to know what foods I can test and most likely tolerate. I am doing so well on my low histamine diet, that I am now in “testing” mode to try and add more variety to my diet. I must say that the thing that seems to have helped me turn the corner in addition to the diet is L-glutamine powder (by Klaire Labs), of which I am taking 5 grams twice a day on an empty stomach. That and keeping my anxiety under control!

        Thanks again!

        Laurie Pevnick

        • You’re welcome, Laurie, and thank you for sharing your L-glutamine tip with everyone!

  • Someone, Somewhere

    Thanks for yet another excellent post, Dr. Ede. Reading this post was my first step in recognizing my own histamine intolerance. Recognizing my histamine intolerance—and avoiding histamine-laden foods—has led to huge improvements in my symptoms (e.g., diarrhea, fatigue, anxiety, acne, tics).

    A few questions, if I may:

    1. Do you know where I can find *original,* *quantitative* research on supposed histamine liberators, such as citrus? For the life of me, I can’t find such research—or even citations thereof—anywhere—even in the 2007 review article, “Histamine and histamine intolerance” ( ) and the book you recommend (Histamine Intolerance: Histamine and Seasickness by Reinhart Jarish). I find this rather peculiar, because these sorts of books and articles usually cite original research, to support their assertions. A comprehensive search at on seems to reveal no original research on this topic, either. This leaves me wondering whether quantitative/formal research was ever performed on the citrus-histamine-liberator hypothesis, or whether the hypothesis has been created/corroborated only by anecdotal observations by clinicians. The reason this is so important to me, is that I have finally come to the conclusion—based on my own anecdotal observations, of my own response to foods—that I am severely intolerant of carbohydrates, in general. On the flip side, I find that I need copious amounts of vitamin C, in order to counteract the histamine in meat. The foods I can find with the highest ratio of vitamin C to carbohydrate of which i’m aware are lemon and lime, and they are the foods I am able to tolerate best, by far, as a complement to my once-daily meal of meat, meat, and only meat. I have read that vitamin C ingestion boosts DAO production. Unfortunately, I have tried pure vitamin C powder, and find that it doesn’t do the trick, for me, the way lemon and lime do. This leaves me wondering whether the supposed histamine liberating effect of citrus outweighs the benefit of its DAO-boosting vitamin C—which is difficult to evaluate, in the absence of original research on this topic. I imagine you might tell me to trust my experience, first and foremost—and I will—but I would also like to confirm (or refute) my experience with original research, if possible.

    2. Do you also find yourself craving copious amounts of vitamin C, when you eat meat? If so, what are your preferred sources thereof? Do you have any problems with lemon or lime?

    3. I’ve read that beef—the meat I seem to tolerate best—is generally hung for two weeks, in the United States, prior to retail sale. This hanging both drains the blood, and tenderizes the meat, but apparently increases histamine, as well. I’ve also read that halal beef is *not* hung, and tends to be sold retail much more quickly, sometimes within a couple of days after slaughter—and should therefore be lower in histamine than most American beef. I’m wondering how significant the difference is. Do you know? Have you seen any numbers, or know where I might find them, if anywhere? I’m having a heck of a time finding grass-fed, halal beef, in Northern California (I’m in the San Francisco area, but willing to drive), and I’m wondering how hard I should work—and far I should drive—to get it.

    PS I just read an interesting article, demonstrating that a low-FODMAP diet decreases urinary histamine levels eightfold! I thought you might find it interesting: “FODMAPs alter symptoms and the metabolome of patients with IBS: A randomised controlled trial” (2016; ).

    • Hello, SS, nice to hear from you!

      Excellent questions all.

      1) I, too, searched and searched for primary research about histamine liberating foods in preparation for writing these posts, but to no avail. If I remember correctly, there were a couple of references cited in other languages from books, not journal articles, but nothing primary.

      2) I personally don’t crave vitamin C when eating an all-meat menu. I haven’t noticed any trouble tolerating lemon or lime.

      3) Yes, most beef is hung for at least 2 weeks before processing. It is very interesting what you say about Halal beef, though! I haven’t looked into that myself…a brief internet search yields little clear information and perhaps a new trend towards aging Halal beef…I will need to ask around…

      4) I just read the fantastic article you linked to; thank you for sharing it! It makes sense that a diet low in fermentable foods such as the FODMAPs diet would lower histamine production, but an 8-fold reduction is nothing to sneeze at:)

      • Someone, Somewhere

        Thanks, Dr. Ede, for your quick and comprehensive reply. My reply to your reply:

        1) I continue my quest for primary research on histamine liberating foods. I’ve combed through more articles, to no avail.

        For example, Maintz and Novak write, in “Histamine and histamine intolerance” (2007):

        >In addition to histamine-rich food, many foods such as citrus foods are considered to have the capacity to release histamine directly from tissue mast cells, even if they themselves contain only small amounts of histamine (Table 4). In vitro studies of persons with a history of pseudoallergic reactions to food have shown a fragility of duodenal mast cells with massive degranulation in the presence of histamine-releasing substances that is significantly greater than that shown by control subjects (85). [page 1189]

        The citation for that sentence is “Ultrastructural study of the mast cells of the human duodenal mucosa” (1984). However, the most that article has to say on the subject of histamine-liberating foods is:

        >The detection of significant degranulation in 4 biopsies out of 6 in patients with false food allergy (pseudo-allergy) indicates that the mucosal mast cells were more fragile than would be expected in response to non-specific histamine release. It is well known that some foods are histamine liberators (Bleumink, 1970). [page 479]

        However, the 1970 article by Bleumink—”Food Allergy: The Chemical Nature of the Substances Eliciting Symptoms”—does not seem to support this assertion, beyond describing classical IgE-mediated food allergies (based on a search of this article for the keyword, “histamine”).

        Since I’m failing to find primary research on this topic, on my own, despite my best efforts, I just emailed Dr. Reinhart (and CCed you). I’ll let you know if he responds, if he doesn’t CC you in his reply. Also, if you’d like me to email you copies of either of the articles I just mentioned, in case you’d like to see them yourself, let me know.

        2) I’m surprised you don’t crave vitamin C, when eating an all-meat menu. Perhaps you’re getting sufficient antioxidants from alternative sources that I can’t tolerate, or perhaps you’re just not as sensitive/sick as I am. Regardless, it’s good to know that you don’t have any trouble tolerating lemon or lime, just as I don’t. Perhaps the concern about histamine liberation by citrus fruit is more theoretical, or anecdotal, than established.

        3) Try as I might, I’ve been unable to find halal, grass-fed beef, in Northern California. I thought I found it, at one butcher, but after about a dozen phone calls to their supplier, I learned that the butcher was mistaken: their halal beef was not, in fact, grass-fed. I found one other, a couple hours away, but they also seemed to be, frankly, BSing me, when they said that their beef was grass-fed. I did discover grass-fed, halal beef for sale online, but buying meat through the mail seems to me to defeat the purpose of trying to get it as fresh as possible. Fortunately, the specialty butcher from whom I normally buy my grass-fed beef, without a middle-man (Marin Sun Farms) told me that their meat goes from slaughter to their retail shop in less than 7 days, so that’s probably the best I’ll be able to do. Perhaps more importantly, I’ve learned to trust my instincts—specifically, from my eyes, my nose, my tongue, and my gut—with regard to freshness, and so far, they seem to be serving me quite well. Also, I always cook meat on the day I buy it.

        4) I’m glad you found the FODMAPs article as interesting as I did. Relatedly, I reduced my CRP 4-fold, and my bodyweight by 25 pounds, in the last 4 months, simply by switching to an exclusively grilled-rare-grass-fed-beef-with-sea-salt-spring-water-lemon-and-lime diet. My IBS-D disappeared, my acne cleared up, and my agitation/fatigue/tics/headaches/inattention improved more than any other treatment I’ve ever tried. Making sure the meat and citrus are as fresh as possible—thanks to your articles on histamine—have improved these symptoms even more. So thanks again for your very helpful posts 🙂

        • Hi SS

          You are a true super-sleuth! Getting to the bottom of the science is what it’s all about, and I will be very curious to see if Dr. Reinhart responds!

          Great that you’ve had success finding relatively fresh local beef. Not an easy task. My only comment on this is that if you were able to find even fresher beef via mail order, so long as it is shipped frozen, that could be a good option. Frozen meats are often fresher than fresh, but freezing changes the texture and flavor of meat to some extent. Short of purchasing your own cows, you may have found the best possible solution…

          • Someone, Somewhere

            Sorry for the slow reply, Dr. Ede. I’m on vacation (as I hope you are, as well!).

            Unfortunately, Dr. Reinhart hasn’t responded to the email I sent him 11 days. I sent Natalija Novak (co-/corresponding author of the 2007 review article, “Histamine and histamine intolerance,” with Laura Maintz, to which I linked, above) a similar email, 10 days ago, and haven’t heard back from her, either. I’m starting to lose hope that I’ll ever find primary research on citrus (or other foods), as a histamine liberator. Meanwhile, lemon continues to feel essential to my health and happiness, so I plan to continue consuming it, until and unless I find compelling evidence that it’s hurting my health, and that a superior (for me) source of vitamin C can replace it.

            I hear you about frozen meat often being fresher than fresh, but I’ve had bad experiences with frozen beef, thus far. Every time I’ve bought frozen grass-fed beef, I’ve been disappointed with both the texture and the flavor. I can’t speak to its histamine content—though said meat did have a funky/unfresh flavor, in general, suggestive of elevated amines—but it makes me wary of dropping any more money on it. Plus, there’s the hassle of making sure I’m home when the meat arrives, trusting/hoping that the meat will arrive in a frozen state, and trusting/researching/gambling on how quickly the halal beef is frozen, after slaughter. So—I’m not optimistic, but I may still give it a try.

            Relatedly: I’m curious whether you’ve found any wild, low-mercury seafood as easy to tolerate—histamine-wise—as grass-fed beef. (I’m purposely including only wild, low-mercury seafood, and grass-fed beef, in this comparison, since they are the only meats—other than game meat, to which I don’t have access—I know of, that eat natural diets, with minimal contaminants.) I’m on vacation, right now, on the California coast. Since I don’t have access to my fancy grill, or preferred butcher, I’ve been struggling to find low-histamine beef in local restaurants, so I threw caution to the wind, last night, and splurged on seafood: shrimp cocktail; steamed clams; and Cioppino (a tomato-based seafood stew that originated in San Francisco, for those who don’t know), filled with crab, mussels, cod, shrimp, scallops, and the like. Predictably, I felt horrible, within minutes of ingestion. Even when I cook live seafood (e.g., crab, mussels, clams, oysters), on my own, I often get sick, presumably because the animals already begin the process of dying/decomposing (poor critters), the moment they leave the ocean. The reason I ask about seafood is that I miss it, and I often get tired of beef—especially since its histamine content, even from my preferred butcher, seems to be so hit and miss—and would like some variety in my diet.

          • Hi SS

            For whatever reason, I generally do fine with ‘steaky’ fishes such as salmon, tuna, sword and halibut. I also discovered I have no problem with shellfish. I’m always careful to buy seafood only if it is frozen or looks very fresh and I’m told it was caught 24-36 hours before. Delicate white fish often doesn’t agree with me; I don’t know if it’s more fragile and breaks down more easily or if the composition is somehow different. I think there’s no substitute for trial and error, since we are each so unique in how we respond to foods, and there are considerations other than biogenic amines, some of which I’m sure we don’t fully understand (or may not even be aware of), which may be playing a role in our food sensitivities.

          • Someone, Somewhere

            Hi Dr. Ede,

            I too do fine, generally speaking, with “steaky” fishes, such as salmon, tuna, swordfish, and halibut. Unfortunately, one of my many ailments—perhaps even my primary underlying ailment—is mercury poisoning. (I clenched my previously amalgam-filled teeth to the point of cracking. Research has shown that bruxism can increase the release of mercury from amalgam—i.e., 50% mercury-containing—dental fillings up to twenty-fold. Hair, blood, and urine tests all showed that my mercury levels were extremely elevated.) Therefore, I feel it’s prudent for me to steer clear of moderate-to-high-mercury fish entirely.

            Unfortunately, I often/usually get sick from shellfish, as much as I love it.

            Though I don’t often eat delicate white fish—its leanness rarely appeals to me, though I do enjoy fresh wild trout, on the rare occasions that I catch it while traveling—I think you might be onto something, when you write, “I don’t know if it’s more fragile and breaks down more easily or if the composition is somehow different.” I’ve recently developed the hypothesis that the less dense a given meat is, the higher the ratio of surface area to volume it has, and the more convoluted the surface of the meat, the faster it builds up in histamine, through increased permeability/availability to bacteria.

            In my experience, the meat of shellfish (e.g., shrimp, crab, mussels, clams) tends to be less dense than, say, a New York strip steak—the latter of which I generally tolerate better. Ribeye—my favorite cut of beef—is interesting. I often find that the less dense meat on the edge opposite the bone—which my butcher tells me is connected to the shoulder—has an off flavor, especially when the meat appears less fresh—whereas the denser eye of the ribeye steak less often tastes off. Pork and chicken rarely taste off to me, but since 100%-foraging pigs and chickens are pretty much impossible to find, these days, I try to make grass-fed beef and wild (low-mercury) seafood my staples.

            The problem, of course, with grass-fed beef and wild seafood, is that I often—as I said before—struggle with their histamine content.

            The two fully-foraging animals with which I’ve resisted experimenting, in general, are lamb and goat. I’ve never particularly liked unseasoned lamb and goat, due to my dislike of gaminess. I’ve enjoyed these meats, when they’re highly seasoned, sauced, or marinated—e.g., in Indian and Middle-Eastern food—but my gut can’t tolerate seasonings, sauces, or marinades, of any sort, at this point, so I no longer have options to mask the gaminess.

            A couple of days ago, in a moment of desperation—because beef is so hit or miss for me, with regard to histamines—I decided to throw caution to the wind, and bought myself some lamb rib chops, threw them on the grill for 5 minutes, and took a bite. To my utter surprise, they were absolutely delicious, with only a hint of gaminess. I wondered why I had been eating beef for so long, when I found I actually preferred the lamb—for only a couple extra dollars per pound—quite a bit. After buying (grass-fed, local) lamb rib and loin chops from a couple of other reputable butchers, in the succeeding days, I’ve discovered that gaminess varies quite a bit, from source to source.

            I also read that goat and lamb are the most consumed animals in the world, and that lamb was extremely popular in the United States, until World War II, at which point soldiers ate quite a bit of mutton, in Europe—since options were limited, and mutton is cheaper than lamb—and lost their taste for sheep. Consequently, we’re at the point where lamb is rarely consumed in the United States, and approximately half of all Americans have never even (knowingly) tasted it. I also heard that a lot of Middle-Eastern and Indian restaurants serve mutton, labeled as lamb, to save money, which strengthens the association between lamb and gaminess. I also read:

            “Chicken and lamb are supposedly lower in histamine than beef and pork” (in one of Judy’s comments at ).


            “I understand lamb isn’t aged…” ( )


            “got me some fresh lamb that was processed and frozen within 3 days of being slaughtered.” ( )

            Like the author of the last link, I’m also finding that (grass-fed, local) lamb is my new best friend.

            Question: Do you know what causes gaminess? I’ve read conflicting accounts, from various sources. Most importantly, I’m wondering if it increases with time, after slaughter—like histamine—and whether it’s connected to biogenic amines, such as histamine, in any way. I’m finding that even the freshest lamb I can find has at least a hint of gaminess (which, fortunately, I can tolerate, as long as it’s only a hint), and I’m wondering what the biological/nutritional significance is thereof.

            Also: Do you like lamb?

          • I don’t know what causes gaminess, but I LOVE lamb and never have any trouble with it, as opposed to beef, which, as you say, is hit or miss for me.

          • Someone, Somewhere

            Lucky you that gaminess doesn’t bother you. Unfortunately, my tolerance for gaminess seems to be severely limited, because I could eat even the least-gamey lamb I could find for only a couple of days, before I lost my taste for it. I’ve since been focusing on poultry, because it seems that seafood, red meat, and pork don’t work well for me, in terms of histamine content, mercury content, and gaminess. I’m still experimenting, but I’m optimistic that poultry may become a workable staple, for me. Fingers crossed!

  • robin

    Hi! I know this is an old post, but I can’t find the info anywhere. Is baby food that is the glass jars or in the pouches automatically high in histamine or does it just depend on what kind of food is in it?

    • Hi Robin

      Very interesting question! Commercially available jars of baby food are pasteurized (sterilized), which kills any bacteria in the food that can produce histamine. However, any histamine already formed in that food will remain. Therefore, the amount of histamine present in a jar of baby food depends on how fresh that food was before it was pasteurized and sealed.

  • Emily

    Leslie – do you have any new information on what you have discovered? There are such mixed diets out there. What you say resonates the most – Zyrtec, Benadryl and Tagamet have helped a bit. First diagnosis was POTS back in 2005. And then Chronic Inflammatory response to mold and chemicals in 2013. I have stumbled onto the MCAS now and see that this is the root of all causes of these other syndromes. I am ready to heal this and need some more information on specific diet. Atarax rx needed it looks like? Any other suggestions would be greatly appreciated . Thank you

  • Kevin

    Hi, I have Histamine Intolerance also – though my HMO only has “Histamine Headache” available as a diagnosis. I work in medical research and have studied/coped-with this condition for a couple of years now. I wanted to say that I thought your article is very good but it does lack the role of gut flora dysfunction that underlies this condition for many. I can tell you that my issue is mainly due to gut flora that are thriving on carbs, e.g., SIBO. You mention the ketogenic diet – well that’s what has saved me. When I am in ketosis, I can tolerate so much more histamine than when not, it’s almost like night and day. Keep up the good work!

  • Olivia

    I know this is an older post, but I wanted to say Thank You for all of this information! Your story is much like mine… starting out with the ketogenic diet and feeling better but realizing something still wasn’t right. I’ve been reading lately where bone broth is the so I jumped on the bandwagon and have been making it and drinking it every day, multiple times a day. Then left to figure out why I know am broke out in hives and my face is so flushed and burning…. duh! now I know ….Histamine reaction! I have been having issues anyways and may actually end up being diagnosed with systemic mastocytosis because of high tryptase levels in my bloodwork (bone marrow test is next), but learning more about histamine intolerance gives me some direction in what to do next. Unfortunately its hard to find a doctor that knows much about HI or SM around here! Thanks again!

    • tickyul

      I’ve known for a long time that canned-fish and certain cheeses make me itch and sneeze……..and I used to eat a lot of both. Cut way back and both problems almost totally went away. I am also a low-carber, I LOVE soup with meat and bones in it…………..luckily it does not seem to bother me.

  • Godfrey

    SO… one or two shots of high-end tequila straight is OUT on a low histamine diet?? COuld I take some DAO with it… I only like to drink once or twice/week… 1-2 shots only… thanks!

  • Mary-Leigh Gray

    no mention of grains/breads/rice
    are they safe to eat?

  • Mary

    Hi – “Seeking Health” Histamine Block is not available online. Do you recommend any other histamine block supplement? Thanks!

  • McCains Smiles online lucknow

    This is post is very nice and great..Thank for a sharing this a post..Thank you..

  • Bonnie Carpenter

    I live in the Seattle, Washington (USA) area – does anyone know of an MD or naturopath who has expertise in this area? I can eat very little without reactions…

  • Yvonne Rautenbach

    i find this confusing because i only sleep badly when i take antihistamine tablets for a pollen allergy but i believe i have food allergies too which affect my bowel

  • Wq

    Outstanding and crystal clear information.
    If you would allow me…
    Ok… let’s sat MANY years of struggle. Severe acne (persistently around lips and chin-side areas+nose very localized, very painful and ugly; ridiculously acute bloating+gas+all that comes along with it, extremely oily skin (after certain meals, i.e. after most foods, i.e. basing on the vast internet research and comparing it to my reactions- probably after histamine containing foods)… there are many others things which complement the full package. Low ‘T’ into the bargain, but that might be due to the great deal of restricting diets all this years trying to figure what is the trigger. Antibiotics, diets, never ending examinations, countless appointments with all kinds of specialists… useless. Now… if what I am going to try, and that is low-histamine food ingestion taking all preventative measures outlined above, if that reveals to be the culprit… look…
    The only issue is that this itself does not seem to be a fundamental reason, something caused in the first place HIT intolerance, and the primary point is to pinpoint what was that so as not to repeat it in the future, to prevent recurrence is the most difficult part.

    What seems the most brutal part of the diet is PROTEIN , which you need if you are a work out lover, especially when you need mess around with highest quality and nothing but fresh,,, It would be way easier if eggs were eatible, but from the looks of it egg whites either cooked or raw all the same – trigger. Same logic applies to dairy, only fresh/uncultured curd or ricotto cheese… where to get it from?! With regard to carbs it is easier, sweet potato/parsnip/buckwheat/oatmeals sounds good to me, no issues. As well as fruits, berries – at least a few are accepted and no problem with that. Fats also seem to aggravate the case, no matter what type of fat, for some reason all fats (if that’s fatty) it translates into symptoms- I’ve read some report which goes about correlation between histamine and fats. Whether gluten is the offender in my case is still remains unclear, probably not at all. Possibly that is yeast and additives in breads. In actuality ”wheat” can be a problem too (and was listed somewhere as a liberator)- as opposed to rye, barley, spelt(which is also wheat technically). All in all… this diet is brutal, psychologically heavy. I do not want to loose my last weight doing this and will try to eat as much calories as I can. Time will show. Article is great. Restricted eating is not great.

  • Nathania

    Hi I come from a low-carb high fat/ paleo/ keto background,and now that pretty much everything makes me sick, I have found myself on a meat-only way of life. Through this I’ve discovered that the biggest trigger for me is fat; I’m not even talking about eating high fat, ie: I can’t eat the fat trimmings off of a rib steak, or if I buy lean ground beef I have to drain as much fat as possible… Any thoughts?

  • elizabeth192

    Dr. Ede, I don’t know if you revisit old post comment boards, but here goes. Are you familiar with Dr. Ben Lynch’s theory that gut bacteria can produce excess histamine? He offers a probiotic supplement, Probiota HistaminX, that contains bacteria that he claims will “blunt your response to histamine, not produce histamine, and degrade and breakdown histamine.” I wonder what you think? Thank you.