Histamine is a compound produced naturally in your cells that serves several key functions in the body. It's generated by mast cells, a type of white blood cell, when we're exposed to an allergen and our bodies attempt to get rid of it. (Cue the sneezing and watery eyes.) It's also tasked with crucial roles in the digestive and neurological systems, helping regulate the production of stomach acid and keeping us alert during the day.
But histamine isn't just produced by our bodies—it also occurs naturally in certain foods. If you suffer from histamine intolerance symptoms, such as headaches, nasal congestion, or fatigue, a low-histamine elimination diet may help you pinpoint and avoid specific foods that trigger your symptoms. But before you begin to overhaul your pantry, read on to learn more about histamine intolerance and how diet may help manage your symptoms.
Here's the 411 on low-histamine foods and how they may benefit your health.
What is histamine intolerance?
Most people tolerate the dietary histamines they consume on a daily basis without issue. However, approximately one percent of the population experiences histamine intolerance, either due to unusually high levels of histamine in the body or because they lack the enzymes necessary to remove it from the system.
When histamine builds up in excessive quantities or fails to break down properly, it may trigger a variety of responses, including headaches, anxiety symptoms, digestive distress, fatigue, and allergy signals such as sinus congestion, sneezing, hives, and difficulty breathing.
These symptoms occur throughout the body because histamine travels through the bloodstream. And, unfortunately, their non-specific nature makes diagnosis difficult. So if you have several seemingly unrelated health complaints—especially if you also take medications that restrict the production of enzymes that break down histamine; gastrointestinal disorders such as leaky gut syndrome or inflammatory bowel disease; or bacterial overgrowth—you should consider consulting with a dietitian.
How to manage histamine-related food intolerances
At present, there are no reliable tests available to diagnose histamine intolerance. Because symptoms vary widely from person to person, it is important to rule out alternative conditions, including food allergies.
Once you've done that, follow the steps outlined below to find your body’s individual histamine sweet spot.
1. Begin a two- to four-week histamine elimination diet
Just as the name suggests, an elimination diet involves removing all foods within a given category and then slowly reintroducing them to see how your body reacts.
Rachel Gargiulo, a certified nutrition consultant, recommends that people dealing with potential histamine intolerance avoid high-histamine foods. Fermented foods should be first on your do-not-eat list—these include fermented dairy products (yogurt, sour cream, buttermilk, kefir), pickled or fermented vegetables (sauerkraut, pickles, kimchi), soy products (tempeh, miso, soy sauce), kombucha, alcohol, and fermented grains such as sourdough bread. You should also avoid aged cheeses, cured meats (sausage, salami), tomatoes (including ketchup), eggplant, spinach, and frozen, salted, or canned fish.
Additionally, it has been suggested that some foods, called “histamine liberators,” may cause your cells to release excess histamine into the body. In order to ensure your body’s histamine slate is wiped as clean as possible, avoid pineapples, bananas, citrus fruit, strawberries, papayas, nuts, spices, legumes, cocoa, seafood, egg whites, and food additives such as colorants, preservatives, stabilizers, and flavorings, which are suspected histamine liberators. (Yes, that means ditching most processed foods.)
As you can see, this elimination diet is super restrictive. This is why experts recommend limiting the elimination period to two to four weeks. Permanently eliminating such a large number of nutrient-dense foods could be both challenging and potentially unhealthy, as it increases the likelihood of nutrient deficiencies.
2. Load up on low-histamine foods
Completing an elimination diet requires some serious planning. To help soften the blow of a few weeks without 'booch and sourdough avocado toast—and to reduce your likelihood of slip-ups—Gargiulo recommends stocking your pantry and refrigerator with your favorite low-histamine staples. These include rice, quinoa, all fruits and vegetables (other than those previously identified as being high in histamine), leafy herbs (thyme, cilantro, oregano), and meats and poultry. In order to maximize the likelihood of success on your program, consume the freshest food available, as fresh food has the lowest histamine content.
Finally, talk to your doctor or dietitian about supplements. They might be necessary to ensure you're getting all the nutrients you need during your program.
3. Keep a diary as you reintroduce eliminated foods
Once you’ve made it through the not-so-fun elimination period, it’s time to pat yourself on the back before proceeding with the reintroduction stage of your elimination diet. This is when you'll start adding eliminated foods back into your diet, one at a time, in order to identify the ones that trigger your symptoms.
It is critical that you keep a detailed diary of the foods you reintroduce and the symptoms you experience, as this record will allow you to identify trigger foods that you may wish to eliminate on a permanent basis. Seek advice from your doctor or dietician regarding how often you should be reintroducing foods. Symptoms may not appear immediately, and you don’t want to risk overloading your system by reintroducing too much, too soon.
4. Consider taking supplements to further reduce histamine
What happens if you've eliminated all high-histamine foods for a month, but you're still experiencing symptoms? Gargiulo says that certain supplements—including quercetin, vitamin C, and stinging nettle—may lessen the effects of histamine build-up in the body. She also noted that local bee pollen has surprisingly positive effects on allergy symptoms. But check with your care team first to make sure they're right for you.
Look, histamine intolerance is never pleasant, and it can be an especially bitter pill to swallow when getting rid of the symptoms requires major changes to your habits and lifestyle. If the elimination diet gets tough, just think about how empowering it'll be to finally figure out your personal trigger foods. Because feeling better would be so much sweeter than any of the high-histamine foods you choose to kiss goodbye, no?
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