Histamine is a chemical involved in your immune system, proper digestion, and your central nervous system. As a neurotransmitter, it communicates important messages from your body to your brain. It is also a component of stomach acid, which is what helps you break down food in your stomach.
You might be most familiar with histamine as it relates to the immune system. If you’ve suffered from food allergies or even seasonal allergies you may have noticed that antihistamine medications like Zytrec, Allegra or Benedryl provide quick relief of your symptoms. This is because histamine’s role in the body is to cause an immediate inflammatory response. Histamine causes your blood vessels to swell, or dilate, so that your white blood cells can quickly find and attack the infection or problem. The histamine buildup is what gives you a headache and leaves you feeling flushed, itchy and miserable. This is part of the body’s natural immune response, but if you don’t break down histamine properly, you could develop what we call histamine intolerance.
Because it travels throughout your bloodstream, histamine can affect your gut, lungs, skin, brain, and entire cardiovascular system, contributing to a wide range of problems often making it difficult to pinpoint and diagnose.
Common symptoms of histamine intolerance include:
- Difficulty falling asleep, easily arousal
- Vertigo or dizziness
- Arrhythmia, or accelerated heart rate
- Difficulty regulating body temperature
- Nausea, vomiting
- Abdominal cramps
- Nasal congestion, sneezing, difficulty breathing
- Abnormal menstrual cycle
- Tissue swelling
What Causes High Histamine Levels?
- Allergies (IgE reactions)
- Bacterial overgrowth(SIBO)
- Leaky gut
- GI bleeding
- Fermented alcohol like wine, champagne, and beer
- Diamine Oxidase(DAO) deficiency
- Histamine-rich foods
In addition to the histamine produced inside your body, there are also a variety of foods that naturally contain histamine, cause the release of histamine, or block the enzyme that breaks down histamine, diamine oxidase.
- Histamine-Rich Foods:
- Fermented alcoholic beverages, especially wine, champagne and beer
- Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc
- Vinegar-containing foods: pickles, mayonnaise, olives
- Cured meats: bacon, salami, pepperoni, luncheon meats and hot dogs
- Soured foods: sour cream, sour milk, buttermilk, soured bread, etc
- Dried fruit: apricots, prunes, dates, figs, raisins
- Most citrus fruits
- Aged cheese including goat cheese
- Nuts: walnuts, cashews, and peanuts
- Vegetables: avocados, eggplant, spinach, and tomatoes
- Smoked fish and certain species of fish: mackerel, mahi-mahi, tuna, anchovies, sardines
- Histamine-Releasing Foods:
- Cow’s Milk
- Wheat Germ
- Many artificial preservatives and dyes
- DAO-Blocking Foods:
- Energy drinks
- Black tea
- Mate tea
- Green tea
Don’t give up! Here is a list of low histamine foods. Just remember though that freshness is vital if you have histamine intolerance!
- freshly cooked meat, poultry (frozen or fresh)
- fresh fish
- gluten-free grains: rice, quinoa
- pure peanut butter
- fresh fruits: mango, pear, watermelon, apple, kiwi, cantaloupe, grapes
- fresh vegetables (except tomatoes, spinach, avocado, and eggplant)
- dairy substitutes: coconut milk, rice milk, hemp milk, almond milk
- cooking oils: olive oil, coconut oil
- leafy herbs
- some herbal teas
Once formed, histamine is either stored or broken down by an enzyme. Histamine in the digestive tract is broken down primarily by diamine oxidase (DAO). The American Society for Clinical Nutrition found that DAO is the main enzyme responsible for breaking down ingested histamine. Low DAO can be caused by –
- Gluten intolerance
- Leaky gut
- DAO-blocking foods: alcohol, energy drinks, and tea
- Genetic mutations (common in people of Asian-descent)
- Inflammation from Crohn’s, ulcerative colitis, and inflammatory bowel disease.
- Non-steroidal anti-inflammatory drugs (ibuprofen, aspirin)
- Antidepressants (Cymbalta, Effexor, Prozac, Zoloft)
- Immune modulators (Humira, Enbrel, Plaquenil)
- Antiarrhythmics (propanolol, metaprolol, Cardizem, Norvasc)
- Antihistamines (Allegra, Zyrtec, Benadryl)
- Histamine (H2) blockers (Tagamet, Pepcid, Zantac)
- Although histamine blockers, a class of acid-reducing drugs, seem like they would help prevent histamine intolerance, these medications can actually deplete DAO levels in your body.
Testing for Histamine Intolerance
- Remove the above high histamine foods for 30 days and reintroduce them one at a time.
- Blood Testing
I recommend a test like the one these labs offer to test for histamine levels and DAO levels. A high ratio of histamine/DAO signifies that you are ingesting too much histamine and that you don’t have enough DAO to break it down.
- Trial of DAO supplements
- If testing is unavailable to you, you could simply try a diet low in histamine and add DAO supplementation at each meal. If your symptoms resolve, you could have low DAO.
How to Treat Histamine Intolerance?
Remove the high histamine foods for 1-3 months and add in supplements of DAO. Most importantly, find the root cause for the histamine intolerance. If you’re on a medication that is causing the intolerance, work with your physician to see if it is possible to wean off of these medications. The main causes are likely to SIBO (Small Intestine Bacterial Overgrowth) and gluten intolerance, which cause a leaky gut. In this case, I suggest reading about how to heal the gut and over time you should be able to stop the DAO and go back to eating histamine-containing foods.
If you’re currently suffering from histamine intolerance, you may not have to avoid these foods forever. It can be a short-term solution until your histamine or DAO levels return to their optimal ranges. Depending on your situation – which is always unique, you may find that you tolerate some foods better than others.