How to follow a low-histamine diet

Histamine intolerance can trigger uncomfortable systems from headaches to itchy skin and nausea. A low-histamine diet can help.

Histamine plays a role in our immune and digestive systems, and helps our neurological function.

Our body naturally produces this chemical, but it can also be found in food.

Some people are less tolerant of histamine – they have too much of it in their system.

This may be because they lack an enzyme called diamine oxidase (DAO), which breaks down histamine in the body, says accredited practising dietitian Nicole Dynan.

“People may lack DAO due to interference by medications or if they have a gut disorder. Some foods also block the release of DAO,” says Nicole, of Dietitians Association of Australia.

How do you know if you can’t tolerate histamine?

There are no standard blood tests to identify histamine intolerance, and an elimination diet is the “gold standard” to identify a histamine problem.

This involves removing foods high in histamine from your diet and slowly adding them back in, one at a time. This should be done with a dietitian who specialises in food intolerances.

“You may be able to tolerate a certain amount of histamine and when you get beyond a threshold, you get symptoms,” says accredited practising dietitian Aloysa Hourigan, of Nutrition Australia.

“You might be fine having avocado on toast in the morning, but if you then have aged cheese at lunchtime or chocolate after dinner – all foods that contain higher levels of histamine – you may release or consume too much histamine and get a headache.”

low histamine diets

Signs of histamine intolerance

Symptoms include:

  • Headaches
  • Skin irritations
  • Diarrhoea
  • Sinus problems
  • Fatigue
  • Hives
  • Digestive problems
  • Nausea or vomiting
  • Dizziness.

What are high-histamine foods?

If you have histamine intolerance you will be advised to avoid or reduce foods with higher levels of the chemical.

These include:

  • Fermented dairy products such as cheese – particularly aged cheese, yoghurt, sour cream and kefir
  • Fermented vegetables like sauerkraut, kimchi and pickles
  • Cured or fermented meats – sausages, salami, fermented ham
  • Wine, beer and champagne
  • Fermented soy products – tempeh, miso, soy sauce
  • Sourdough bread
  • Tomatoes, eggplant and spinach

Some foods don’t contain high levels of histamine, but they are “histamine liberators” and promote the release of the chemical in our body.

These include pineapples, bananas, citrus fruits, strawberries, nuts, spices, legumes, seafood and egg whites.

low histamine diet

What are low-histamine foods?

Low-histamine foods include:

  • Fresh meat, chicken and fish
  • Eggs
  • Gluten-free grains
  • Apples and just ripe bananas
  • Potatoes, pumpkin, sweet potato, zucchini, carrot, cucumber, celery and shallots

“If you cut out certain foods, you need to make sure you still have nutritional balance in your diet. Otherwise you miss out on some vitamins and minerals,” advises Aloysa.

“For example, if you follow a low-histamine diet you may not have as much citrus fruit, which is a great source of vitamin C.

“So, you need to add fruits and vegetables that contribute to vitamin C like blueberries, guava and melon.”

A low-histamine day on a plate

Breakfast: Eggs on gluten-free toast

Lunch: Salad sandwich with gluten-free breads but without tomatoes, avocado and spinach

Dinner: Fresh fish, potatoes, zucchini and carrot

Snacks: Coconut yoghurt, tinned or peeled pear or grated apple, a plain gluten-free biscuit.

Source: Nicole Dynan, DAA

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Written by Jenna Meade.