This Is the #1 Food To Avoid if You Suspect You Have Histamine Intolerance, According to Experts
It's probably not what you think.
Nowadays, there are plenty of things that can trigger food allergies and sensitivities, from wheat to nuts to soybeans. Although you may commonly associate them with seasonal allergies, histamines can also prove problematic when it comes to what you eat. In fact, it’s a condition known as histamine intolerance, and it can affect around 1 to 3 percent of individuals, according to a 2020 study. Histamine is even trending on TikTok, with over 38 million views of videos that cover histamines.
Since it can affect up to 10 million people in the United States, find out if you or a loved one is showing signs of histamine intolerance and learn how you can improve symptoms.
What Are Histamines?
Jolene Hart, CHC, health coach and author, says that histamines are chemicals that are released as part of the body’s natural immune response to allergens. They cause an inflammatory reaction that helps the body respond to the presence of these allergens.
Allergist Dr. Nathan Lebak, MD, of Aurora Health in Wisconsin further defines histamines as compounds that are found in certain white blood cells, which can be located in many of our tissues, including the skin, lungs and gut.
He says, “In general, histamine can cause the blood vessels to enlarge, stimulate nerves in the skin to initiate itching, and can work in the gut to contract, resulting in diarrhea or vomiting.”
And although we normally link histamine to allergic reactions, Dr. Lebak says that there are other contributing factors in how strongly histamines respond. He explains that histamine is broken down primarily by an enzyme called diamine oxidase (DAO), which ensures that the levels of histamine in the body stay regulated. The levels of DAO can vary in some people, thus leading to elevated histamine levels and responses to histamine.
What Is Histamine Intolerance?
Although histamines can be good in several instances, it isn’t so good when it builds up too much in the body. Hart says that this can be caused by the body not breaking down the histamines efficiently.
Specifically termed "histamine intolerance," the condition can be the result of accumulated or ingested histamine that is different from an allergic reaction, Dr. Lebak says.
He differentiates between the two, saying that while a typical allergic reaction is caused by an exaggerated immune reaction to an allergen, including foods, pollen or dander, histamine intolerance describes the reactions to elevated amounts of histamine in the body and is not thought of as a true allergic reaction.
“Histamine can build up in the body through decreased activity of DAO,” he says. This decreased activity can be brought on by medications, such as antibiotics, antidepressants and NSAIDs, or a genetic predisposition.
Hart adds other potential root causes of histamine intolerance, which can include gut infection or inflammation that’s resulted from food intolerance, ongoing stress or parasites.
And histamine intolerance may increase as you get older. “Your ability to break down histamine can change over time as your body changes,” Hart says.
Dr. Lebak says that the symptoms of histamine intolerance can be quite diverse and vary from individual to individual, depending on one’s unique organ system. He says that skin issues can include a flushing rash, itching and hives. Gastrointestinal symptoms include diarrhea and vomiting, but can also include constipation and discomfort. Cardiovascular symptoms, which can be common with allergies, are less frequent in histamine intolerance but can include low blood pressure or increased heart rate.
It can be very tricky to diagnose histamine intolerance. Dr. Lebak says that currently, there are “no well-described diagnostic criteria.” This is due to the fact that there are not yet reliable tests to check the levels of DAO in the blood. Researchers are actively studying this, however, and new diagnostic techniques are in the pipeline. Typically, a doctor will recommend an elimination diet in which histamine-containing foods are taken out for several weeks to determine if there is an improvement without the ingested compound.
The #1 Food To Avoid If You Suspect You Have Histamine Intolerance
And the winner for the top food to avoid if you’ve determined that you do indeed have histamine intolerance? It’s dairy!
“The most common food type to avoid with histamine intolerance is certain dairy products, such as cheese (especially aged parmesan), yogurt, sour cream, buttermilk and kefir. Milk itself is lower on the list of concerning foods,” Dr. Lebak shares.
And although this tends to be the leading histamine-laden food category, Hart says that the number one food to avoid can be extremely personal and depend on the person.
“I recommend keeping a food journal to notice which foods from the high histamine list you react to most often,” she says. “You will also likely find that your reactions to histamine-containing foods are inconsistent. Your reactions are relative to how high your histamine load is on any given day.”
Related: The Best Foods for Healthy Lungs—And the Ones You Should Avoid
Other Foods To Avoid
While, again, foods to avoid “can be quite personal,” as Hart says, it can be helpful to be aware of the foods that might overwhelm your histamine load, which increases the amount of histamine your body will need to break down.
According to our experts, some histamine-filled foods to avoid include:
Fermented foods
Aged/cured/smoked meats and cheeses
Vinegar and pickled foods
Dried fruits
Avocado
Eggplant
Spinach
Tomato
Cashews
Walnuts
Alcohol (especially wine and beer)
Strawberries
Pineapple
Banana
Chocolate
Shellfish
Soy sauce
Miso
Some types of bread, including sourdough
Canned meats (especially fish)
Fatty fish (tuna, salmon, mackerel)
Related: Doctors Explain Exactly Why You Sneeze—and a Few Tricks You Can Use to Stop Yourself From Sneezing
Foods That Can Help
While this may seem like a long list of foods to avoid, there are still plenty of foods out there that you can enjoy, and some may even ease your symptoms.
“In general, fresher meats are considered safer as part of a low-histamine diet,” Dr. Lebak says. “Similarly, fresh fruits and vegetables that are lower in histamine are recommended to be eaten as fresh as possible. These include carrots, garlic, onions, asparagus, apples, pears, cherries and peaches.”
Hart says that onions can be helpful because they’re high in the phytochemical quercetin that helps lower histamine.
“Foods that are high in the DAO enzyme are particularly helpful too, as this enzyme also breaks down histamine,” she adds. “This category of foods includes broccoli, chard, almonds and pumpkin seeds.”
At the end of the day, Dr. Lebak says that it’s essential to distinguish between traditional allergic reactions and histamine intolerance.
“That process begins with talking to your primary care doctor and a consultation with an allergist—including testing if warranted,” he says. “Allergic reactions can be life-threatening and require both strict avoidance and monitoring.”
Next up, the 10 best dairy-free options to try if you’re cutting out milk.
Sources
Jolene Hart, CHC, health coach and author.
Dr. Nathan Lebak, MD, an allergist with Aurora Health in Wisconsin.
Biomolecules: “Histamine Intolerance: The Current State of the Art”
