Histamine intolerance reflects a hypervigilant and overprotective state of our body. Although it can mimic allergies, histamine intolerance can develop or worsen due to chronic stress, estrogen dominance and gut imbalances. Other triggers like certain foods, acute stress and temperature changes can further “fill the bucket” until finally the bucket “overflows” and symptoms appear.

More on histamine intolerance symptoms and common causes here.

How to address histamine intolerance: Confirm, Reduce Triggers and Rebalance
There is currently no definitive test for histamine intolerance. After ruling out any true allergies, the next step is to avoid foods that contribute to higher histamine levels. This first step helps to confirm histamine intolerance as well as reduce many of the histamine triggers and calm down your symptoms.

Foods that are high in histamine tend to be foods that are cured, fermented, cultured or aged. It is in the processing of these foods where histamine content increases so this is why leftovers, canned foods and bone broth (simmered at low heat for a long time) can be problematic for those susceptible. In addition, there are foods that can actually slow down your body’s ability to breakdown histamine so it’s a good idea to avoid those in the beginning also. Here are some foods that may exacerbate histamine intolerance symptoms. Avoiding these types of food is often called a Low Histamine Diet.

  • Alcoholic beverages especially wine, champagne and beer
  • Fermented foods like sauerkraut, pickles, vinegar, soy sauce, kefir, kimchi, kombucha
  • Cured or aged meats: bacon, salami, pepperoni, luncheon meats, hot dogs and smoked fish
  • Soured or cultured dairy like aged cheeses, yogurt and buttermilk
  • Wheat and corn
  • Dried fruits like prunes, dates, raisins
  • Some nuts: walnuts, cashews
  • A few fruits: citrus, bananas, strawberries, papaya and pineapple
  • A few vegetables: tomatoes, avocados, spinach, mushrooms, eggplants
  • Cacao/chocolate, cinnamon, nutmeg, glack and green tea
  • Artificial preservatives, food additives and dyes
  • Refrigerated leftovers and canned foods

It may seem like a long list of foods but there are many more foods that are usually well tolerated like freshly cooked meats or flash frozen fish, gluten-free grains like rice and quinoa, most fruits and vegetables (except those mentioned above), most nuts and seeds (except those mentioned above) and herbal teas and coffee all usually well tolerated.

Note: In addition to histamine reactions, we can have other reactions to food like food sensitivities, lactose intolerance, and true allergies. For this reason, the list above is just a starting point. Two people with histamine intolerance can react differently to different foods. After the elimination phase, a strategic food reintroduction is an important step to identifying personal food reactions.

Although limiting alcohol and artificial preservatives is probably beneficial for most people, many of the above foods are part of a nutrient rich diet. Just like an elimination diet is only one step in healing the gut, following a low histamine diet is only the first step in resolving histamine intolerance. Typically reducing histamine triggering foods for 3-4 weeks is enough time to see if symptoms improve. Avoiding foods that trigger symptoms is also helpful in managing symptoms while rebalancing the underlying causes like gut health and hormone imbalances. A low histamine diet is only recommended when it’s part of a larger therapeutic strategy.

In combination with a low histamine diet, nutrients and herbs can be helpful to reduce histamine levels in the body. I like to use a combination that includes quercetin, nettles and Vitamin C. This can give us further symptom relief as we figure out our personal food triggers and treat adrenals, gut and hormone imbalances.

Rebalance: Emptying the Bucket
In our bucket analogy, stress, poor gut health and hormone imbalances “fill” the histamine bucket. Certain foods can also add to the bucket causing it to eventually “overflow” triggering the above symptoms. A low histamine diet helps reduce symptoms quickly by preventing this “overflow” so that we can take the time to address chronic stress, toxicity, gut damage and estrogen dominance. Addressing these deeper imbalances “empties the bucket” often allowing us to reintroduce many of the “histamine foods” that previously triggered symptoms.

Histamine related symptoms can mildly or severely impact our daily lives and may be an important indicator of deeper imbalances, yet they are often tolerated as “just allergies”. Unfortunately, due to the increasing environmental toxicity and our modern lifestyle, I suspect we’ll see more and more histamine intolerance. Thankfully nutritional and lifestyle modifications can greatly improve histamine intolerance. My hope is that this helps you to identify whether histamine intolerance is an issue for you and shows you how to get started on addressing both the symptoms and the deeper imbalances that exist.

In health,
Dr. Carin