A Low Histamine Diet
Histamine intolerance is a bit of a misnomer as histamine is an essential part of human health. Go back and read more about histamine functions in a previous post. It is important to remember that problems arise with histamine when there is an imbalance between histamine production and enzymatic breakdown. When one considers how to treat histamine problems, both parts of the histamine life cycle must be considered.
Lowering Histamine Production
Lowering histamine production can be as straightforward as reducing exposure to environmental allergens to reducing certain foods. An intolerance to histamine is not considered a food allergy, but a pseudo-food allergy. Just as with a typical food allergy, avoidance is key.
These foods are highest in histamine:
Cured meats (including fish)
Alcohol (especially red wine)
Fermented foods (sauerkraut, kefir, etc)
There also foods that have been shown to provoke histamine release and thereby be indirect high histamine foods. These include:
Nuts & Peanuts
Fish & Crustaceans
To assess, try a histamine-free diet for at least 4 weeks. In conjunction, trial traditional H1 and H2 antagonists which block the action of histamine. These includes common over-the-counter medications like Pepcid, Tagament, and Benadryl. Take care as some medications in this class can cause drowsiness.
Boosting Enzymatic Activity
Some foods naturally contain high quantities of histamine degrading enzymes so may be incorporated in the diet. Kidney and liver are high on the list for the adventurous eater. Supplements are also available containing pig-derived kidney and liver that can be taken in lieu of offal cooking.
Supplements that support enzyme activity and may theoretically enhance histamine breakdown include copper (as copper glycinate), vitamin B6, and vitamin C.
Quercetin, a potent flavanoid, can block histamine release. It also has the benefit of reducing oxidative stress and aiding the immune response during some bacterial infections.
Under the supervision of your doctor, prescriptions may be warranted to control histamine metabolism and improve your symptoms. Medications are used which stabilize mast cells—histamine producing cells. These include β2 agonists (common asthma drugs), cromoglicic acid (Nasalcrom), and ketotifen (Zaditor).
Have no fear… some improve with their ability to handle histamine once underlying issues are treated. Those with irritable bowel, inflammatory bowel disease, gut permeability, etc should be able to resume a diet with histamine once gut function improves.
1 Maintz L & Novak N. (2007) Histamine and histamine intolerance. Am J Clin Nutr.
2 Schink M et al. (2018) Microbial patterns in patients with histamine intolerance. J Physiol Pharmacol.