Histamine is a neurotransmitter that, among other things, regulates the immune system. Histamine is involved in a variety of reactions, from mild itching to weals and all the way to migraine headaches.

Histamine is vital for survival and causes no problems for the vast majority of people. However, some people have a condition known as histamine intolerance, which causes them to be sensitive to foods and substances that increase histamine levels.

Many doctors and dietitians haven’t heard of histamine intolerance, and, chances are, neither have you. However, histamine intolerance is a legitimate medical problem with a fair amount of supporting research.

Histamine intolerance is problematic because it’s often triggered by foods most people consider healthy, including spinach, oranges, sauerkraut, and fish.

Exposure to too much histamine causes inflammatory and allergy-like symptoms, which include acne and other inflammatory skin problems.

Quick summary

Studies have linked excess histamine levels to various inflammatory skin problems and shown that reducing histamine can also benefit the skin.

Excess histamine exposure can lead to a variety of symptoms, including:

• Neurological: Headaches, dizziness, nausea, sleep problems, symptoms resembling panic attack, fatigue, confusion.
• Gut: Abdominal cramps, diarrhea, heartburn.
• Skin: Itching, hives, swelling, flushing, rash, eczema, acne.
• Respiratory: Nasal obstruction, sneezing, runny nose, seasonal allergies, asthma.
• Eyes: Irritation, redness, watery eyes.
• Circulatory: Drop in blood pressure.
• Tissue swelling, especially on the face, mouth, and throat.
• Irregular periods.

However, lack of these symptoms doesn’t mean you don’t have histamine intolerance. I had almost none of those symptoms. The only histamine-related symptom I had was very mild itch on the areas where I also got acne. And yet, low histamine diet has been effective in calming my skin and gut.

Histamine intolerance often responds very quickly to low histamine diet. The best way to test is to go on a low histamine diet for a week.

The recommended treatment for histamine intolerance is low histamine diet combined with 1 g of vitamin C a day. You should stay on the diet for 2 to 4 weeks (as long as it takes for the histamine-related symptoms a clear and then a week more). You can keep taking vitamin C as a preventive maintenance to boost your histamine tolerance even after the diet.

This list contains what I believe to be the main problem foods for people with histamine issues:

• Alcoholic beverages: Champagne, red wine, beer.
• Fish: Mackerel, herring, sardine, anchovies, tuna, and just about any fish that is not very fresh.
• Cheese: Hard and matured cheeses. Fresh cheese (Mozarella, Ricotta, cottage cheese, etc.) that spoils quickly is usually low in histamine.
• Dairy: Yogurt, sour milk, kefir, and other fermented dairy products.
• Meat: Fermented sausage, salami, ham, cured and aged meats, liver and organ meats.
• Bakery products: Bread and other bakery products raised with yeast. Yeast-free bakery goods (like biscuits) should be ok.
• Vegetables: Sauerkraut and all fermented vegetables, tomato, spinach, eggplant.
• Fruits: All dried fruits, citrus fruits (orange, grapefruit, lemon, and lime), banana, kiwi, most berries, papaya, pineapple.
• Most nuts.
• Condiments: Vinegar, soy sauce, fish sauce.
• Fermented soy products: Natto, miso.

Gut problems are known to cause histamine intolerance. As such, it’s recommended first to go through the gut health protocol before treating histamine intolerance.

Histamine intolerance

Histamine intolerance refers to an imbalance between exposure to histamine and the body’s ability to detoxify it. Given high enough dose, everyone is histamine intolerant.

The gut contains an enzyme called diamine oxidase (DAO) that deactivates histamine and prevents it from entering systemic circulation, which allows most people to eat histamine-rich foods without any problems.

Those with histamine intolerance often have a deficiency in DAO, which results in excess histamine exposure and the symptoms that follow.

Again, I want to emphasize that histamine intolerance is a balance between exposure and the body’s capacity to deal with it.

Everyone has a level of histamine that they tolerate without symptoms. Exceeding that level (called a person’s “limit of tolerance” or “tolerance threshold”) can result in symptoms. Even healthy persons may develop severe headache, or flushing as a result of consuming massive amounts of histamine in a meal, but if ingested at lower concentrations only a few sensitive individuals will experience an adverse reaction.

Histamine intolerance https://www.foodsmatter.com/allergy_intolerance/histamine/articles/histamine_joneja.html

Here’s an easy way to think about histamine intolerance. Think of a river. Usually, the river flows smoothly, and the people living near the river are happy. But due to heavy rains or downstream obstructions the river sometimes floods.

This is kinda what happens in people with histamine intolerance. They are exposed to more histamine than their body can clear, and it floods out of the digestive track and into the body. This happens almost always because there are problems with the DAO enzyme that ‘detoxifies’ histamine in the gut.

In our river analogy, problems with DAO represent downstream obstructions or reduced water clearance. When the river is obstructed, even normal amounts of rain can cause severe flooding. That’s why foods that most people can eat without problems cause issues for those with histamine intolerance.

Unlike many other food allergies, the response is cumulative. If the river is close to overflowing, then even mild additional rains could cause flooding. However, a river that is only ‘half full’ can absorb much more water before flooding. This cumulative trigger makes histamine intolerance tricky to pin down.

Based on this simple analogy, it should be immediately obvious that there are two solutions to the problem. Reduce the amount of histamine you are exposed to, and increase your body’s capacity to detoxify it.

It’s also difficult to say how much histamine is ‘too much’ for you. It depends on your body’s ability to clear it, and, I suspect, there’s a lot of individual variation in histamine tolerance. But everyone has a limit. Studies have shown that giving large doses of histamine causes problems even in those who aren’t histamine intolerant.