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Histamine intolerance

Histamine is a natural substance produced by the body and is also present in many foods. It is released by the body during times of stress and allergy.

What is Histamine?

In an allergic response, an allergen stimulates the release of antibodies which attach themselves to mast cells. When histamine is released from the mast cells it may cause one or more of the following symptoms:

  • Eyes to itch, burn, or become watery
  • Nose to itch, sneeze, and produce more mucus
  • Skin to itch, develop rashes or hives (Urticaria)
  • Sinuses to become congested and cause headaches
  • Lungs to wheeze or have spasms
  • Stomach to experience cramps and diarrhoea

Histamine is a vasoactive amine which causes dilation of the blood vessels (flushing, rash, itching) and increased mucus production (runny nose, productive cough), and bronchoconstriction (wheezing, cough). Because histamine is contained in almost all body tissues, especially the lungs, nose, sinuses, skin, intestinal mucosa and certain blood cells (mast cells, basophils), it is able to cause a wide variety of symptoms.

The release of histamine can be caused by almost any allergen. Examples include inhaled allergens ( pollen, dustmite, cat dander), drugs (penicillin, sulphur, aspirin), stinging insect venoms, and foods (egg, wheat, milk, fish, etc).

Histamine in Foods

There are many foods that contain histamine or cause the body to release histamine when ingested. These types of reactions are food intolerances, and are different from food allergy in that the immune system is not involved in the reaction. The symptoms, however, can be the same as a food allergy. Some asthmatics are particularly sensitive to histamine in foods, reacting with an asthma attack.

Foods that contain the chemical tyramine can trigger headaches. Foods that may have large amounts of tyramine include: fish, chocolate, alcoholic beverages, cheese, soy sauce, sauerkraut and processed meat.

Fermented foods may cause allergy symptoms because they are either rich in histamine or because yeast or mould is involved in the fermentation process.

Histamine-Rich Foods (including fermented foods):

  • Alcoholic drinks, especially Champagne and cheap red wine.
  • Anchovies
  • Avocados
  • Cheeses, especially aged or fermented cheese, such as Parmesan. Also Stilton, Roquefort and other blue cheeses.
  • Cider and home-made root beer.
  • Dried fruits such as apricots, dates, prunes, figs and raisins (you may be able to eat these fruits without reaction if the fruit is thoroughly washed).
  • Aubergine (US eggplant)
  • Fermented foods, such as pickled or smoked meats, sauerkraut, etc. Soy sauce.
  • Fish, including tinned and smoked fish
  • Mushrooms
  • Processed meats - sausages, hot dogs, salami, etc.
  • Sour cream, sour milk, buttermilk, yogurt - especially if not fresh.
  • Soured breads, such as pumpernickel, coffee cakes and other foods made with large amounts of yeast.
  • Spinach
  • Tomatoes - especially tinned and tomato puree
  • Vinegar or vinegar-containing foods, such as mayonnaise, salad dressing, chutney, ketchup, chilli sauce, pickles, pickled beetroot, relishes, olives.
  • Yogurt

Histamine-Releasing Foods:

  • Alcohol
  • Bananas
  • Chocolate
  • Eggs and uncooked egg white
  • Fish
  • Milk
  • Papaya
  • Pineapple
  • Shellfish
  • Strawberries
  • Tomatoes

Allergy tests for these foods will be negative because the cause is histamine intolerance, not food allergy.

Treatment consists of avoiding histamine-rich foods. Taking an antihistamine will block the reaction to histamine in foods but it will only be effective if taken in advance.

Research at Cornell university has found that quercetin, a compound fund in apples and red onions reduces the release of histamine and other allergic substances and when combined with Vitamin C decreases sensitivity to allergens and lessens the production of mucus.

See BestBuys for Food Allergy here

Acknowledgements: Jeffrey Tulin-Silver, M.D.& Suchetha Kinhal, M.D.
Comprehensive Food Allergy Clinic of West Bloomfield, Michigan