Histamine intolerance - including list of histamine-rich and histamine-releasing foods
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. Although we talk of histamine ‘intolerance’ it is neither allergy, nor intolerance, but more a condition of excess histamine from inside or outside the body and an inability to break it down sufficiently.
Almost any allergen can cause histamine to be released. Examples include inhaled allergens (pollen, dustmite, cat dander), drugs (penicillin, sulphur, aspirin), stinging insect venoms, and foods (egg, wheat, milk, fish, etc). In an allergic response, the 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 in Foods
There are many foods that contain histamine or cause the body to release histamine when eaten. 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.
- Alcoholic drinks, histamine levels high in Champagne and cheaper red wines, moderate in beer and white wine.
- Aged or fermented cheese, such as Gouda, Parmesan, Emmenthal and Camembert. 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.
- Mackerel, tuna, sardines
- Tinned and smoked fish
- Processed meats - especially salamis and Continental sausages, Westphalian ham, hot dogs etc.
- Sour cream, sour milk, buttermilk, yogurt - especially if not fresh.
- Sourdough, pumpernickel,other baked goods made with large amounts of yeast
- Tomatoes - especially tinned and tomato puree
- Vinegar or vinegar-containing foods, such as sauerkraut, mayonnaise, salad dressing, chutney, ketchup, chilli sauce, pickles, pickled beetroot, relishes, olives.
- Eggs and uncooked egg white
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
Many people with histamine intolerance have low levels of Diamine Oxydase (DAO), the main enzyme responsible for breaking down ingested histamine. Some foods also act as DAO-blockers, preventing the enzyme from breaking down histamine.
Some prescription or over-the-counter drugs may also interfere with this enzyme::
- theiohyline - taken orally to treat the symptoms of asthma or other lung conditions that block your airways, such as emphysema or chronic bronchitis.
- heart medications
- muscle relaxers
- pain medications (aspirin, naproxen, indomethacin, diclofenac)
- gastrointestinal medications
- malaria and TB drugs
You can counteract low levels of Diamine Oxydase (DAO) with a natural supplement called DAOSiN.
The following food is recommended for a low-histamine diet:
- Water, coffee and tea
- Potatoes, rice and noodles
- Cereal products
- Fresh dairy products, like buttermilk, curd cheese and cream cheese
- Vegetables like leaf salads, cauliflower, broccoli, chicory, field salad, cucumber, carrot, garlic, pumpkin, sweet pepper, mushrooms, radish, rhubarb, asparagus, zucchini, onion
- Fruits like apple, nectarine, peach, plum, cherry, melon, gooseberry, blueberry, lemon
- Herbs and spices
- Plant oil, vinegar essence
- Meat, poultry, fresh fish except tuna, mackerel, sardines (fresh or frozen, not tinned)
- Fresh eggs
Research at Cornell university has found that quercetin, a compound found 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.
Acknowledgements: Jeffrey Tulin-Silver, M.D.& Suchetha Kinhal, M.D. Comprehensive Food Allergy Clinic of West Bloomfield, Michigan