Having elevated levels of histamine in the body can cause plenty of unwanted reactions. For some, these symptoms are minor. But for others, this can be a lifelong condition that needs to be managed and monitored to avoid flare-ups and attacks.

In this article, we explore everything you need to know about histamine intolerance: from common symptoms, potential causes, why it isn’t currently a diagnosable condition, and available treatment options.

So, is histamine intolerance a standalone medical condition? Or is it a side effect of underlying health issues? Let’s get into it.

What is histamine intolerance?

Histamine is part of our immune system response. It’s a chemical mediator made naturally in our bodies. Its primary function is to be released by mast cells (a type of white blood cell) when they are triggered. When this happens, histamine is one part of the reaction cascade that causes inflammation within the body.

When working properly, this system is designed to be a short-term protection mechanism. But, in some people, histamine is either released too much or not properly removed, resulting in high levels building up throughout the body over time.

Histamine intolerance, also known as enteral histaminosis or sensitivity to dietary histamine, is a proposed condition to explain a person’s inability to metabolize histamine. It’s not currently recognized by the American Academy of Allergy and Immunology as a standalone condition, as more research is needed to properly define and diagnose it.

Symptoms of histamine intolerance

Not everyone presenting with symptoms of histamine intolerance has the same experience. The location and type of symptoms, as well as their severity, are fully dependent on the organ systems affected by the histamine-induced inflammation.

Gastrointestinal symptoms are thought to be the most common, but someone with histamine intolerance may also experience cardiovascular, skin-related, or respiratory symptoms.

Here are some of the most commonly reported symptoms of high histamine levels:

• Bloating
• Constipation
• Diarrhea
• Sneezing
• Nasal congestion
• Difficulty breathing
• High heart rate
• Headaches
• Migraines
• Itchiness
• Skin flushing

Causes of histamine intolerance

Histamine intolerance is not a universally recognized medical condition, and research is ongoing.

A 2024 research review suggested that symptoms may be linked to how histamine is processed in the body, with multiple factors thought to play a role rather than a single underlying cause.

In some people, other conditions can explain symptoms of histamine intolerance. This may include allergies or digestive conditions like irritable bowel syndrome.

If symptoms are more complex or affect multiple body systems, doctors may also consider mast cell disorders such as MCAS or mastocytosis.

You might notice symptoms after consuming high-histamine foods. However, tolerance varies, and diet alone doesn’t explain symptoms in all cases. Common high-histamine foods include:

• Alcohol
• Cured meats
• Fermented foods like kimchi and sauerkraut
• Chocolate
• Aged cheeses
• Tomatoes, eggplant, and spinach
• Fish
• Strawberries, pineapple, and citrus fruits
• Nuts and peanuts

How to get a histamine intolerance diagnosis

There are no widely accepted diagnostic criteria for histamine intolerance.

Despite this, if you or a loved one is experiencing ongoing and unexplained symptoms, speaking to a doctor can kickstart diagnostic testing for potential causes.

Diagnostic tests will be based on your presenting symptoms, and you may be referred to an allergy or gastrointestinal specialist. Your physician may recommend allergy testing, blood tests, and undergoing food experiments while you keep a food diary (more on that below).

Treatment for histamine intolerance

There is no standardized treatment protocol for managing histamine intolerance. Instead, current treatment options rely heavily on identifying possible causes and managing existing symptoms to reduce your risk of a flare-up.

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Getting treatment for underlying causes

For some people, elevated histamine levels can be explained by an undiagnosed medical condition.

Exploratory diagnostics can rule out any potential immune system or allergy conditions that could be causing your symptoms.

Medications

Depending on your medical history, your doctor may prescribe medications to help manage your symptoms.

Antihistamines: Both H1 antihistamines (cetirizine, loratadine, and fexofenadine) and H2 antihistamines (ranitidine and famotidine) can treat symptoms of elevated histamine. Acting as blockers on histamine receptors throughout the body, these medications help reduce inflammation and symptoms like flushing, itching, abdominal pain, and headaches.

Mast cell stabilizers: Cromolyn sodium prevents mast cells from releasing histamine. Taking this medication can help reduce symptoms throughout the body.

Eating a low-histamine diet

Many people experiencing symptoms of histamine intolerance can successfully reduce the severity and frequency of flare-ups with a low-histamine diet.

A low-histamine diet involves removing foods that are either naturally high in histamine or cause a significant release of histamine in your body.

Here are some examples of foods that are naturally low in histamine:

• Fresh, non-aged meat
• Salmon (fresh or flash frozen)
• Non-citrus fruits (apples, blueberries, mangoes, peaches, pomegranates)
• Gluten-free grains (amaranth, arrowroot, buckwheat, millet, rice, quinoa)
• Non-dairy milks (almond, coconut, hemp)
• Fresh vegetables
• Olive oil
• Coconut oil
• Almonds
• Potatoes
• Flax and chia seeds
• Butter and ghee
• Cream, cream cheese, ricotta
• Soft cheeses that have not been aged or fermented

Running a food experiment and keeping a food journal

A low-histamine diet doesn’t have the same effect on everyone. Many people with symptoms of histamine intolerance can eat foods high in histamine without their symptoms worsening.

Trial and error is a big part of managing histamine intolerance, as it helps you identify what works and what might be triggering symptoms. That’s why removing and adding foods to your diet systematically is often recommended.

To run a food experiment, remove foods high in histamine from your diet for 14 days. During that time, document what you eat, how you feel, and any changes you notice in symptom severity. 

After that 14-day period, slowly start adding higher histamine foods back into your diet. Track and record your symptoms throughout this whole process. Over time, you will have a data set of information about potential trigger foods and how they affect your symptoms.

You can take this information to your doctor, enabling them to create a treatment plan that will actually work for you.

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Frequently asked questions

What is a low-histamine diet?

A low-histamine diet focuses on eating foods that are naturally low in histamine while avoiding those that may trigger its release. Common low-histamine foods include gluten-free grains, fresh salmon, non-citrus fruits like apples, blueberries, and peaches, non-dairy milk, fresh vegetables, olive oil, potatoes, chia seeds, and flax.

How can you heal from histamine intolerance?

Healing from histamine intolerance primarily involves reducing the amount of histamine your body produces or is exposed to. For people struggling with chronic high levels of histamine, symptoms can be managed through medications and lifestyle changes to reduce the likelihood and severity of symptom flare-ups.

How can you get rid of histamine in your body?

Histamine is a chemical mediator that occurs naturally in the human body. It’s not possible to remove it completely. To reduce the amount of histamine in your body, medications such as antihistamines and lifestyle modifications like eating a low-histamine diet can help.

Disclaimer: Human Health is a health tracking platform and does not provide medical advice, diagnosis, or treatment. The information in this guide is intended to support, not replace, conversations with qualified healthcare professionals.

Sources:

1. Biochemistry, Histamine (2026)
2. Histamine intolerance: the current state of the art (2020)
3. Histamine intolerance: fact or fiction?, The American Academy of Allergy Asthma and Immunology
4. Histamine Intolerance: Symptoms, Diagnosis, and Beyond (2024)
5. Food Intolerance: The Role of Histamine (2021)
6. Mastocytosis, The Cleveland Clinic
7. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Johns Hopkins Medicine
8. Foods high in histamine, WebMD
9. Medications to treat mast cell diseases, The Mast Cell Disease Society
10. A quick introduction to the low histamine diet, The Cleveland Clinic‍
11. Low histamine diet, Johns Hopkins Medicine

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