One of the primary ways to manage histamine intolerance is by making dietary changes, particularly by eating low-histamine foods.

In this article, we get into the nitty-gritty of what you need to know about the low-histamine diet, exploring what histamine intolerance is, foods to eat and avoid on a low-histamine diet, and tips and tricks to make the adjustment less daunting.

Dietary changes always involve trial and error to see what works best for you, so we’ve written this guide to be a helpful resource to get you started.

Here’s what you need to know.

Understanding histamine intolerance

Histamine is a naturally occurring chemical released by the immune system. Its primary function is to trigger allergy symptoms and inflammation when the body is exposed to a potentially harmful foreign pathogen.

In some people, high levels of histamine collect in the body and cannot be adequately flushed out.

Histamine intolerance is not currently recognized by the American Academy of Allergy and Immunology, but for people living with symptoms, it’s very real.

Typical symptoms include:

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

Histamine intolerance is thought to be caused by a variety of factors, including genetics, dietary choices, level of alcohol consumption, pre-existing medical conditions like inflammatory bowel disease, medication side effects, and more.

In some cases, high histamine levels in the body are related to allergies or a mast cell condition like mast cell activation syndrome (MCAS) or mastocytosis.

What is a low-histamine diet?

A low-histamine diet involves intentionally limiting the consumption of high-histamine foods to reduce the risk of a flare-up.

Not everyone reacts to high-histamine foods in the same way. Because of this, trial and error is a large part of adapting this diet to your lifestyle and body’s needs.

Foods to try (low in histamine)

The following foods 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

Foods to avoid (high in histamine)

A fair number of foods are high in histamine. As part of a low-histamine diet, you might avoid or limit the following:

• Aged and fermented cheese, like parmesan, blue cheese, and brie
• Alcoholic beverages
• Artificial colors and flavors
• Avocado and eggplant
• Kiwi, pineapple, papaya, strawberries, passionfruit, plums, bananas
• Citrus fruits, like oranges, lemons, grapefruits, and limes
• Dried fruits
• Walnuts and cashews
• Certain seasonings, including all-spice, anise, cinnamon, chili powder, clove, curry powder, cayenne, MSG, nutmeg, and paprika
• Chocolate
• Eggs, especially raw
• Fermented foods like kimchi, sauerkraut, and yogurt
• Canned fish
• Flavored milk
• Legumes, including peanuts, soy beans, and chickpeas
• Licorice
• Pickles and vinegar-based condiments
• Probiotics
• Processed meats like jerky, pepperoni, and hot dogs
• Shellfish
• Sour cream and buttermilk
• Spinach, squash, tomatoes
• Unpasteurized milk
• Wheat
• Leftovers that have not been frozen

{{pro-tip-1}}

How to eat a low-histamine diet

Removing histamine from your diet completely is near impossible and not advised, as it could lead to malnutrition. Instead, the goal is to reduce exposure and identify patterns.

The best way to determine which foods may or may not be a trigger for you is to conduct a 14-day food challenge: 

Step 1: Keep a food and symptom journal

Before changing your diet, you need to understand your baseline.

For a few weeks leading up to the challenge, eat as you would normally, but keep a detailed journal.

Try to record what you eat, when you eat, when symptoms occur, the type of symptoms, and how severe they are, as reactions may not always be immediate.

Step 2: Eat a low histamine diet

Over a 14-day period, remove high-histamine foods from your diet. Focus on fresh, minimally processed foods where possible, as histamine levels can increase in aged, fermented, or leftover foods.

The goal is progress over perfection, so don’t stress if you don’t follow the diet perfectly. Continue with your food and symptom journal to collect more data about how you feel.

Step 3: Slowly reintroduce high-histamine foods

After your 14-day challenge, slowly start to reintroduce high-histamine foods, ideally one at a time, to see how you react.

Wait a few days between each new food so you can clearly track any changes, as symptoms may be delayed.

Maintaining your food and symptom journal will be essential during this part of the test to see if there are any notable changes or patterns. This process can help you identify whether certain foods may be contributing to your symptoms, although it does not confirm a diagnosis.

Will the low-histamine diet ease my symptoms?

The goal of the low-histamine diet is to explore patterns and better understand what may be contributing to your symptoms.

Following a low-histamine diet may help reduce the frequency or severity of symptoms for some people. However, not everyone will notice an improvement. Responses can vary depending on individual tolerance and other contributing factors.

Symptoms may also be triggered by factors other than food, such as stress, environmental exposures, or underlying health conditions.

Practical tips for implementing a low-histamine diet

The idea of significantly changing your diet and tracking changes can be overwhelming at first. Here are some low-histamine diet tips and tricks to help make the process more straightforward:

Whenever possible, eat fresh

Histamine levels naturally increase the less fresh a food becomes. Because of this, try to eat foods that are as fresh as possible.

When that isn’t an option, being intentional about how you store your foods can have a big impact on histamine levels. Minimizing bacteria production is key. As much as you can, try to be savvy about refrigerating and freezing meals and ingredients. 

Investing in quality air-tight containers can also help slow the natural creation of histamine in food as it ages.

Ensure you are still consuming enough calories

While eating a low-histamine diet, ensure you are eating enough calories each day.

If at any point you are concerned with your intake or feel worse while eating this diet, speak to your doctor about other options you can explore.

Cook your own food

The way food is cooked impacts its histamine levels. It’s generally recommended to avoid grilling food, as it creates more histamine than steaming or boiling. This is why preparing your own food lets you control how it’s cooked.

The goal is progress, not perfection

There is no “one way” to eat a low-histamine diet. For some people, foods high in histamine don’t impact their symptoms. It is also possible for people to experience a flare-up while eating foods low in histamine.

Because of the variable nature of this condition, perfection isn’t the goal of the low-histamine diet. Instead, it’s about learning about your body and making adjustments over time.

Keep a food journal to track symptoms

Trying to remember how you feel when conducting a food challenge isn’t as helpful as keeping a food and symptom journal. It’s easy to forget things like timings and ingredients.

Be sure to log as much information as you can, including what you eat and how you feel. Over time, this will give you helpful insights about your health and symptom triggers.

You can also take this information to a doctor to advocate for a personalized treatment plan.

{{inline-cta-1}}

Frequently asked questions

What foods are low in histamine?

Examples of foods that are low in histamine 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.

What are the symptoms of histamine overload?

People experiencing a histamine overload often report symptoms similar to an allergic reaction.

Some of the most common symptoms include flushing, itchiness, rash, headaches, migraines, nasal congestion, sneezing, high heart rate, bloating, diarrhea, constipation, abdominal discomfort, and in severe cases, difficulty breathing.

What foods are high in histamine?

Some examples of foods high in histamine include alcoholic beverages, aged cheeses, chocolate, citrus, eggs, pickles, probiotics, soy products, wheat, unpasteurized milk, and artificial colors and flavorings.

A histamine elimination diet can help you identify foods that may be triggering your symptoms.

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. What is Histamine?, The Cleveland Clinic
2. Histamine intolerance: fact or fiction?, The American Academy of Allergy Asthma and Immunology
3. Histamine Intolerance: Symptoms, Diagnosis, and Beyond (2024)
4. Mastocytosis, The Cleveland Clinic
5. Low histamine diet, Johns Hopkins Medicine‍
6. A quick introduction to the low histamine diet, The Cleveland Clinic