Histamine Intolerance

A histamine intolerance or intolerance occurs when foods with a high histamine content cause health problems. The cause is attributed to a deficiency in the histamine-degrading enzymes diamine oxidase (DAO) and/or histamine-N-methyltransferase (HNMT), or in an imbalance between the supply and degradation of histamine. Eighty percent of the affected patients are middle-aged women. Disease symptoms may disappear during pregnancy, but reappear after pregnancy.

Histamine intolerance is neither an allergy to food nor a food intolerance, but a disorder of histamine breakdown. However, it can be a consequence of or a companion to other food intolerances or allergies.

What is histamine?

Histamine is a tissue hormone that is produced and stored in the mast cells and in special white blood cells. Histamine plays a central role in all allergic reactions and performs numerous regulatory tasks in our body. Histamine is involved in supporting the immune system and in many important biological processes, such as metabolism in the gastrointestinal tract, appetite regulation, sleep-wake cycles and water regulation in the body.

Histamine is broken down by the enzyme diaminooxidase (DAO) into ineffective imidazole acetaldehyde. Histamine is not only produced by the body, but is also contained in many foods. If there is a histamine breakdown disorder, foods that contain a lot of histamine should be avoided.

Clinical overview

A histamine intolerance can manifest itself in different symptoms. Gastrointestinal problems are often observed, but skin rashes, urticaria or headaches are also observed. Histamine intolerance is very often accompanied by other food intolerances such as lactose or fructose intolerance.

Therapy

If a histamine intolerance is suspected, a specialist should always be consulted. If a histamine intolerance is present, the simplest and best therapy is to remove foods with a high histamine content from the diet. The best known histamine-containing foods include tomatoes, various types of cheese, certain types of fish, red wine and beer. Fruits can also contain histamine, such as raspberries, oranges, pears or bananas.

The following lists do not claim to be exhaustive. Ultimately, each person affected must find out for himself or herself which foods can be tolerated and which cause symptoms.

Food with high histamine content

  • Red wine
  • Preserved foods
  • Innards
  • Smoked ham and sausage products
  • Many fish products, in particular canned fish
  • Seafood
  • Matured cheeses (the higher the degree of ripeness, the higher the histamine content)
  • Some vegetables like tomatoes, spinach, avocados
  • Some fruits like citrus fruits, pears, strawberries, raspberries, or bananas
  • Preserved vegetables from a can or a jar
  • Legumes and soy products
  • Wheat
  • Various types of beer, such as wheat beer
  • Fruit and vegetable juices
  • Coffee, black tea
  • Chocolate and cocoa
  • Various types of nuts
  • Yeast
  • Wine vinegar

Low histamine food products:

Meat (exception: pork)

Fresh, unprocessed sausages, boiled ham, turkey ham

Fresh fish such as pike-perch, sole, John Dory, cod

Vegetables such as carrots, leeks, cauliflower, broccoli, peas, cabbage, zucchini, beetroot, pumpkin, onion, cucumber, paprika, lettuce, corn, radish, asparagus, chard, paprika

Dairy products such as milk, yogurt, cream cheese, buttermilk, sour cream, whipped cream, very young cheese, butter

Cereals and starchy side dishes such as rice, potatoes, corn, spelt, oat flakes, quinoa

Fruit, such as apples, blueberries, cherries, currants, apricots, melons, nectarines, peaches, mango, litchi, persimmon, rhubarb

Nuts, such as almonds, poppyseed, coconut

Spices, herbs