When you hear the word histamine, you may think of allergies. During allergy season, its not uncommon to take an antihistamine medicine to help reduce your sneezing, itching, and runny nose. So, what is histamine and what does it mean to eat a low histamine diet? Histamine is made naturally in the body and is involved in many functions like immune function and carrying messages between nerve cells. It’s just when there is an imbalance between the histamine produced and histamine broken down that health issues can ensue. Let’s look at how a low histamine diet, along with a low FODMAP diet, can help those with histamine intolerance improve quality of life.

What is histamine intolerance?

When someone is intolerant to certain foods, then exposure to that food can trigger symptoms. For example, if someone is lactose intolerant, then eating dairy products that contain a lot of the milk sugar lactose can trigger symptoms. However, a histamine intolerance is a bit different.

Symptoms of a histamine intolerance such as fatigue, hives, nausea, vomiting, and headaches, are not triggered by exposure to histamine. The symptoms are caused instead by an already high buildup of histamine in the body. This buildup could be caused by a lack of the enzyme diamine oxidase (DAO) that normally breaks down histamine. Low DAO levels can be caused by certain medications that block DAO function, conditions like inflammatory bowel disease (IBD), or histamine-rich foods that cause DAO to dysfunction.

Benefits of a low histamine diet

By reducing exposure to histamine in the diet, it can help certain people with histamine intolerance to reduce symptoms. For example, research shows that a histamine-free diet can help those with chronic urticaria, or hives find relief. Other research shows that this type of diet could also benefit those with the skin condition atopic dermatitis.

When it comes to gut health though, the low histamine diet shows great promise to help those with conditions like irritable bowel syndrome. Research shows that those with IBS seem to have many mast cells in their body. Mast cells, a type of immune system cell, releases histamine during allergic and inflammatory reactions. Therefore, its hypothesized that a low histamine diet could benefit those with this condition.

Low FODMAP and low histamine diet for IBS

Although the low FODMAP diet is usually the first line of defense for those with IBS, research shows that FODMAPs may also alter histamine levels in some people. Therefore, a combined low FODMAP-low histamine diet may be beneficial for those who still experience some digestive symptoms while following the low FODMAP diet.  Here are some basics of the low histamine diet:

• Avoid histamine-rich foods like alcohol, fermented foods, dried fruits, avocado, eggplant, spinach, smoked or processed meats, shellfish, and aged cheese.
• Avoid foods that can trigger histamine release like alcohol, bananas, tomatoes, wheat germ, beans, papaya, chocolate, citrus fruits, food dyes and additives, and nuts like walnuts, cashews, and peanuts.
• Avoid foods that block DAO production like alcohol, black tea, green tea, energy drinks, and mate tea.

When combined with the basic guidelines for the low FODMAP diet, here are the foods you should focus on consuming for the low FODMAP-low histamine diet.

• Fresh meat
• Fresh fish
• Eggs
• Gluten-free grains like quinoa or rice
• Non-dairy milks like coconut milk or almond milk
• Fresh vegetables that don’t include high histamine vegetables (tomatoes, eggplant, spinach, or avocado) or high FODMAP vegetables like cauliflower, asparagus, onions, or garlic; examples of safe vegetables on this diet include:
  • Alfalfa sprouts (2 cups)
  • Arugula (2 cups)
  • Bean sprouts (3/4 cup)
  • Bell pepper (FODMAPs not detected)
  • Bok choy (1 cup)
  • Broccoli (3/4 cup)
  • Cabbage (3/4 cup)
  • Carrots (FODMAPs not detected)
  • Collard greens (1 cup, chopped)
  • Cucumber (FODMAPs not detected)
  • Daikon white radish (1/2 cup)
  • Jicama (1/2 cup)
  • Kale (1/2 cup)
  • Lettuce (trace to no FODMAPs detected)
  • Okra (7.5 pods)
  • Olives (1/2 cup)
  • Parsnips (FODMAPs not detected)
  • Potato (FODMAPs not detected)
  • Radish (FODMAPs not detected)
  • Rutabaga (1 cup, diced)
  • Seaweed (FODMAPs not detected)
  • Spaghetti squash (1/2 cup)
  • Sweet potato (1/2 cup)
  • Swiss chard (1 cup, chopped)
• Non-citrus fruits that are low FODMAP and low histamine include cantaloupe (1 cup), dragon fruit (no FODMAPs detected), grapes (no FODMAPs detected), kiwi fruit (2 small, peeled), pineapple (1 cup, chopped), plantain (1 medium fruit, peeled), rhubarb (1 cup, chopped); although strawberries are low in histamine content, they are thought to trigger release of histamine and should be avoided.
• Cooking oils like olive oil

Take home message

If you find yourself experiencing allergy symptoms along with the digestive distress of IBS, then you may also have a histamine intolerance. Those with histamine intolerance may not always have allergy issues, but it could be a sign that this intolerance may be causing problems in your body. In that case, a low FODMAP-low histamine diet may benefit you. For more information on gut health and low FODMAP resources and products, be sure to visit the Casa de Sante website.