The Relationship Between Histamine Intolerance and Food

by | May 6, 2021

Article by Lauren Arnett, RDN, LD
Functional Medicine Registered Dietitian Nutritionist at KanodiaMD

If you experience seasonal allergies, then you're probably all too familiar with those uncomfortable and unwanted symptoms like watery eyes and a runny nose. But did you know that you could also experience those symptoms and more with certain foods— like a scratchy throat, skin rashes, itching, heart palpitations, frequent headaches, anxiety, fatigue or feeling flushed when drinking red wine.

If you experience any of these symptoms, you may have something called histamine intolerance. Not to worry! In this article, I'll explain what is happening in your body and what you can do about it.


What are Histamines?

Histamines are chemicals that affect the immune system (a key mediator in inflammation) the digestive system and the central nervous system (CNS). Histamines are produced and stored in mast cells and released when there is a potential invader. This occurs during allergen exposure which can lead to symptoms such as itching, sneezing, headaches, asthma, rashes, hives and more (cue those uncomfortable and unwanted symptoms we were talking about). This is your body’s natural immune response.

Histamines are necessary! They are part of our defense system. So the goal is not to rid the body of histamines, it's just that having too much at a time causes us to run into issues. You may be familiar with antihistamine medications—especially during “Allergy Season.” They block the histamine response to prevent those uncomfortable symptoms when we have too much in our body.

Too Many Histamines & The Histamine Bucket

There is a great visual to explain how histamines become “too much”— The Histamine Bucket. If your bucket is filling up and enzymes are not doing their job to break down the histamine fast enough, then the bucket continues to fill and begins to overflow. The bucket overflowing = symptoms = histamine intolerance.

What exactly fills up the bucket? Stress, medications, NSAIDS, high histamine foods, environmental allergens and lack of sleep to name a few. The main takeaway is that food and environmental allergens are not the only factors to consider.

Diamine oxidase (DAO) is the specific enzyme the digestive tract needs to to break down histamines. If you're deficient in the DAO enzyme, then your histamines are not being broken down properly. There are various causes for diminished DAO enzyme activity, including genetics, medications, compromised gut health, stress, bacterial overgrowth and more. I highly recommend consulting a functional medicine practitioner to identify and address the specific root cause of your histamine imbalance.

What Can I Do To Lower My Histamine Level?

Here are a few suggestions for what you can do to reduce symptoms if you have histamine intolerance:

  1. Add supplemental support to balance the immune response. At KanodiaMD, we like to recommend HistaEze, which is a  combination of quercetin, nettle leaf and vitamin C.
  2. Avoid high histamine foods:
    • Processed and cured meat products—sausage, ham, salami, bacon
    • Aged cheeses
    • Fermented foods—sauerkraut, soy sauce, kombucha, all types of vinegar (except apple cider vinegar)
    • Alcohol—wine, ciders, beer and other fermented alcoholic drinks
    • Dried fruits
    • Certain veggies—eggplant, tomatoes, spinach
    • Certain nuts & legumes—cashews, walnuts, peanuts
    • Canned and smoked fish
    • Wheat products
  3. Avoid foods that trigger the release of histamines like alcohol, banana, papaya, pineapple, spinach, citrus fruits, artificial preservatives, chocolate, cow’s milk, nuts, shellfish, strawberries and egg whites.
  4. Avoid DAO enzyme-blocking foods like alcohol, energy drinks, black, green and maté teas.
  5. Increase low histamine foods:
    • Fresh fish and poultry
    • Herbal teas
    • Vegetables and leafy greens (EXCEPT spinach)
    • Olive oil
    • Herbs
    • Blueberries
    • Cooked pasture-raised & free-range organic eggs
  6. Increase histamine reducing nutrients like quercetin, omega 3 fatty acids, vitamin C, and vitamin B6 to help reduce histamine levels.

Did you notice that alcohol is a triple threat? (High histamine, triggers a release and DAO blocking) Yikes!

Helpful Histamine Hints

Fresh is best! — Avoid processed meats, aged cheeses and leftovers. Store food in the freezer vs. the fridge.

Ferments are not your friend — Foods like sauerkraut, kombucha, kimchi are great for the gut microbiome, but not for histamine intolerance.

Everyone has their own threshold tolerance — You may be able to tolerate more or less. It’s all about finding your own personal balance.

Food is not the enemy! — Histamine intolerance is more than just what you eat. Luckily, we can use food as a tool to support your histamine bucket.

There is a root cause — Seek out a qualified functional medicine practitioner to identify YOUR issue with histamines. Many times finding the right eating plan can help immensely.

Please reach out to us at KanodiaMD with any questions about your health journey. And if you want to learn how to add foods into your diet that help get rid of excess histamines, join us for a class in our ‘Nourishing Plate’ Teaching Kitchen—contact nutrition@kanodiaMD.com for more information.


As always, we’re happy to discuss your health needs. Just contact our office to set up an appointment.