Home General Medicine Histamine Intolerance: Causes, Symptoms and Treatments

Histamine Intolerance: Causes, Symptoms and Treatments

Verified By Apollo General Physician July 22, 2022 4155 0
Histamine Intolerance: Causes, Symptoms and Treatments
Histamine Intolerance: Causes, Symptoms and Treatments


Histamine intolerance occurs when there is an increase in histamine levels in the body. A person may suffer from histamine intolerance for numerous reasons, such as consuming certain foods containing high histamine levels, underlying health conditions, and medications. An intolerance to histamine is also thought to be due to a lack of an enzyme called diamine oxidase. 

This blog gives a comprehensive understanding of histamine intolerance, its causes, symptoms, the foods to avoid, and the medical treatment.

What is histamine intolerance?

If a person has histamine intolerance, then it does not mean the individual is sensitive to histamine. It is an indication that the body has produced excess histamine. When histamine levels increase or if the body is unable to break down histamine properly, it can affect normal functions of the body.

What are the symptoms of histamine intolerance?

Histamine is related to common allergic responses and symptoms. Many of these are identical to those from histamine intolerance.

While they may differ, some common reactions that are associated with this intolerance include:

In more severe cases of histamine intolerance, people can experience:

When should you call the doctor?

People must speak to the doctor to evaluate histamine intolerance and other possible similar conditions. Conditions such as mast cell disorders, true allergies, or underlying digestive disorders may look similar to histamine intolerance. When these possibilities are evaluated and addressed, an elimination diet can be initiated to see if the symptoms improve. The underlying issues must first be corrected for the best possible outcome. Since the diet is restrictive, people must consult a dietician to ensure proper nutritional intake.

What are the causes of high histamine levels?

The body naturally creates histamine along with the enzyme diamine oxidase (DAO) which is responsible for breaking down histamine present in foods. When the body develops a DAO deficiency and is unable to break down histamine, it can develop into an intolerance. Here are some of the few reasons that affect DAO enzyme levels:

  • Medications that block DAO functions or prevent production.
  • Gastrointestinal disorders, such as inflammatory bowel disease and leaky gut syndrome.
  • Histamine-rich foods cause the DAO enzymes to function improperly.
  • Foods that trigger histamine release or block DAO enzymes.

Another contributing factor to developing histamine intolerance is bacterial overgrowth. Bacteria grow when the food does not digest properly, leading to histamine overproduction. Therefore, normal levels of DAO enzymes cannot break down the increased levels of histamine in the body, leading to symptoms .

How can histamine levels be controlled with diet?

There are several ways to control histamine levels through diet, such as the following:

Foods to Avoid

Some foods are high in histamine and may trigger inflammatory reactions and other symptoms. The foods that are high in histamine include:

  • Alcohol and other fermented beverages
  • Fermented foods and dairy products like yoghurt and sauerkraut
  • Dried fruits
  • Avocados
  • Spinach
  • Eggplant
  • Processed or smoked meats
  • Shellfish

Certain foods trigger histamine release in the body including:

  • Alcohol
  • Bananas
  • Beans
  • Papaya
  • Chocolate
  • Tomatoes
  • Wheat germ
  • Citrus fruits
  • Nuts, specifically walnuts, peanuts, and cashews
  • Food dyes and other additives

Some foods block DAO production, including:

  • Alcohol
  • Black tea
  • Green tea
  • Energy drinks

Foods to Eat

When people have histamine intolerance, the doctors recommend incorporating low-histamine foods into their diet to help reduce symptoms. It is advised that the patient consult a dietician before eliminating certain foods from their diet.

Some foods that are low in histamine include:

  • Eggs
  • Fresh meat and fish
  • Non-citrus fruits
  • Gluten-free grains like quinoa and rice
  • Dairy substitutes such as coconut milk and almond milk
  • Fresh vegetables except for tomatoes, spinach, avocados, and eggplant
  • Cooking oils such as olive oil

What are the medical treatments for histamine intolerance?

Apart from dietary changes, there is no fixed treatment for people with histamine intolerance. However, the following approaches can help:

  • Taking antihistamines
  • Including DAO enzyme supplements
  • Corticosteroids
  • Avoiding medicines that are related to histamine intolerance, which can involve switching medications


Many foods contain high histamine levels. If the body is not able to break down this chemical adequately, it may cause a diverse range of symptoms, which are often gastrointestinal. People can manage histamine intolerance with dietary changes, taking antihistamines or enzyme supplements, and avoiding or restricting the use of medications that trigger the release of histamine.

Frequently Asked Questions (FAQs)

1. What is the function of histamine?

Histamine is a chemical that is responsible for  major functions such as communicating messages to the brain, triggering the release of stomach acid to help with digestion, and is released  after injury or allergic reaction as part of the immune response

2. How long does it take to get relief from histamine intolerance symptoms?

It can take three to four weeks to get relief from the symptoms of histamine intolerance. Research has found that 90% of people with histamine intolerance who follow a low-histamine diet for four weeks have a reduction in symptoms.

3. Is there a test that can diagnose histamine intolerance?

Doctors often diagnose histamine intolerance after excluding the health conditions that cause similar symptoms. They may begin the diagnosis with testing for food allergies and intolerances.

For people with chronic intestinal symptoms, a gastroenterologist can also order tests for:

●   Celiac disease

●   Lactose intolerance

●   Irritable bowel syndrome

●   Inflammatory bowel disease

Typically, doctors recommend patients with histamine intolerance maintain a food diary because it can help identify symptoms and diet patterns. The doctors may also check their DAO levels and enzyme activity levels with a blood test.

Verified By Apollo General Physician
Our expert general medicine specialists verify the clinical accuracy of the content to deliver the most trusted source of information, making the management of health an empowering experience.

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