Histamine intolerance: these foods are problematic

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Histamine intolerance is difficult to diagnose and is often detected quite late. The only way of establishing the intolerance with certainty is by a process of elimination of histamine-containing foods.

What is histamine intolerance?

Along with lactose intolerance and fructose intolerance, histamine intolerance is one of the most common forms of food intolerances. People with histamine intolerance are unable to effectively break down histamine in the body. They have an imbalance in the supply and breakdown of histamine, with the result that histamine accumulates in the body. The disorder affects an estimated 1% of the population in Switzerland. Healthy people can break down histamine with the help of the enzyme diamine oxidase (DAO) and histamine N-methyltransferase (HNMT).

Histamine explained in brief

Histamine is a substance that is produced in the body and secreted during allergic reactions, for example, or in defence against foreign substances. Histamine is also hidden in many foods and produced in large quantities when food ages or spoils.

Histamine intolerance: non-specific symptoms

Because the symptoms of histamine intolerance are similar to those of an allergy, food poisoning or a cold, histamine intolerance is difficult to recognise. The symptoms occur spasmodically after meals and are chronic.

Symptoms of histamine intolerance

  • Sudden reddening of the skin and itching on the body
  • Digestive problems such as nausea, vomiting, diarrhoea
  • Drop in blood pressure, dizziness, rapid heartbeat
  • Runny nose, chronic colds
  • Headaches, migraines
  • Red eyes, swollen lips
  • In women: menstruation pain

Low-histamine diet for treatment

At first glance, a low-histamine diet seems rather limited. But there’s actually a wide range of tolerable options to help those with the condition. Ideally, the food you eat should be fresh, unprocessed and colourful.

Eat more of these foods

  • Fresh meat and fish
  • Fresh fruit such as redcurrants, blackcurrants, mango, apples, apricots, rhubarb and cherries
  • Fresh vegetables such as potato, carrot, leek, cucumber, beetroot and lettuce
  • Dairy products such as cream cheese, quark, yoghurt and milk

Foods to avoid

For the therapy, eliminate foods containing histamine, such as aged and fermented foods and drinks. In other words, everything that is preserved for longer periods of time.

  • Canned, pickled and ready-made products
  • Sausage meat such as salami, bratwurst, cervelat, liver sausage
  • Long-aged hard, soft and processed cheese such as Emmental, Parmesan, Camembert
  • Pulses such as lentils, beans, soya beans
  • Vegetables such as spinach, tomatoes, aubergine, avocado
  • Alcoholic drinks, especially beer and wine
  • Foods that contain yeast

Diagnosis of histamine intolerance

There is currently no reliable laboratory diagnosis because it’s not entirely certain what the causes of histamine intolerance are. From a scientific point of view, a blood analysis or stool sample to determine the enzyme DAO or histamine do not provide conclusive evidence.

Elimination diet

The best way to find out if you have histamine intolerance is with an elimination diet. The first step is to see a doctor, who can start by ruling out lactose, gluten and fructose intolerance. If the condition is still suspected, the next step is to keep a diet and symptom diary. This means eating a low-histamine diet and documenting all meals and how you feel afterwards.

  1. Elimination diet over 2 weeks:
    with a strictly low-histamine diet
  2. Test phase over 6 weeks:
    with a systematic re-introduction of high-histamine foods

Therapy for histamine intolerance

The best therapy for those affected is and remains a personalised low-histamine diet. In individual cases, the therapy is combined with antihistamine medication or dietary supplements.

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