The low down on histamine intolerance



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When you’re trying to heal your gut from a lifetime’s worth of mistreatment, it could be from a result of antibiotics, incorrect diet, disease, stress, or a combination of these factors, it can be really frustrating when all of your hard work and dietary changes fail to improve your varied, unpleasant symptoms.

Headaches, bowel irregularities, fatigue, energy depletion, skin eruptions such as hives and rashes, all these things could be the result of just about anything and it’s hard to know where to begin.

You may have experimented with specific diets such as the low FODMAP, GAPs, Paleo, Veganism or quitting a certain ingredient in an attempt to rid yourself from your inexplicable symptoms.

In the case that you’ve failed to see any improvement, a low histamine diet may finally give you the answers that you’ve been desperately searching for.

What are histamines?

Histamines are neurotransmitters that are produced during any allergic response. Histamine’s role in the body is to cause an immediate inflammatory response and serve as a warning sign to your immune system, notifying it of any potential attackers. It’s this inflammation that gives you the swollen, puffy eyes or skin breakouts when you experience an allergic reaction. This may explain why doctors prescribe anti-histamines when you present with a food or seasonal allergy.

Histamines are essentially important chemicals that communicate messages from your body to your brain and a component of the stomach acid responsible for breaking down the foods you eat. Importantly from a gut-health perspective, histamines can be absorbed from histamine-containing foods. They can also be produced by bacteria in the gut.

What is histamine intolerance?

In healthy people, the production of histamines is balanced out by an enzyme called diamine oxidase (DAO), which breaks down the histamines and ensures they are never given the opportunity to accumulate in the body. But some people have a deficiency of DAO, so histamine levels are able to run wild.

Impaired methylation can also be a cause of histamine intolerance. Histamine N-methyltransferase enzyme (which, like DAO, is also involved in histamine breakdown) requires methylation to function efficiently, and so compromised methylation will cause a decrease in the breakdown of histamine and allow levels to accumulate. When this happens, it can cause headaches, lethargy, irregular bowel movements, itchiness and leave you feeling, rather miserable.

While this is normal and part of the body’s natural immune response, if there’s a prolonged period where you don’t break down histamine properly, you could develop what’s known as histamine intolerance.

Because it travels throughout your bloodstream, histamine can affect all of your bodily systems, including your gut, skin, brain, lungs and cardiovascular system. This explains why it may cause such a wide range of problems.

The most common symptoms of histamine intolerance include: headaches, increased arousal, hypertension, vertigo/dizziness, body temperature and bowel irregularities, anxiety, nausea, cramps, flushing, difficulty breathing, hives, fatigue, tissue swelling, and irregular heart beats.

How do I test for histamine intolerance?

If you, like most, are reading the broad range of symptoms associated with histamine intolerance and thinking to yourself “that’s me!” as you tick each one off in your head, then rest assured that less than one percent of the population is actually histamine intolerant, so there’s a very good chance that you’re all good! However, this doesn’t mean you might not be sensitive to high histamine foods, in which case knowledge is power.

There are a few options available to you when testing for histamine intolerance. You can ask your doctor to have a DAO test to determine whether your DAO levels are normal or low, indicating a potential histamine build up.

However, since other enzymes can also degrade histamine, this test isn’t a foolproof method of diagnosis. Another method is to get a skin-prick test done, however again this may give conflicting results.

Women face even tougher challenges when testing for Histamine intolerance, as levels can fluctuate during different phases of the menstrual cycle and during pregnancy and breast-feeding .

Bearing all these challenges in mind, to date, the best method that doctors apply for diagnosing histamine intolerance is an elimination diet where histamines are entirely removed from the diet for four weeks. This is then followed by a reintroduction challenge. While this may seem simple enough, again there are a few complications associated with the elimination diet.

What is involved in an elimination diet?

The biggest source of histamine in food isn’t actually the food itself, it’s the bacteria on the food that naturally produce histamine as part of their metabolic process. So, while we often hear that fermented foods do wonders for gut health (and they do), for those with histamine intolerance this is anything but true. In fact, even leftovers can occasionally have enough bacteria present to trigger symptoms.

If you’re intending on doing an elimination diet remember to seek professional advice from your health care practitioner.

Foods that are high in Histamine and that should be entirely avoided on the elimination diet include:

Fermented Foods

Saurkraut, Pickles & Kim Chi


Soy sauce, Tamari Sauce & Miso

Yeast containing foods e.g., beer, breads & cakes

Tempeh & Tofu


Dairy products – milk & most cultured dairy e.g., cheeses, kefir, yoghurt, sour cream, buttermilk, sour cream, cottage cheese & ricotta

Leftover meat – especially meat that has been stored in the fridge for >2 days

Fish – the longer after its been caught, the higher its histamine content – the worst are canned & tined fish e.g., tuna, salmon & sardines

Shellfish – especially smoked or canned seafood

Processed, cured, smoked & fermented meats – e.g., sausages, salami, pepperoni & bacon

Long cooked bone broth

Nuts – especially walnuts & cashews

Eggs – especially egg whites

Beans & Legumes – chickpeas, soy beans & peanuts






All tomato products

Olives in vinegar or brine

Red beans


Dried fruits – prunes, cranberries, dates, figs, raisins, & currants

Most berries – strawberries & raspberries





Alcohol of all types – especially wine & beer

Coffee beans (that are fermented)

Cola & Energy Drinks


Cinnamon, cloves, chili powder & anise

Nutmeg, curry powder, cayenne & cloves

Vinegar products – including apple cider vinegar, ketchup & mustard

Chocolate & Cocoa

All products containing cocoa & raw cacao

Artificial Colours & Preservatives

Especially benzoates & sulphites, nitrates, glutamate (MSG) & tartrazine

There are also foods that don’t contain histamine themselves, but that can cause your body to release more of it.

These include:

  • Citrus fruits, banana, strawberries, pumpkin, kiwifruit, grapefruits, prunes, peas, eggplant, spinach, mushrooms, avocados, papaya, & pineapple
  • Most spices
  • Pork
  • Nuts
  • Raw Egg Whites
  • Tea – black, green & mate
  • Many medications & over the counter vitamins

As with most dietary issues, individual sensitivities to these foods vary significantly. Most people only have trouble with the very high-histamine foods, and so there’s no reason to eliminate the second category of foods unless absolutely necessary.

A good idea when exploring an elimination diet is to cut out the very high histamine foods first, and then experiment with different additions and subtractions once you can determine whether it’s helping or not.

Keeping a food journal may also be very beneficial to keep track of what your personal triggers are.

The good news is that the elimination diet is only temporary. As your gut heals, your ability to metabolize histamine increases, and you can slowly begin to introduce more of it in your diet without suffering symptoms.

Also, many people discover through an elimination diet that they don’t react to some high histamine foods at all, and therefore only really need to cut out one or two big histamine offenders.

Many high histamine foods are actually quite healthy and so you could be missing out on very important nutritional sources if you cut them out without necessity.

How does gut bacteria affect histamine Levels?

 The biggest non-food source of histamines in most of us is our gut flora. While certain types of bacteria produce histamines, others degrade them. Too many histamine-producing bacteria can cause your system to build up histamine levels faster than your DAO can empty it.

It can occur that histamine intolerance appears later in life, particularly if you have been taking antibiotics or have made a dramatic diet or lifestyle change. When the gut flora begins to grow back after any sort of disruption, the potential for bacterial overgrowth problems (especially a predominance of histamine-producing bacteria) is high.

Also, the mucous lining of the intestinal wall is what mainly produces DAO. If your gut lining is irritated (for example, by a range of inflammatory foods like grains and legumes), then DAO production decreases, and the symptoms of histamine build up rear their ugly head. This may explain why many people with digestive issues do so well on a diet that is low in grains and legumes. 

How do I help to heal my gut on a low histamine diet?

While it may involve a little planning, gut healing on a low-histamine diet is certainly possible. While it’s true that fermented foods are great for restoring normal gut flora, sauerkraut certainly isn’t the be-all and end-all.

A good probiotic supplement, and (provided you don’t have any FODMAP intolerances) a diet rich in prebiotic foods such as chicory root, artichokes, dandelion greens, garlic, leek, onion and asparagus can be of assistance.

While probiotics such as Lactobaciullus rhamnosus suppress histamine receptors, prebiotics are carbohydrates that are indigestible for humans but that act as a food source for beneficial bacteria (the probiotics).

Nigella sativa, or black cumin, is a spice that has been used in Ayurvedic medicine for centuries, and has recently shown promise as a natural anti-histamine for treating seasonal allergies.

DAO supplements are also available. However, these have had mixed results and come with a hefty price tag making them a poor choice for long-term treatment.

You can also make certain dietary changes to improve your symptoms. Vitamin B6, copper, and Vitamin C are DAO cofactors, so make sure your diet is rich in these nutrients.

Vitamin B6 can be found in chicken, turkey and potatoes. Liver and asparagus are rich sources of copper, and finally vitamin C can be found in all fruits and vegetables, particularly in kiwifruit, oranges, and berries. 

As with any food elimination diet, there’s no point in following something when you know in your gut (excuse the pun) that it isn’t helping. Nevertheless, if your dietary attempts to date have failed then there is no harm in temporarily trying out a low histamine diet to see if it works for you.

If you’d like to join my Heal Your Gut four week program click here. Or to purchase the Heal Your Gut print book click here.

33 Responses to “The low down on histamine intolerance”

  1. healingjourneygirl says:

    Dear Lee,
    Were you sensitive to histamine when you were sick? I have experience with almost all the above (bacterial overgrowth with bacteria that release histamine, undermethylation). When I read the story about your illness I could totally relate. I am not going to tell my story here, as I want to move on with my life. However, all I will say is that my symptoms were debilitating to the point where I was unable to work for a year (I was also extremely unwell for two years prior to that). My lowest weight was 40.9kgs! Thankfully I found an amazing doctor to help me on my road to recovery (one that is knowledgable about the above information you have presented here). It really does take time to heal from gut dysbiosis. There were times where I could not see the end of the tunnel (I didn’t know if I was even going to get better). Unfortunately, so many doctors are unaware about the above information you have presented here. So, so important, as there are many people out there who have stories like ours but have not been able to find someone to help then what is going on with their body and how to heal. Thank you for your work. xoxo

    • Jade says:

      Hello there! I’m 21 years old and I read with interest your comment as I have been suffering from identical health issues for the same amount of time (a year of extreme illness, but bothersome gut problems for a decade before that). I dream of getting better and have just been placed on a course of antibiotics, which I am hoping shall improve things. You couldn’t give me the name of your doctor or provide me with a few pointers, could you? Warmest regards, Jade

  2. Therese says:

    Please help! I have been trying to heal my gut for almost a year, I have read every book, my story is the same, hives, histamine, parasites, under methylation, I am soooo over it. I can’t find a doctor who knows how to help. Can someone direct me in any direction – help help – please. I just can’t get improvement.

    • lee says:

      The best thing to do is read the Heal Your Gut book or eBook or consider the four week program to give your gut some relief and help you to identify those ingredients that are bothering you. Once you have given your system a rest you’ll be in a much better position to really heal your gut and take your healing to the next level.

      • Chrissie says:

        H Lee 🙂
        I’m so relieved to have come across this fantastic info.
        I have been experiencing high histamine symptoms for over a year and did not realise what it was. I also have methylation issues (due to MTHFR). Lots of food intolerances etc.
        I seem to be okay with some of the high histamine foods but am struggling to get myself on track…it seems overwhelming!
        I was relieved to read above that you can still heal your gut while cutting out foods that are high histamine.

        I’d love to do your 4 week program but am wondering if it would cater to my issues?


        • Lee says:

          Hi Chrissie I am glad it helped. Yes you can still do the heal your gut program but a low histamine version 🙂 lee x

    • LIL says:

      I had similiar symptoms and have had a remarkable recovery with Methyl Guard by Thorne and Motil Pro.

  3. Kerry Dansie says:

    I have allergies to many things, the most significant being gluten, dairy & duck. Duck gave me explosive diarrhoea. The gluten & dairy presented as a cough that got worse over the period of 4 years. I couldn’t hold a conversation without coughing, people on the street would avoid me, because they thought I was infectious. In this time I saw 5 different doctors & an ENT specialist. I was diagnosed with everything from asthma to bronchitis & psychosomatic.I was put on inhalers ect, but nothing helped. I was convinced that I had lung cancer from passive smoking. A friend put me onto a great naturopath on the Gold Coast who helped me tremendously. I find that by simply avoiding my triggers, I have no symptoms.

  4. Gail says:

    I have been trying the histamine illumination diet which seems to help some, but there’s more going on. I am reduced heterozygous for MTHFR, have severe adrenal fatigue, heavy metals, parasites, and possibly still tickborne diseases. I was treated for many years with antibiotics for Lyme disease and coinfection’s and did detox for heavy metals and parasites. When the adrenal fatigue was triggered hard by a holistic protocol for Lyme disease I went down hard and also during that time contracted lead through our water source which we have remedied now. I’m finding it extremely difficult to even do the mildest detoxification, and the adrenal coach has been somewhat helpful but did not find the high night time cortisol because they don’t do testing! I found out on my own after many months which has made everything much more difficult. I still have to take some meds for anxiety and depression, and have weaned down to 25 mg of trazodone to help sleep plus a Benadryl. For the past two years sleep has been extremely difficult to put it mildly. I have a new doctor lined up but cannot see her until the end of March most likely. I will look into the methyl guard by Thorne and the Motil Pro. I am also taking digestive enzymes, working up slowly in my vitamin C, eating organic as much as possible, and taking quercetin and bromelain if need be. I’ve also ordered zeolite and have century 21 homeopathic parasite detox, but I don’t think my adrenals can handle ieither one of these at this point. Hopefully the histamine illumination diet will continue to help, but if anybody has any other suggestions I’m open to it! Thank you so much! Blessings to all.

    • Lee says:

      Thanks for your note 🙂 my other suggestion would be our love your gut powder for a heavy metal detox as it is very very gentle. Lee

  5. Gail says:

    Thank you Lee. I have some diatomaceous earth, but was afraid that that would overwhelm my whole system because it would kill off so much at one time. I am afraid that with the stage for adrenal symptoms, My entire body would be totally overwhelmed. I’m just not sure where to start, and keep trying to boost the adrenal function. I looked up your suggestion and it sounds like a very good product though. Thank you so much. C

    • Lee says:

      I would start very slowly just 1/2 tsp a day to begin and see how you feel and always check with your doctor if you are worried about anything. Lee

  6. Gail says:

    Thank you Lee. Blessings to you, Gail

  7. Carolyn says:

    Hi Lee, is the ‘Heal you Gut Powder’ beneficial to take when histamine sensitive and intolerant? do you know if is it high or low in histamine?
    Warm regards, Carolyn

  8. Karen says:

    This is exactly what happened to me. I went on the low FODMAP diet hoping for any answers. The worst thing was anxiety like symptoms, and I already knew that during my worst times, I could cut to basic easily digestible foods, mashed potatoes, saltine crackers for a couple of days, and get ok.

    Over the years, I had tried everything. Ulcer diet, gallstones diet, lactose intolerance diet, low sugar diet. Sometimes I just had terrible troubles, it was really messing with my ability to drive. I feared heart trouble, brain tumors, you name it.

    The first 3 days of the low FODMAP diet, I was inadvertently following the low histamine diet as well. Everything improved so drastically that I wanted to cry. Then, I had fish with lemon juice and felt like I got hit by a truck.

    So I searched more, and finally came upon histamine intolerance, mainly due to one symptom, whooshing in the ears. On and off I had this for years, and since I have gotten histamines under control, I have not had it again.

    • Lee says:

      That is wonderful!

    • Robin L Schroth says:

      Hi Karen
      Can you tell me what you did to get your body back on track. I don’t know what to do. So much information and I feel like, all I am doing is spending money on supplements….help. °

      • Lee says:

        Hello 🙂 I think that less is more when it comes to getting back on track. Firstly look at your gut health and try to eat a whole foods diet and make sure you are staying hydrated. Also health is a holistic approach – mind, body, spirit. Lee x

  9. Madeline Levy says:

    Hi..does anyone know any herbs or suppliments that help DAO or reduce histamine? Its so difficult excluding so many foods including salicylates in food as I also have salicylate intolerance!

  10. Babra ufuoma Ukoli says:

    I need an enzyme doctor. I have to see one. Can anyone tell me which doctor specializes in enzymes

  11. Dana says:

    Thanks for the well written informative article. I didnt know I had histamine intolerance until I was in my 50’s. A guy in a health food store who was studying to be a nutritionist told me that I must have histamine intolerance. I have had some improvement on a low histamine diet, but pollen season just is terrible and my bucket is full all the time from when I get up in the AM, so it doesnt matter how low histamine my diet is (well not too much)
    Anyways, I would like to mention that I also did not know that I had pyroluria until recently, which is genetic and depletes B6 and zinc. It turns out that many foods and supplements I was taking were high it copper also and it all made me worse.

    Please do note this when telling people to possibly take copper as a supplement, it can be very bad for many people. I also read that the DAO enzyme does not need that much copper, so most people get that fine in their diet. Dr Walsh doesnt recommend anyone supplement copper.

    Dr. Walsh wrote a book called Nutrient Power where he discusses how to treat anxiety, depression, schizophrenia, etc using many different minerals and nutrients like zinc, magnesium, B6, Vit C, etc. Most doctors dont know the root cause of this can be copper-zinc imbalance, methylation issues, and other related. Also histamine of course can cause anxiety.

    Women have more issues due to the connection between histamine and estrogen and there is also a connection between high copper and estrogen (and pregnancy). I am so lucky to have histamine intolerance, pyroluria and undermethylation. The docs tell me I have fibromyalgia (30+ years) Ugggh.

    Thanks again!

  12. Hello all
    I am suffering from histamines issues could we use dandelion tea I am getting rashes n hives pls help me is there any doc pls share their I am very sick how to remove heavy metals parasites pls

  13. Chloe. says:

    Hi Lee . Been suffering 20 months now with the most scariest of symptoms. Stool taste in mouth urine taste, bladder problems
    S bowels found a mass on my kindney then ct sakd nope nothing there. absolutely debilitating time of life. Done test have 3 high yeast , clostridia , klebsillia high oxalates, please could you tell me should o still carry on with the kill off protocol worh extremely high histamine levels ? Also does histamine cause manic deepression episodes?

    • Lee says:

      Hello, I would advise a low histamine diet and the love your gut capsules. Histamine issues cause inflammation and release of histamine could be responsible for mood and depression.

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