Histamine is a compound that is best known for its role in the body’s immune response to foreign proteins, specifically the allergic response. It can trigger a cascade of inflammatory reactions. On a day-to-day basis, histamine in small amounts helps regulate functions throughout the body.
Histamine is produced by white blood cells in our bodies called mast cells, but it also occurs naturally in many foods. The amount of histamine in foods may be dependent on the food or external factors such as ripening stage, storage, processing method, and origin.
If your histamine levels are already running high for any reason, then consuming histamine-rich foods may trigger a variety of symptoms, from the skin (rashes, hives, facial swelling) to the digestive tract (diarrhea, rapid onset bloating, nausea, reflux/indigestion, throat/chest tightening) to the cardiovascular system (rapid heartbeat, flushing) to neurological symptoms (migraines, dizziness, “brain fog”). When this is the case, symptoms are typically managed through a combination of medications and a low-histamine diet.
There is no single authoritative version of the low histamine diet, because individual tolerance of foods varies and histamine content can vary significantly among specific foods as well. If your symptoms are controlled on this low histamine diet, work with your dietitian to liberalize it to the greatest degree possible.
Avoid foods naturally high in histamine:
- Spinach
- Eggplant
- Red/ripe tomatoes (green tomatoes are OK)
- Avocado
- Cherries
- Soybeans and soy products
- Yeast Extract (yeast itself as an ingredient is OK)
Avoid fermented foods, pickled foods and foods that spoil quickly:
- Aged cheeses (e.g. gouda, cheddar, camembert, roquefort, bleu cheese, emmentaler, swiss, parmesan)
- Cold cuts, charcuterie and cured/processed meats (e.g. prosciutto, salami, nitrite-preserved bacon/ham/hot dogs, aged sausages)
- Dry aged meats/steaks
- Cultured dairy foods (yogurt, kefir, buttermilk, cultured cottage cheese/cream cheeses
- Kombucha
- Olives, sauerkraut, pickles, relish
- Canned, smoked, or salted fish (e.g. mackerel, herring, sardines, canned tuna, lox, smoked whitefish)
- Vinegar-containing condiments: commercial salad dressings, ketchup, mustard, mayonnaise, hot sauce, BBQ sauce
- Fermented condiments: Soy sauce, teriyaki sauce, fish sauce, liquid aminos, coconut aminos, miso, other Asian condiments (e.g., black bean paste, etc)
- Leftover meats or spoiled foods
- Shellfish (especially shrimp that haven’t been de-veined), unless cooked from the live state
- “Fresh” (thawed) fish sold at supermarket (individually quick frozen fillets are usually fine)
Limit foods with histamine-releasing capacities:
- Citrus fruit (lemon, lime, orange, grapefruit)
- Berries (strawberries, raspberries, cranberries)
- Stone fruits (apricots, plums, nectarines)
- Papaya, pineapple
- Grapes
- Pumpkin seeds
- Tea, cola
- Liquorice
- Certain spices: cinnamon, cloves, anise, nutmeg, curry powder, chili powder
- Foods preserved with sulfites, like dried fruit, frozen potatoes, red wine
- Foods preserved with BHA or BHT (e.g., some breakfast cereals)
- Baked goods that contain bleached flour (commercial breads and pastries)
- Foods that contain artificial food coloring, especially tartrazine (FD&C Yellow #5)
Limit alcohol intake, avoid if possible. Alcohol blocks the function of the enzyme that breaks down histamine.
- Especially red wines (these contain sulfites in addition to high histamine levels)
- White wines
- Beer
Proteins break down as a normal part of food aging. One protein component, histadine, decomposes into histamine and can cause problems in histamine-sensitive people. To maintain symptom control, it’s best to avoid consuming high-protein “leftovers”, including meats, poultry, beans, and dairy. Leftover lower-protein foods, such as grains, fruits and vegetables, are less likely to pose a problem. As always, pay attention to your symptoms and adjust accordingly.
So what CAN you eat on a low-histamine diet?
| Low histamine fruits | • Apple • Banana • Blueberries • Coconut • Dragon fruit • Kiwi • Guava • Melons (all) • Mango • Peaches • Pear • Starfruit • Lychees • Figs • Rhubarb • Juices or jams made from any of these fruits that do not contain sulfites as a preservative |
| Low histamine veggies | • Asparagus • Beets • Broccoli • Brussels sprouts • Carrots • Cauliflower • Cabbage • Cucumber • Lettuce • Green beans • Corn • Kale • Peppers • Zucchini • Onion • Garlic |
| Low histamine proteins | • Eggs, fully cooked (especially yolks) • Fresh meat, chicken, turkey (avoid leftovers) • All legumes EXCEPT chickpeas, lentils, red beans and soybeans/tofu • Individually quick frozen fish fillets • Uncultured cheeses: cottage cheese, cream cheese, ricotta, mascarpone, Indian-style “paneer” cheese, fresh mozzarella • Plain milk, fresh cream (watch out for spoilage) • All plain/salted nuts and seeds EXCEPT pumpkin seeds • Natural nut butters (no preservatives) • Sunbutter • Plain or vanilla protein powders with no added colors, sweeteners, preservatives: Jarrow brown rice/hemp or Nutribiotic rice protein |
| Low histamine grains/ starches | • Potato and sweet potato (fresh. Avoid frozen potato products/French fries due to likely sulfite content.) • Corn, popcorn • Rice (all varieties), rice cakes, rice crackers • Breads, crackers and baked goods made with unbleached white flour (e.g., organic) or whole wheat flour • Plain pasta • Couscous • Homemade biscuits or scones that use baking soda/powder as a leavener and unbleached flour • Whole grain crackers that do not contain yeast or preservatives (e.g., Wasa, Triscuits) • Whole wheat or organic white bread, buns, etc. that does not contain prohibited preservatives, or similar gluten-free alternatives • Plain cereals such as corn flakes, shredded wheat, rice cereal, oats/oatmeal, cream of wheat and cream of rice • QuinoaBuckwheat (kasha, soba noodles) • Millet |
| Low histamine seasonings | • Oil, ButterSalt/pepper • HerbsAll spices not listed under prohibited • Onion/garlic, scallions, chivesSugar, maple syrup, honey, corn syrup |
| Low histamine beverages | • Milk • Coffee • Many herbal teas (no zingers or zests) • Juice/nectars made from approved fruits • Club soda • Among alcoholic drinks, vodka or gin most likely to be tolerated |
| Low histamine treats/ sweets | • More natural vanilla ice creams with short ingredient lists (Ciao Bella, Haagen Dazs) • Homemade or more natural chocolate chip cookies and cakes made with unbleached flour, real butter, sugar, eggs etc. |
Sample low histamine meal ideas
Breakfasts:
- Shredded wheat cereal/milk/banana
- Melon/fat-free ricotta cheese and hard boiled egg(s)
- Udi’s Au naturel or vanilla granola/ricotta cheese
- Rice cakes/peanut butter/banana/honey
- Light Rye toast/ricotta cheese/honey/fresh figs or guava jelly
- Smoothie: milk/banana/mango
- Wasa Lite Rye or Whole Grain or Flax Seed Crispbreads topped with:
- natural almond butter
- ricotta cheese/olive oil/salt/cucumber or ricotta cheese/honey & fresh fig
- Pancakes made without bleached flour or buttermilk, served with maple syrup and sliced banana, such as.:
- Bob’s Red Mill Organic 7 Grain Pancake/Waffle Mix
- Van’s Homestyle Pancakes or Gluten-free pancakes (frozen)
- Frozen waffles without restricted ingredients, served with nut butter or syrup and chopped apple, such as.,
- Van’s Whole Grain Organic or Whole Grain Organic Flax
- Kashi 7 Grain waffles
Lunch/Dinner:
- Garden salad with grilled chicken or steak: Lettuce, carrots, peppers, onions, cucumbers, corn, squash, beets… (No spinach, cheese or tomato). Dress with oil, garlic and herbs.
- Homemade split pea soup (no ham), whole wheat roll & garden salad
- Pasta with olive oil, herb-grilled chicken breast & broccoli
- Steak or fresh/quick frozen salmon, baked potato & asparagus
- Roasted chicken, brown rice & grilled zucchini
- Roasted turkey breast, mashed potatoes & green beans
- Black beans, rice, roasted chicken & garden salad
- Grain bowl made with quinoa, pinto beans, corn, zucchini & cucumber
- Turkey or beef meatballs, pasta with olive oil & steamed broccoli
- Polenta (such as Bob’s Red Mill)/black beans with cumin/salad (as above)
- Turkey sandwich with fresh mozzarella cheese on whole wheat bread
- Whole wheat pasta/olive oil/shaved carrots/zucchini slices/ricotta cheese
- Homemade black bean burger/bun/caramelized onion
Snacks
- Natural popcorn (look for simple ingredients like: olive oil, salt)
- Beanitos Original Black Bean Chips
- Original Tortilla chips or Potato chips (salted; not otherwise seasoned)
- Terra Chips (all varieties)
- Nature’s Bakery Gluten-free Fig Bar
- That’s It fruit bars: Apple/blueberry, Apple/mango; Apple/fig
- Peanut butter/apple or banana
- Plain roasted or salted nuts (not seasoned/flavored otherwise)
- Plain whole wheat crackers without preservatives, such as Triscuits
- Melon & ricotta or cottage cheese
- Hard boiled egg
- Granola without dried fruit, soy or cinnamon (just oats, nuts, sweetener)