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Histamine Intolerance: Causes, Symptoms, and Dietary Choices

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Histamine intolerance is a condition that affects many individuals, yet it often goes undiagnosed or misdiagnosed. It occurs when there is an imbalance between the production and breakdown of histamine in the body, leading to a buildup of this chemical. This can result in a wide range of symptoms that can be debilitating for those affected. In this article, we will explore the causes, symptoms, and dietary choices associated with histamine intolerance, providing valuable insights based on research and expert opinions.

The Role of Histamine in the Body

Histamine is a chemical compound that is naturally produced by the body and plays a crucial role in various physiological processes. It is involved in the immune response, regulating stomach acid production, and acting as a neurotransmitter in the brain. Histamine is also present in certain foods, such as fermented products, aged cheeses, and alcoholic beverages.

Under normal circumstances, histamine is broken down by enzymes called diamine oxidase (DAO) and histamine N-methyltransferase (HNMT). However, in individuals with histamine intolerance, there is a deficiency or dysfunction of these enzymes, leading to an accumulation of histamine in the body.

Causes of Histamine Intolerance

While the exact cause of histamine intolerance is not fully understood, several factors have been identified as potential contributors to its development. These include:

  • Enzyme deficiencies: As mentioned earlier, a deficiency or dysfunction of the enzymes DAO and HNMT can impair the breakdown of histamine, leading to intolerance.
  • Gut health issues: Conditions such as leaky gut syndrome, small intestinal bacterial overgrowth (SIBO), and gut dysbiosis can disrupt the balance of bacteria in the gut, affecting histamine metabolism.
  • Dietary factors: Consuming foods high in histamine or those that trigger the release of histamine can contribute to intolerance. Additionally, certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics, can interfere with histamine breakdown.
  • Genetic predisposition: Some individuals may have genetic variations that make them more susceptible to histamine intolerance.
  • Underlying health conditions: Histamine intolerance can be associated with other conditions, such as mast cell activation syndrome (MCAS) and histaminosis.

Symptoms of Histamine Intolerance

The symptoms of histamine intolerance can vary widely among individuals and may resemble those of other conditions, making diagnosis challenging. Some common symptoms include:

  • Gastrointestinal symptoms: These can include abdominal pain, bloating, diarrhea, constipation, and nausea.
  • Respiratory symptoms: Histamine intolerance can manifest as nasal congestion, sneezing, runny nose, and asthma-like symptoms.
  • Skin manifestations: Itchy skin, hives, rashes, and flushing are common symptoms experienced by individuals with histamine intolerance.
  • Headaches and migraines: Histamine can trigger headaches and migraines in susceptible individuals.
  • Cardiovascular symptoms: Some individuals may experience low blood pressure, rapid heart rate, or heart palpitations.
  • Neurological symptoms: Histamine intolerance can cause brain fog, dizziness, anxiety, and even panic attacks.

Dietary Choices for Histamine Intolerance

Managing histamine intolerance involves making dietary choices that minimize the intake of histamine-rich foods and those that trigger histamine release. While individual tolerances may vary, the following dietary guidelines can be helpful:

  • Avoid high-histamine foods: This includes fermented foods, aged cheeses, cured meats, smoked fish, and alcoholic beverages.
  • Be cautious with leftovers: Histamine levels in foods increase as they age, so it is advisable to consume freshly cooked meals and avoid leftovers.
  • Choose fresh foods: Opt for fresh fruits, vegetables, and meats, as they generally have lower histamine levels.
  • Consider a low-histamine diet: Some individuals may benefit from following a temporary low-histamine diet to identify trigger foods and alleviate symptoms.
  • Avoid histamine-releasing foods: Certain foods, such as citrus fruits, tomatoes, and chocolate, can trigger the release of histamine in the body and should be consumed in moderation.
  • Support gut health: Probiotics and prebiotic-rich foods can help restore a healthy balance of gut bacteria, potentially improving histamine metabolism.


Histamine intolerance is a complex condition that can significantly impact an individual’s quality of life. Understanding the causes, symptoms, and dietary choices associated with histamine intolerance is crucial for effective management. By identifying trigger foods, minimizing histamine intake, and supporting gut health, individuals with histamine intolerance can experience relief from their symptoms and improve their overall well-being. If you suspect histamine intolerance, it is advisable to consult with a healthcare professional for proper diagnosis and guidance.

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