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Don’t fear the fridge! Histamine intolerance is bigger than food

Article at a Glance
  • Food plays a role, but the condition known as histamine intolerance is multifactorial: traditional allergy, genetics, lifestyle factors, and the health of the microbiome all play a role in developing issues with histamine.
  • Physical location alone can trigger histamine intolerance.
  • Paying too much attention to high histamine food lists will leave you with nothing you can eat, which is not healthy. Histamine intolerant or no, you will need to eat food.
  • Watch out for products, like alcohol and NSAIDs, that decrease diamine oxidase, the enzyme used to break down extracellular histamine.
  • Gut repair and the microbiome play a big role in combatting histamine issues.
  • Rule out mast cell activation disorder with your doctor, which can be done by measuring serum tryptase levels.
Genes Mentioned

Scientifically reviewed by Dr. Aaron Gardner

Histamine intolerance.

A real condition with a very unfortunate name.

No one is actually histamine intolerant, we all need histamine, it’s an essential neurotransmitter. (R) However, as with anything, too much of a good thing can cause problems. When we accumulate more histamine than our body can handle, symptoms begin, and we’re said to be “histamine intolerant.” But by this definition, every one of us is histamine intolerant, as heavy doses of histamine cause food poisoning. (R)

If you’re reading this blog, you’re likely in the midst of internet research, which can be useful. For example, I never understood until recently that it was an overload of histamine that sometimes caused my insect bites to swell beyond normal, and I wouldn’t have found this information were it not for commentators like Dr. Ben Lynch, who has written about having the same issue. So, yes, do your research. But a word of caution is in order as well. Before you go too far down the high histamine food list rabbit hole, it’s important to remember that histamine intolerance is multifactorial. Food gets all the attention, but food is just one of the issues that cause histamine to build up to unhealthy levels in the body. Severe reactions to high histamine foods are very likely a warning sign that one of the five factors I discuss below is out of balance, especially the microbiome.

For me, one of the aggravating issues was getting my wisdom teeth out while living in a region of the country where I have severe allergies. Wisdom teeth surgery equals antibiotics and high dose NSAIDs, both of which kill off healthy gut bacteria, lower levels of diamine oxidase (the enzyme our bodies use to clear histamine) and invite the spread of pathogens, like Candida, that can help cause reaction to high histamine food, or really just cause immune cells to go haywire in the first place.

As I continue on a gut repair protocol, and move to a season where my allergies aren’t as severe, I don’t exclude all histamine rich food, except for the very worst offenders like aged cheese, tea and wine.

Remember, all food contains some histamine. Even if you suspect you have an issue with histamine intolerance, you are not permanently unable to deal with histamine, you just need to do some digging to get a handle on what is the primary driver behind your overactive immune system.

Consider this quote from Chris Kresser:

Histamine intolerance is unlike other food allergies or sensitivities in that the response is cumulative, not immediate. Imagine it like a cup of water. When the cup is very full (high amounts of histamine in the diet), even a drop of additional water will cause the cup to overflow (symptoms activated). But when the cup is less full, it would take more water (histamine) to cause a response. This makes histamine intolerance tricky to recognize. 

Histamine intolerance is not static

So, what factors contribute to the histamine overload Chris references? There are five big ones. 

  1. Allergic reactions to allergens like pollen, dust and ragweed
  2. Diminished genetic ability to clear histamine
  3. Compromised gut health that is producing histamine, or unable to clear it
  4. Lifestyle: stress and substances that block histamine clearance, like NSAIDs and alcohol
  5. Food that is high in histamine (biogenic amines)

#1 Allergy, environment and histamine intolerance

Science Grade:  

This is a big factor almost no one talks about, but allergy to the environment triggers the immune system to produce histamine, which starts to fill the histamine bucket. 

In my experience, especially when the gut has been compromised, seasonal allergies alone can bring histamine levels to the very top of the bucket. For example, immediately after my wisdom tooth ordeal, I couldn’t eat the same way in Austin, Texas as I did when I spent time on the California coast, especially during grass pollen season in Austin. The air-borne allergens took up a good chunk of my histamine bucket, leaving me with reduced wiggle room for food. I would react to foods in Austin that I did not react to in Sonoma for example. The same was true for supplements. I benefit from Lions Mane in California, but because Lions Mane produces Nerve Growth Factor (which is also produced by mast cells when they degranulate and release histamine), I don’t tolerate it as well in Texas, and even experienced intense itching on my arm, which is a known side effect.

In the quote I included above, Chris talks about a “full histamine glass” due to high levels of histamine in the diet. But what about the scenario where the glass is full due to seasonal allergies? If you live in a city where your allergies are particularly bad, your body is constantly producing histamine independent of what you eat. This means that location alone can be the cause of histamine intolerance.

To this point, Dr. Janice Joneja wrote an excellent blog post on the subject of histamine that everyone should read. This quote stands out as particularly important:

A person with histamine intolerance will typically experience a constant fluctuation in the signs and symptoms of histamine excess in response to changing conditions. For example, when a person is experiencing allergy to air-borne allergens such as seasonal pollens, the histamine released in the allergic response alone might put them into the symptom range. In such a case, avoiding histamine-associated foods will no longer relieve their symptoms because their total level of histamine will remain above their limit of tolerance. This explains the observation that during their “pollen allergy season” many people find themselves reacting to foods (usually histamine-rich foods) that they could normally eat with impunity.

Dr. Joneja’s commentary explains why some people feel so much healthier on the coasts. In fact, there are whole communities of people who rate places they’ve lived based on how they felt in that location. Described as the “locations effect,” those suffering from chronic fatigue and mold sensitivity have described significant improvement when they visit certain climates, especially coastal and arid climates.

A word of caution about the locations effect groups. While their stories are useful in understanding that one’s physical health can be affected by location, and dramatically so, becoming phobic of place after place due to an often vague notion of “mold toxins” is I believe a sickness mentality that will keep people feeling unwell. The goal is to enjoy our food and to enjoy our homes. I mention the locations effect community because I think location plays a larger role in health than the medical community recognizes, but the “extreme mold avoidance” lifestyle, is in my view, just another high histamine food list – an unsustainable lifestyle that prevents full participation in, and enjoyment of life.

Now, having said that, I recognize that there are some people who have such great sensitivity, that they can only thrive in certain environments. My discussion above is not intended to marginalize these groups, but rather to encourage those of us with more benign issues, not to take this location issue too far.

Nonetheless, when the impact of location comes on your radar, you start to realize how much of an impact it can make.

For example, a good friend’s wife was just telling me how amazing she felt in Croatia, and how that all went away when she came back to southeast Michigan. Her puffy eyes and sniffles returned with abandon. Similarly, I’ve noticed that I feel incredible after just a few days in Southern California. I don’t believe this is a coincidence for either of us. San Diego and coastal Croatia are both mediterranean climates where Texas and Michigan allergens are largely non-existent.

It makes logical sense we’d both feel better in climates where we have very few allergies.

Related to this issue of allergy and mold avoidance in the chronic fatigue community, which at their essence are issues rooted in air quality, if you’re having issues with histamine intolerance, it may not be a bad idea to identify potential mold exposure in the past. Mold toxins will cause mast cell activation, which is the process your body undergoes when it releases histamine and other inflammatory substances from immune cells. If a portion of your body has been colonized by mold toxins, conditions like histamine intolerance may not be far behind. Detoxifying from the mold exposure could be what solves the histamine issue, because it could be the chronic release of mold toxin into your body that is driving the activation of your immune system. 

To find out if you have elevated mold toxicity, there are two labs that offer high quality mycotoxin panels: Real Time Laboratories and Great Plains Lab. These are both simple urine tests, but elevated mycotoxins from these labs indicate an issue with mold.

For a discussion of how mold toxins link with mast cell and histamine issues, I have included with interview with Dr. Neil Nathan, a mold and mycotoxin expert and clinician, below. Dr. Nathan’s new book “Toxic” is also recommended.

#2 Genetics

Science Grade:  

Note: finding a genetic marker for histamine intolerance does not necessarily mean you will have trouble clearing histamine, it serves as a “clue” to dig deeper into lab work and symptoms.

There are two primary enzymes that break down histamine in the body: diamine oxidase (DAO), and histamine N-methyltransferase (HNMT). (R) (R) (R) Both DAO and HMNT production are coded for specific genes. The AOC1 gene makes DAO, and the HNMT gene makes HNMT.

So as not to confuse the DAO enzyme with the DAO gene, take a look at Aaron’s post: You say DAO, I say DAAO.

DAO breaks down “free histamine,” like the histamine found in the gut, while HNMT processes histamine in the cell.  Variants in the AOC1 gene have been associated with reduced DAO activity. This Italian study found that 10 out of 14 patients with histamine intolerance had very low levels of serum DAO.

The thing to remember about DAO is that not everyone has the same amount, and that your day to day habits play a role in shaping your DAO levels. Some people are genetically more efficient at clearing histamine than others, and lifestyle factors can either improve, or inhibit, DAO levels. Antibiotics, alcohol, local anesthetic and NSAIDs, like Motrin, all further reduce our natural ability to clear histamine by reducing DAO levels.

Aaron’s research indicates that histamine issues often coincide with gut problems because histamine, when chronically elevated in the gut, can cause an increase in zonulin, which is a protein shown to break apart the epithelial wall, which is the lining that keeps the contents of the gut from entering the blood stream.

One of the factors we use to categorize people into diet groups for the custom nutrition plans is histamine.

#3 Gut Health

Science Grade:  

Mast cells reside in large numbers in the gut, so a chronic allergic response paired with an inability to clear the histamine (due to reduced DAO) will irritate the gut over time. (R) According to Dr. Nathan, mold and fungus tend to colonize the gut and the sinus areas with the greatest frequency.

Decreased DAO levels are linked to a number of inflammatory bowel conditions, including Crohn’s disease and ulcerative colitis. (R) I list leaky gut as a condition that can be caused by allergy in my post 6 strange conditions caused by allergies.

To make matters worse, many fermented foods, marketed for “gut repair,” actually produce histamine. Lactobacillus casei, found in many probiotics, is said to be one of the worst offenders. Collagen, another gut repair supplement, is also very high in histamine.

Even undigested animal protein can ferment in the gut causing histamine levels to rise. (R) Excessive protein consumption is one that doesn’t come up in most histamine discussions (many proteins are listed as “safe”), but histidine is an amino acid in protein that converts to histamine. Too much animal protein can cause histamine levels to rise, (R) and your ability to digest protein can be a function of blood type. Although the blood type diet has largely been debunked, the one redeeming scientific feature is hydrochloric acid levels in the stomach. There is actually good science that shows a strong link between certain blood types and their stomach acid levels. Those with more hydrochloric acid have a greater ability to digest animal protein.

For more on that subject, check out: The blood type diet has been debunked, or has it?

There also appears to be a link between small intestine bacterial overgrowth (SIBO) and histamine intolerance, with some people reporting renewed ability to eat histamine rich foods after following a SIBO protocol. This story is extreme, but provides a nice example.

Further, there appears to be a link between SIBO and NSAID use. (R) For people with an already diminished capacity for clearing histamine due to decreased DAO levels, NSAID use could make matters even worse. If you’ve had a recent life event that necessitated use of NSAIDs, it could be the cause of SIBO and histamine intolerance.

Last, we know that Candida degranulates mast cells and can contribute to histamine intolerance as well. In my post on treating Candida, I cite a paper written by a Dr. Truss who theorizes that Candida infection can result from inflammation stemming from a chronic allergic response.

Many Candida infections are secondary to allergic responses of the mucous membranes of the respiratory tract, urethra and bladder

Now, to give both sides, there is also a Quack Watch article on Dr. Truss, but I list the theory here nonetheless as it may clue in a reader as to how better deal with an episode of histamine intolerance.

If you suspect Candida as an issue that is leading to histamine intolerance, a good protocol to try is low carb (less than 50g of carbohydrate a day) for a week, and see how you feel. A low carbohydrate diet, which is by definition low in amolyse (the enzyme that converts starch to sugar) will also stop feeding mold if that is an issue. Both toxic mold and Candida can colonize the gut and sinuses, which can lead to many of the symptoms we associate with histamine intolerance.

The bottom line that gut dysbiosis, in all its forms, can contribute to, or even cause, histamine intolerance. In many cases, healing the gut will clear up issues with histamine.

#4 Lifestyle

Science Grade:  

Lifestyle choices can impact histamine levels in a big way. How we live, what we put in our bodies, and stress levels all contribute to how we handle histamine.

In my case, histamine issues worsened after having my wisdom teeth out.


Prior to the operation, my doctor asked that I take a few days of antibiotics prophylactically as a precaution against infection. Taking antibiotics has been proven to inhibit DAO activity. Of course, I also took local anesthetic, another known DAO inhibitor. (R) I also reluctantly took high dose Ibuprofen for a number of days after the operation to ease pain, which is another big no no when it comes to histamine. This is especially the case if you have certain SNPs in the AOC1 gene. (R) Both antibiotics and NSAIDs limit DAO production. In doing research for our guide to Genetics and Nutrition, Aaron added NSAIDs as contraindicated for the T allele of ACO1 rs10156191.

So, as you can see, I stumbled upon the perfect storm of lifestyle factors that can add up to histamine intolerance. I took antibiotics, NSAIDs, and local anesthesia, all while living in an environment where my allergies are severe.

What are some other lifestyle factors that can contribute to our histamine bucket overflowing?

Believe it or not, strenuous aerobic exercise releases histamine. (R) This is not to say exercise should be avoided, it’s just meant to point out that lifestyle factors play a role in the amount of histamine circulating in our bodies.

Alcohol is another big one. Alcohol, especially red wine, contains high levels of histamine, and is also a DAO inhibitor. If you have histamine issues, it’s best to cut out booze altogether until you can right the ship. 

#5 Diet

Science Grade:  

In the histamine intolerance blogs I’ve read, diet is usually mentioned first, perhaps because it’s easiest to control. However, as this post discusses, the other four factors listed above will directly affect what foods you can handle.

If you’re living in a city where you have very few allergies, have good stress management and strong histamine genes, your likelihood of developing histamine intolerance goes down.

If you’re drinking alcohol all the time, eating sugary foods and taking antibiotics whenever you catch a cold, your likelihood of developing issues with high histamine food goes up.

The goal is to decrease your histamine load so that you have more room for error when it comes to food, because if you follow a histamine free diet for long enough you will effectively starve yourself. 

My experience with histamine food lists

Especially here in Austin during the spring, I can feel anxiety levels fluctuate based on what I ate the day before. I have major grass allergies to certain species of grass that grow in Texas, and spring is grass pollen time in Austin, so my room for error with histamine foods seems to be reduced. If I load up on high histamine foods one day, I won’t feel as good the next, so I can personally attest to the importance of limiting histamine rich food.

However, food is not the only factor.

Whether you have an issue with histamine or not, you are going to have to eat to be healthy.

Exhaustive food lists detailing every food known to man as “high histamine” are not helpful. If the list stopped at dairy, cheese, red wine, and processed meat, that would be one thing. But spinach, avocado, and tea? Seems like a cruel joke. The fact is, most high histamine food lists contain many items that are nutrient rich and healthy as “foods to exclude.”

In my case, and before histamine came on my radar, I was unknowingly eating a very high histamine diet. Cutting out some of the obvious worst offenders, like cheese, and limiting animal protein, seemed to go a long way towards resolving my issues. 

Nonetheless, most of the blogosphere hyper focuses on high histamine food lists, which causes those of us trying to balance histamine levels to associate food with stress and to unnecessarily limit what we eat. Let me repeat: histamine issues or no, you’re going to have to eat. 

When we’re stressed, as when we are obsessing over whether to eat a cherry or a dried apricot, we release more histamine. (R)

While I do feel better by keeping an eye on, and limiting, dietary sources of histamine, a couple weeks of scouring high histamine food lists drove me crazy. I no longer use them, or reference them. I have a solid idea of which foods are highest in histamine, and which ones I don’t do well with, but I also understand that virtually all food contains some histamine. If you have an issue with histamine, and you try in earnest to keep it under control, eventually you will get a sense for which foods cause problems, and what you can get away with. The truly scary part is when you see how much extra wiggle room you have in certain places. 

Why am I not eating a zero histamine diet

I am not eating a zero histamine diet because I find it almost impossible to get enough nutrients, and completely impossible to enjoy life.

My new lower histamine diet takes into account my status as a single man who has to live in the world and be social.

75% of the time, I keep an eye on histamine, but if I’m out to dinner with friends, I am not going to obsess over what entree has the absolute lowest histamine levels. On a recent trip to Sonoma with my family, I abstained from wine, but basically ate everything else I could get my hands on. I felt fine (in my opinion, largely because of location).

I stay away from red wine and most cheese, but have been reintroducing foods like small amounts of avocado, banana, walnuts, and other foods commonly listed as “exclude” on high histamine food lists.

My strategy is to remove “low value” histamine foods, i.e. foods that are high in histamine that I don’t enjoy all that much, and totally exclude the “obvious” histamine offenders like red wine, cheese, and all processed meat.

Extreme diets are not sustainable

The implied consensus view when confronted with a histamine issue is to remove every last drop of histamine from your diet, and if you’re very sick, this may be necessary for a time. However, it might not be. You’ll have to learn what your body needs.

Not everyone processes histamine in the same way. If you’re sensitive, being mindful of histamine is a good idea. However, viewing food as the enemy isn’t the solution. Viewing a laundry list of food as “bad” is not going to take you where you want to go. Diminished ability to deal with histamine, does not equal zero ability to deal with histamine.

Extreme diets are not sustainable.

How many really healthy people do you know who eat as if they are navigating a mine field?

See also: Welcome to Austin, now lay off the sauerkraut

Don’t let histamine issues, or any other health project you’re working on, put your mind into a sickness mentality. Keep in mind that dietary histamine is only one factor that contributes to your overall histamine load. The idea is to eat smart and stay healthy, not to panic and start to fear your fridge.

If you want to reduce histamine, there are plenty of places to do it besides the fridge.

My current histamine protocol

Lifestyle factors working for me right now in allergy land (Austin, TX):

    • Meditation
    • Yoga
    • Limit caffeine (lots of popular caffeinated beverages are high in histamine, but I will still do tea and an occasional coffee under the “don’t fear the fridge” rule)
    • No gluten
    • Limit dairy, especially cow dairy
    • Trips to the California coast (worth an experiment if you have traditional allergies)
  • Whole food, plant based diet 75% of the time has been helping tremendously (not 100% vegan, though). I notice I don’t need to be as strict when I travel outside of Texas
  • Very little alcohol

Plant based “histamine reset” diet

Note: some of the foods I list below are considered off limits on some high histamine food lists. This may not be the right protocol for you.

I have received emails lately asking what I eat when I go plant based to lower histamine levels. As I mention above, I don’t reference a high histamine food list, or really even think all that much about histamine on most days. Having said that, I do find the diet I list below as helpful when I want to reset and really focus on balancing out my system. I will go on a strict, whole foods, plant based diet for 3-5 days and find that these strict diets have benefits that last for days and weeks after. In some sense, what I list below is a kind of modified Prolon diet, albeit with far more calories.

Breakfast – pressure cooked buckwheat porridge (Pocono brand), small amount of walnuts, 1 banana, hemp milk. You can also do oats, but the whole glyphosate issue has deterred me. I use a pressure cooker (Instant Pot) as supposedly, the pressure cooking process completely eliminates the lectin in buckwheat, but not in oats. Buckwheat is also high in quercetin, which is a known mast cell stabilizer. Yes, I know bananas and walnuts are higher histamine foods, but I walk on the wild side with these reset diets 🙂 If you’re really sensitive, just cut out the walnuts and banana, or maybe just use half a banana.

Lunch – sweet potato of your choice, pressure cooked or boiled, with broccoli, and a side of canned black beans with BPA free lining, plus a green salad with broccoli sprouts, homemade olive oil, mustard and apple cider vinegar dressing. Since this is about the lowest histamine meal you could imagine, I will often add to this a little bit of kimchi for flavor, but again, if you’re really sensitive, leave off the kimchi and the mustard in the dressing.

Dinner – same as lunch.

Now, I wouldn’t recommend eating like this forever, but if you want a regimen to lower histamine levels, this is one that seems to work for me as a detox protocol.

My top supplements for histamine intolerance

Below is a list of the supplements I have found helpful for histamine issues. I have tried each of these products myself, but cycle them. I don’t recommend taking multiple new supplements at one time. Better to take a small dose of one, journal for a few days, and then determine whether it works for you.

Histamine intolerance supplements on Amazon

TypeBrandWhat it does
B. Longum Moringa BB536 strainSeeking HealthAids in breaking down histamine and ammonia, increasing levels of butyrate
L. Plantarum LP299v strainSolgarProbiotic that balances microflora
Saccharomyces boulardiiThorneEffective binding agent to detoxify gliotoxin
Diamine oxidaseUmbrelluxBreaks down extracellular histamine, including in the gut
Vitamin CWhole FoodsDiamine oxidase co-factor, calms and centers
Vitamin B6SolgarDiamine oxidase co-factor
ZincSolgarPrevents the release of histamine from mast cells
QuercetinOrtho MolecularPowerful antioxidant
CurcuminThorneNSAID replacement, restores gut health
L-theanineJarrow FormulasPrevents the release of histamine from mast cells
BerberineThorneMay reset histidine metabolism

B. Longum Moringa BB536 strain

I wrote about this probiotic strain in my post about probiotics and brain health. Lots of probiotic blends contain a strain of B. Longum, but few specify which strain. As I touched on in my brain health post, there is emerging evidence that B. Longum aids in breaking down histamine and ammonia, as well as increasing levels of butyrate, a short-chain fatty acid responsible for protecting the gut wall.

Some of you may also want to mix it up with the Bifidobacterium blend by Seeking Health, as they have B. Longum (strain not specified) and B. breve. This tandem was shown to slow tumor growth in mice, per Jennifer’s post a few weeks back. I do cycle on and off of this ProBiopure Morinaga BB536 product as well so as to introduce a greater diversity of strains.

L. Plantarum LP299v strain

Like B. Longum, L. Plantarum has frequently been mentioned as one of the best strains of probiotic bacteria for combating histamine issues, and there are some studies that back up these claims. One of the problems with accessing beneficial bacteria strains through commercially available supplements is that manufacturers throw “the kitchen sink” into the bottles, thinking all strains must be good. Rather than take my L.plantarum alongside strains that are said to be histamine producing, such as L. casei, I isolate good products that give me single strains to experiment with.

The L. plantarum LP299v strain by Solgar is my go-to at the moment.

Saccharomyces boulardii

This is a long post, but if you read the whole thing, you will remember my discussion of mycotoxin panels and mold toxicity. In some people, mold and yeast, like Candida will be what is causing their issues with histamine. The good news is that we have lab tests available to either confirm or rule out these issues. If you get the Great Plains or Real Time Labs testing done, and find that gliotoxins are elevated, Dr. Neil Nathan, in his book Mold and Mycotoxins, recommends S. boulardii as an effective binding agent to detoxify gliotoxin, which can be elevated due to mold, or some believe solely due to Candida overgrowth. I tend to go with Thorne’s product for this.

For a thorough rundown of why and when to take S. boulardii, take a look at this blog post.

Diamine Oxidase

As we’ve learned here and in other DAO-focused posts, diamine oxidase, or DAO, is the enzyme our bodies use to break down extracellular histamine, such as the histamine found in the gut. I’ve found that supplementing with some DAO after a histamine-rich meal can be helpful.

Vitamin C

Well, it doesn’t get much more boring than this, right? But when I was having what felt like high histamine days, taking 1,000 – 1,500mg of Vitamin C calmed and centered me. Of course, as we document on our AOC1 gene page, Vitamin C is a diamine oxidase co-factor, so this makes sense.

Studies have also shown that Vitamin C helps to degrade histamine directly, but be careful, as I mention in a recent blog, not all Vitamin C is created equal. There are concerns about heavy metal toxicity in Vitamin C sourced from China

The Whole Foods Vitamin C brand listed here is organic, made from a food-based source, and I have looked at the supply chain to ensure there are no heavy metals.

Vitamin B6

Another co-factor for producing diamine oxidase, vitamin B6 in small doses has been helpful, although just like zinc, which I will mention next, be very careful with B6 dose. Taking too much can cause nerve damage, and I noticed that I felt a tingling in my feet when I took 50mg a few days in a row.

This is a supplement that requires conservative dosing.

We also recommend Solgar Vitamin B6.


Concentrations of zinc actually prevent the release of histamine from mast cells. (R) When I came across this research, intuitively it made sense since zinc regulates immune system activity and histamine intolerance is tightly linked to the immune system. My experience supplementing with zinc has been that low doses are better.  When I have experimented with large 50mg doses, I’ve found tremendous benefit in the short term, but notice that I need to rapidly back off and move to a maintenance zone or I will start to experience unpleasant side effects.

In my case, I believe a transition to a more plant based diet left me zinc-deficient, and a large preliminary dose helped me put my levels back to normal. The 22mg Solgar zinc supplement also is recommended.

See also: Zinc has many health benefits but don’t overdo it


As a proven mast cell stabilizer (R), quercetin is one of the usual suspects on the histamine supplement circuit, but it’s a powerful antioxidant that has shown efficacy in a number of contexts, so don’t pigeon hole this mighty flavonoid. In fact, my post on how apple consumption has been linked to decreased risk if cancer in a number of large epidemiological studies is largely about the health benefits of quercetin. I have cycled on and off with a 500mg quercetin and 150mg bromelain regimen in the mornings and have found that somewhat helpful.

For that experiment, I used a Whole Foods brand product, although I have also used a “natural antihistamine” called D-Hist by Ortho Molecular which I think is a better product because of the addition of nettles, Vitamin C and NAC, all of which have been shown to help with histamine issues.


I use curcumin in place of NSAIDs, which are contraindicated for certain AOC1 genotypes and which won’t do wonders for anyone regardless of genetics. Yes, I am aware of a rat study which showed that curcumin reduced DAO levels. Even if that applies to humans, NSAID use is much worse for DAO and curcumin has been shown to be helpful in restoring gut health in human studies. In addition, the studies are conflicting. This study in mice found that curcumin reduced histamine levels.

I also list Meriva’s phospholipid blend here as well, which is another good option, although as I detail in my post on curcumin formulas, may not be recommended for everyday use due to the phosphatidylcholine.

For more on the potential health implications of phosphatidylcholines, take a look at our TMAO posts.


As Aaron and I wrote about in our theanine post, theanine is another supplement that benefits the immune system and has been shown to inhibit the release of histamine from mast cells. (R) (R) Theanine is even more interesting in light of the fact that it is a glutamate antagonist, and histamine can reduce glutamate release, an especially important factor for people with GAD1 SNPs.

I found that the 100mg dose of Jarrow Formula’s theanine was plenty for me, though currently they only sell the 200mg dose. This is another supplement that I stagger — I don’t take it every day.

An interesting note on berberine

I’ve written about berberine twice so far on the blog: once as an anti-cancer supplement and once on a men’s health post I did on prostatitis. So, you may be asking, why am I bringing it up in this histamine post?

Good question, and it’s because of a few snippets of this prostatitis rat study I found. One of the pathways the authors of a rat study on nonbacterial prostatitis found to be disrupted in afflicted rats was histidine metabolism. Authors further found that berberine effectively reset histidine metabolism, which helped alleviate prostatitis:

Our findings also show that berberine exhibited preventive efficacy against NBP by adjusting these multiple metabolic pathways to their normal states. Particularly, berberine can effectively regulate the metabolism pathways of histidine, nicotinate and nicotinamide, phenylalanine, arginine and proline, and tyrosine, and can exert a good therapeutic effect on NBP.

Now, for those of you who don’t know, histidine is an amino-acid precursor to histamine, meaning histidine is part of what makes histamine. This small rat study suggests that berberine may help the body better metabolize histidine, which could have beneficial effects for people with histamine intolerance. Presumably, one of the reasons people with histamine issues do well on a more plant based diet is their inability to deal with all the histidine in meat. Is it possible berberine resets a disrupted metabolic pathway?

Maybe, although the answer is far from conclusive. If you decide to try berberine (we like Thorne’s berberine product), be very cautious with dosing! This is a strong supplement that will lower blood sugar.

Closing thoughts

Having knowledge of histamine intolerance is empowering, but not if it causes you to fear your fridge.

High histamine food lists can provide a framework for what foods to consider avoiding, but not everyone with histamine intolerance needs to avoid all histamine rich foods all the time.

Basic genetic testing, through a provider like 23andme, can give you a window into potential problems with histamine clearance. It also makes sense to see an allergist and get tested for common environmental allergens. Knowing what your air-borne triggers are can help you plan food choices around seasons that will be the worst for you. For me, it’s spring time in Austin.

Avoid yogurt, and other fermented foods that contain histamine producing bacteria.

If it’s not essential use, consider avoiding NSAIDs and antibiotics, they can both disrupt production of the enzymes that degrade histamine.

Last, remember to relax. Stress causes mast cells to release histamine. All of us can get rid of some amount of histamine — the trick is to figure out where your ceiling is and stay beneath it.

Good luck.

John O'Connor

John O'Connor is the founder of Gene Food. Read his full bio here.

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  1. Mick says:

    Apart from minimizing high histamine foods, I’d also add get a Igg food intolerance test. I avoided doing it because it was expensive and people claim the results are bogus – and other say it solved all their problems.

    All I know is that my genetics is asthma/eczema/hayfever type and the list of foods that came back as extremely reactive was everything people have been saying for a while for people with asthma/eczema/hayfever to avoid; ie. citrus, nuts, eggs, diary [whey was ok], wheat, pseudo grains, tomatoes, etc….

    So if yo can afford it, try it.

  2. SuAnn says:

    I’m not sure yet if histamine intolerance is what I have. My MAIN symptom is dizziness. Not vertigo, and not dizzy spells, but just constant dizziness. The reason I think it is HI is, I also have some itching and have for a while; I have headaches; and the exercise “thing” is so true. I’ve been to the ER twice in the last 2 weeks, because the dizziness got so bad, and on both of those days, I had exercised pretty good on an elliptical. Additionally, I’ve been on antibiotics a good part of the year because of constant sinus infections, which we recently learned were not going away because I had 4 dental implants that were INSIDE the sinus cavity. I recently had them removed, but the dizziness DID start several days before that. I’ve also taken a lot of NSAID’s because I had a broken foot earlier in the year, and then all the dental/sinus issues. So, it just seems that my current state of dizziness is HI. Anyone ever have dizziness as a symptom, or know someone who did, OR, does this all sound like a reasonable analysis? I was also taking apple cider vinegar until yesterday when I learned of what MIGHT be going on. Thank you.

  3. Genius Turner says:

    Thanks for the excellent post, John.

    Of late I’ve noticed there appears to be a correlation between body heat and mast cell activation. Namely, after a round of exercise I invariably notice a small number of hives; it’s as though histamine sufferers would be best served to monitor the inflow/outflow of energy. In short, everything from caffeine and heat, in general, which is a form of energy, all seem to trigger histamine.

    At any rate, thanks for the insight! Keep up the good work.

  4. Jean-Pierre says:

    Some good info here, but some bad advice too. Apple Cider Vinegar is a definite no no for those with histamine intolerance.

  5. Christina says:

    Just curious, have you had allergy testing? Did you test positive for seasonal allergies? I have read most histamine intolerance responses are not true ige allergies.

  6. Elaine Moore says:

    Great article. I have an irregular heartbeat and palpitations when i take most probiotics but don’t have any significant symptoms from tea, red wine or cheese. I’ve ordered diamine oxidase and some probiotics with non-histamine producers. I do have the SNP mutation for low diamine oxidase and i take many antioxidants. Is this primarily a gut issue?

  7. Femke says:

    Thanks for this very clarifying article. This completely explained what I have suspected these last couple of months. I’ve had a stressful period followed up by my season allergies and ‘all of a sudden’I’m histamine intolerant. With very severe complaints. For e.g: Can’t eat tomatoes without lying wide awake at the moment and having heart palpitations and heat flushes while during winter I eat a lot of tomatoes without any problem. Had some issues with food during earlier springs, but not anything like this…. Love that you mentioned Dr Janice Joneja, think she’s fab. Thanks again, xx from the Netherlands

  8. jodi says:

    My 8 year old son has suffered from severe environmental allergies since he was 2. He takes a high dose of anti-histamines daily along with flonase and asthma medication. In the spring though, the higher levels of pollen cause him to develop anxiety. It has been suggested to me that he needs to lower the candida levels in his gut. Any suggestions on how to do this without a major diet change? He eats well balanced meals, but he’s 8 so there are snacks in there and I’m not going to be able to get him to eat buckwheat porridge.

  9. Gino Côté says:

    Greay article but you are confusing High Histamine with Histamine liberator. For example, Coffee is not hight in Histamine its a Histamine liberator. It contain zero Histamine.

  10. martha says:

    I would like to understand the relationship between histaminosis due to DAO deficit and high ammonium levels. From what I’ve read in your fantastic blog, the answer may be in the low levels of gastric acid? Can a high protein intake in the diet increase ammonium and histamine at the same time by these low levels of gastric acid?
    On the other hand, is it possible to have headaches when it rains or the weather is humid due to a problem with mycotoxins?Thank you so much…great job 🙂

  11. Samia says:

    Hi John,
    Do you ever take antihistamines during allergy season? Natural remedies don’t seem to work for me when the weather is particularly bad (usually rainy days with mild temperatures). I used to take Zyrtec daily and when I stopped my symptoms came back 100x worse so I’m always hesitant to take any antihistamines but my allergies are unmanageable right before spring. Would be grateful for any insight!

    • Hey Samia, yes, I do. I will intermittently take loratadine and Zyrtec on and off when I feel my allergies are particularly bad. I do not take them everyday for any extended period.

  12. Mick says:

    Hi John

    1. I feel you’ve forgotten to highlight an import point. You mention it once during the above but don’t mention it’s Lectins [” the pressure cooking process completely eliminates the lectin in buckwheat, but not in oats”]. I think avoiding high Lectins foods is an important thing and if you are going to eat high Lectin foods, do what you mention and pressure cook those foods as it destroys the lectins.

    2. HealingHistamine website has some good recipes for a low histamine diet. Sadly Yasmine past away but the family is still looking after the website and taking orders for her books [i’ve got one of the cooks books and its great]. Yasmine’s focus was all about not getting bogged down in food lists of what NOT to eat and slowly expanding the diet – a sensible approach


  13. Paula says:

    Hi John,
    This comment/question is long, so skip to last 6 lines for actual question!!
    I loved this post, but now I’m more confused than ever. I’ve been reading so much that my brain is about to explode. I have had symptoms of eczema all my life but they have gotten worse over the years. Tons of corticosteroids topical and orals when flair ups were bad. I never wanted to take those scary eczema drugs, so 7 years ago I went Whole 30 and found foods that triggered my eczema. Easy to avoid- if I chose to have any of those foods, I’d just be aware of accumulation, and limit other offenders—so to say, I practiced balance. Fast forward to this Dec, I started getting super itchy and literally pummeled my legs in my sleep— until bruised. (I had acrylic nails which are rounded edges instead of sharp so scratching won’t let you break skin, so I found out). I thought, wow, I guess I had a few too many cookies this holiday season. Continued itching all over my body beyond my normal eczema, but wasn’t putting anything together. I eat typically a 90% organic well-sourced diet that includes some animal protein. Did a Whole 30 again to ‘reset’ and get rid of those things previously identified and that I had been partaking (because I’m human), but this time, my eczema was getting increasingly worse and now had a rash on my trunk, neck, arms…WTH?? I started researching gut dysbiosis, I felt like despite my good food, I wasn’t absorbing any nutrients. I found GAPS diet and started the intro and got worse!! I felt tired, then got the flu. One thing lead me to another and I arrived here. Here’s the big, possible epiphany??…. I started thinking back and I remembered my PCP talked me into getting a flu shot, which I have always avoided, even though I am a dental hygienist and it is strongly recommended- not required. It seems all my terrible symptoms started about 2 weeks after that….I can’t find anything that may link HI to flu vaccines. Did my histamine cup runneth over?🧐 Am I crazy? Do I treat SIBO, leaky gut, or HI?I’m seriously confused, and feeling defeated.

    • Waverly says:

      Hi Paula,

      Oh my gosh, I also suspect my last flu shot in triggering some terrible symptoms I have been having! Literally no one except naturopaths seem to listen to me about this. I was also super run down (recently had a baby and also have another child, about 3.5 at the time), having not slept wee, for years. I will never ever get another flu shot. I have had adverse vaccine reactions in the past that took about one year to clear up. I hope you are feeling better now. (Not sure you will even see this, but I wanted you to know you are not alone with the flu shot thing).

      And thanks to John for the helpful article!

      Best to all.

  14. Sara says:

    Hi John, thank you for the excellent article, very helpful! I was just wondering what your thoughts on two things that I find skyrocket my allergy response:
    1. Sugar, sweets etc
    2. Lack of proper sleep!
    So why isn’t sugar mentioned anywhere regarding food histmane response or does it have an indorect effect on histamine production? Also I know that sleep has something to do with it because when i sleep late and get up early feeling exhausted I just have a very bad allergy day!
    One more question, how bad is canned tuna? I

  15. Marie says:

    I just want to clear this out; Tea is not good if you’re histamine intolerant, right (“the very worst offenders like aged cheese, tea and wine.”). But a pill with L-Theanine is ok? I’ve been drinking a lot of green tea since I thought it was good for me! But now I understand that I probably have histamine intolerance, can I change that green tea-drinking to a L-Theanine intake instead?
    Best Regards: Marie

  16. Diane says:

    Thank You, John.
    Glad to see you can approach this from a sensible perspective. I little rationalism can go a long way when we want to develop a lifestyle for long-term sustainability. Great ideas here!

  17. Carol says:

    Although I do understand why you are encouraging people not to freak out when they determine histamine is behind their symptoms, it does feel a bit irreverent towards those of us who have no choice but to hunker down and avoid the food. It is the only thing I CAN fully control, and, when I don’t control it I suffer drastically for it. When my histamine cup runneth over, regardless of the reason, experimentation has proved to me that I can eat only a narrow number of vegetables, and that is where I must stay for several months until the levels drop. Any deviations lead to an immediate undoing or exacerbation within 5 minutes of ingestion. I do take the important supplements to help assist, and eventually I can relax a little bit and try a few nuts, or a piece of bread. I can’t do what you describe for yourself and have a bit of high histamine here or there. Please don’t imply that we are going overboard or acting erratically if we have to jump all in. Often, we learn something valuable on that ‘jump in’ journey. Other than that, thanks for a great article.

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