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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. He is passionate about nutrition, genetics, and wellness and uses this blog to publish self experiments as well as some of the research that the Gene Food team does internally to highlight stories of bio-individuality.

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  1. carole field says:

    Do you or Gene Food have a contact number? Also, important query: If DAO supplements are made from egg, is that not a conflict? Are not the whites suspect? Thanx for the answer in advance.

  2. Beth Brady says:

    Hi John,

    You write that you avoid “Most” cheese. What cheese do you eat? I have just started to lower histamine foods from my diet after checking every box for histamine intolerance. Unfortunately, there is no way I can sustain the diet. I have been eating fish and my diet is mostly plant based, however I like feta cheese in salad and well as plain yogurt. Just was hoping you could weigh in as you seem reasonable. Thanks Beth

    • Hey Beth,

      Yes, as a general rule, I avoid all cow dairy and opt for goat and sheep dairy on occasion instead. I will have a goat milk yogurt every so often (once every couple weeks), and I also like feta cheese. For a rundown on how sheep and goat dairy differ from cow, this blog post is a good starting point:

      At the end of the day though, the blogs and papers can only tell you how others reacted, not how you will react, so best to keep track of the foods that really get you and stay more lenient with nutrient dense food that your body needs and tolerates a bit better – usually plant foods, but not always. Overall though, I don’t eat much dairy. It definitely isn’t a staple of my diet.

      Hope that helps and good luck.

      • andres says:

        John, I am curious why would you avoid cow dairy but not sheep goat one. The only difference IMHO is the type of protein A1 vs A2, but I would presume that difference would not have any difference on amine generation and consequent histamine intolerance. Am I wrong?

  3. Carl says:

    Hi John, I had a bunch of reactions to one of the new age Monoclonal Antibody medications. The clinic put me onto anti-histamine med. Turns out all MABs are cleared the same way. Next time, I’ll impliment your regime ahead of time. This issue affects a large and growing population of patients with severe conditions. It would be interesting to run a blog on this topic. Thanks.

  4. Kathy says:

    Great article and site! Just stumbled upon it. Completely agree that histamine issues are larger than just food. I have heavy-duty pollen/mold allergies (confirmed by testing). Can definitely relate that at certain times of the year, like now in spring, it doesn’t take much to overflow my histamine bucket.

    An issue that I don’t see mentioned very much is pollen cross-reactivity with food (and sometimes other pollens). Certain pollens cross-react with fresh fruits and vegetables; there are many charts online that list the cross-reactions. So, for example, when grass pollen is high, I avoid eating fresh tomatoes, melon, and bananas so I don’t overflow the histamine bucket. I’ve found that awareness to be super-helpful in keeping my symptoms under control.

    Thanks so much for this excellent site!

  5. Alisha says:

    Austin year round is a nightmare for me, not just spring.Nine years and no relief. I think I’d rather just move.

    • My Chase banker told me he knows 7 people in the last 6 months that have left Austin due to allergies. Probably the best city in America right now, but the allergies are brutal, I agree. August is a good month for me because everything burns off, expect the mold of course.

  6. Crosswind says:

    I think I’m dealing with *Glutamate sensitivity too. I have DAO+/- mutation, HNMT, MTHFR & others that affect histamine breakdown, but also mutations that block my ability to handle *glutamate. My holistic MD told me to even caution taking glutamine supplement. Shares the same pathway & a conversion link.

  7. Rae says:

    I really appreciate the levelheadedness in this article. I’m so glad that I came across it first, before looking for other information. I also have found that B5 can help quite a bit, as it supports the adrenal glands which are also a factor In suppressing histamine. Thanks again!

  8. Kay says:

    Hi John!

    I tend to have GI issues with Vit C supps, and flushing/headache/swooning with Vit B supps. Is it possible to get a DAO supp without Vit C in it?

    Thank you!

    • Hey Kay, the DAO I list in this post only has 10mg of Vitamin C, which is a very low dose. I am not aware of another DAO supplement on the market, but that’s not to say there isn’t one out there.

    • andres says:

      All DAO supps come from the same factory in Germany, different companies just affix their company labels.
      There are a few brands out there that sell without vitC.

  9. kathleen says:

    Hi John,
    What a great read! I’ve been eating low histamine diet and really miss the old foods I can’t partake in right now.
    I acquired CDiff months ago and have been on the road to recovery. I’m sure it was due to the back to back antibiotics I had to take for other health related issues, but the treatment for the CDiff I think finally did my gut flora in.
    I think more western doctors need to know about the side effects caused by antibiotic (broad spectrum specifically) and work harder to educate their patients on other, dare I say, holistic approaches to treatment – instead of heading straight to the antibiotic shelf.
    I have faith that my histamine tolerance will spring back after my gut heals. The tricky part has been – how to heal a gut while you’re histamine intolerant?
    Traditional methods of collagen supplements or bone broth irritate the situation. Bad.
    I’m taking the approach that it’ll just take time and unfortunately, I will not be able to utilize the leaky gut healing options normally suggested. Could I be wrong?

    P.s. Your Austin allergy story hit home as my family is from S.A. I noticed I tolerated EVERYTHING better on my last visit to S.A. when I went in early March, instead of November.
    Guessing Mountain Cedar?

    • Kathleen, thanks for the comment. It makes sense that collagen and bone broth are problematic as they are both high in histamine. I wrote a post about unconventional ways to heal the gut that you find useful:

      Another thing to talk to your doctor about is a mycotoxin panel as a positive test result there will help the two of you zero in on additional strategies. Have you tried S. boulardii?

      And yes, sadly, central Texas is a major hotbed for allergies, people have no idea what it’s like until they experience firsthand!

      • Kathleen says:

        Thanks for the reply John!
        I was taking S.Boulardi until two weeks ago when I decided to take a break and switch to a probiotic with b.infantis, b.lactis, b.longum, and b.bifidum.
        All are supposedly less harmful on a sensitive gut. My plan is to rotate between these two probiotics for biome diversity.

        Heading over to your article on unconventional ways to heal the gut now.
        If FMT is mentioned I won’t be calling you. Haha!

        And thanks for the tip on mycotoxin.
        Have a great weekend!

    • Fran says:

      Oh my goodness – I feel the same. I feel as though I’ve accidentally given myself Histamine Intolerance whilst trying to heal my gut. I was consuming recommended amounts of certain foods daily – Apple cider Vinegar, avocados, bone broth, fresh fish, dried dates, olives, lots of vegetables, tomatoes, green tea… Plus I stopped eating gluten and dairy. And while my digestion got SO much better so quicky after years of struggling, from one day to the next I started getting a drippy nose, congestion in the sinuses, a tight chest like I can’t breath deep enough and it doesn’t seem to get better now no matter what I eat/don’t eat. What a minefield ! Any updates on your healing journey or has anyone experienced similar stuff ?

      • luce says:

        EXACTLY the same as me! I thought I was eating healthily! Now I can’t seem to eat anything! Nasal conjestion, can’t breathe, tight chest, redness in my face and eyes. 🙁

      • Alicia says:

        Fran! Everything you wrote is exactly what happened to me! Working on trying to heal the gut. But I do add i have CIRS and Lyme disease which adds to the insane pathways to navigate heading.

      • Cheri says:

        Exactly the same story with me!! I’ve been eating bone broth twice a day, lot’s of avocado’s, and collagen, along with all the others you mentioned thinking I was healing my gut issues!! UGHH…wow, this has been so eye opening and frustrating! That being said…I’ve learned a lot in the last few hours reading all of this, and will go to my Naturopath with my questions and tests I want in hand…crazy stuff! I was sure doing everything wonder my allergies have been the worst ever lately!

  10. Josh says:

    I’ve always felt like taking nasal antihistamine spray has caused me a lot of brain fog. Do you think I should just muscle through seasonal allergies in order to maintain my mental acuity?

  11. KP says:

    I’ve learned more than any doctor I’ve been to about my gut issue.
    I’ve been having food intolerance problem since 10 years ago, in recent years to the degree I couldn’t eat any spices, including garlic, onion, ginger, soy sauce, etc. I’m going to use the supplements you recommended.. Thank you!

  12. Alyson says:

    Very interesting that you bring up Lion’s Mane – a supplement I love and rely on every day for an unrelated condition. I never would have connected it to being part of my worsening histamine intolerance. Thanks so much for mentioning it!

  13. David K says:

    Just now learning about histamine intolerance, I have bad environmental allergies and live in mid-florida (not a good combination).
    Would you recommend starting with gut issues? Should I take DAO daily?
    Any insight would be helpful.
    Thank you,
    David K.

    • Hey David,

      Thanks for the comment. I’d start by seeing a good doctor who can test you for foods that you have an IGG reaction to, as well as an IGE panel of traditional allergens. Other than that, difficult to say without knowing more. Have you tried zero sugar for a few weeks?

  14. Eileen says:

    Phew…what a confusing medical journey I have been on the past several months!! I have been diagnosed with chronic urticaria and angioedema. I have no history of allergies of any kind, went to my allergist and ruled out allergies as the cause of my full body hives and face swelling. If I don’t take an am and pm dose of antihistamines, I break out!! I drank excessive amounts of kombucha for about 2 years, I had sporadic hives (which I thought might have been bug bites) then someone gave me water Keifer grains and I started making my own water Keifer …a few days later boom…angioedema and hives!!! My theory is I have gut disbiosis, maybe sibo. Currently I am taking oregano oil and olive leaf oil for 2 weeks, adding a soil based probiotic ( one you mentioned above) I will buy the other mentioned to add more strains. I was taking quecetin complex with ester c by solgar but stopped because i was afraid it had stuff that aggravated the situation. I want to add something to heal my gut lining, any suggestions? Have you heard of Restore, any opinions? Everyone says they avoid foods that bother them but I am on a maintenance dose of antihistamines, so I don’t really react to anything. I have tried stopping the antihistamines and no matter what I eat within 24 hours I am a wreck a mess!!

    • Hey Eileen, my inclination is to take a smaller and smaller range of supplements, focusing in on the ones I know work for me. Prescript assist is good for me, but I cycle it, so I only take it about a week a month. I take B. Longum more often, but also cycle. I wrote about oil of oregano in this post on Candida. I don’t love it because it acts as an herbal broad spectrum antibiotic and will likely wipe out good bacteria with the bad. If you’re looking for a good supplement that is anti-microbial, but also promotes the body’s detox pathways, take a look at glucoraphanin / sulforaphane, and pycnogenol for an anti-fungal that also acts as an antioxidant. Restore is basically just glutamic acid, which I don’t like because some people have mutations in their GAD1 gene that prevent glutamic acid from effectively recycling into GABA. But ultimately, the best course is to work with a good doctor who can run the appropriate labs and get to the bottom of the situation.

      • Eileen says:

        Thanks John for responding so quickly! Finding a good functional doctor is part of the struggle. I will read more of your posts…very informative ☺️

  15. Loriann Rivard says:

    Hi John, Read your article, found it to be very helpful to me. However, I have a quick question, could you please share with me what type of Vitamin C you use? Ascorbic acid seems to be the enemy for me, ugh!! Ive tried CamuCamu, its not helping. Appreciate your help, Thank you so much. Lori

    • Hey Loriann, I have been taking 365 Brand Vitamin C with Rose hips, which is ascorbic acid. I do know that calcium ascorbate is alkalizing and ascorbic acid is acidic, so perhaps you may tolerate calcium ascorbate better. Having said that, I usually stay away from calcium supplements due to the role calcium plays in excitoxicity, although admittedly, this is getting perhaps a bit too far down the rabbit hole.

  16. shauna peterson says:

    Dear John, Thanks so much for your wise words. I’ve been stressing myself out and fearing the fridge after someone suggesting I may have sibbo and histamine intolerance. If you listen to all the blogs and food lists, your right you’d starve. Lucky for me my symptoms are not severe. Will increase meditations. The Diet Poem Conflicting dietary information has brought me to my knees, Paleo, anti histamine, or going gluten free? Who to trust and listen to, I think I’m going to sneeze! Perhaps a lemon water fast? Oh honey, pass the cheese.

    • Thanks for the comment Shauna, glad you found the post useful! Yes, I find focusing in on some core changes makes for a much more sustainable solution than obsessing over food lists that are often 100 foods long.

  17. Katie says:

    I find this very interesting. I recently had 23 and Me DNA testing, and have the ability to access the raw data. What specific genes can I look at to determine if I have a histamine issue? By no means am I a genetics expert, so please dumb it down lol. I can search by the specific name of the gene so hopefully there is one I can search! I also find it really interesting that meditation helps, any clue as to why? Also curious to hear what you think about the correlation between allergies and anxiety – do you think that is a histamine connection?

    • Katie, regarding allergies and anxiety, yes, there is a connection, which you can read about here. As far as genes to look at, take a look at AOC1, we have a few SNPs for that gene listed in our guide. Regardless of the condition, or genetic profile, stress isn’t good for us, period. Stress is thought to exacerbate conditions like histamine intolerance and Candida. Presumably calming the mind and bringing down cortisol levels helps keep histamine levels in check. For more on that, check out this study.

    • Kaitlan Murphy says:

      Histamine intolerance can be caused by more than things than genes. I was diagnosed with a parasite in the fall 2017. I have had serious anxiety over the last few years and histamine intolerance symptoms. Since getting rid of the parasites, my anxiety has not completely abated, but is 80 percent less.
      Getting tested for parasites may be a road you want to pursue. I recommend getting a Vega test. I was tested at my local hospital as well as through a Natural Path and the Natural Path’s Vega test was more detailed in it’s diagnosis.
      Histamine symptoms are lessening as well as a slowly repair my gut health.

  18. Ally says:

    Hello- I’ve had multiple blood tests that proved nothing. My glands swell on each side of my face and glands under my chin. It’s histimines releasing and they can at any moment. Two years on low histimine foods and still no answers to causes. Frustrated. Any advice? Thanks!!

  19. Sammy says:

    Hello !

    I would like to know if there is any link between Ezetimibe and Diamine oxidase enzyme ? Thats the only medication I take and developed panick attacks ( adrenaline rush ) that did not go away for 3 months till I went on a low histamine diet now for 2 weeks and that helped a lot .
    Thank you so much


    • Sammy, poking around for a minute online this morning, I did seem to come across some literature that would indicate that Ezetimibe may have an impact on DAO levels, but nothing concrete I can link to yet. I am not familiar with that drug, but we will try to mention it in a future post, or update this one if we find a study.

    • John B says:

      Well, it is a possibility that this monoclonal antibody gives you and allergic response increasing your histamine levels if it shares part of the protein structure with some antigen that you are allergic to, pollen, dust mite feces, etc.

      In particular dust mites are very potent allergens that people do not pay much attention to and the are everywhere in our houses specially if we like to have a comfortable temperature. They are a source of inflammation whether you are allergic or not !
      If you are allergic to pollen there are many chances you are allergic to dust mites.

  20. Siobhan Loughran says:

    l am just dipping my toe in the histamine ocean because of my daughter who seems to have chronic pelvic pain and aura without migraine. Yesterday we gave her an antihistamine which seemed to lift the aura caused by hayfever and perhaps more, and we started to look into migraine aura caused by histamine and possibly the cause of cpps as well! Thank you for your down to earth approach because my daughter had just said ‘well what can l eat?’ and l was starting to panic.

    So if you think you have hayfever problems in Austin, come to Ireland in July when all the hay is being made!

    Thanks John,


    • Siobahn, thank you for the comment. I am glad my post could help in some small way. After starting to see an issue with histamine, my reaction was the same as your daughter’s! The lists are overwhelming, but not everyone will have issues with all histamine rich foods, and the same foods won’t necessarily bother us for our whole lives, that was the point of my blog.

      What I am really into researching at the moment is the role of the gut, and also one’s physical location, in how they deal with histamine intolerance. I would be curious top find out whether your daughter’s histamine issues abate during certain seasons, or whether they are reduced in different locations, a mediterranean climate for example. I travel often, which is how I noticed my symptoms improving, and improving dramatically actually, in California. When one of the histamine producing factors are lessened, for example lower pollen count, it seems that there may be more room for food. This is confirmed by Dr. Janice Joneja’s work. Also true of gut health, if, for example, a condition like SIBO is producing lots of histidine. Even though they aren’t listed on traditional high histamine food lists, I have been also having good results avoiding grains. Last, I had no idea that Ireland could compete with Austin on the allergy front, I thought we were the allergy capitol! Thanks again for the comment and good luck!

    • Annmarie Kostyk says:

      Oh my gosh! I visited Dublin/Malahide last November. I thought I was going to die by the time got home. The mold is terrible! I was sick for 3 weeks.

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