In this piece, functional medicine practitioner Will Cole, DC, explains how histamine intolerance could be at the root of your health issues and shares what you need to do to heal. To learn more, check out his mindbodygreen class, The Elimination Diet: A 60-Day Protocol to Uncover Food Intolerances, Heal the Gut, and Feel Amazing.
Bone broth and fermented foods are great for healing your gut. Beans and spinach are healthy staples for a plant-based diet. Smoked meats and fish are perfect if you're eating Paleo.
Right? Well, for some people, no! In some cases, because of something called histamine intolerance, all those "healthy" foods that are supposed to be great for you can actually make you feel worse. It's an underlying cause of inflammation and chronic symptoms that I often see in patients.
What is histamine intolerance?
Histamines are chemicals produced during any allergic reaction. When an allergen triggers your immune system, a type of white blood cells called mast cells release histamines during the inflammatory-immune response. This is part of a healthy, balanced immune system.
There are also foods that naturally contain histamine, or trigger the release of histamine in the body.
But problems occur when there's an overload of histamine from a dysfunction or deficiency of the enzymes that break histamine down, called histamine N-methyltransferase (HNMT) and diamine oxidase (DAO). Without the enzymes to effectively get rid of excess histamine, the overflow can cause a lot of problems. This is histamine intolerance.
What are symptoms of histamine intolerance?
Histamine intolerance is basically an allergic reaction without the allergen, sometimes called a "pseudoallergy." So the typical symptoms of histamine intolerance are similar to allergic reactions (like rash, trouble breathing, and a runny nose).
Other common symptoms that I see in patients with histamine intolerance:
- brain fog
- digestive problems
- hormone imbalances
- low blood pressure
- low sex drive
- racing heart
Foods to avoid with histamine intolerance:
These are the foods that could cause an overload of histamine:
- Alcohol (including wine)
- Bone broth
- Canned foods
- Fermented foods (kefir, kimchi, sauerkraut, yogurt)
- Legumes (chickpeas, soybeans, peanuts)
- Processed foods
- Smoked meat products (bacon, salmon, salami, and ham)
Foods that release histamine
These foods are low in histamines but can trigger the release of histamine and create problems for people with histamine intolerance:
- Citrus fruits (kiwis, lemon, lime, pineapple, papayas, plums)
Diamine Oxidase (DAO) enzyme blockers
- Energy drinks
- Teas (black, green, yerba)
What to do if you have histamine intolerance:
If you struggle with the symptoms above or find that these foods give you problems, there are a few important steps to take. Here's what I recommend:
1. Find out for sure.
In my clinic, I run labs to look for a high histamine/DAO ratio. This suggests that you're eating too many histamine-rich foods for your body and that you don't have enough enzymes to break them down.
2. Get to the root of the problem.
Why might people have histamine intolerance in the first place? As a functional medicine practitioner, my goal is to get to the root cause of inflammatory problems like histamine intolerance. A few common possibilities:
- leaky gut syndrome
- small intestinal bacterial overgrowth (SIBO)
- gluten intolerance
- nutrient deficiencies
- medications (NSAIDS, pain medications, among others)
- methylation impairments
- disorders like mastocytosis, which leads to too many mast cells
3. Eliminate your problem foods.
An elimination diet is the gold standard for uncovering foods that trigger inflammation for you. The elimination diet I cover in my mindbodygreen video course is low-histamine-friendly, and I'll walk you through how to reintroduce foods after 60 days to find out which ones are causing you problems.
4. Focus on eating fresh foods.
Bacterial growth in foods left unrefrigerated can increase histamine. So try to eat fresh foods as often as possible, and freeze leftovers immediately in single-serve portions.
For a low-histamine diet, focus on these foods:
- Coconut milk
- Egg yolk
- Fresh wild-caught fish
- Fresh organic meat
- Fresh vegetables (except eggplants, tomatoes, and spinach)
- Gluten-free grains (rice, corn)
- Herbal teas
- Noncitrus fresh fruits
- Rice milk
4. Heal your gut.
Foods aren't the only ways you can overload on histamines. Gut bacteria imbalances of the microbiome can also release histamine and trigger symptoms. Problems like leaky gut syndrome, SIBO, and candida overgrowth could be fueling your histamine intolerance.
Note: Certain probiotic supplements, especially those containing prebiotics, won't agree with you if you have bacterial overgrowths.
5. Eat foods that help your body get rid of excess histamines.
I recommend increasing your intake of foods with vitamin B6, vitamin C, and copper.
Vitamin B6: chicken, turkey, and potatoes
Copper: asparagus and liver
Vitamin C: fruits and vegetables (except for those high in histamine)