On A Low-Histamine Diet? Don't Make These Common Mistakes
If you suspect that a histamine intolerance is the culprit behind your headaches, stomach pain, diarrhea, rashes, flushing, anxiety, or rapid heartbeat, the next step is to experiment with a low-histamine diet. But once you read the list of foods you're supposed to avoid, you might feel frustrated and discouraged. How is it that all the foods you really love are the ones that contain higher levels of histamine?
It can be anxiety-provoking to say goodbye, even temporarily, to foods that have been staples in your daily life for so long. That's why when I put my patients on elimination plans, I like to emphasize what they can eat and create meal and snack ideas based on that. The biggest mistake you can make is to ruminate on everything you can't have and forget all the delicious foods you can eat.
Once that's out of the way, it's important to avoid other common histamine diet mistakes, like:
1. Thinking all "healthy" foods are low-histamine foods.
Because when it comes to histamine, the general rule of thumb for a low histamine diet is to stick with fresh and minimally processed foods as much as possible. This is because bacteria convert the amino acid histidine to histamine over time, and protein-containing foods like aged, cured, or smoked meats, as well as fermented and aged cheeses, sourdough bread, and sour cream will be high in histamine.
Histamine will also build up in fermented and pickled foods like yogurt, vinegars, sauerkraut, kombucha, and alcoholic beverages. Foods cooked for a long time, such as bone broth or slow-cooked meals, are likely to be high in histamine too. As you can see, a low-histamine diet might require you to cut down on a lot of foods that are otherwise healthy.
2. Ignoring important food prep guidelines.
In addition, it's not just the type of food—but how the food is prepared and when—that really matters. Protein foods with possibly higher bacterial count, such as raw meats, poultry, and fish, are likely to accumulate histamine over time. Buy them fresh and cook or freeze them the same day as freezing stops histamine buildup. Don't leave them in your fridge for a few days, and definitely not on your counter or in your car. Alternatively, buy frozen products like individually wrapped salmon or cod fillets. To thaw, place them in a sealed bag and submerge in cool water for 15 to 30 minutes instead of leaving them in the fridge overnight.
3. Forgetting to store leftovers correctly.
Remember to be careful with leftovers. If you cook in batches or prep your meals on the weekend, you can continue to do that, but freeze what you're not going to eat right away. Transfer the leftovers to glass containers in individual meal sizes (or enough to feed your whole family for one night) right after the food cools off. Invest in glass containers as you never want to reheat in plastic. When you reheat the meal, do it quickly in the oven or the microwave as opposed to letting it thaw in the fridge overnight.
4. Not getting into the nitty-gritty of high-histamine foods.
There's no way you can eat a zero-histamine diet (since your body already contains naturally produced histamine and needs it for critical functions). Instead, your goal is to keep your histamine intake as low as possible by eating foods low in histamine and avoiding the foods that trigger additional histamine release.
You might notice discrepancies between the lists of low- and high-histamine foods you came across. That's to be expected because histamine content in food is difficult to quantify. It will depend on the bacteria the food was exposed to, how long it sat unrefrigerated or unfrozen for, it's level of ripeness for vegetables and fruit, how long it sat in transport time (for meats and fish especially), and other handling, storing, and cooking processes. Do your best, and don't stress about being 100 percent perfect.
Here are the basic do's and don'ts to keep in mind when you're on the low-histamine diet.
Fresh or frozen chicken, turkey, beef, lamb, pork. Choose organic, grass-fed, or pasture-raised as much as possible and cook right away. Fresh fish like salmon, cod, trout, and flounder. Avoid tuna, mackerel, sardines, anchovies, shellfish, and anything canned. If you can't guarantee freshness, frozen may actually be better because it tends to get flash-frozen immediately. Eggs are tricky. Start out without them. Experiment two weeks into the diet with egg yolks first, and try the egg whites last.
All are allowed except for tomato, eggplant, spinach, and mushroom. Eat raw broccoli, cabbage, and bell peppers because they contain vitamin C, which helps reduce histamine release.
Fresh or frozen blueberries, blackberries, apples, pears, grapes, watermelon, cantaloupe, honeydew, plum, mango, peach, pomegranate, cherries, and apricots. Avoid overripened and dried fruit.
White potato, sweet potato, beets, winter squashes, quinoa, oat, rice, buckwheat, and millet. Avoid wheat, barley, and rye initially. They contain gluten and FODMAPs that can cause stomach pain and bowel issues and may interfere with results.
Oils and fats
Olive oil, coconut oil, sunflower oil, shredded coconut, coconut flour, chia seeds, flaxseeds, hemp seeds, pumpkin seeds, sunflower seeds, and macadamia nuts.
Sweeteners, herbs, and spices
Dairy and dairy alternatives
Fresh mozzarella, cottage cheese, ricotta, coconut milk, almond milk, rice milk, hemp milk, and herbal teas are all good to go.
5. Staying on the histamine diet for too long.
Keep in mind that this diet is difficult and restrictive, and you shouldn't stay on it for more than two to four weeks. If you feel better, then the next step is to find the root cause of your histamine issues. In other words: why your body started releasing too much histamine and/or stopped metabolizing it properly.
I always recommend working with a provider who understands histamine intolerance to help you uncover your own individual triggers. These may include gut inflammation, dysbiosis, SIBO, yeast overgrowth, leaky gut, and food sensitivities. Medications like NSAIDs, H2 blockers for acid reflux, antihistamines, antidepressants, and a few others interfere with histamine metabolism, so talk to your doctor about your options. If you have a genetic variation that interferes with histamine, healing your gut and taking the right supplements can reduce the severity of symptoms and allow you to eat a more flexible diet. As an integrative and functional dietitian, I can't stress enough the importance of addressing the root causes instead of chasing symptoms and limiting your diet long term.
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