Low Histamine Diet – Unnecessary restriction?

A low histamine diet is a diet whereby you eliminate histamine containing foods. These specific foods contain compounds called vasoactive amines which includes histamine. The purpose of this diet is to help reduce the amount of histamine present in your body so as to avoid inflammatory, allergy-like responses such as itching, rashes, flushing skin and gastrointestinal upset. It is a diet commonly investigated by sufferers of chronic skin conditions and pollen allergies as well as those suffering from conditions such as Mast Cell activation syndrome and histamine intolerance. As well as having high levels of histamine, some of these foods contain a compound called ‘putrescine’ which is thought to interfere with the natural breakdown of histamine in the gut, causing overall levels to remain high. Having said this, current research is emerging suggesting that the histamine within foods is not released in the same manner as by our mast cells internally, suggesting that it may not contribute to overall histamine levels after all and that avoiding these foods may cause you to miss out on some vital nutrients.

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So what are these foods that contain histamine? Funnily enough, the list changes depending on where you look. A total of ten scientific studies that provided specific recommendations on the foods that must be avoided within the framework of a low-histamine diet were found and each had a different list of foods to be avoided. The only unanimous food type listed to be excluded was fermented foods.

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I looked at what Allergy UK had listed as their foods to avoid whilst on a low histamine diet;

· Champagne ,wine, beer, cider

· Coffee, cocoa, chocolate

· Sauerkraut

· Fermented soya products including miso and tempeh

· Blue cheeses, Parmesan cheese, Camembert, Emmental, old Gouda, Cheddar and other hard cheeses, fresh and hard sheep and goat cheeses

· Cured meat especially pork products e.g. sausages and other processed meats (ham, salami, pepperoni, bacon)

· Fresh or canned tuna, sardines, mackerel, salmon, herring, processed fish products e.g fish pastes, smoked or dried pickled fish

· Tomatoes, pickled cabbage (sauerkraut), broad beans, aubergine, spinach

· Peanuts, tree nuts

· Oranges, tangerines, bananas, pineapple, grapes, strawberries

Compared to what an article written by a Registered Dietitian on Healthline has listed;

· fermented dairy products, such as cheese (especially aged), yogurt, sour cream, buttermilk, and kefir

· fermented vegetables, such as sauerkraut and kimchi

· pickles or pickled veggies

· kombucha

· cured or fermented meats, such as sausages, salami, and fermented ham

· wine, beer, alcohol, and champagne

· fermented soy products such as tempeh, miso, soy sauce, and natto

· fermented grains, such as sourdough bread

· tomatoes

· eggplant

· spinach

· frozen, salted, or canned fish, such as sardines and tuna

· vinegar

· tomato ketchup

See how many differences you can spot! This kind of different information can be confusing.

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To me that seems like a large list of foods that, if cut out all at once, could lead to a restrictive diet. In addition, the level of histamine present in these foods is incredibly difficult to quantify and depends largely on their method of production, storage and how long they’ve been aged for in the case of cheese and alcohol. There is also evidence now emerging to say that the histamine in foods, does not actually contribute to the overall level of histamine released from our body. In addition to this, histamine intolerance is hard to diagnose and of course there are environmental triggers that could be contributing to overall high histamine levels.

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If you suspect you may have a histamine intolerance or are interested to see if any of these foods do exacerbate your symptoms, the best thing you can do is keep a food-symptom diary. This is a way of recording what you’re eating throughout the day and any symptoms you may feel. It is a good idea to keep this diary for at least two weeks and then look back and see if any patterns standout such as erupting in hives 30 minutes after eating a bowl of strawberries. It is likely that if you eat some of the foods listed above regularly and haven’t noticed a reaction, you do not need to eliminate them. However, should you notice a pattern with a certain food, the next step would be to work with a dietitian to eliminate the food and then reintroduce it properly and safely over a number of weeks to fully establish if you are intolerant. It is recommended that the low-histamine diet is not followed by anyone for more than four weeks at a time due to is restrictive nature.

Some more tips for lowering the amount of histamine within foods are to;

· Cook all your own meals using fresh produce

· Avoid junk foods and highly processed foods

· Eat only fresh foods that have been kept in a refrigerator

· Speak with a dietitian or a nutritionist about getting all the nutrients you need while on this diet

Any questions, just get in touch!

Happy Tuesday Everyone x

References

1. Low Histamine Diet. Healthline. [Online] Jan 07, 2020. [Cited: 02 21, 2023.] https://www.healthline.com/health/low-histamine-diet.

2. Histamine Intolerance. Allergy UK. [Online] 08 18, 2021. [Cited: 02 21, 2023.] https://www.allergyuk.org/resources/histamine-intolerance/.

3. Low-Histamine Diets: Is the Exclusion of Foods Justified by Their Histamine Content? Sònia Sánchez-Pérez 1 2 3, Oriol Comas-Basté, M Teresa Veciana-Nogués, M Luz Latorre-Moratalla, M Carmen Vidal-Carou. 5, s.l. : Nutrients Journal, 2021, Vol. 13.