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Histamine Intolerance 101

Integrative & Functional Nutrition focuses on the root cause of symptoms.

Sometimes, many symptoms can be tied back to the same root cause, or source.

Some of the ‘root causes’ that I run into when it comes to digestive and brain health are:

  • Gut-Based Imbalances (overgrowth of bacteria, not enough of the good bacteria)
  • Out-of-Whack Blood Sugar
  • Micronutrient Insufficiencies
  • Poor protein digestion
  • Malnourished Mitochondria (energy powerhouses!)
  • Genetic SNPS that influence nutrient needs & nutrient processing
  • Low-grade inflammation

Lately, it seems I’ve been running repeatedly into another root cause which is linked with a whole host of symptoms: histamine intolerance.

Symptoms that are seemingly unrelated can all potentially be linked back to histamine.

What is Histamine?

Histamine is known as a biogenic amine, produced inside our bodies and also found naturally occurring in certain foods.

Histamine can bind to receptors on cells in many parts of our body: our brain, digestive tract, white blood cells, uterus, skin, respiratory tract & even our cardiovascular (heart) system.

Histamine intolerance can cause allergic-type symptoms

Having lots of histamine on board can cause symptoms like including waking up frequently during the night, skin flushing, headaches, nausea, or dizziness, congestion, sneezing, hives, diarrhea & asthmatic symptoms.

There are two major determinants of how histamine impacts you:

  • How efficiently you break down histamine
  • Total overall LOAD of histamine that is circulating, including histamine from the food that you eat

Food Source of Histamine

Although there are many foods which contain varying amounts of histamine, some of the highest are:

  • wine
  • beer
  • aged cheeses
  • sauerkraut
  • ketchup
  • smoked or canned fish
  • spinach
  • eggplant
  • red wine vinegar

Other foods, including tomatoes, papaya, egg white, chocolate & citrus fruits could have histamine ‘releasing’ properties, making histamine more available.

When you look at that list of foods, you might wonder why everyone isn’t constantly running around with a runny nose and itchy eyes (although many people are). That’s because it’s not just about the histamine…but what your body DOES with the histamine that counts.

About Histamine Breakdown

Two primary enzymes influence histamine breakdown: Diamine oxidase (DAO), the activity of which can be blocked by certain medications and alcohol and Histamine N-methyltransferase (HMNT): inside cells. DAO activity can be blocked by alcohol and certain medications, while both can be influenced by genetic traits.

Certain drugs can lower levels of the histamine-degrading enzyme DAO

Increased availability of histamine + impaired histamine breakdown=the perfect storm for histamine intolerance

Total Histamine Load

In addition to foods consumed and genetics, levels of histamine can also be influenced by stress, hormones, pharmaceuticals & even certain gut microbes.

Low-Histamine Elimination Diet

A solid first step to see if histamine is a culprit in symptoms is to undergo a short-term elimination diet where histamine content is kept low.

This short-term elimination diet can help you to more clearly see how many of your symptoms are connected to higher-histamine foods that you are eating.

Since symptoms associated with histamine intolerance are dose dependent, meaning that histamine-rich foods should be gradually re-introduced (challenged) to establish a level at which symptoms are manageable. For those with factors depleting or blocking histamine breakdown, those factors should also be addressed.

Interested in seeing what a sample low-histamine diet looks like? You can download a full copy here.

Low-Histamine Inspiration

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    If you are trying to distinguish between lots of mystery symptoms after eating, let’s jump on a complimentary clarity call. Together, let’s see if we can figure out your individual root causes so that you can finally feel better.


    Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr. 2007;85(5):1185–1196. doi:10.1093/ajcn/85.5.1185

    Reese I. Nutrition therapy for adverse reactions to histamine in food and beverages. Allergol Select. 2018;2(1):56–61. Published 2018 Sep 1. doi:10.5414/ALX386

    Wang Y, Kasper LH. The role of microbiome in central nervous system disorders. Brain Behav Immun. 2014;38:1–12. doi:10.1016/j.bbi.2013.12.015

    About Sarah Ferreira

    Sarah Ferreira,MS,MPH,RD,CDN,CNSC,IFNCP,CHWC is a Registered Dietitian Nutritionist with complementary certification as an Integrative and Functional Nutrition Certified Practitioner and Certified Health and Wellness Coach. She is the owner of Mindfully Nourished Solutions, where she uses a whole-person, whole-food approach to explore the impact of nutrition on mood and cognition. Her individualized approach integrates an assessment of nutritional, genetic, environmental, and lifestyle factors into a collaborative nutrition care plan using cutting-edge research designed to facilitate meaningful and restorative changes based around client goals and priorities.

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