What Is Histamine Intolerance?

Could histamine intolerance be causing your mysterious food reactions? Nutrition Diva investigates the science behind this increasingly common diagnosis.


Monica Reinagel, MS, LD/N, CNS
3-minute read
Episode #294

Symptoms attributed to histamine intolerance include asthma, chronic eczema, sinusitis, fatigue, itching, dizziness, stomach cramps, and diarrhea. Although these symptoms can just look like an allergic reaction, allergy testing can come up completely negative—with can be both mystifying and frustrating, for both doctor and patient.

The long list of possible symptoms, along with the absence of any definitive diagnostic test, make “histamine intolerance” a good candidate for over-diagnosis. But if you have chronic or recurring symptoms that you’ve been unable to find any other cause or cure for, I can understand the appeal of a possible explanation—especially if the symptoms are affecting your quality of life to a significant degree.

The next step would be to try a low-histamine diet to see if it makes you feel any better.  (And if it were to bring you relief from long-standing misery, who cares how many placebo-controlled trials have been done?)

What Can You Eat on a Low-Histamine Diet?

If you Google “low histamine diet,” you’ll have no trouble pulling up lists of foods to be avoided and foods that are safe. The problem is that no two of these lists are the same. Some foods, such as cured meats, fish and shellfish, cheese, wine, beer, and sauerkraut, show up on all the lists as being high in histamines. But you’ll find cottage cheese listed as safe on one list and prohibited on another, for example.

Unfortunately, the data on the histamine content of foods is pretty limited, and that leaves room for a lot of speculation, interpolation, and just plain error. In next week’s episode, we’ll take a closer look at the low-histamine diet and try to make sense of these conflicting recommendations.

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Maintz L, Novak N: "Histamine and histamine intolerance,"Am J Clin Nutr. 2007 May;85(5):1185-96.

Photos of sneezing woman and allergy sign courtesy of Shutterstock.


About the Author

Monica Reinagel, MS, LD/N, CNS

Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes' most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation's leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show. 

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