Treatment for histamine intolerance

People with a histamine intolerance must stick to a low-histamine diet. This is a challenge: food can be categorized as histamine-rich or low-histamine, but for the same foods, the histamine content varies tremendously. It depends in particular on a food's maturity, storage conditions, and processing.

Frusano therefore carefully tests every batch of food declared histamine-free for histamine. Those affected can tell that the food is histamine-free by looking at the histamine-free label in the shop.
For these products, we have also carried out storage tests with subsequent analysis in order to keep the risk for consumers as low as possible.

In general, we recommend careful testing of the individual's tolerance threshold.

Since microbial spoilage begins quickly, individuals with histamine intolerance should aim to consume fresh foods whenever possible. 

Foods to be avoided for individuals with histamine intolerance:

  • Hard cheeses
  • Aged sausage products (i.e. salami)
  • Mackerel and tuna
  • Processed fish (i.e. pickled herring, smoked salmon)
  • Tomatoes, spinach, eggplant, and avocados
  • Ripe bananas, strawberries, papaya, citrus fruits
  • Pickled or fermented foods (i.e. sauerkraut)
  • Soy sauce
  • Chocolate
  • Nuts
  • Coffee, black and green teas
  • Energy drinks
  • Alcohol, particularly red wine, sparkling wine, and champagne (the sparkling Frusano organic Fili-Secco is an exception, as the histamine content is below the detection limit).

Since the formation of histamine depends on many factors and the storage time also plays a role, the content of histamine in foods of the same group can vary greatly. In general, histamine can be found in any food, but can be detected in larger quantities within products such as processed fish and other aged or fermented foods. In fermented products, however, the formation of histamine can be reduced by using certain starter cultures.

Many of our customers with histamine intolerance report that they are particularly troubled by long-lasting foods, such as those in cafeterias or on hot buffets.

Yeast extracts, which are added to many processed foods as flavor enhancers, are often classified as histamine-contaminated. Yeast extract is made from fresh yeast and is found in many spicy foods such as sauces, broths, spreads and pre-packaged meals. In fact, these foods often cause severe discomfort for individuals with histamine intolerance. Whether this is always and exclusively due to yeast extracts remains unclear at the present time.

In general, shorter storage times and lower temperatures are required for histamine-free and low-histamine products.

Elimination phase

For three weeks after the diagnosis, a patient should completely eliminate histamine-containing foods from their diet. If the patient is symptom-free, then the testing phase can start.

Testing phase

An individual's tolerance threshold can be determined in this phase. During the next six to eight weeks, histamine-containing foods are gradually added to the diet. Initially, patients should consume only small quantities, and only try one new food daily.

Long-term diet

When the patient knows their personal tolerance threshold, they should eat only low-histamine foods while making sure they still get adequate nutrition. Whole food products, high-fiber foods, and vegetables should definitely be on the menu.

Supplemental vitamins

Some studies suggest that in addition to adhering to the diet, a daily dose of vitamin C and vitamin B6 helps alleviate symptoms. A deficiency of one or both of these vitamins seems to encourage histamine intolerance.

Additional therapy options: anti-histamines and DAO-enzyme replacement therapy

Depending on the type of symptoms, medication can help alleviate the symptoms. Certain antihistamines, for example, alleviate asthma, nasal congestion, or rashes. Discuss this with your doctor to determine whether this is the correct course of treatment for your body. 

Individuals with histamine intolerance have reported positive results from enzyme supplementation along with the consumption of food. Similar to individuals with lactose intolerance who can take lactase before consuming lactose-containing foods, individuals with histamine intolerance can take a DAO-containing extract, which can be taken prior to consuming histamine-containing foods.

Please see also:

What is histamine intolerance?

Symptoms of histamine intolerance

Diagnosing histamine intolerance