Therapy for Histamine Intolerance

People with 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 maturity, storage conditions and processing.

Since microbial spoilage begins quickly, individuals with Histamine Intolerance should eat all foods as fresh as possible.

Critical foods for individuals with Histamine Intolerance include:

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

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.

In addition, it is often claimed that any yeast and yeast products contain large amounts of histamine. Experts argue, however, that conventional baker's yeast is almost histamine-free. However, it does contain about three percent histidine, which can be converted to histamine, though only if the yeast also contains the necessary enzyme. This is not the case per se, but can be caused by contamination of the yeast products. Yeast dough must be worked at about 32 degrees Celsius. At the same time, this temperature provides the bacteria optimal conditions for producing the enzyme that can convert histidine into histamine. The histamine content of yeast biscuits is therefore only high if the yeast has been contaminated during production.

Frequently, yeast extracts, which are added to many processed foods as flavor enhancers, are generally classified as histamine-contaminated. Yeast extract is made from fresh yeast and is found in many spicy foods such as sauces, broths, spreads and ready-to-serve 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.

Elimination phase

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

Test phase

The individual 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 a new food daily.

Long-term diet

When the patient knows their personal tolerance threshold, they should eat accordingly, low-histamine, but 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 rash. Discuss this with your doctor.
Individuals with Histamine Intolerance report good results from enzyme supplementation along with the consumption of food. Similar to individuals with Lactose Intolerance, who can take the enzyme lactase before the consumption of lactose-containing foods, individuals with Histamine Intolerance can use a DAO-containing extract. It is taken in capsule form immediately before the consumption of histamine-containing foods.

Please see also:

What is Histamine Intolerance?

Symptoms of Histamine Intolerance

Diagnosing Histamine Intolerance