Author: Pamela Kullman (Histamine Expert)

The low-histamine diet is increasingly adopted for addressing issues like skin rashes, headaches, and bloating. Many believe that histamine intolerance (HIT) is not sufficiently recognized as a health concern. For individuals dealing with HIT, adhering to a low-histamine diet is often the main course of action. Before delving into the specifics of this diet, we’ll first explore what histamine and histamine intolerance are, and then evaluate the effectiveness of the low-histamine diet.

What is histamine?

Histamine is both a hormone and a neurotransmitter. It is contained inside mast cells, along with a thousand inflammatory chemicals, which are part of the immune system. Histamine has a number of roles in the body. It controls appetite, it is a temperature regulator, it controls cardiac contractions in the heart, it controls gastric secretions to prepare for digestion and of course, many of us know it is responsible for the allergic response leading to a multitude of symptoms or anaphylaxis. Mast cells are in every inch of the body, especially in areas of the body that connect directly to the world like skin, eyes, ears, nose, mouth, the genitalia, etectera.

Mast cells not only release histamine but over a thousand different inflammatory chemicals which perform different things. Mast cells can choose to only release some of its chemicals in the case of histamine, it can choose one of its inflammatory chemicals or it can degranulate(explode) and release all of its chemicals at once. This means wherever your mast cells choose to release their histamine and/or inflammatory chemicals, you can have many different symptoms which can rotate with each reaction or like those with histamine disorders, we tend to get hit with our own personal set of symptoms. Some may get acid reflux, constipation or diarrhea whereas another may get asthma, blurry eyes, migraines and yet another may get shortness of breath and heart palpitations/tachycardia.

Did you know that histamine can be behind mood and memory issues? When mast cells degranulate in the brain, it can affect the mood centre ( anxiety, depression, panic attacks, irritability, rage, OCD, behavioural issues and paranoia) and the memory centre (short term memory loss, inability to focus or concentrate, brain fog, forgetting words and names, even slurring words can happen)

What is a Histamine disorder & histamine intolerance?

This is an issue that can develop either genetically or through other means.

Histamine disorders land on a spectrum, each form having different reasons behind their malfunction and a different modus operandi.

Histamine intolerance (not literally intolerance as we need histamine to function, and it’s a natural part of our body’s chemical make up) can be due to low DAO, an enzyme naturally found in the gut that processes histamine in food, along with its partner HMNT, another histamine processing enzyme. We can be low in either enzyme but the only enzyme available to supplement is DAO. Most forms are from pork but plant based ones are also available.

Another form of histamine intolerance is where the body genetically has problems with methylation of histamine. This means the body cannot process histamine fast enough which allows for histamine to build up and cause symptoms.

Mast Cell Activation Syndrome (MCAS)

Mast cell activation syndrome can be a genetic condition but it can also develop from periods of extreme stress, trauma, abuse, ptsd, a virus or a hormonal milestone like puberty, childbirth or menopause.

Mastocytosis

Mastocytosis is another genetic, or possibly stress induced condition as with MCAS, but it’s issues stem from excessive mast cells in the body that when triggered release far more histamine,than the other conditions, which often lead to Anaphylaxis. Also there are varying forms of Mastocytosis, some more serious than others.

Possible Histamine Symptoms:

You don’t have to have all of them. We all get affected in certain areas.

• Fatigue
• Pain (often in a fibromyalgia-type pattern)
• Lightheadedness
• Headache
• Itching
• Tingling
• Nausea
• Feeling hot or cold or both (and intolerance of heat or cold)
• Swelling in potentially any part of the body
• Eye irritation like blurry, watery, achy, dry eyes
• Shortness of breath
• Acid reflux
• Brain fog
• Rashes
• Hives
• Abdominal discomfort
• Throat irritation
• Fast or irregular heartbeats (palpitations, tachycardia)
• Sweats
• Environmental allergies and medication and chemical sensitivities
• Chest discomfort or pain
• Easy bleeding or bruising
• Diarrhea or constipation
• Difficulties with swallowing
• Flushing, burning, heat wave type feeling
• Anomalies with vision, feels like you need a new prescription.
• Irritation/sores in the mouth
• Waxing/waning enlargement and tenderness of lymph nodes
• Urinary frequency or hesitancy, the only way the body can get rid of excess histamine is peeing.
• Frequent sense of urinary tract infection despite urine tests often showing no infection. This issue is called Interstitial cystitis. Please get your urine cultured before going on antibiotics. If no bacterial growth, IC is likely the issue.
• Frequent or odd infections
• Poor healing
• Sinusitis
• Unexplained weight gain or loss
• Dental deterioration despite good dental hygiene
• Cough
• Anxiety/panic attacks/OCD/ Paranoia
• Unusually uncomfortable or heavy menstruation
• Asthma
• Hair thinning/loss
• Depression
• Insomnia
• Tremor
• Brittleness and ridging of nails,
• Unusually vigorous insect bite reactions, they often swell up a lot
• Weakness
• Edema
• Blood sugar fluctuations (mast cells affect blood sugar and blood sugar affects mast cells)
• Sensitivity to low pressure systems, airplane pressure change
• And the list goes on…….

Histamine conditions and Histamine associated medical conditions

• Histamine Intolerance (HIT)
• Histaminosis
• Mast Cell Activation Disorder (MCAD, MCAS, MCA)
• Mastocytosis
• Systemic Mastocytosis
• Multiple Sclerosis
• Fibromyalgia
• Narcolepsy
• IBS
• Crohn’s
• Parkinson’s
• Alzheimer’s
• Heart disease
• Migraines
• Oxalate issues
• Histamine comorbidities and associated issues
• Ehlers Danos syndrome ( EDS)
• POTS – Postural Orthostatic Tachycardia Syndrome

Why did I develop histamine issues?

Our bodies were never meant to eat the kind of foods society has created. Chips, cotton candy, sugar,margarine, cakes, deep fried this and that, processed foods,etc.If our body has a hard time processing foods it was never designed to eat, it is bound to break down.

Stress, pesticides, plastics, heavy metals and other toxic messes have also likely damaged our body and our genes.

In the case of Histamine Intolerance, it may be dao issues caused by certain foods, certain medicines or supplements which deplete our dao or we are just plain short on dao. There are DAO supplements available to help with this as I indicated earlier. Or it is genetics which alter our methylation ability making it harder to keep up with histamine processing.

In the case of mast cells, any period of extreme stress like trauma, abuse, hormonal milestones, ptsd, and viruses,etcetera can affect the nervous system. When mast cells go into defence mode in the presence of danger of some kind, after the danger is defeated or passed, mast cells should go back to normal but for others, the mast cells sometimes remain in defence mode, continuing to man the castle gates seeing all as a threat. This creates overreactive mast cells which respond to everything.

There are also many other root causes of histamine disorders too numerous to name.

An imbalance in microbiome or environmental change in the gut can lead to histamine release or a number of health issues such as those below.

• Gut dysbiosis
• Bacterial overgrowth
• Parasites
• SIBO
• Candida overgrowth
• Mold exposure and illness
• Oxalate sensitivity (this plant toxin can cause Candida overgrowth )

All these release toxins in the body. For example, Endotoxins in the case of candida overgrowth and mycotoxins in the case of molds. This would make someone with a histamine disorder very sick, flooded with toxins. Another non food trigger we don’t need.

Canxida Cleansing was my solution for my Candida overgrowth and my Mold Illness after much research, it seemed a superior choice. It was a clean supplement with few additives People with histamine disorders tend to be quite sensitive to certain supplements, spices, medicines and additives. Histamine people don’t do well with certain spices like cloves ,which is in the Canxida Cleansing product, but for some reason I was able to tolerate it, perhaps due to it being in extract form. I did start in a small amount, like half a pill, and worked up. I managed to tolerate three tablets a day with little histamine release. It was successful in defeating my candida overgrowth and mold issue.

I will always keep this in my supplement cupboard for any future candida overgrowth, mold exposures or whenever I have to take antibiotics. Antibiotics kill good and bad bacteria, causing die off and microbiome imbalance which in turn lead to candida overgrowth. This is why I also purchase the Canxida Cleansing’s partner, Canxida Probiotic Enzyme to take with Canxida Cleansing. It helped digest foods so there was no large chunks of food in my gut fermenting and feeding the candida overgrowth and the probiotics helped restore necessary gut flora.

Testing for histamine disorders:

Your everyday allergist is not going to recognize Histamine Intolerance as an issue. They don’t believe in it. Some may understand Mast Cell Activation Syndrome but most won’t. This was my experience.

If you are lucky enough to find a mast cell specialist, testing is not infallible. I explain below.

Mast cell testing and normal results. Do I not have Mast cell/ Histamine issues if it comes back normal?

Tryptase, if raised, often points to a possible diagnosis of Mastocytosis, a more rare form of mast cell issues. If low or normal, this points more to mast cell activation. It is necessary to test close to a severe reaction or anaphylactic episode as tryptase takes a long time to get to the blood stream.

Other tests fail because of mishandling by the labs, or the patient, as the specimen needs to remain chilled and in the dark, at all times, or the histamine and/or the inflammatory chemicals start to degrade. Most mast cell chemicals like histamine and other inflammatory chemicals have a half life of 30-60 seconds, so not easy to catch and often samples need sending far away to labs to analyze, if any mishandling happens, normal/negative results.

Besides testing issues, there are also problems with Doctors not recognizing or understanding mast cell issues or even being aware of their existence. The medical community is in the junior stages of understanding histamine disorders. Doctors get exactly one minute of training on mast cells. Dr. Lawrence Afrin, a mast cell specialist in the USA, discusses that in this video. This is discussed 7:58 minutes in to the video below.

At 19:11 minutes in to the video, he discusses testing challenges for mast cell issues.

What is The Histamine Bucket?

I love this analogy as it does really help explain in laymen’s terms how we get to the point of reaction. Those with a histamine disorders or allergies will be subject to the gradual fill and overflow of said bucket from food and non food triggers,leading to symptom development.

Histamine can be triggered by foods or NON FOOD triggers.

All food contain histamine in varying levels. There is no food that has NO histamine.

We eat foods everyday which add to our histamine bucket. With high histamine foods our bucket fills quickly but even with lower histamine foods, it still contributes to our overall level.

Our body also releases its own histamine to perform certain duties.

And then the non food triggers are more environmental factors that contribute to our histamine load.

All of this adds up in high histamine in the body and if the body is somehow compromised and is not up to the task of processing histamine, we have symptoms.

The Histamine Diet:

This diet is actually quite healthy but it does require us to avoid, or minimize, the following foods:

High Histamine foods

• Aged foods: like cheese, dried meats, beef, etc
• Fermented foods: like pickles, yogurt, wine and beer
• Leftover meat, fish and eggs
• Over Ripe fruit and vegetables like avocado and bananas
• Histamine appreciates with bacterial content. Wine, yogurt, pickles, yeast, cured meat like bacon or salami, cold cuts, beef, bone broth, sauerkraut, leftover meat, fish and eggs,etc..
• Certain spices ( cloves, cinnamon, nutmeg, cayenne, paprika, chili powder, anise, curry, allspice, turmeric (sub in curcumin which is turmeric extract) and black pepper (sub in white or pink pepper).
• Beverages: beer, wine, black tea, lemon water, coffee (Purity coffee online is a safe alternative)
• Caffeine ( histamine liberator) coffee, chocolate, colas, teas
• Dyes ( red and yellow is the worst)
• Preservatives (e.g. nitrites, sulfites, anything canned or some commercially dried fruits)
• Certain veggies (spinach, curly kale, tomatoes, eggplant, etc)
• Certain fruits (citrus, strawberries, plantains,etc)
• Histamine liberators (not necessary to avoid all, some we may tolerate eventually in small amounts) like melon, banana, egg whites
• Lectins are also histamine liberating, legumes would fall in this list but other veggies contain lectins as well, some more than others. E.g. chickpeas, celery, peas, etc
• Processed or packaged foods
• Junk foods and snacks
• Flavours: Soya sauce, Tabasco, Worcestershire sauce, ketchup, vinegars, Dijon mustard, spicy flavourings,etc.
• GMO (genetically modified) foods
• High pesticide foods

Low Histamine foods or Mast cell stabilizing foods

• Fruits: apples, peaches, grapes, blueberries, cherries, coconut
• Vegetables: broccoli, cauliflower, asparagus, Brussel sprouts, zucchini, carrots,cabbage, onions.
• Meat: freshly cooked meat and poultry. Fresh or frozen. You can find low histamine meat producers online. Examples of these companies are:
  • • Northstar bison
    • White oak pastures
    • Vital choice, wild seafood and organics
• Grains: potatoes, corn, rice, oats. Flours, etc.
• Fats and oils: animal fats, butter, olive oil, coconut oil
• Dairy: fresh unaged, pasteurized, not fermented is best. Full fat Cream cheese (has less additives), fresh mozzarella, cheese curd, goat cheese, cottage cheese (safe for some), ricotta cheese. I am able to do all aged cheese in moderation after a year on histamine diet. I can also do some yogurts now but we do have to be careful on the bacterial cultures used, some are histamine producing like casei and Bulgaricus(in a lot of Greek yogurts)
• Spices and flavours: parsley, rosemary, oregano, basil, thyme, garlic, onion pdr, ginger,salt are some.
• Beverages: water, fruit juices (not citrus or any that are high histamine), coconut water, herbal teas like chamomile, stinging nettle or ginger teas. I tolerate ginger ale now, sometimes 7UP or Sprite.

Non Food Triggers:

• Stress: good (excitement) and bad (anger, crying, sadness, worry, depression)
• Weather: barometric pressure, temperature, extreme hot and cold, storms, winds, humidity
• Vibration
• Friction
• Exertion and Exercise (especially high impact exercise), anything that sends your heart rate above 100 bpm releases histamine
• Toiletries: like soap, shampoo, creams, hair dyes, makeup, nail polish, toothpaste
• Household Chemicals and cleaning products
• Scents or fragrances
• Seasonal and Year round allergies
• Dyes and Preservatives
• Viruses
• Electromagnetic Energy from cell phones, tvs, computers
• Medicines like antibiotics, anesthetics, cold meds
• Fluorescent Lights
• Dehydration and Malnourishment
• Digestion
• The sun
• Chlorinated pools
• Probiotics like casei and bulgaricus are two histamine producing probiotics found in some probiotic supplements and some yogurts.

And many more……

Can you see how our buckets continue to fill over time between food and non food triggers till suddenly symptoms emerge? Depending on the histamine disorder, symptoms can be annoying to life threatening, in the case of an allergy or Mastocytosis.

The only control we have is watching our histamine intake through diet as we can’t control many of the non food triggers except to avoid as many as we can.

Quick tips on the diet:

• Freeze leftover meat and fish. Buy fresh meat or poultry or Frozen fish that are safe on histamine diet list.
• Prepare eggs from fresh.
• Read labels, and avoid preservatives, dyes, additives, chemicals, thickeners and any other high histamine ingredients like citric acid or citrate forms of mineral supplements.
• Avoid processed, packaged or canned foods as best you can
• Eat a good diet of fresh fruits and vegetables that fall on the lower histamine list.
• Avoid a large amount of beef as it is an aged meat and higher in histamine. Pork, lamb or even bison are better tolerated for some. Ground meat is not the best for us, higher bacterial content but doable on occasion after stabilizing your histamine.
• Be conscious of histamine liberators, those are foods that are not high histamine but they do cause histamine release. Examples are banana, melons, legumes (lectins in legumes are a histamine liberator, boiling them sometimes reduces lectins to lower histamine). We all vary in the histamine liberators we react to so once you stabilize* , you may be able to tolerate some.
• Amines and tyramines can also cause histamine reactions for some, example would be ,string beans or cottage cheese. Try them and see your tolerance.
• Seafood should be avoided as it can be dicey for histamine since each fish or shellfish are handled differently when caught. If they are not gutted immediately upon catching or not flash frozen, they would be higher in histamine. See the Intolerance app mentioned below or the SIGHI list for safe fish and seafood.

* stabilize defines when you have been on the low histamine diet for awhile, and have been able to maintain lower histamine levels for 5 weeks or so. You can then add back some higher histamine foods BUT not in large amounts and not every day or your histamine bucket will fill quickly. Remember, you are not cured, you are healed only.

Helpful supplements for histamine disorders:

I will premise my suggestions with, don’t do a ton of these all at once. They are salicylates due to their herbal nature, they are concentrated being dried, and could be dangerous to do too many at once. Everyone is different, with different medical issues and some supplements can interact with medicines and other supplements so consult a doctor or pharmacist before trying these supplements.

• Quercetin, is one of the best along with its counterparts, Luteolin and Rutin. They are mast cell stabilizing bioflavonoids. This means they calm the mast cells so they do not release histamine. Be careful not to purchase citrus form bioflavinoids as they would liberate histamine. Also, avoid doing too high a dose in one sitting as it can put a strain on kidneys. A 400 mg dose or less per sitting would be ideal.
• Nigella Sativa/Black cumin seed, this is also mast cell stabilizing and anti inflammatory. Again, avoid high doses. Too much of a good thing is not necessarily good. It comes in seed, supplement or oil form and I believe, a tea.
• Holy Basil, this is another mast cell stabilizer and comes in supplement or tea form.
• PEA (Palmitoylethanolamide) supplement.
• Perilla seed extract supplement.
• Ginger.
• Stinging nettle.

There are many more but you get the idea.

Getting started on the diet:

There is a lot of misinformation out there on histamine disorders. There is actually one article that says our life expectancy is A YEAR! LOL That is very incorrect. I am on year 12 of my issues and I know many in their 70s who are still kicking with this issue. Don’t panic!

The food lists are also contradictory which makes it confusing, overwhelming and frustrating for beginners. I have posted places that are helpful in providing more accurate info below in the resources section.

This is not a death sentence. Yes, there will be some adaptation to foods and activities, there is no way around it. BUT, would you not want to get rid of symptoms over retaining that coveted food that is driving your mast cells to distraction? I would. In fact, I DID adapt and get rid of symptoms and am much happier and healthier now. You will be able to eat a lot on the diet once stable. Can you return to your previous diet, not totally. If you do, your symptoms will return with a vengeance. Find new treats to replace reactive ones. It is doable.

Eat antihistamine, anti-inflammatory and low histamine foods to maintain lower histamine levels. Food is medicine and honestly, I do not need regular antihistamines much with such wonderful, powerful nutritious foods in the diet that act as natural antihistamines.

Supplements can also assist in lowering symptoms as well. Mast cell stabilizers are my go to. Examples would be Quercetin, Luteolin and Rutin which are found in food as wonderful bioflavonoids to help calm mast cells to prevent histamine release. These are available in supplement form. Be careful not to overdo in dosage as they can put a strain on the kidneys taken in large doses. A dosage of no more than 400 mg a sitting is best.

Antihistamines, part of the mast cell protocol that Mast cell specialists assign, can have their down side. They can actually cause histamine rebound so I keep those for when I absolutely need them. However, there are some people that need them to survive so I am not medicine shaming here. We are not cookie cutter people, we all need different things to give us our quality of life.

The human side is hard to battle when you feel that vegetables and fruits are all you can have. This is not the case. Once you stabilize, you can add some treats in, in moderation. 90% nutrition and 10% junk is a doable ratio. When you don’t feel limited then the diet is much more achievable. It is not a diet per se but a lifestyle change. Embrace it and feel better.

Risks to the Histamine diet

The histamine diet is not, in my opinion and experience, risky. It encourages healthy eating and avoidance of processed foods. I have been 12 yrs on the histamine diet, and I also have an oxalate sensitivity and gluten allergy which reduces my foods a bit more. I am healthy, eat well and have adapted my life to these issues requirements. Everyone has different health histories so it is hard to make a blanket statement that ANY diet is safe. It is best to consult your doctor and dietician to make sure any diet you need to pursue is safe for you.

The bottom line

We are not meant to remain low histamine forever. We are allowed to add back higher histamine foods once we stabilize our histamine levels, preferably the more nutritious ones, but NOT in large amounts and NOT everyday or our histamine bucket fills quickly. There are some foods that I can never add back as I remain reactive to them but I found replacements that satisfy me and moved on.

Histamine disorders tend to be permanent for most of us so one must always be mindful of our histamine buckets. We can heal but we aren’t cured.

The best approach, make mindful decisions, taking into consideration all contributors to your daily histamine levels, then making decisions from there on food and activities.

Yes, histamine is a very complex thing and mast cells even more so. The body is a wonderfully complex machine. There is HOPE and there is HEALING. Tomorrow is a new day.😊

Resources:

I admin a facebook support site, Histamine Intolerance, contains a ton of info on histamine issues, the diet and we provide support to everyone. I also do one on one help to get started on the diet should you need it. I have been histamine conscious since 2012 and have lived this lifestyle, been thru all you are going through and am now doing my best to help others succeed at this diet as well and regain some quality of life.

My site address link is below:

• Histamine Intolerance (closed for privacy)
• Another good support site is: Mastocytosis and mast cell disorders:an integrative approach
• SIGHI food list

This App called Intolerances available on GooglePlay and iTunes is very helpful to look up foods on the go. Check off histamine in settings and it will search for histamine in every food you look up on it.