Why a Low Histamine Diet?

There are many different diet types out there to chose from. Some are good, some are awful, but all are individual to the person and the health situation they are currently in.


With many of our clinic's clients having MCAS (Mast Cell Activation Syndrome), we talk about the low histamine diet a good deal. So, let's take a bit of time to review what this diet is and who it can be beneficial for.


What is histamine, you may be wondering. Histamines can be found in our own bodies and in the food we eat as well. Within our body, they are chemicals produced by our immune system (mostly in the mast cells and basophils) in response to an irritant or invader that will result in inflammation. Usually, this is a protective mechanism that is helpful in fighting off something we don't want in our systems, aides in digestion, and is an important neurotransmitter.


Histamines are also found in different quantities in the food we eat. Not only can a food carry a higher histamine count, it may also be considered a histamine "liberator" when we consume it. There are three categories of histamine importance when looking at food:

  • Histamine Rich Foods

  • Histamine Releasing Foods

  • DAO Inhibitors

Histamine rich foods are self explanatory, carrying a high histamine load right off the bat. Histamine releasing foods may not be high in histamine content, but can trigger the release of histamines once ingested. DAO (Diamine Oxidase) is something our body produces to break down the excess histamine that builds up in the body. A DAO inhibitor will block this effect, and the histamine content will remain elevated.


It is very important to note that histamine intolerance and MCAS are two separate conditions that may or may not have overlap in symptoms with each individual. As all of our immune systems and inflammatory levels vary, it is also important to note that everyone's food reaction is different, no matter the histamine content of the food. MCAS also involves the reaction to and release of mediators other than just histamine. The takeaway: do what works for you and understand that someone else's diet may work for them.


Those that have a histamine intolerance should find benefit in sticking to a low histamine diet. Those with MCAS may want to adopt a low histamine diet in order to control the overall histamine load in attempt to regulate the body's mast cell reactions.


Symptoms of a histamine intolerance may include, but are not limited to

  • Headaches/migraines

  • Fatigue

  • Difficulty falling and staying asleep

  • Hyper or Hypotension

  • Vertigo or dizziness

  • Arrhythmia, or change in heart rate

  • Difficulty regulating body temperature

  • Anxiety

  • Digestive Issues

  • Nausea, vomiting

  • Abdominal cramps

  • Flushing

  • Nasal congestion, sneezing, difficulty breathing

  • Sinus issues

  • Abnormal menstrual cycle

  • Hives

  • Tissue swelling

It's obvious that these symptoms can effect every and anything. It is difficult to tell if histamine is the cause, and most are unable make sense of it until they eliminate the foods from their diet. In regards to MCAS, the symptoms are all similar with more of a systemic reaction reported along with food intolerance, and also a history of triggers other than food such as stress, environment, and other system stressors. Food is a small part of the MCAS picture.


To lower the histamine content in food, whether you have a histamine tolerance, or are trying to lower your histamine intake in attempt to help with MCAS, the first start is to avoid the high histamine foods:

  • Fermented foods

  • Alcohol

  • Tomatoes

  • Chocolate

  • Strawberries

  • Spinach

  • Dried fruits

  • Processed and smoked meats

  • Shellfish

  • Aged cheese

  • Vinegar

  • Soured foods

  • Most citrus fruits

  • Walnuts, cashews

  • Leftover food

There are lists throughout the internet on histamine releasing foods and DAO inhibitors, but I purposely do not list all of them here as there is not enough research done or agreement yet on this topic. There can even be some disagreement found on histamine food content in general. Some additional items that have a strong crossover in some of the research and lists are: bananas, wheat, certain teas (green, black), pineapple, food preservatives and dyes, and some spices such as cinnamon.


As mentioned before, it is extremely important to understand that one's diet is completely individual to their make-up. Especially in the case of MCAS, one food is not guaranteed to be a triggering event for everyone at every moment. If you are lowering your histamine content, stay away from the high histamine content food listed above and also leave out the foods that you personally don't feel your body responds well to. Once you calm down the inflammation (usually about 3 weeks), you may be able to re-introduce them with a better reaction (see our blog post on the elimination diet).


The more sensitive and irritated your system seems to be, the more likely you need to be consulting with a medical professional that understands food reactions and the medical conditions you are presenting with. Everyone has an algorithm that works for them, it just takes time doing the math to figure it out.