When to follow a low-histamine diet?
People with a food allergy can develop symptoms when they eat something they are allergic to. The histamine level in the body then rises. With histamine intolerance, symptoms can occur after eating foods that contain a lot of histamine.
In both cases, symptoms can develop, such as itching, a blocked nose, insomnia or abdominal complaints. With histamine intolerance, the symptoms arise from eating food that triggers histamine production or food that contains histamine. This causes an increase in histamine in the body. Histamine intolerance involves a deficiency of the enzyme that breaks down histamine, namely a deficiency of diamine oxidase (DAO). Below, we provide information about histamine intolerance, how you can develop an eating pattern and how the symptoms of histamine intolerance can be reduced.
What is histamine?
Histamine is a substance that has many functions in the body and plays a role in immune responses, the production of stomach acid and the dilation of blood vessels. Histamine is produced and stored in so-called mast cells. In normal amounts, histamine plays an important role in the body. But an increase in histamine can cause symptoms. The blood vessels then dilate, which can be visible and noticeable because the cheeks become red. An increase in histamine often causes palpitations.
Allergy and histamine
During an allergic reaction, histamine is released from mast cells after eating products to which you are allergic. The amount of histamine in body tissues, the intestines and the blood increases. This is therefore a purely internal reaction that only occurs when you have an allergy. A food allergy can be caused by a particular food, such as eggs or tomatoes. People may also be sensitive to a number of foods or have an allergy to grass or tree pollen.
Enzyme that breaks down histamine
Another syndrome is histamine intolerance. An excess of histamine can be caused by the absence of a particular enzyme in the body that should break down histamine. This is the enzyme diamine oxidase. A deficiency of this enzyme causes histamine levels in the intestine and blood to become too high. In short, the amount of histamine in the body can increase:
- because of an allergy,
- because of foods that contain a lot of histamine and products that release histamine when there is a deficiency of the DAO enzyme.
An increase in histamine in the body causes dilation of the blood vessels, a runny nose, itching, insomnia, palpitations or headaches. Itching and shortness of breath are often the result of food allergies and hay fever. The combination of allergic reactions with insomnia or the development of red cheeks when drinking red wine is fairly characteristic of histamine hypersensitivity due to an enzyme deficiency. Many people are unfamiliar with histamine intolerance. They therefore do not readily recognise where the symptoms described above come from. It can then be useful to be tested for histamine intolerance.
Histamine and food
Histamine occurs naturally in various animal and plant products. Processed and fermented foods in particular contain a lot of histamine, for example aged cheeses, mould-ripened cheeses and sausages. Fermentation is a natural process in which beneficial bacteria help food keep for longer. Lactobacillus brevis is a beneficial bacterium used for fermentation, and histamine can therefore be released during this process.
Histamine intolerance test
Histamine intolerance can be investigated by having the histamine level in the stool measured with a test. How do you do that? On day 1, consume a glass of red wine, chocolate, some aged cheese and nuts. The next day, take a stool sample. You use a special collection tube for this and send it to the laboratory, where the histamine level is measured. Normal histamine values are between 0 and 107 uU/ml.
Foods containing histamine
Sauerkraut contains bacteria that cause fermentation and therefore has a very high histamine content. Canned fish, such as tuna, contains a lot of histamine because of an increase in bacteria. Eating fresh fish that has been kept too long and is almost spoiled can also cause acute histamine poisoning. In addition, there are foods that contain little histamine but do release histamine when you eat them. Chocolate is an example. People who are sensitive to histamine are better off not eating it. Chocolate, cheese, nuts and red wine should not be eaten. There are also many foods, such as tomato and avocado, that contain histamine. You can use these histamine-containing products in very limited amounts, but the meal should not contain more than 50 mg of histamine.
Advice: follow a low-histamine diet
With a low-histamine diet, you avoid substances/products that contain histamine or release histamine. Below is an overview of products that are better avoided or, in some cases, not eaten at all.
1. Avoid the products below
- Chocolate
- Herbs and spices: cinnamon, anise, sesame seed, clove, mustard seed, cumin, coriander, chervil,
ginger and nutmeg. Use sparingly. Vanilla can cause symptoms. - Menthol and peppermint: liquorice, Marmite, ketjap.
- Canned fish, smoked fish: can contain a lot of histamine, 200 to 400 mg per kg.
- Sausages: these can contain up to 470 mg/kg histamine. Freshly made sausage can be eaten.
- Mould-ripened cheeses and aged cheese: older cheeses, for example strong mature mould-ripened cheeses, can contain 400 to 600 mg histamine per kg.
- Soy, legumes and nuts: peanuts, sunflower seeds, walnuts and cashew nuts contain a moderate amount of histamine.
2. Use the products below in limited amounts
Products with a moderate histamine content may perhaps be used once a week. You should judge for yourself whether these foods cause symptoms. Follow the rotation diet for this. You eat different products every day and note whether you develop symptoms. Foods that contain histamine and may possibly be used in limited amounts:
- Egg white.
- Pork and lamb, liver and meat from various types of game contain a lot of histamine.
- Beef, chicken, turkey and horse contain a small amount of histamine.
- Sausages and products made by the butcher often cause more symptoms.
- Some types of fish contain a lot of histamine, particularly mackerel, tuna, cod, herring, sardines, prawns (prawn crackers) and shellfish. It is better not to eat canned fish.
- Tomatoes contain 26 mg histamine. 100 grams therefore contains 2.6 mg histamine. When you cook tomatoes, the histamine content decreases.
- Avocado: one kilogram of avocado contains 26 mg histamine. You can therefore eat one or two avocados a week, but certainly not every day.
- Spinach, sauerkraut, beetroot and mushrooms, bell pepper, rhubarb.
High histamine content: kiwi, strawberries, melon, pineapple, grapefruit and raspberries.
- Beans: fresh green beans, runner beans and legumes can contain a moderate amount of histamine.
Alcohol has the general property of dilating blood vessels, such as cider, beer and red wine.
- Tea can contain a moderate amount of histamine.
The rotation diet
With histamine intolerance, the products listed above can often be used once a week. You can then assess for yourself whether you tolerate them. Eat these products in rotation. So do not combine avocado with tomato or cheese, for example, and do not combine beetroot with mackerel. The histamine levels then become too high. For variation and planning of your diet, see the rotation diet.
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