A silent issue from a dietitian’s perspective
In everyday life, common complaints such as digestive problems, skin redness and itching, postnasal drip, nasal congestion, or recurrent headaches may sometimes remain unexplained despite blood tests and other medical evaluations. In such cases, one frequently overlooked cause may be histamine intolerance, which occurs when the body is unable to adequately break down histamine.
Excess histamine can affect multiple organs and systems, leading to a wide range of symptoms.
What Is Histamine?
Histamine is a naturally occurring biochemical messenger in the human body and plays a vital role in many physiological processes. It is involved primarily in the immune system, nervous system, and gastrointestinal tract.
Main functions of histamine include:
- Immune system:
When the body encounters an allergen or infection, histamine is released. This causes blood vessels to dilate, allowing immune cells to reach the affected area more easily. Clinically, this process may present as redness, swelling, itching, and nasal discharge. - Digestive system:
Histamine stimulates gastric acid secretion, thereby supporting digestion. - Nervous system:
It contributes to wakefulness, alertness, and the regulation of certain cognitive functions. - Circulatory system:
By promoting vasodilation, histamine helps regulate blood flow and oxygen delivery to tissues.
In summary, histamine is not harmful by nature; it is essential. Problems arise when histamine accumulates in excess or cannot be sufficiently degraded. Under normal conditions, histamine is broken down by an enzyme called diamine oxidase (DAO), primarily in the intestines. When DAO activity or availability is reduced, histamine may accumulate in the body.
What Is Histamine Intolerance?
Histamine intolerance is not a food allergy.
It is a condition that results from the body’s reduced capacity to degrade histamine derived from foods or from substances that trigger histamine release.
Scientific studies associate histamine intolerance with:
- Disruption of gut microbiota
- Use of certain medications
- Chronic or prolonged stress
- Diets rich in histamine-containing foods
Symptoms of Excess Histamine
Because histamine can affect multiple systems, symptoms vary widely among individuals.
Common symptoms include:
- Bloating, abdominal pain, diarrhea
- Facial flushing and itching
- Headaches and migraine attacks
- Palpitations and dizziness
- Nasal discharge and a sensation of shortness of breath
- Fatigue, irritability, and mood changes
- Facial and generalized edema
A key characteristic of these symptoms is that they often worsen after meals.
What Is a Low-Histamine Diet?
The aim of a low-histamine diet is to reduce histamine intake and prevent its accumulation in the body. This approach is not based on strict prohibitions but rather on a personalized and balanced dietary strategy.
In the scientific literature, a low-histamine diet is described as the first-line and most effective intervention for managing histamine intolerance.
What Is a Low-Histamine?
1. Basic principles
- Freshness is essential. Histamine levels increase in foods that are stored or left to stand for long periods.
- Fermented and processed foods are typically high in histamine.
- Individual tolerance varies; the same food may trigger symptoms in one person but not in another.
2. Foods generally recommended to be avoided
(High in histamine or capable of triggering histamine release)
Fermented foods
- Aged cheeses, yogurt, kefir
- Pickles, vinegar, soy sauce
Processed meats
- Salami, sausage, cured meats
Seafood
- Shellfish
- Tuna, mackerel, sardines (especially canned)
Certain fruits and vegetables
- Tomatoes, eggplant, spinach
- Strawberries, bananas, citrus fruits
Other
- Alcohol
- Chocolate
- Foods containing additives and preservatives
3. Foods generally better tolerated
(Low in histamine when consumed fresh)
- Fresh meat and poultry (not stored for long periods)
- Freshly cooked fish (consumed immediately)
Vegetables:
Zucchini, carrots, broccoli, lettuce
Fruits:
Apples, pears, blueberries
Carbohydrates:
Rice, potatoes, oats, quinoa, buckwheat
Fats:
Olive oil, coconut oil
An Important Note from a Dietitian’s Perspective
A low-histamine diet should not be followed long-term without professional guidance. Excessive dietary restriction may lead to vitamin and mineral deficiencies, particularly in women and adolescents.
In clinical practice, dietitians typically apply:
- A short-term elimination phase, followed by
- A gradual reintroduction of foods based on individual tolerance.
The goal is not strict avoidance, but a personalized balance.
It is also important to note that not all digestive or skin complaints are related to histamine. Accurate diagnosis and professional nutritional guidance are essential.
What Are Benefits of a Low-Histamine Diet?
Scientific evidence suggests that individuals following a low-histamine diet may experience:
- Improvement in gastrointestinal symptoms
- Reduction in facial and generalized edema
- Decreased frequency and severity of headaches and migraines
- Improvement in skin-related symptoms
Histamine intolerance has become more apparent in modern life due to lifestyle and dietary habits. In individuals experiencing unexplained digestive issues, skin reactions, or recurrent headaches, histamine should be considered as a potential contributing factor.
Nevertheless, the solution does not lie in unverified food lists, but in evidence-based knowledge, professional support, and individualized nutrition planning.
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References
- Maintz L, Novak N. Histamine and histamine intolerance.
American Journal of Clinical Nutrition
DOI: 10.1093/ajcn/85.5.1185 - Reese I. et al. Evidence for dietary management of histamine intolerance.
International Journal of Molecular Sciences
DOI: 10.3390/ijms26189198 - Matysiak J. et al. Histamine intolerance – current state of knowledge.
Journal of Medical Science
DOI: 10.20883/medical.e727
Schnedl WJ et al. Diamine oxidase supplementation in histamine intolerance.
