Intolerances connected to foods such as dairy, gluten, or eggs is quite common but histamine intolerance is not talked about nearly as often. “People hear the word histamine and think of allergies, hay fever, and sneezing. Most people don’t know that histamine is a natural component of foods as well,” says integrative physician and registered dietitian Amy Burkhart, MD, RD. If you’ve never heard of histamine intolerance, you are likely not aware of the signs and symptoms of it or the foods that are most likely to cause a reaction. Consider this your guide to learning about and navigating histamine intolerance, detailing everything you need to know.
What is histamine intolerance?
According to Dr. Burkhart, most people don’t have to think about whether or not histamine is in their foods. She explains that for these people, the body breaks histamine down without an issue. “But, some people are unable to break down or metabolize histamine in a typical fashion, so they can experience symptoms when they eat foods containing histamine,” she says. “It depends on the total amount of histamine eaten in a day and variables that affect the histamine content of the food. Stress and exercise release histamine and can also add histamine to the overall ‘histamine load,’ increasing symptoms.” Functional registered dietitian and gut health expert Nour Zibdeh, RD, says that histamine is released naturally in the body and has important roles and functions. “It’s released when the immune system is exposed to a foreign substance like environmental allergens or food sensitivities. We can also get histamine from certain foods,” she says. “Our body is equipped with two enzymes that break down histamine. If the enzymes can’t keep up with clearing the excess histamine, the histamine ‘bucket’ overflows and people start to experience histamine intolerance.” Zibdeh echoes what Dr. Burkhart says about the number of histamines the body is introduced to matters. “The more foreign substances, including environmental allergenics, food sensitivities, and underlying infections, the more histamine will be produced,” she says. She also says that people who experience other gut issues (such as SIBO, candida, or leaky gut) are more prone to histamine intolerance because the major enzymes that break down histamine are found in the gut.
What are the signs of histamine intolerance?
Both experts say that the signs of histamine intolerance span a wide gamut. Zibdeh says that congestion, sneezing, postnasal drip, sore throat, coughing, acid reflux, stomach pain, nausea, bloating, gas, diarrhea, skin itching, hives, eczema, rashes, skin flushing, muscle and joint pain, headaches, anxiety, increased heart rate, low blood pressure, and insomnia are all possible signs. “The challenge with determining whether or not someone has histamine intolerance arises from the fact that histamine has many actions in the body,” Dr. Burkhart says. “It can be challenging to differentiate symptoms from other conditions, but researchers are working on tests and algorithms for evaluation.” For this reason, if you are experiencing any of the above symptoms regularly, it’s important to work with a doctor or dietitian who can help you pinpoint the root problem.
What foods are high in histamines?
In terms of what foods are high in histamines, Dr. Burkhart says that this is a difficult question to answer. “The histamine content of food is affected by many variables. It is difficult to measure the histamine content of food because of these variables and the agreement on what foods are ‘high histamine’ is that there is not much of an agreement,” she says. She adds that this is why high-histamine food lists often look different, depending on their source. Dr. Burkhart does say, however, that researchers have been studying this and the most common high-histamine foods seem to be aged cheeses, grated cheese, canned fish, and fermented foods such as kombucha and sauerkraut. Zibdeh says that dried fruit, eggplant, tomato, spinach, avocado, shellfish, and tuna have all been known to be high-histamine foods as well. In fact, she says that some people discover that they are histamine intolerant by accident after integrating more gut-healthy foods into their diet, like fermented foods only to find that their digestive symptoms only get worse. Since many high-histamine foods are actually full of nutritional benefits, Zibdeh emphasizes that avoiding them is not meant to be a long-term plan. “With the help of a dietitian who knows the ins and outs of histamine and gut health, you can improve your gut health so you can slowly reintroduce some of the beneficial foods that are also high in histamines like sauerkraut, yogurt, avocado, and other fruit,” she says. Navigating food intolerances is never fun and can be quite complicated, but working with an expert can make it a lot easier. With their help, you’ll be back to enjoying avocado toast and kombucha before you know it. Next up, here are 10 ways to restore your gut health.
Sources
Amy Burkhart, MD, RD, integrative physician and registered dietitianNour Zibdeh, RD, functional registered dietitian and gut health expert
