Histamine Intolerance: A Surprising Cause Of Inflammation

Underlying Causes of Anxiety + Depression, and Natural Remedies to Try Dr. Will Cole

For healing your gut, bone broth and fermented foods are good food medicine. Beans and spinach are nutrient dense food sources. Smoked meats and fish are great protein options. These foods are all healthful choices for anyone seeking to feel better….aren’t they?

Actually, for some people, these “healthy” foods are anything but, due to a condition many people don’t even know they have called histamine intolerance. (1) If you are histamine intolerant, bone broth, fermented foods, legumes, spinach, and smoked foods can make you feel a whole lot worse, and I have found that for many of my patients, it is an underlying cause of inflammation and chronic symptoms.

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What is histamine inflammation & intolerance?

Histamines are chemicals in your body produced in response to allergens. Specifically, your body produces white blood cells called mast cells to release histamines during the inflammatory-immune response to allergens. This is part of a healthy, balanced immune system. Many foods naturally contain histamine, or trigger the release of histamine in the body.

Problems occur however, when there is a dysfunction or deficiency of the enzymes that break down histamine (those enzymes are called histamine N-methyltransferase (HNMT) and diamine oxidase (DAO). Without the enzymes to effectively get rid of excess histamine, you could experience a histamine overflow, which can cause a lot of problems. This is histamine intolerance.

What are symptoms of histamine intolerance?

Histamine intolerance is basically an allergic reaction without the allergen, sometimes called a “pseudoallergy.” The typical symptoms of histamine intolerance are similar to allergic reactions (like rash, trouble breathing, and a runny nose) but also go beyond your typical sneezing, to include:

  • anxiety
  • brain fog
  • digestive problems
  • eczema
  • fatigue
  • hormone imbalances
  • irritability
  • low blood pressure
  • low sex drive
  • migraines
  • nausea
  • racing heart

If you typically experience any of these symptoms after eating high histamine foods, you may have a histamine intolerance.

Foods to avoid with histamine intolerance:

High-histamine foods

These foods (2) could cause an overload of histamine:

  • Alcohol (including wine)
  • Bone broth
  • Canned food
  • Cheese
  • Chocolate
  • Eggplant
  • Fermented food (kefir, kimchi, yogurt, sauerkraut)
  • Legumes (soybeans, chickpeas, peanuts)
  • Mushrooms
  • Nuts
  • Processed foods
  • Smoked meat products (bacon, salami, salmon, ham)
  • Shellfish
  • Spinach
  • Vinegar

Foods that release histamine

These foods are low in histamines but can trigger the release of histamine and create problems for people with histamine intolerance:

  • Avocados
  • Bananas
  • Citrus fruits (kiwi, lemon, lime, papayas, pineapple, plums)
  • Strawberries
  • Tomatoes

Diamine Oxidase (DAO) enzyme blockers

These foods block the enzyme that controls histamine:

  • Alcohol
  • Energy drinks
  • Teas (black, green, yerba)

What to do if you have histamine intolerance:

If you struggle with the symptoms above or find that these foods give you problems, here’s what I recommend:

1. Find out for sure

In my functional medicine clinic I run labs to look for a high histamine/DAO ratio. This suggests that you’re eating too many histamine-rich foods for your body, and that you don’t have enough enzymes to break them down.

2. Get to the root of the problem

Why might people have histamine intolerance in the first place? As a functional medicine practitioner, my goal is to get to the root cause of inflammatory problems like histamine intolerance. A few common possibilities:

3. Eliminate your problem foods.

An elimination diet is the gold standard for uncovering foods that trigger inflammation for you. The elimination diet I cover in my mindbodygreen video course is low-histamine-friendly. I’ll walk you through how to reintroduce foods after a period of elimination time to find out which ones are causing you problems.

4. Focus on eating fresh foods.

Bacterial growth in foods left unrefrigerated can increase histamine. Eat fresh foods and freeze leftover immediately in single-serve portions.

For a low-histamine diet, (3) focus on these foods:

  • Coconut milk
  • Egg yolk
  • Fresh wild-caught fish
  • Fresh organic meat
  • Fresh vegetables (except eggplants, tomatoes, and spinach)
  • Gluten-free grains (rice, corn)
  • Herbal teas
  • Non-citrus fresh fruits
  • Rice milk

5. Heal your gut.

Microbiome imbalances can also release histamine and trigger symptoms. Problems like leaky gut syndromeSIBO, and candida overgrowth could be fueling your histamine intolerance.

Probiotics can help. In one study, (4) two strains of bifidobacterium suppressed histamine release, and in another, (5) Lactobacillus rhamnosus suppressed histamine receptors.

Note: Certain probiotic supplements, especially those containing prebiotics, won’t agree with you if you have bacterial overgrowths.

6. Eat foods that help your body get rid of excess histamines.

Increase your intake of foods with vitamin B6, vitamin C, and copper.

Vitamin B6: chicken, turkey, and potatoes

Copper: asparagus and liver

Vitamin C: fruits and vegetables (except for those high in histamine)

Black cumin (6) and quercetin are also two natural medicines that have antihistamine properties.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

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Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.

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