Could Histamine Intolerance be Impacting Your Autoimmune Healing?


What is histamine?

Histamine is a natural substance that our immune cells produce as a part of the stress response, usually after encountering an allergen. When histamine is released, the following body systems are affected accordingly:

  • Skin — itching, swelling, rashes, hives
  • Eyes — itching, burning
  • Nose — itching, sneezing, runny
  • Lungs — wheezing, coughing
  • Digestive — cramps, diarrhea
  • Vascular — headache

You may have experienced a histamine response if you’ve ever been bitten by a mosquito or received a bee sting. The swelling, redness, and itchiness that you get is a direct result of histamine being released at the site of the wound. Histamine is also involved in allergic reactions, like the seasonal allergies so many people experience.

It is important to note that histamine is both produced by the body, as well as a substance that can be consumed in food. Making things more confusing, some foods stimulate the body to produce more histamine. We’ll talk more about all of this in a little bit!

What is histamine intolerance?

Histamine intolerance generally refers to a person’s inability to tolerate high-histamine or histamine-producing foods in the diet. Unlike an allergy, however, histamine intolerance can come in varying degrees of severity. For most people with a histamine intolerance or sensitivity, their symptoms are produced when the histamine level passes a certain threshold. Think of it like your histamine tolerance level being like the top of a glass of water. All of the high-histamine and histamine-producing foods you consume add water to the glass, but you only experience symptoms of excess histamine when that glass overflows. Even healthy people without any day-to-day issues with histamine can experience scombroid poisoning, or an extreme histamine reaction resulting in eating fish with excess bacteria. We all have a limit to the amount of histamine we can tolerate without symptoms, but those with histamine intolerance just have a lower threshold, or a smaller “glass.”

Those experiencing histamine intolerance experience fewer symptoms when avoiding foods that they know trigger symptoms. This can be tricky as high-histamine and histamine-producing foods do not create the same symptoms in everyone, making it necessary for everyone to determine their own threshold of certain foods (much like what we do with the elimination/reintroduction on the Autoimmune Protocol!).

What causes histamine intolerance?

If you are experiencing the symptoms of histamine intolerance, it is important to look into potential causes as treatment can sometimes resolve the issue or at least make it more manageable. Here are some root causes to look into:

  • SIBO (small intestine bacterial overgrowth) — SIBO can be an underlying cause of histamine intolerance due to the overgrowth of bacteria producing excess histamine from undigested food.
  • Methylation — We’ve talked about methylation on the blog before (for more info start here), and sometimes those who have impaired methylation, whether from genetics or another cause, can have issues or changes in their tolerance to histamine.
  • Genetics — In addition to the genetic component to methylation, some people have mutations on the enzymes that degrade histamine (like diamine oxide, or DAO). Less enzyme activity means that these people are likely to tolerate histamine less than the general population.
  • Medications — Some medications inhibit DAO enzyme activity and can cause symptoms of histamine intolerance.

Which foods are high in histamine or inhibit the breakdown of histamine?

There are many foods that either contain histamine, cause the body to release it’s own histamine, or inhibit the breakdown of histamine in the body. For those who are histamine intolerant, modifying the diet to exclude or minimize these foods can help lower the unpleasant symptoms that can transpire, and careful reintroduction can help you determine your threshold of tolerance.

Histamine-Rich Foods

  • Alcoholic beverages (esp. beer and wine)
  • Cheeses (esp. those that are aged)
  • Dried fruit
  • Fermented foods (sauerkraut, kombucha, kefir, yogurt)
  • Cured or processed meat products (bacon, salami, deli meat)
  • Smoked meats (esp. seafood)
  • Seafood (unless caught, cooked, and eaten very quickly)
  • Vinegar-containing foods (pickles, olives)
  • To a lesser degree — some fruits and vegetables like citrus, avocado, eggplant, mushrooms, spinach, and tomatoes

Histamine-Releasing Foods

  • Alcoholic beverages
  • Bananas
  • Chocolate
  • Eggs
  • Fish
  • Milk
  • Papaya
  • Pineapple
  • Shellfish
  • Strawberries
  • Tomatoes

Those who are incredibly sensitive to histamine will also react to leftover proteins in bone broth. It is important to remember that not all histamine intolerance looks the same, and that many people that experience histamine intolerance symptoms have foods that really trigger their symptoms, and others that may be on the above lists that they are able to eat in smaller quantities.

My experience with histamine intolerance

A certain flavor of histamine intolerance runs in my family — my mother, sister and I all get headaches when we drink red wine or eat chocolate. I’m also sensitive to cured, smoked, or fermented meat products, all of which produce a headache if eaten in larger than a bite-size quantity. Most of the other foods on the high histamine list, including fermented vegetables, probiotic drinks like kombucha, and dried fruit have never given me issues, even in large quantities. Since this runs in my family, I suspect that we have some genetic predisposition to a mild dysfunction in the ability to break down histamine.

While I can easily avoid the meat products that cause me issues at home, traveling presents a problem as I have less access to fresh food and these preserved proteins are very convenient. I am careful to moderate my intake while on the road, and use this DAO supplement any time I eat a high-histamine food to help break things down just in case. I don’t avoid any of the high-histamine foods that haven’t caused me problems in the past, and I don’t avoid any of the histamine-releasing foods.

If you think you’re suffering from histamine intolerance, what should you do?

First, try a low-histamine and histamine-producing diet to see if that resolves your symptoms. If so, you likely have some form of histamine intolerance, and knowing this information can help you manage your symptoms better.

Next, seek out your root cause of histamine intolerance and get treated for it, if possible. This might mean asking your doctor to test you for SIBO, getting tested for methylation issues, and examining any medications you are on to see if they are impacting your tolerance to histamine.

Lastly, if you have found your root cause and are undergoing treatment, your histamine intolerance is likely to improve. This is very common in the case of SIBO — many people have symptoms of histamine intolerance appear when they develop the overgrowth, and disappear when it is successfully treated. It is time to reintroduce these high-histamine and histamine-releasing foods slowly and methodically, as to determine your personal threshold, and experiment with DAO supplementation if needed. You may find that like me, there are only certain histamine foods that cause an issue, and in specific quantities. You can use this information to avoid symptoms in the long run.

Have you experienced histamine intolerance? I’m curious if you’ve found your root cause and if treatment brought any change to your symptoms!


About Mickey Trescott

Mickey Trescott is a cook and one of the bloggers behind Autoimmune Paleo. After recovering from her own struggle with both Celiac and Hashimoto’s disease, adrenal fatigue, and multiple vitamin deficiencies, Mickey started to write about her experience to share with others and help them realize they are not alone in their struggles. She is a certified Nutritional Therapy Practitioner by the Nutritional Therapy Association, and is the author of The Autoimmune Paleo Cookbook, a guide and recipe book for the autoimmune protocol, and AIP Batch Cook, a video-based batch cooking program. You also can find her on Instagram.


  • Dianne B says

    The DAO supplement you are reccomending is no longer available. I have had a difficult time sourcing ANYTHING similar. Do you know of anything since there is no confirmed release date for Histame?

    I have checked with Pure, Thorne, Protocol, Klair, Metagenics – with no results.

    Please help


  • Justa Mayorgaj says

    Great article! I stumbled across Histamine intolerance a little over a year ago while trying to figure out a possible diagnosis an allergist gave me of mastocytisis or urticarial vastosis (sp?) which lead me to a Facebook group ran by The Low Histamine Chef. One common denominator for all the people there seemed to be autoimmune disorders. I cut out all potential histamine rich/releasing foods and almost had immediate relief. But it wasn’t enough, I was still experiencing severe raynauds and felt nauseous, dizzy, and tired all the time, especially after a stressful event. It was to the point where my life was being overrun by my illness. My husband gifted me The AIP Cookbook for Christmas last year and I started the diet (or I like to say lifestyle) the beginning of this year. I stuck to my low histamine foods initially but eventually was able to add a few back in. It’s been 6 months and I still can’t believe how much better I feel. I felt so bad for so many years that I thought it was normal. My energy is 3-4x better and I rarely get raynauds or any of the the other symptoms unless I eat something I shouldn’t have. I try to avoid that but life happens. I move on happily knowing that I’m healing and eventually I may be able to eat differently. I’m also happy to say the foods aren’t horrible at all. In fact, I’m glad I did AIP because I’ve tried so many new foods and they’ve turned out to be my absolute favorites! Thanks again for this post and your cookbook! It was a total life changer for me 🙂

    • Mickey Trescott says

      Hey Justa thanks for sharing your story! I am sorry you had to experience that, but really happy you’ve been able to do some healing!

    • Does the Low Histamine Chef also follow the AIP protocol? I know there are some high-histamine foods on the AIP, but I’m looking for some menus and recipes that are both.

      • Mickey Trescott says

        Hi Loretta,
        I am not familiar with them so I don’t know, but I suspect it would be difficult to write exclusively low-histamine recipes. Many recipes are naturally low histamine, the issue is more how the food is stored and then consumed. Hope it helps!

  • Justa Mayorga says

    I also forgot to mention that I started taking high dose probiotics daily to help with what I was suspicious to be SIBO. I had been taking about 15-20 CFUs sporadically but now the magic number for me has been 60 CFUs. I was hesitant to use any of the fermented foods in the cookbook after all I knew about Histamine Intolerance. The high dose probiotic seemed to do the trick.

  • Mel says

    Hi i suffer from a vast array of allergies and as a result i have chronic, ongoing sinus issues. Constant congestion, pressure (head and eyes), recurring ear infections. I avoid gluten and have done for many years, but that is not eliminating the symptoms. I was thinking i need to go Paleo as in eliminate grains all together, but do you think i need to do the AIP instead? could this be a histamine issue? Most recently my reaction reached another level and i woke up one morning with a horrid rash all over my face which i now know is called perioral dermatitis. Four weeks later and it’s still there. I was also diagnosed with fibromyalgia so obviously i suffer from ongoing unexplained pain.

    • Mickey Trescott says

      Hi Mel! I can’t address medical conditions since I’m not a doctor, but a lot of people find the elimination diet the best way to get to the root of their food sensitivities. I think given your skin issues it would be wise to play with eating low-histamine for awhile to see if if helps any. Good luck!

    • Ana says

      For fibro worth checking out oxalates…that can also be an issue (and can go hand in hand with histamine issues)

    • Joni says

      Try Osmia Organics Black Clay soap for your perioral dermatitis. I broke out with it about 2 years ago. After my doc prescribed creams with black box warnings I started googling. Came across this as many said they found resolution once using it. Took about 3+ weeks for complete resolution for me (and my 11 year old son who had it recently from changing hormones) but totally cured it. It has been 18 months and it has never returned. I have continued using it as I don’t want it returning. It’s expensive, but worth every penny. Good luck!

      • Mickey Trescott says

        Joni–thanks for sharing! I’ve heard of people getting perioral dermatitis as a food reaction, like when they have gluten.

  • Thank you so much for this – it is so timely for my healing journey! I’ve been doing AIP for several months now and just recently discovered my histamine intolerance first through the guidance of the Paleo approach and then confirmed through my NAET practitioner. Neddless to say, I’m hungry for any and all advice and insight, so this article was wonderful! Out of curiosity, have you or anyone you know had experience with histamine treatment through NAET? I’m considering doing that myself, although I haven’t heard of that specific treatment being done. Thanks in advance!

    • Mickey Trescott says

      Hi Fallon–thanks for chiming in. I have not heard any feedback about histamine treatment through NAET. I would love it if you would share your experience here afterwards, if you can!

      • Missy says

        I tried NAET through my knowledgeable naturopath years ago and found it to be so bogus. As an RN, I admit to my skepticism. So far, eating an alkaline, anti-inflammatory diet for seven months now has me on the road to healing. I feel substantial changes in my energy and sharp thinking. Skin clearer than in years and lost 25 lbs. on purpose with a nutritionist. At 63, am within 20 # of my high school weight; going slow has prevented the skin sags. Unfortunately has worsened the fibromyalgia pain and that is why I am considering this, also at the suggestion of my naturopath. Perhaps excluding nightshade veggies would help.

        • Mickey Trescott says

          Thanks for sharing Missy–did you specifically do NAET for histamine intolerance? I find your story interesting. I always tell folks to try diet before going for the less proven, expensive natural treatments. Glad that is working for you!

          • Emily says

            I have had huge successes for many issues using NAET but haven’t tried for histamine yet. If it’s just an allergy, much better to clear it than have to give up yet another food. (in my experience)

  • Ana says

    Thank you so much for covering this! I started AIP not realising my issues were histamine related, and got much worse on AIP as i inadvertently started having more high histamine foods–bone broth, batch cooking that I didn’t freeze right away… so i got worse and worse, till suddenly i tolerated many less foods than before i started out. luckily i figured out my issues were around histamine, and now i’m realising oxalates as well — which can also cause a histamine release in some people. treating this means i can slowly build up the foods i eat (though no high histamine foods yet). i only wish i’d known sooner!

    PS worth adding bladder issues / interstitial cystitis to your lists–the histamine & oxalate forums are currently full of bladder talk, but the IC forums don’t seem to recognise these causes… 🙂

    • Peggy says

      Ana, yes on the oxalates! Although I have histamine issues still on low ox diet, they are definitely less. My fibromyalgia-like pain is 90% better with that discovery. So glad to see it being mentioned more often. AIP actually can be extremely high ox with all the sweet potatoes, spinach, chard, some kinds of kale, and many more, especially following many of the AIP recipes.

    • Mickey Trescott says

      Hi Ana, thanks for sharing your experience! I’m sure others will find it helpful here.

  • Danielle says

    Hi Fallon,
    I’ve been seeing a NAET practitioner for 3.5 years and have had amazing results treating my vast array of allergies. I’d honestly find a practitioner in your area and stay clear of self treating yourself as simple as it sounds it is actually very complex. I have a vast array of autoimmune issues and the process is complex and slow. Be aware as much as you may want to begin treating your histamine issues you may have to begin with some more basic treatments and work up to the histamine. Don’t get discouraged it works, but it is a slower therapy but the results are amazing.

  • Joni says

    Hi Mickey,
    I have been working my way through AIP, SIBO and histamine intolerance. I cannot tolerate coconut at all. Coconut oil is ok. I have continued eating blanched organic almonds for “filler” as tests and monitoring symptoms have shown I do no react. However, I know eating them in quantity everyday is only going to lead to intolerance. I struggle feeling full without them though. I get shaky hungry and very irratible. Carrots & cucumbers simply do not take the edge off. I try to watch the quantity of avocado (hustamine) I consume. Any advice for fat/density to help me feel satisfied?

    • Mickey Trescott says

      Hi Joni! Its hard for me to make specific recommendations without knowing more. My suggestion would be if you have SIBO and are experiencing histamine intolerance, your best bet is to find a practitioner to test and properly treat the SIBO. Once you eradicate it, you should be able to expand your diet.

      I’m not a believer that eating something every day is necessarily going to lead to an intolerance. If almonds are helping you get through right now while you troubleshoot the SIBO and resolve the histamine intolerance, I don’t see an issue with eating them if you don’t react otherwise.

      The biggest thing is to not try to deal with the SIBO alone, but get it treated as the underlying cause of all of the issues, and for this you need a doctor on board. Hope it helps!

  • Miranda says

    I was using Histame and I felt so much better on it . I don’t know when stores will restock it. But I found this one that has a higher enzyme and looks like a clean product. Only thing is your practitioner must order it. Thankfully my Naturopath likes the product and contacted the business.

    • Mickey Trescott says

      Thanks for sharing that product — I’m not sure what is going on with Histame and I am hesitant to make another recommendation without trying it. That product by Xymogen contains rice so it wouldn’t work on the elimination diet, but if you know you tolerate rice OK it might work for you. Thanks for sharing the link!

  • Lori says

    Histamines were a HUGE roadblock for me on my healing journey as well. I confirmed my suspicions with genetic testing and eliminating suspect foods. Seeking Health does make a good DAO supplement that I found works very well. I heard Dr Dan Kalish speaking about histamines being a big problem in his medical practice, and he recommends a book by Mariska de Wild-Scholten, more info at The cascade of possible histamine symptoms is surprisingly varied. Important to know that certain probiotic strains can help break down histamines and some will produce them, making the problem worse.

    • Mickey Trescott says

      Thanks for your input and the link! Yes on the probiotics–a lot of people with SIBO especially will have a reaction to them.

  • Thank you Mickey for this information. I’ve recently had a super major flare-up without knowing what caused it. I had also recently read an article about Co-Infections with RA and how that can affect your existence! Your article also points out an issue I hadn’t considered as well and will be checking it out with my Rheumatologist next week. Very timely information. Thank you again Mickey.
    Bless you and have a marvelous day.

    • Mickey Trescott says

      So happy you found it helpful! Best of luck to you!

  • Julia says

    Thank you for this post, perfect timing for me as I am going through all of this. A few questions, the histamine food lists seem to vary what do you think of tea- black is out isn’t it but what about green or matcha and Yerba mate? Is coffee better (decaf of course). Is bone broth ok? And any suggestions or recipes for dressings? I love ACV and am so lost without it, I am a dressing, sauce kind of gal:) also thanks so much for the DAO supplant as it is hard to find without corn or other starches. Too bad it is all out of stock though!! Thanks again, Mickey!

    • Mickey Trescott says

      Hi Julia,
      The histamine food lists vary because people’s reactions vary so much on the spectrum, it is really hard to pinpoint how much histamine is in a food and how a person is going to feel eating them. All of your queries (green tea, black tea, mate, coffee, broth) might be borderline for some folks, I’d play it safe and remove and then reintroduce just like anything else. If you react to ACV I’d leave it out, if not it should be fine to have or you can replace with lemon juice. Just a reminder that if you react to some histamine foods but not others, you only need to avoid the ones you react to. It can get really restrictive quite quickly!

  • Suzanne says

    The self-hacked guy has a long but great article on high histamine:

    I started using the Bifidobacterium probiotics he recommended and got rid of hives and vertigo within a week. Kicking turmeric to the curb helped, too; it’s a DAO inhibitor.

    • Mickey Trescott says

      Thanks for sharing–I didn’t know that about Turmeric. Its a pity since it has so many great qualities–I might try having turmeric only with meals that are low-histamine, instead of avoiding it entirely.

      • Suzanne says

        We really have to be savvy about our foods choices, don’t we?

  • Janelle says

    Oh yikes, I’ve just figured out this is completely an issue for me. Unfortunately, I’m also unable to tolerate any reintroductions and am Low FODMAPs, and very sulfite sensitive (going back to allergy in infancy). It’s getting a bit insane. I’m a degreed nutritionist and I don’t know what to eat anymore. I’ve seriously got one of the worst cases of food intolerance I think in existence, from what I’ve seen. Things improved a lot initially and now I’m noticing sensitivities to things that didn’t seem to be an issue before, especially these histamine foods. The list of foods I can consume seems to get smaller and smaller and I’m not sure what to do anymore. I can’t starve but I can’t deal with feeling so ill all the time.

    I think something that I don’t see mentioned much in AIP community is the relation of food intolerance to trauma. I have had survived massive amounts of trauma since childhood and always had digestive issues because of it. As the PTSD got worse, so did the digestive issues and sensitivities and spike in autoimmune and autoimmune-related health conditions. I think I have had a bad case of SIBO and gut permeability since childhood due to trauma. “The Paleo Approach” explains what can happen to the gut-brain axis during stress pretty well. It all makes sense now, at least, even if I’m not sure I can fully heal physically from the effects trauma had on my brain and body.

    Anyways, the more food I take out, the more things I notice I’m sensitive to and what I can eat has become so limited I’m not sure this is healthy anymore. (About ten different vegetables, and now only two fruits, some herbs, and lower histamine meats…that’s it!). Any tips?

    • Mickey Trescott says

      Hey Janelle! I am so, so sorry to hear your story. I also had the experience of “uncovering” more food sensitivities as my diet got stricter. First, I do think there is a connection to trauma, this has been established in the research. Not my wheelhouse, but I have seen some articles out there and I would definitely search pub med if this interests you!

      About the histamine intolerance–if you believe this stems from SIBO, your best bet is to put all of your resources (energetic, financial, whatever) into getting in to see a great practitioner who can test and treat you. For some folks, this is a long road, but you could potentially resolve the histamine and low-FODMAP restrictions on your diet by successfully treating the SIBO. I’d also look into someone who is experienced at methylation, as this usually has a part to play.

      Hope you start feeling better soon Janelle!

    • Heather says

      I feel very much in the same boat, Janelle. My list is equally only a handful of items from each food group and I am quite discouraged by the fact that even those seem to be giving me reactions now. I am sorry for your struggle! I hope we can both find answers that help and heal, soon.

  • Hi, Mickey. Do you know of any low-histamine menus and recipes that also follow the AIP protocol? I know there are some high-histamine foods on the AIP, but I’m looking for some more menus and recipes that are both AIP and low-histamine, aside from substituting certain ingredients. Thanks!

    • Mickey Trescott says

      Hi Loretta, since histamine intolerance is so unique to the individual I am guessing a meal plan would be quite difficult to come up with that would work for everyone. I would start by finding your triggers, and then creating your own meal plan from there. Real Plans can be a great resource once you figure this out, as you can select foods like fish out of your meal plan and they cater to AIP.

  • Jo says

    I was diagnosed with breast cancer seven years ago. Surgery was followed by chemo and radiotherapy. Then the following year the urticaria began. It has been six years now of chronic urticaria and thousands of dollars spent trying to find a cure. Reading the articles here it seems far more complicated than I could have imagined. My question is, am I correct in thinking I need to follow an AIP diet but also have low histamine foods and if this is correct, where do I find a list of low histamine foods, please?

    • Mickey Trescott says

      Hi Jo! With uticaria, I would definitely wonder about histamines. You can try the Autoimmune Protocol while being mindful of the high-histamine foods up above and see if it produces any result for you. Many foods are low-histamine, its basically anything that is not on the list above. With histamine as well, how you cook/store food is a factor. Hope it helps!

  • Andrea says

    I started going to NAET and we started with environmental items since food did not seem to be a problem. I have dealt with menieres (like vertigo) for a while and always had major issues during seasonal allergies. A friend who has menieres too also seems to have come the same conclusion with her menieres.

    During the last few sessions of my NAET my practioneer said she could not clear the histamines so today I have been searching the web concerning this. As I read about histamine intolerance and all it symptoms I feel like this is my problem. I have decided to eat zero carbs for the next 30 days and would like to start taking a DAO supplement but it seems very hard to find one—any suggestions. Feel like I am still don’t grasped the entire histamine intolerance issues but I want to start doing something to hopefully feel better.

    • Mickey Trescott says

      Hi Andrea,
      Sorry to hear about your histamine intolerance. There are many DAO supplements on Amazon, I’m not personally using one right now so I don’t have a recommendation, but just be sure to double check the fillers and other ingredients to make sure it doesn’t have anything you are sensitive to. I would also suggest trialling a low-histamine approach instead of or in addition to a low carb approach–I think you might get more bang for your buck there.

  • Debbie says

    I just your article after 3 months on AIP. I couldn’t figure out why anytime I tried to heal my gut with bone broth or fermented foods I ended up an itchy mess. The last experiment was a probiotic. Epic fail!! Itched like crazy for 3 days. My Dr tested me about a year ago for MTFHR but told me little about it. I found by reading people with Methylation can have histamine issues. Just knowing that helped so much. I felt like a failure because I couldn’t “heal my gut”. So I am learning what I can handle and what I can’t. It really is so individual. Thanks for your article?

    • Mickey Trescott says

      Debbie – I am so happy it helped you put the pieces together! I hope you are able to get things sorted soon.

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