AIP and Histamine Intolerance – The Complete Guide

This article was originally posted in June 2016, but has since been updated and expanded to accommodate new research.

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 symptoms can be experienced:

  • 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 seasonal allergies.

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 don’t contain histamine, but actually stimulate the body to produce more histamine. We’ll break all of this down later in this guide!

What is histamine intolerance?

Histamine intolerance is the inability to tolerate high-histamine or histamine-producing foods in the diet.

Unlike a food 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. For some people, their threshold is very low, while others can tolerate more.

Think of 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 that comes from eating fish with excess histamine-creating bacteria.

Everyone has a limit to the amount of histamine they can tolerate without symptoms, but those with histamine intolerance just have a lower threshold, or a smaller “glass.” Even among those who regularly experience histamine intolerance, experiences can range from mild to severe, and tolerances to foods can vary wildly.

How is histamine intolerance managed?

Those with histamine intolerance experience fewer symptoms when avoiding foods that trigger their symptoms, whether they be high-histamine or histamine-producing foods.

This can be tricky as high-histamine and histamine-producing foods do not create the same symptoms in everyone, making it necessary for each person with histamine intolerance to determine their own threshold of certain foods (much like what we do in general with the elimination and reintroduction phases of the Autoimmune Protocol!).

This might look like changing the diet to remove high-histamine and histamine-producing foods, and then reintroducing them one at a time, in varying quantities and combinations, to assess tolerance.

In addition to symptom management through dietary changes, those with histamine intolerance can sometimes find a relief of symptoms through the successful treatment of underlying health conditions that may be causing it in the first place.

What causes histamine intolerance?

Anyone experiencing the symptoms of histamine intolerance should work with a healthcare provider to look into potential root causes and to see if there are any treatment options available for issues that come up.

Some common 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. You can read more in our article SIBO: The Definitive Guide.
  • Dysbiosis – Other infections like bacterial or yeast overgrowths and parasite infections can also cause histamine intolerance.
  • Methylation dysfunction — 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.
  • CIRS – Chronic inflammatory response syndrome is a condition many who have been exposed to mold toxicity develop, and can cause histamine intolerance.
  • Heavy Metal Toxicity – Those who have high levels of heavy metals can develop histamine intolerance.
  • 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?

As I explained before, foods can either contain histamine, cause the body to release 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 unpleasant symptoms.

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

It is important to remember that not all histamine intolerance looks the same, and that many people that experience its 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. This is why you won’t find a resource for low-histamine recipes that accommodates every type and severity of histamine intolerance – it really can vary a lot from individual to individual.

When to modify AIP to accommodate histamine intolerance

In general, if you don’t notice an issue eating high-histamine or histamine-producing foods, there is no reason to avoid these foods while in the elimination phase of the Autoimmune Protocol.

Exceptions are those with conditions that directly affect the skin (like psoriasis) or those that cause symptoms similar to histamine intolerance (like autoimmune urticaria). This is why in the AIP Psoriasis/Eczema study, the researchers asked participants to avoid the highest-histamine foods (fermented foods and cured meats) in their implementation of the Autoimmune Protocol, as there is a lot of anecdotal evidence that histamine intolerance is much more common in these groups.

My experience with histamine intolerance

A certain type 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 I eat more than a few bites. 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 my family members and I have a 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. 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. I don’t consider myself as having a full-blown histamine intolerance, but I’m mindful not to overdo it with the foods I know cause me issues in certain quantities.

What to do if you experience histamine intolerance

First, try a low-histamine and low-histamine-producing food diet for a short while 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 through dietary modification.

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

Lastly, if you have identified your root cause and are undergoing treatment, your histamine intolerance is likely to improve. This is very common in the case of SIBO — many SIBO patients have symptoms of histamine intolerance appear when they develop the overgrowth, and disappear when it is successfully treated. Same with those that have CIRS or heavy metal toxicity.

Once you treat an underlying cause, you may be able to try reintroducing some of these high-histamine or histamine-releasing foods slowly and methodically, to determine your new food list and threshold. Some people find supplementing with DAO can be helpful, although be cautious as it is difficult to find brands that don’t have unwanted fillers (I don’t have any specific recommendations, sorry!).

If you are one of the people who has a genetic issue (like me!), and there are only certain histamine foods that cause an issue, and in specific quantities. You can then 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 co-founder here at Autoimmune Wellness and a co-teacher of AIP Certified Coach. 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 has a Master's degree in Human Nutrition and Functional Nutrition, and is the author of three best-selling books--The Autoimmune Paleo Cookbook, The Autoimmune Wellness Handbook, and The Nutrient-Dense Kitchen. You can watch her AIP cooking demos by following 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


    • Karen says

      I have used Seeking Health Histamine Block in the past with pretty good results. It is available on Amazon.

      • Mickey Trescott says

        Thanks for sharing your experience with that product, Karen!

    • monica says

      I have been to the ER 4 times because I have SIBO and my checks and arms get red, and my throat tightens. The dexamethasone isn’t doing a thing, nor is benadryl. I’m dropping weight fast, down to 96 lbs. I ordered the DAO supplimment but it will take up to two weeks. I cut out bananas and a few other things. I get applegate turkey slices (no nitrates, minimally processed). When can I safely get back on my med for SIBO? Thx!!

      • Mickey Trescott says

        Hey Monica! I am so sorry to hear of your struggles, but we are not medical practitioners here and can’t advise you on medication choices. I hope you are able to find the support you need ASAP! Sending healing vibes!

        • Pam says

          I just finished antibiotic treatment for SIBO. I read that I should go low fodmap. But since I’m dealing with RA and leaky gut, AIP is also an option. However, while eating log fodmap in the past I found healthy foods like spaghetti squash caused terrible bloating. Listening to my body, I think I have a histamine issue. Which diet would you suggest or combination?

      • JESSICA Davidson says

        Check! All Applegate chix and turkey slices have chemical Carageenan! To keep the meat thick to take out of package.

      • Sarah says

        Hi Monica,
        Curious if you ever find it difficult to take a deep enough breath with the sensation of the throat tightening. I have that experience and have always suspected that it was actually related to some sort of digestive issue but haven’t been able to figure it out. Doing the AIP diet now and hoping that I will find relief from that tightness, my GERD, and all inflammation. Would be helpful to know if tight throat and difficulty getting a deep breath are linked to SIBO because then I would explore that more.

        • Abbey says

          Hey Sarah,
          Did you ever figure out what was causing your symptoms of difficulty taking deep enough breaths? Or anything that helped? I too struggle with this and am going to try to lower my histamine intake as an experiement for this. AIP alone hasn’t helped with this specific symptom.

          • Jo says

            Hey: curious to hear if low histamine helped your throat?

    • Sharon M Emery says

      Hi there. I have purchase DAO supplement via an Austrian company. I am currently using A website called, awaiting my delivery, should be next week.

      I believe the enzyme is made in Austria.

    • Judith Alley says

      I purchase our DAO supplement from Seeking Health the supplement company of Dr. Ben Lynch. His book “Dirty Genes” is very informative and he sells great supplements.

  • 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.

    • Cory says

      I used to have horrible sinus problems; congestion, puffy eyes, etc. I attributed it to seasonal allergies since I was already gluten and grain free. Within weeks of starting AIP and giving up dairy my sinuses were clear and have stayed that way, even in the height of allergy season.

    • Lola says

      I get really bad sinuses from dairy intolerance. Not lactose but all dairy (caesin protein) try cutting out dairy abs remember that sine things take longer to leave your system than others. Gluten takes 9 months I’ve heard and dairy isn’t a fast mover either. Give it time. Good luck

    • Portia Thomson says

      Hey Mel! Did you find a cure or cause for your Perioral Dermatitis? i am struggling with it!

    • Amnily says

      Hi Mel, just in case you visit these comments again, I wanted to suggest what has been a lifesaver for my chronic ear aches/infections. It’s over-the-counter Mullein-Garlic herbal ear drops (any health food store will have them). They’ve been a miracle product for me. I’ve had chronic ear infections since childhood and was looking for an alternative to antibiotics. For me, my entire family, and friends, these herbal ear drops are the solution. At the first sign of something going on in an ear, I put these drops in. I haven’t needed antibiotics since starting to use them for over a decade now.

  • 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)

      • Ashley Pickens says

        Hello, I was intolerant of literally everything besides 100% grass fed beef by the time I saw an NAET practitioner. I successfully healed my SIBO a year and a half ago but my histamine intolerance was not budging then I realized I had a salicylate intolerance, oxalate intolerance and the list goes on. I found out I had hypothyroidism then got diagnosed with Lyme Disease. It’s been a long journey. The treatment works. I can now eat high histamine foods, salicylates, high oxalate, night shades and more. I of course was skeptical of the treatment at first but I had nothing to lose. I’m so glad I took the plunge. It has saved me. I have a long road ahead of me still but at least I can eat!

  • 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.

    • Gemma says

      I am 5 weeks into the elimination phase, and suspect I feel slightly worse because of histamine. I don’t want to reintroduce any foods until I feel better but I’m worried if I also cut out all of the histamine foods I will not be eating very much! Would you recommend continuing with the elimination phase and removing all of the histamine foods? And if so how long would it take to confirm this was the issue?

      I am assuming taking an antihistamine for a few days instead is going to send me backwards!?

      Thank you in advance for your help 🙂

      • Mickey Trescott says

        Hey Gemma! Sorry to hear – you could try going low histamine for a couple days to see if that affects your progress. If you can’t sort it out, or if you discover it is histamine and need to look for your root cause (Like SIBO or methylation issues), I recommend looking for a functional medicine practitioner to help guide you. Good luck!

  • 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!

    • Dianna says

      I was reading (either the mast cell 360 or another recommended long hauler nutrition blog), that decaf coffee is actually worse than regular simply because of the process of preparing the bean to be decaf. Look for clean coffee and type that doesn’t heat up or blend with toxins or molds

  • 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?

    • Priscilla says

      Hi, Suzanne. That link is no longer available. Do you mind sharing the brand name of the probiotic that you used? Thank you.

  • 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.

    • Amanda says

      I hope you have found happy health Janelle. Your story sounds like mine. I’m very sensetive and all over the map with food reactions. I’m starting with healing my gut, mold detox, and the AIP. I listened to this recently and it was very helpful. Best of everything to you.

  • 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!

      • Lena says

        Hello Mickey,
        I have the HI and so far taking probiotics, detoxing liver, taking all kinds of supplements, meditating do not help, I am still inflamed from most innocent stuff I am eating.
        I am tempted to try your book, I see one comment with smb saying this diet has helped her, this is encouraging. However I would first like to know, 1. how many high-histamine products are in your recipes (I must especially avoid everything acid, fermented, no grapes, no tomatoes, no cocoa, no red fruits, no vinegars, etc). 2. Another issue is that I am a vegetarian and without grains nor soy I will have to eat meat? Is there a lot of meat in your recipes? 3. Are there foods fuelling candida in your recipes as well? This is my issue too but following anti-candida diet does not help me reduce inflammation, so I gave up on it. Thank you!

        • Mickey Trescott says

          Hey Lena! I don’t recommend trying AIP as a vegetarian unless you are able to eat fish and shellfish, which may be problematic for histamine intolerance. Otherwise, I do think a lot of the recipes would fit the bill, although replacing acidity can be tough. For candida I recommend working with a practitioner to obtain treatment as dietary changes alone are usually ineffective. 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.

  • Stacy says

    I was just diagnosed with chronic autoimmune urticaria after a positive lab test called the chronic urticaria index. My Doctor says that essentially I have antibody that attaches to my mast cells and causes a massive histamine release. It is considered an autoimmune disorder. Have your heard of this? I have another autoimmune disease ,ulcerative colitis, which is currently in remisssion! Thank u

    • Mickey Trescott says

      Hi Stacy, yes we have many readers with autoimmune urticaria. It can be tricky with the extra layer of histamine issues, but you should be able to find a way of eating that helps you manage well. Good luck!

  • Holly Hansen says

    I found this blog post on Twitter and really enjoyed it. I see that you recommended Histame. That product no longer contains the DAO enzyme. Just FYI, the DAO enzyme can be found exclusively at Thanks for sharing your stories. I am especially loving the recipes!

    • Mickey Trescott says

      Hi Holly, thanks for the update – I was wondering what was going on with the formulation of Histame as it has been off the market for awhile and then reappeared.

  • Kristina says

    Can you recommend a good supplement to help? The ones mentioned are not available to buy or the ingredients have changed. This is definitely my problem and I would love to finally get some help!

    • Mickey Trescott says

      Hi Kristina! See the product a reader mentioned here in the comments. I don’t have personal experience with the company she mentions, but it looks like they are the only one with actual DAO in it. Hope it helps!

  • Yesmeen says

    Had a CT scan with contrast yesterday and broke out with crazy red welty, rashy armpits! Ugh! Am I allergic to the contrast? Is this a histamine reaction? What can I do for relief? Can you recommend something? I’ve resorted to OTC cortisone cream because I can’t stop itching! Help!

    • Mickey Trescott says

      Hey Yesmeen! That sounds super uncomfortable – definitely give your doctor a heads up, but you could be allergic to something in the contrast, perhaps the iodine?

    • Natalie says

      If it was Gadolinium, that is a heavy metal and it can exacerbate heavy metal toxicity issues. :/

  • Tiffany Taylor Kenney says

    Hi! I have a question regarding histamine intolerance and SIBO, as I currently have both conditions. For the histamine issue, experts say to avoid fermented foods, and for SIBO the experts recommend eating fermented foods, so what should I do, eat or avoid fermented foods? Thank you!

    • Mickey Trescott says

      Hey Tiffany! I can’t tell you what will work best for you, but if you get a reaction when eating fermented foods, I don’t recommend eating them. Often times, treatment of SIBO can improve or reverse histamine intolerance, so I would encourage you to get tested and treated for the SIBO so hopefully you can take care of both issues. Good luck!

  • Lisa Infantino says

    Hi Mickey,

    I’ve wanted to try your cookbooks for ages but am afraid to purchase them because of my severe Mast Cell Activation disease (officially diagnosed by a New York City immunologist in January 2018 after searching four years and 24 doctors!) My histamine levels can easily get crazy high and then the cascade of the following issues begin or worsen…

    I suffer from vertigo (requiring hospitalization), urticaria, severe flushing, dermatographia, histaminosis, persistent severe fatigue, brain fog, fibromyalgia, a slew of GI disorders (was treated for SIBO, ulcers, healed myself from Barrett’s Esophagus & GERD, gastritis, diverticulosis, IBS), allergies, chronic rhinitis, bursitis, arthritis, spinal stenosis, carpal tunnel, hypothyroidism, tinnitus, sleep problems. If my histamine gets too high all of my health issues can flare up. It’s just crazy and can’t even describe how awful it’s been for me. I’ve been on disability and unable to work for 5 years now.

    So, I must be super cautious with histamine, but I need new foods and recipes to incorporate into my dietary protocol. I feel AIP can help but I fear the emphasis on high histamine foods. Will AIP layered with a low histamine diet be too restrictive? Is it even possible to do AIP if on a low histamine diet?

    The low histamine diet has been my saving grace, however, because it allows rice, oats, quinoa and other starches, it absolutely expands my repertoire of the recipes I can create and therefor feel so less restricted and frustrated by my diet. Considering how small my world has become due to my disability, the frustration of this diet only adds to it. However, I do find that if I eat too much of those foods I gain a little weight and experience a bit of the GI symptoms, but not the other histamine symptoms. I feel good otherwise when eating these foods, plus the added variety is a god-send.

    Anyway, I’m at my wit’s end here trying to figure out what is best for me. The ND and nutritionist I went to did little to help. It was Andrea Nakayama’s Full Body Systems course in functional nutrition that I took two years ago that has turned my life around and has gotten me out of bed and off all meds except the natural desiccated thyroid, but I’m not quite there. I’m hoping that the improvements I’ve experienced, while awesome, are not as good as I can get, because it’s still not enough to fully reclaim my life. There’s a missing piece and maybe it’s AIP.

    Thanks for reading all this. I’m hoping that AIP might be doable for me with my severe histamine/MCAD condition. What are your thoughts, and are there enough recipes for me in your cookbooks given my health issues?

    Thank you!

    • Mickey Trescott says

      Hi Lisa! Thank you for sharing your story, and I’m sorry for what you’ve been through! The short of it is that histamine is going to be a layer applied to any diet you choose, and the differences are more in how you implement (like not cooking broth for a long amount of time, getting fresh meat and freezing leftovers immediately) than the diet itself. A lot of folks with extreme histamine intolerance can implement AIP with modifications (I’ve worked with many in my coaching practice). I don’t think that the protocol is going to HEAL histamine intolerance though–for that you need to identify and treat the root cause (be it methylation dysfunction, SIBO, etc.). I think the recipes would be useful to you if you are comfortable identifying practices and substitutions that would work for your HIT expression–but the book is not written specifically to set you up for success in managing HIT. I rely a lot on batch cooking, which can be problematic. Wishing you success as you continue to navigate your journey, Lisa!

  • Kelly Couch says

    I bought the 28 day meal plan. Looks amazing. A couple of questions? I thought cinnamon was OFF the HIT diet list. Same for avocado and also mango. What am I missing here? Thanks so much!

    • Amy says

      I was thinking of purchasing this too….but I’ll wait to see if your question is answered.

  • Sabrina says

    There is an additional cause of histamine intolerance, namely mast cell activation syndrome, typically as part of the triad of dysautonomia, Ehlers-Danlos Syndrome and MCAS. Those with this triad live in excessive vasodilation, and since histamine is a vasodilator, intolerance ensues. To be sure, insufficient DAO may be at play, but this triad is an important cause of histamine intolerance—and it can start as a result of dysautonomia onset (after a virus, injury, etc).

    • Mickey Trescott says

      Thanks for sharing Sabrina! I’m aware of MCAS and its impact on histamine. I’m due to give this article an update since it is a few years old, and I’ll be sure to include some info about this as well.

      • Amy says

        I’m anxious to read what you come up with about MCAS, Mickey! I’m pretty positive this is what I have, but have not been able to find a doctor where I live who can properly diagnose it. My symptoms are chronic constipation, swollen lymphnodes, fatigue, and currently, I’m covered in hives! I’m a mess and would really love to get some help with this! I can’t find a DAO supplement without rice starch or corn which are high allergens for me, so I go without but I feel like I’m wasting away, because I’m afraid to eat anything! 🙁

  • Julie says

    I just saw the link to this on your email newsletter. It is so crazy because I’ve been to all kinds of doctors from naturopaths to allergy to ear, nose & throat… for all of these symptoms and nobody mentioned or seems to know about Histamine Intolerance. I heard about a year ago from a business colleague. Another interesting thing is that at the naturopath, I had the allergy blood test done and many of the histamine releasing foods (banana, egg, pineapple, etc) can up as my intolerances. I got my naturopath to do blood work from Dunwoody labs and sure enough, my body is making a lot of histamine and not enough DAO to break it down. It also said that my immunoglobulins were low. After reading a ton of comments on different products. I take the DAO supplement from seeking health, called Histamine Block. I also found an amazing probiotic that’s in spore form (some probiotics cause histamine response!) called MegaSpore. I also take their IgG supplement. Honestly, following a low histamine diet is extremely challenging… and it is hard to know what the particular triggers are since the symptoms can be subtle. The supplements do help though.

    • Mickey Trescott says

      Hi Julie! I’m sorry to hear about your struggles with histamine intolerance, but I bet you are happy to know it is one of the pieces to your puzzle! Some people find that over time, with treatment or addressing root causes their symptoms of histamine intolerance can improve. Wishing you luck as you navigate this!

  • claire kurdelak says

    Dr. Lara Briden, author of The Period Repair Manual, talked about histamine intolerance during perimenopause in an interview on the Phoenix Helix podcast. This was life-changing for me. Apparently the clearance and estrogen and the clearance of histamine rely on some of the same systems, and when estrogen is high, as it can be in perimenopause (when it can also vary crazily, going very low as well as high) histamine can build up. I think your followers could benefit from hearing about this, since so many Autoimmune people are women.

    • Mickey Trescott says

      Thanks for sharing this angle, Claire!

  • Amy says

    Are there any cookbooks available for low histamine aip and/or paleo diets?

    • Mickey Trescott says

      Amy, see the low-histamine cookbook linked just below the author section of this post. It has low histamine AIP recipes!

      • Amy says

        THANK YOU, Mickey! I’ll give it a try. I do better when I have a plan. I’m trying to tweak some of your recipes from your books…but having plan already laid out is most helpful. Wish there were more resources for a low histamine diet. THANK YOU for sharing this info!

  • Amy says

    Mickey, how do mushrooms fit in to a low histamine diet? I’ve noticed on other lists online to be high, and I see them in the Clean Plate cookbook mentioned here.

    • Mickey Trescott says

      Hi Amy! I think mushrooms can be a trigger food for some people, but they tend to be “lower on the list.” If you are worried about them, I would leave them out for a few days and see how you do with small quantities.

  • Brenda says

    I have a technical question about fermented or pickled food. I enjoy a particular brand of refrigerator-case sauerkraut for its probiotics. It lists only three ingredients: cabbage, salt, and distilled water. Would this contain the problematic fermentation in histamine intolerance? If so, should the “pickled” red onions made with lemon juice and salt also be avoided or is there a difference in the process? Your recipes have made this journey so much easier! We prepared your entire Easter Feast in 2019 for our family of twenty-four. Everyone raved and no one suspected it was “diet” anything!

    • Mickey Trescott says

      Hey Brenda! Thanks for the question! If you have histamine intolerance, it is likely that the sauerkraut will cause issues, but it is impossible to be 100% sure without experimenting a little. I would give it a break for awhile, and then reintroduce to see if you have any symptoms. The pickled onions are likely to have less histamines, but could still pose a problem for some folks with histamine intolerance. Individual tolerance varies and doesn’t always line up with the food lists, and can be dose-dependent so it is important to experiment for yourself and see what affects you. Good luck!

  • Natalie says

    Mickey – great to see this issue being addressed. I’ve been on AIP since the SAD to AIP in Six Weeks course in January 2015! I’ve since been able to reintroduce eggs, many seeds, nightshades, and most nuts, but the principles of AIP continue to be a lifesaver for me – thanks to you and Angie both!

    I had major histamine issues after an improper chelation treatment recommended by my FMP. In the past two years I’ve been doing the Andy Cutler Chelation (ACC) protocol, and as I’ve detoxed I’m finding that I no longer struggle with histamine issues. Anyone with silver fillings or a history of toxicity issues should consider exploring metal as a hidden root cause – one that many traditional docs will fail to identify and treat properly. My story (both about AIP and ACC) are available on my website at

    • Mickey Trescott says

      Hi Natalie! Thanks for sharing! Really interesting to learn about your histamine intolerance cropping up after chelation. I have worked with clients in the past that have found their histamine intolerance improve when an underlying factor has been addressed. So glad you are feeling better!

  • Rachel Tara says

    Hi! Thanks for this great article!
    I’ve been helping my little one heal from histamine intolerance, severe eczema and allergies over the past couple of years and we’ve learned a lot about healing from this on AIP! We started out with AIP + low histamine diet (it was hard but worth it!!) and now he can eat high histamine foods with no problem (specifically bacon, fermented foods, citrus, strawberries, chocolate) and is in the reintroduction phases of AIP. He is a happy and healthy 2 1/2 year old now, with eczema nearly gone and hopefully growing out of sensitivities and allergies as the years go by! We are so thankful!! We did not specifically find a root cause (although he has been to a naturopath), but we focused on healing his gut and healing through many healthy foods, homemade juices, smoothies and soups. A good homeopathic practitioner has helped a ton too! Working through the hard days, day by day, viewing and working for the healing one moment at a time 💛

    • Mickey Trescott says

      Rachel, so happy to hear of your success with your little one! Wishing you both continued health.

  • Isabel says

    Hello Mickey!
    Many thanks for this amazing article, it’s very well exaplained!
    I am taking this chance to ask a question: I used to have seasonal allergies, but when I starte AIP and I was living in the city, my seasonal allergies dissapeared. A few months ago, I decided to move to a quieter place, close to nature, and my seasonal allergies reappeared! I am still on AIP (and finally reintroducing), but because of my seasonal allergies, which are usually very strong, I started taking anti-histamine pills. What about that? Could this be reason why I feel better in terms of my intestinal issues? How could taking this pill affect to this histamine intolerance?
    Thank you in advance for reading! 🙂

    • Mickey Trescott says

      Hi Isabel! While some people do see an improvement in other immune-related issues (like seasonal allergies!) when they get their gut health in check, a lot of that reaction is going to be determined by your exposure to the allergen. It sounds like being out in the country is provoking that. Anti-histamines can certainly positively affect gut issues if they are caused by excess histamine. You’ll need to chat with your healthcare provider for next steps, but I would try investigating to see if you have any other underlying factors causing a higher histamine response. Good luck!

  • Lisa Weber says

    Hi Mickey!
    thank you for all your in depth information on the blog! I’m getting ready to start the AIP diet in an attempt to work on my chronic idiopathic angioedema (in my case swelling of tongue and oral mucosa, unrelated to any known allergens). I know that I probably need to be aware of high histamine food and I’m wondering if you could give a more detailed list of the foods researchers asked participants to avoid in the AIP Psoriasis/Eczema study? Was it just the foods you list in this article (Fermented foods–sauerkraut, kombucha, kefir, yogurt; Cured or processed meat products–bacon, salami, deli meat)? Thanks!

    • Mickey Trescott says

      Hi Lisa! Thanks for the comment. Unfortunately I don’t have a good list, but I did read an interesting research study this week about histamine content in foods. You might find this helpful as you seek more info about what foods may be an issue for you:

  • Melissa Sansone says

    I started AIP about 6 weeks ago.
    I have been hypothyroid since the birth of my last child 17 years ago. She was 6 months old when i was admitted to the hospital with diverticulitis and micro perforations in my bowel.
    My doctor tested tsh and found it to be high at a 10. I have since then taken levothyroxin at increasing doses through the years. Currently at 137mcg.
    So a friend got me to try AIP. Were both nurses she healed her hashimotos through AIP. I feel better. Im going to ask for thyroid antibodies test.
    Since following the diet and taking supplements from amy meyers i do feel better. I had to slow down on the supplements due to skin rashes and sores i attribute to die off.
    So today i scooped the cats litterbox.
    I have always had a mild allergy to cats that i thought i had out ground! I started to have a really bad coughing runny nose itchy eye cat reaction! Is this somehow related to hisamine and healing and and the whole diet thing?

    Sometimes the rash and internal itching is so bad from die off(i assume) that i would take an allergy pill to stop it.

    Is all of this related?

    On another note i do feel better though i still am having sluggish days but i imagine i just need to continue to eat AIP. I did add cassava last week in the form of fresh cooked , flour, and chips.
    Did i add cassava too early? I was getting bored.
    I do struggle with extremity fluid retention which is wayyyy down since starting AIP.

    • Mickey Trescott says

      Hi Melissa! Thanks for adding your experience here. If you are allergic to cats, that can definitely cause histamine reactions, but unfortunately I don’t think that dietary measures will make you any “less” allergic (I know a lot of folks wish it worked that way!).

      In terms of cassava, it is an AIP included food, but some folks do find they are sensitive to it. When in doubt, you can leave it out for a week or two just to be sure. Hope it helps, and good luck!

  • Amber says

    So I need both an AIP food protocol with high histamine issues. So I just follow the AIP and take out High Histamine foods? Is there a good list for me to look into to make sure I’m following this to the T. I know I have some of the other root causes. Haven’t found a doctor to address them with me so I’m hoping the AIP and low histamine diet will help those too or if you have advice/suggestions let me know.

    • Mickey Trescott says

      Hi Amber! Since histamine intolerance is very individual, I recommend modifying your AIP elimination to also exclude any foods that cause you symptoms of histamine intolerance. This might not involve all foods on the high histamine list. Hopefully this helps you stay comfortable as you search for a provider who can help you troubleshoot. Good luck!

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