histamine

Histamine intolerance

April 14, 2024

There are many theories you may come across when searching for explanations for an upset stomach. A less common cause is histamine intolerance. Histamine is a natural substance involved in all allergic reactions and helps the immune system defend itself against foreign substances. When histamine is released, symptoms can arise that are sometimes mistaken for IBS.

Lack of enzymes, not allergies

Histamine intolerance is not classified as an allergy because it occurs when the body absorbs too much histamine from food. This is due to a deficiency, or reduced production, of the enzyme diamine oxidase, known as DAO, which breaks down histamine. It’s the same principle as lactose intolerance. The body is unable to handle and break down the histamine already present in food or triggered by certain foods. Only one to two percent of the world’s population completely lack the DAO enzyme, but more people may have temporarily reduced production, for example, when the gut is imbalanced.

Diffuse symptoms

Symptoms such as increased heart rate, palpitations, a drop in blood pressure after meals, headaches, migraines, digestive issues, eczema, itching, or redness can be signs of histamine intolerance. It is relatively difficult to get a diagnosis of histamine intolerance within the healthcare system, even though it is possible to measure your DAO levels. Therefore, the solution may be to personally try reducing the intake of histamine-releasing foods for a period of time.

Belly Balance digital treatment

Are you ready to take back your life from IBS? Our app provides the tools and guidance you need to manage IBS effectively.

Histamine in foods

Histamine is naturally present in certain foods. However, how food is handled also affects histamine levels. For example, long storage, high temperatures, and poor hygiene increase histamine in food.

Examples of histamine-rich foods:

  • Various types of aged cheeses
  • Mackerel
  • Tuna
  • Anchovies
  • Sardines
  • Red wine
  • Aged meat products such as salami, sausages, and smoked ham
  • Spinach
  • Tomatoes
  • Sauerkraut
  • Soy sauce


There are also foods that seem to release histamine in the body without showing a classic IgE reaction:

  • Milk
  • Pineapple
  • Citrus fruits
  • Chocolate
  • Fish
  • Pork
  • Strawberries
  • Papaya
  • Shellfish
  • Spinach
  • Tomatoes
  • Egg whites


As you can see, MANY foods are restricted, but just because they are on the list doesn’t always mean they won’t work for you—it’s important to experiment. Also, remember that knowledge about histamine intolerance, its symptoms, and treatment is not yet fully evidence-based, so don’t hesitate to seek help from a dietitian if you’re unsure.

Histamine and FODMAP

Histamine intolerance has nothing to do with FODMAP; rather, it’s a condition where the body lacks an enzyme. If you have digestive issues and aren’t improving or fully recovering with FODMAP, it may be worth testing for histamine intolerance. A tip is to try low-FODMAP foods from the histamine list; otherwise, you risk not knowing where the symptoms are coming from. Foods that generally work well for those combining a low-FODMAP diet with a low-histamine diet include rice, quinoa, gluten-free pasta, buckwheat, spelt sourdough bread, oats, blueberries, and eggs.

Sofia Antonsson 
Reg. Dietitian, Belly Balance

Read more about