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Starting the Low Histamine Diet
Confusion. It can be overwhelming hearing what you’re not supposed to eat. Before this particular doctor appointment, I had never heard of a low histamine diet. If I had read about it on the internet, I would’ve chalked it up to another trending fad. My doctor handed me a pithy little list of what to avoid, which left me wondering, “Well, what SHOULD I be eating?” I found an extensive histamine food content list from a Swiss association (SIGHI) that matched up with all the no-no’s of my specialist and went from there.
This is an elimination diet. The idea is to minimize the amount of histamine getting into your system by means of your food to see if doing so can get you feeling any better. Read about best practices, and get a grocery list and free recipes at the Low Histamine Diet Page.
Low Histamine Food List
Here’s a food summary I used as a guide when starting my ultra-low histamine diet. Lowest means foods with lowest possible histamine-wise. Medium means foods with some low amount of histamine, so consume in smaller amounts.
Dairy
The Swiss List now details that pasteurized milk “may be incompatible as long as the bowel is still irritated.” It should be added that some patients find that reducing or eliminating dairy has them feeling better, so it’s yet another diet option to consider!
Lowest: butter, cottage cheese, cream cheese, young gouda, mascarpone, pasteurized milk, mozzarella, ricotta
Avoid aged cheeses. Organic dairy products generally have less additives, making them a great option.
Meat
Lowest: beef, chicken, turkey, fresh fish
Avoid aged meats.
Starches
Lowest: cornflakes, oats, quinoa, rice (rice cakes, rice krispies, rice noodles)
Low/Med: wheat (pastas, cereals, bread, etc.)
Nuts
Pretty much avoid this category, though macadamia nut appears to be low.
Fats
Lowest: olive oil, canola oil, margarine
Vegetables
Lowest: artichoke, asparagus, beets, sweet bell pepper, bok choi, broccoli, cabbage, carrot, cauliflower, celery, chicory, corn, cucumber, fennel, green beans, lettuces, parsnip, pumpkin, radish, squashes, sweet potato, yam, white onion, zucchini
Avoid anything pickled, and nightshades (includes spicy peppers, eggplants & tomatoes).
Fruits
Lowest: apple, apricot, blackberry, blueberries, cherries, coconut, cranberries, dates, grapes, lingonberries, lychee, melons, nectarine, peaches, persimmon, pomegranate, raisins
Avoid citrus.
Sweeteners
Lowest: caramel, fructose, honey, lactose, maple syrup, sugar
Avoid artificial sweeteners and malt extract.
Spices
Lowest: cinnamon, turmeric
Low/Med: ginger, nutmeg, poppy seeds, vanilla extract
Avoid: soy sauce, balsamic & wine vinegars
Tea:
Lowest: chamomile, peppermint tea, holy basil, verbena, rooibos
Avoid: black tea
Other Beverages:
Lowest: carrot juice, cherry juice, cranberry juice
Low/Med: coffee, sodas
Avoid: alcohol, energy drinks, chocolate drinks
Don’t forget to freeze left-overs (especially protein), because histamine is produced as microbes break-down food!
I personally have felt a marginal difference on the low histamine diet, but others feel immensely better and swear by it. After a few weeks of hardcore elimination dieting, I decided to just avoid the highest histamine offenders for most meals. A huge improvement through the process was finding a few more mild triggers like malt and cloves. A huge benefit was just generally cleaning up my diet and getting into green smoothies. Clearly my body has trouble enough staying healthy, so why not give it plenty of nutrients to do the best it can. Maintaining a decent appetite can be a struggle for a lot of us POTSies, so smoothies offer a way to get in calories and decent nutrition! After years of restricting calories and intense workouts, I never imagined missing an appetite. Nothing like chronic illness to make you appreciate the most simple things.
Free Low Histamine Diet Recipes
Reference: Foods selected based on their histamine content as defined in the histamine food list provided by SIGHI.
Cinnamon is on most ‘avoid’ lists…
Cinnamon is actually listed as a “zero” on the extensive Swiss Interest Group for Histamine Intolerance list all my posts are based on. I reference it everywhere… please check it out! http://www.mastzellaktivierung.info/download/foodlist/21_FoodList_EN_alphabetic_withCateg.pdf
Since everyone is different in their sensitivities, each person needs to tailor their own list. Histamine is by no means the only thing a person, especially a person with a mast cell disorder, is probably sensitive to. Starting with foods that are low histamine is simply a great place to start. Actually many with mast cell disorders are additionally sensitive to salicylates, so if you have trouble with many low histamine foods, it’s worth looking into a salicylate sensitivity… http://salicylatesensitivity.com/about/food-guide/
Hope this helps!
Hi there, thanks for this interesting and informative article. I just wanted to let you know that your links to that salicylate website no longer work, I don’t think it exists any more. There’s a link in the main article.
First, I am new to histamine considerations. I’m very happy to have found your blog. I’ve seen a few that seem to have a lot of info that conflicts with the SIGHI lists, so it’s great to find one that I can trust.
Second, how is the histamine content of Mozzarella sticks? The Simple Truth Organic brand of shredded mozzarella has these ingredients: organic low-moisture part-skim mozzarella cheese (organic cultured pasteurized reduced fat milk, salt, microbial enzymes), powdered cellulose (added to prevent caking).
The same brand of mozzarella sticks has only these ingredients: CULTURED PASTEURIZED PART SKIM ORGANIC MILK, SALT, ENZYMES
Hi Liz! Thanks- I’m glad some of my work here is actually useful! The histamine content of a specific food or preparation isn’t something we can readily measure, so we’re left with general guidelines derived from food sample testing, which is probably done with lab testing using immunoassays or liquid chromatography. All I can think to say is that for cheese, the fresher the better! Serious Eats’ Chef Alton Brown explains that low-moisture mozzarella (like your sliced or shredded cheese) is favored for a lot of recipes like pizza, and explains that it’s processed by allowing the fresh cheese to sour and age. This would logically put it in the “aged” cheese category, which we’re generally told to avoid, but I wonder if it is fresher than a lot of other cheese options. I personally don’t have an issue with mozzarella in any form, but then again I only eat cheese in modest amounts like on a slice of pizza once in a while. Hope you get to enjoy! Here’s the link I referenced: http://slice.seriouseats.com/archives/2011/02/the-pizza-lab-the-best-low-moisture-mozzarella-for-pizzas.html
Thanks Brandy.
I think you’re right about it being less aged than other cheeses. I took another look at the SIGHI list. Besides mozzarella, it lists cottage cheese and ricotta as also being histamine free. They’re not aged, but nor are they commonly eaten in a super fresh state, so I’ll assume that various forms of mozzarella are fairly low histamine. I’m collecting easy forms of protein – things that I can keep on hand that don’t require preparation before eating. Fortunately there are a few nuts on the list as well.
Btw, I’ve found that organic cheeses tend to have fewer additives than others.
Thanks for sharing, and that’s a great point about organic cheeses… I’ll have to add that!
I agree 100%. I find that I tolerate fresh mozzarella I the ball form, but the cheese sticks (aka string cheese) must be just old enough to tick off my GI mast cells.
Hey there! Reading this list as a POTsie and suspected MCAS. I’m feeling frustrated by the overlap of great POTS foods and bad histamine foods, like pickles and dried meats… how do you keep a high salt diet for POTS without tons of histamine?!? I’m very overwhelmed.
That can definitely be a frustrating aspect of having both these conditions! Know it may only really be an issue long-term if you try the low histamine diet and find that eliminating those particular salty foods has you feeling better… if not they should be added back in. The long-term goal of the diet is to have the widest variety possible, only eliminating what makes you feel worse (if anything actually does) histamine or otherwise. I’ve never eaten much salt to begin with, so I learned to be heavy-handed with my salt shaker to douse a lot of my savory foods with plenty of salt. For sandwiches I even take to salting each individual layer. It adds up quicker than you might think. I also recommend supplementing with some products if you’re not doing that already. This page might be helpful… https://www.naughtylittlemastcells.com/how-to-up-your-salt-intake/ Wishing you the best!!
I generally get the majority of my salt from 1/4 teaspoon of sea salt with Liquid IV, in a 38 oz glass, and 4-7 glasses a day. This has been safe for me, keeping the histamine monster at bay.
One thing to remember with allergic reactions, either be MCAS or Histamine Intolerance Syndrome (HIS) (and the allergist says there is a very fine line between the two) is that while POTS may be very impacting for us, the allergic reaction has to be the main concern, stay free from any and all reactions. I think we all agree that breathing is a high point everyday. 😉
I am just discovering this way of eating after having visited the ER one too many times and now carrying an Epipen. I have anaphylactic shock reaction, always begins in my face/mouth/lips and then progresses to my uvula and ……………
I want you to know that I totally appreciate this page and have saved it to my favorites! Thank you for your willingness to help those of us who are just learning, and appreciate the blessing of life, and want to continue on!
I do have a question, and wonder if you would possibly know the answer.
*Does a reaction that always begins around the mouth always indicate that the anaphylactic reaction is due to an ingested food?
Trying to narrow things down here, but without much assistance from a physician who seems competent, I feel a bit at a loss.
Hi Vicki! Thanks for sharing- I’m glad some of this is being put to use! This question definitely is one for a real medical professional, but I could say that if it was me, I would definitely question what is physically triggering my mouth… maybe a food, maybe something I’m breathing and inhaling. For me, triggers can be hard to pin down and prove, especially because my reactions are almost always delayed and not immediate. Hindsight can be much clearer with some time. If you’re not already I’d suggest making a detailed daily log like I describe on the Low Histamine Diet page to help you identify potential causes and patterns. Also I’d recommend checking out Facebook support group pages where you can search and solicit other patient experiences if you’re not doing that already too. They might also have some suggestions for finding a great specialist, which is hugely important! The Mastocytosis Society actually is now using inspire.com as a place for their nurses to answer patients questions, so that could be a great option. Wishing you all the best and hope you’re hanging in there!
Hi Brandy, thanks for the Inpire.com link!
That’s encouraging, nurses taking this serously.
Hi Vicki –
Has anyone looked at whether or not you may have a nickel allergy?
Just want to say, “Thank you!” for posting this information.
It is really appreciated…
Thanks, Janice! Comments like these keep me motivated to keep the site up and running. Hope all’s well!
Would be interested if anyone has a latex food sensitivity along with the Mast Cell/histamine issue? Many of the low histamine foods are on the latex food list so my food choices are limited. Would like to know how they deal with it.
I am allergic to latex and thus avocados, bananas, and melons. I thought because nothing else gave me anaphylactic shock that they were ok. I had no idea there was a list of histamine foods. I stumbled upon it finally after 65 years. I eat pork, beef, chicken, all organic grass fed. I eat cruciferous vegetables, mangos, blueberries, blackberries, filtered water. I olive oil, pure maple syrup, and salt and pepper for salad dressing. I just posted a comment today about my ordeal, it covers a lot. As I say in that comment, I am sticking to these foods for at least a month to give my system a rest and then see if I can start adding things back at one at a time. I am doing unflavored bovine protein powder, mangos or blueberries, a little maple syrup and filtered water for breakfast and a snack before bed sometimes. I do decaf coffee, black. The caffeine does not give me a histamine reaction, but I think because of my system being so clean the caffeine is just too much..
I also have a nickle allergy, so no spinach among many other things. Here is a list of foods I have been able to eat: yams, kale, onions, garlic, avocado oil (even though I am allergic to avocados, go figure), extra virgin olive oil, leeks, parnips, no nitrate or nitrite bacon, maple syrup, halibut, (I haven’t tried wild salmon since I started the histamine diet) beef, pork, chicken (all organic and free range), brussel sprouts, cauliflower, rhutabagas, turnips, decaf coffee, basil, marjoram, most herbs, zucchini, most squashes, nothing on the high histamine list or nickle list and then some. I am freezing left overs. I went to a restaurant yesterday and order the steak (medium rare) salad with no bleu cheese or anything else, with a side of olive oil for dressing and salt and pepper with a cup of decaf coffee. It was fine. Today I had roasted vegetables for lunch with a mango protein smoothie for breakfast.
Yes , i have a latex allergy as well
I cant eat bananas, kiwi, coconut, avocardos and most nuts and seeds. Aloe vera also contains latex
Hope it helps a little. Its frustrating because so man healthy foods have latex
Is it the caffeine in black tea that is the problem? For example would decaffeinated tea or white tea be a better choice if following a low histamine diet? Thanks.
Sorry for the late response! Check out the Swiss SIGHI list. They have a variety of different teas listed with details that show that certain teas like black and green tea contains blockers of diamine oxidase (DAO) or of other histamine degrading enzymes. The teas listed above as “safest” don’t have those inhibitors according to SIGHI.
I stumbled upon the food histamine intolerance accidentally when I was doing the Meyer’s Way for autoimmune. I have horrible chronic eczema since birth. I had a knee replacement surgery May of 2018 and, because I am a carrier of staph, I had to have a total of 3 surgeries and 3 clean outs because I got 3 staph infections following each operation. I have a spacer knee now since October 2018 and have been working on fixing my immune system all along and am going way down the rabbit hole. When I discovered the histamine information I started working on that. The only things I have been avoiding eating most of my life has been avocados, bananas, and melons, because of anaphylactic shock. I had given up all grains, dairy, eggs, legumes, nuts, etc. and still had no relief from my itching eyes and horrible eczema. I had settled on coconut milk and coconut products as a way to clean up my system. I started looking at all of the different histamine lists and coconut was always on the low histamine list, which I figured was good/correct. I finally found one site that said coconut is a high histamine. I was incredulous. I stop all coconut products immediately and within 24 hours my eyes had stopped itching and my eczema was almost gone. That kind of opened the flood gate. This has been in the last two weeks. Now when I eat something I know within 30 minutes to a couple of hours that I am allergic or intolerant to it. I have now added coconut, apples, cannabis (unfortunately) and I am still adding to the list. I am going to continue eating low histamine foods for at least 30 days after I no longer have a reaction to any foods I am eating to see if my system will clean up. I now feel like my immune system will be able to fight the staph if it returns after my final knee operation in the next month. I have a spacer knee at this time and we have been waiting until we could get my immune system in check. I am so excited. I have now read that histamine intolerance can affect your estrogen and so I am hoping to fix that too, since my menopause has been so intense. I was on bio-identicals for 13 years and ended up with a lumpectomy in my left breast. Luckily it was the most curable kind, but I know that it was because my system was so out of whack. I was only on 1.875 grams of combined estrogen with 100 grams of progesterone. Most women would not have gotten cancer with that. Since I had to give up the bio-identicals I now have intense hot flashed every hour to an hour and a half. I can’t wait to fix it.
Curious, I am on bio-identical creams. 1 mg estriol per day and 50 mg progesterone. I have been on this for many many years. Were you on the creams? I heard this combo prevents breast cancer.
I was exposed to a high does of flame retardant. Since then I have had these horrible reactions usually beginning in the afternoon about 1 or 2 pm. Itchiness, sinus and seasonal allergy problems. I can’t hardly stand my clothes as my skin is hypersensitive. I have been to allergist and dermatologists to no avail. This has been going on for about seven years. I have done all sorts of elimination diets that did’t work. To make a long story short I had never heard about “Histamine Intolerance”. So glad I found your site. At list I know now I am not crazy…thanks 🤓🌻
Do you mind if I ask how you were exposed to flame retardants? I found my baseline got progressively worse each time I was exposed to flame retardant treated foam mattress products like memory foam mattresses and toppers. I’m sorry you’re having to go through this too. Hope you find some more things that help you feel a bit better!
Mine started when I got a new couch—flame retardant. The. The food issues started. I learned that all new furniture has voc (dangerous chemicals) at varying levels. It takes time for them to “gas off”.it could be resin or flame retardant or formaldehyde. The more ventilation you have, the quicker the “gassing off period”. Also, brand new wood plank floors take almost 2 years to gas off. A couple things you can do is douse the furniture with baking soda, let it sit for 2 hours, and vacuum well. Use a mask while doing it. They have handheld vacuums with us light to kill germs and gets rid of bed bugs at HSN. The second thing is to get an air purifier that 1) has charcoal filter 2) is True HEPA 3) deals with VOC. Read descriptions carefully. Plus you want the other benefits such as deals with allergens, mold, mildew, pollen, pet dander. I only learned about histamine intolerance less than a week ago, but mine started with this new sofa.
This is very interesting! My son has POTS and now is experiencing MCAS, which lead me here. One of the things that we did this past year was to get him a new mattress and new memory foam pillow. That was in April and his symptoms showed up in June and are just getting worse. I did notice a strong smell of chemicals in his room at the beginning but don’t smell anything anymore. I am concerned though since we did just get him a new pillow this past weekend. It doesn’t smell, but it is made of memory foam. Do the reactions go away after the gassing off period? I’m just trying to connect the dots.
I read somewhere that ginger deteriorates histamine. Can anyone comment on this? Also I read eating manuka honey helps to rebuild a healthy gut that MAY be the cause of some people’s low or dysfunctional DOA. Can anyone comment on this?
my wife is on a low histamine diet. She is African we found that green sweet peppers are OK. Green Bell Chilli peppers are Ok but not red ones .
Also maggi fry seaoning is Ok
Just wondering if you care about oxalates and lectin, if they impact you too as it happens with many people who have some sort of histamine overload.
Hi! Personally I haven’t found these compounds to be issues for me, but other patients do mention them.