histamine intolerance

Histamine hack: Here’s how to safely eat fermented foods

Histamine is a compound that’s released from immune cells. Some gut bacteria and cells belonging to the nervous system also make histamine.

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After three months on a low-histamine diet, you can start reintroducing gentle, histamine-rich foods like young coconut kefir. Click here to shop our starter.

A healthy small intestine is full of enzymes that get rid of histamine.

Histamine is what drives the most common signs of an allergy. Itchy, red eyes; sneezing; runny nose; and congestion are all part of the histamine response.

While your own cells make histamine, you also consume histamine with the food that you eat. Fermented foods — including cultured vegetables and young coconut kefir — naturally contain high amounts of histamine.

If you have symptoms of histamine intolerance, like a runny nose, headaches, asthma, or itchy skin, that’s no way to live. Your histamine tolerance lies in the gut.

For most of us, this isn’t a problem. But if you’re not able to break down histamine, it ends up accumulating in your body.1

This can lead to signs of histamine intolerance, including:

  • Asthma
  • Diarrhea
  • Headache
  • Hives or red, itchy skin
  • Low blood pressure
  • Rapid or irregular heartbeat
  • Stuffy or runny nose

Histamine intolerance looks a lot like an allergic response. If you think that you’re histamine intolerant, rule out an allergy with a skin prick test.

What is histamine intolerance, and which foods cause reactions?

By some reports, roughly 1 to 3 percent of people are histamine intolerant, and 80 percent of that population is middle-aged.2,3

This number is controversial. We also see high levels of histamine in those with:

  • Food allergies
  • Irritable bowel disease, which includes Crohn’s disease and ulcerative colitis
  • Irritable bowel syndrome

Eating high-histamine foods or having an allergic response can cause histamine levels to skyrocket. But histamine only accumulates when you can’t break it down.

Two enzymes are responsible for breaking down histamine. They are DAO (diamine oxidase) and HNMT (histamine-N-methyl-transferase). When these enzymes aren’t working as they should — or if we’re genetically wired to have underactive enzymes — we begin to show signs of histamine intolerance.

You can help the DAO enzyme do its job by making sure your diet is rich in vitamin C and vitamin B6. Research shows that these vitamins can reduce your histamine load by supporting DAO enzyme activity.4,5

Those with histamine intolerance are unable to tolerate high-histamine foods.6,7 This includes:

  • Aged cheese (like manchego, parmigiano, gouda, gruyere, roquefort, and cheddar)
  • Alcoholic drinks (i.e., wine, beer, and spirits)
  • Chocolate and vanilla
  • Cured meats (such as chorizo, salami, and sobrassada)
  • Eggs
  • Fermented foods, including sauerkraut and young coconut kefir
  • Processed or partially processed oily fish (like tuna, sardine, mackerel, and herring)
  • Spices (such as cinnamon, chili powder, and cloves)
  • Spinach, tomato, and eggplant
  • Vinegar

Citrus fruits are on the list of foods to avoid too. This is because citrus fruits free up histamine — adding more work to an already overwhelmed system.

Getting to know the enzymes that detoxify histamine

People with histamine intolerance should also steer clear of foods rich in long-chain fats. However, medium-chain fats in coconut oil or palm oil are not a problem. Long-chain fats stimulate the release of histamine during digestion.8

But your body is smart. It wouldn’t release a potentially dangerous compound (like histamine) without also throwing in the enzyme that destroys it.

This enzyme (DAO) breaks down histamine and prevents it from accumulating in your body. It literally detoxifies the histamine. As it turns out, you release the most DAO in the small intestine.9 A healthy small intestine is full of enzymes that get rid of histamine.10

Scientists speculate that accumulating histamine is only a problem for those who do not make enough DAO — leading to an imbalance in histamine or histamine intolerance.11

There are a few factors that influence DAO activity. In women, the menstrual cycle can actually predict how much of this detoxifying enzyme is available.12 For example, during the luteal phase (after ovulation), a healthy woman has higher levels of DAO. This means that it’s easier for her to detoxify histamine after she releases an egg and before she menstruates.

But one of the most important factors that influence DAO activity is diet. As we mentioned earlier, a healthy small intestine is full of enzymes that break down histamine. When the small intestine is inflamed or leaky, there is less DAO and more histamine.

Studies show that the soluble fiber that you get through your diet can boost levels of enzymes, helping to break down histamine and safeguard against leaky gut.13,14

You can enrich your diet with soluble fiber by eating plenty of:

  • Grain-like seeds, like quinoa, millet, amaranth, and buckwheat
  • Hearty green winter vegetables
  • Ocean vegetables or seaweeds
  • Sour fruits, like sour green apples and berries
How would you like your next few months to look, and what would you like to achieve? Use our Gut Recovery Masterclass to set your intention.

So, is histamine really the bad guy?

What histamine does depends on which histamine receptors are activated. (There are four types of histamine receptors in the body.) It also depends on whether or not you have enough enzymes to clean up excess histamine.

Histamine gets a bad rap — but it’s neither good nor bad.

For example, some of the probiotics in fermented foods produce histamine. But research shows us that histamine manufactured by gut bacteria actually regulates the immune system and has an anti-inflammatory effect.15

If you believe that you’ve recently developed histamine intolerance, avoiding high-histamine foods may make you feel better. But it won’t heal the root of the disorder. Your diet, your inner ecosystem, and your immune system (which includes histamine) all work together in concert. Restoring balance is ultimately more important than avoiding trigger foods.

These restorative tips only apply to those who do not have genetic histamine intolerance:

  1. Go on a low histamine diet.
  2. Focus on the 7 Universal Principles of The Body Ecology Diet, which ensure that you’re eating plenty of fiber.
  3. After three months, begin reintroducing histamine-rich foods. Start with young coconut kefir.

To fully heal histamine intolerance and welcome fermented foods back into your life, you must heal your gut first.


  1. 1. Smolinska, S., Jutel, M., Crameri, R., & O’Mahony, L. (2014). Histamine and gut mucosal immune regulation. Allergy, 69(3), 273-281.
  2. 2. Maintz, L., & Novak, N. (2007). Histamine and histamine intolerance. The American journal of clinical nutrition, 85(5), 1185-1196.
  3. 3. Comas-Basté O, Sánchez-Pérez S, Veciana-Nogués MT, Latorre-Moratalla M, Vidal-Carou MDC. Histamine Intolerance: The Current State of the Art. Biomolecules. 2020;10(8):1181. Published 2020 Aug 14. doi:10.3390/biom10081181.
  4. 4. Johnston, C. S. (1996). The antihistamine action of ascorbic acid. In Subcellular Biochemistry (pp. 189-213). Springer US.
  5. 5. Martner-Hewes, P. M., Hunt, I. F., Murphy, N. J., Swendseid, M. E., & Settlage, R. H. (1986). Vitamin B-6 nutriture and plasma diamine oxidase activity in pregnant Hispanic teenagers. The American journal of clinical nutrition, 44(6), 907-913.
  6. 6. Rosell-Camps, A., Zibetti, S., Pérez-Esteban, G., Vila-Vidal, M., Ferrés-Ramis, L., & García-Teresa-García, E. (2013). Histamine intolerance as a cause of chronic digestive complaints in pediatric patients. Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva, 105(4), 201-207.
  7. 7. Kohn, J. B. (2014). Is There a Diet for Histamine Intolerance?. Journal of the Academy of Nutrition and Dietetics, 114(11), 1860.
  8. 8. Ji, Y., Sakata, Y., Li, X., Zhang, C., Yang, Q., Xu, M., … & Tso, P. (2013). Lymphatic diamine oxidase secretion stimulated by fat absorption is linked with histamine release. American Journal of Physiology-Gastrointestinal and Liver Physiology, 304(8), G732-G740.
  9. 9. Shakir, K. M., Margolis, S., & Baylin, S. B. (1977). Localization of histaminase (diamine oxidase) in rat small intestinal mucosa: site of release by heparin. Biochemical pharmacology, 26(24), 2343-2347.
  10. 10. Luk, G. D., Bayless, T. M., & Baylin, S. B. (1980). Diamine oxidase (histaminase). A circulating marker for rat intestinal mucosal maturation and integrity. Journal of Clinical Investigation, 66(1), 66.
  11. 11. “DAO Deficiency.” International Society of DAO Deficiency, 2018.
  12. 12. Hamada, Y., Shinohara, Y., Yano, M., Yamamoto, M., Yoshio, M., Satake, K., … & Usami, M. (2013). Effect of the menstrual cycle on serum diamine oxidase levels in healthy women. Clinical biochemistry, 46(1), 99-102.
  13. 13. Nakao, M., Ogura, Y., Satake, S., Ito, I., Iguchi, A., Takagi, K., & Nabeshima, T. (2002). Usefulness of soluble dietary fiber for the treatment of diarrhea during enteral nutrition in elderly patients. Nutrition, 18(1), 35-39.
  14. 14. Fukudome, I., Kobayashi, M., Dabanaka, K., Maeda, H., Okamoto, K., Okabayashi, T., … & Hanazaki, K. (2013). Diamine oxidase as a marker of intestinal mucosal injury and the effect of soluble dietary fiber on gastrointestinal tract toxicity after intravenous 5-fluorouracil treatment in rats. Medical molecular morphology, 1-8.
  15. 15. Ferstl, R., Frei, R., Schiavi, E., Konieczna, P., Barcik, W., Ziegler, M., … & O’Mahony, L. (2014). Histamine receptor 2 is a key influence in immune responses to intestinal histamine-secreting microbes. Journal of Allergy and Clinical Immunology, 134(3), 744-746.
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