By Amy Burkhart, MD, RD   Updated 2025

The low histamine diet is being used to treat problems such as rashes, headaches, bloating, long-haul COVID-19 symptoms, and histamine intolerance (HIT). For those suffering from HIT, the low histamine diet is the primary treatment. After briefly explaining histamine and histamine intolerance, let’s discuss the low-histamine diet and determine if it works.

Histamine is a chemical found naturally in all cells of our body.

It is an important component of the immune and nervous systems. Histamine can trigger the immune system and cause symptoms like swelling, rashes and watery eyes. If it affects the nervous system it may cause problems such as headaches, digestive problems and pain.

In addition to the histamine that our body makes, it is also naturally present (or can develop) in certain foods. Histamine content is especially high in fermented foods. But wait – aren’t fermented foods supposed to be good for you? Keep reading for an answer to that question!

Histamine intolerance (HIT) isn’t a true allergy like we see with bee stings or peanuts. It is a mismatch between too much histamine in the body and the speed at which the body clears it.

IIf too much histamine is released, it is not broken down fast enough; a person doesn’t feel well. Individual histamine tolerance varies from person to person—picture histamine tolerance like a unique water bucket for each person, influenced by various health factors. As the bucket fills, symptoms may arise when it overflows. Notably, gut health plays a significant role in determining how your body responds to foods containing histamine. Understanding and managing your histamine tolerance is crucial for maintaining well-being.

For a more detailed explanation of histamine intolerance, read my previous article on histamine intolerance.here or at the link below.

Bloating is the most common symptom of histamine intolerance

Other symptoms include:

• Diarrhea
• Migraines or other headaches
• Stomach pain  or IBS
• Anxiety
• Fast heart rate
• Hives, itching
• Red color/flushing of skin
• Wheezing
• Watery eyes
• Sleep disruption/trouble sleeping
• Swelling of the tongue/mouth
• Severe menstrual pain

It may be difficult to diagnose HIT because the symptoms are similar to those of other conditions, including food intolerances, IBS, and gluten sensitivity. Because of this, it is important to speak with your doctor about other possible causes of your symptoms prior to making a diagnosis of histamine intolerance.

How Does It Help?

Following a low-histamine diet helps manage symptoms by:

• Reducing the overall amount of histamine you consume from foods
• Eliminating foods that interfere with the DAO enzyme, which is responsible for breaking down histamine in your body. When certain foods block this enzyme, histamine builds up and continues to cause discomfort.

Remember, this is a “low histamine diet,” not a “no histamine diet.” The goal is to decrease histamine levels. Eliminating histamine completely is impossible.

Symptoms of histamine intolerance often worsen by the end of the day, especially when multiple high-histamine foods are eaten throughout the day. Remember the “bucket” analogy? Symptoms occur when the histamine “bucket” overflows from the combined effect of naturally occurring histamine and that found in food. While it’s difficult to control the body’s natural histamine production, dietary changes can help manage symptoms.

Finding the right foods to avoid involves trial and error, so each person’s diet will differ. However, there are general tips to guide you, and the provided food lists are a helpful starting point. These lists outline foods to either avoid or include, helping reduce the chance of symptoms.

Quick Tips To Get Started

• Fresh is best. Foods’ histamine content increases as they age or spoil. Eating fresh food helps minimize histamine production.
• Avoid fermented foods. Fermented foods contain high amounts of histamine. While fermented foods are typically good for gut health, they are problematic if HIT is present.
• Read labels, avoid products that contain high histamine ingredients
• Freeze it.  Some research shows that freezing foods lessens histamine generation in foods. Consider freezing leftovers, especially meats.
• Avoid artificial coloring and preservatives. Food additives, dyes, and preservatives such as benzoates and sulfites can release histamine. Remember to check medications and supplements, too.
• Pasteurized dairy may be better. Some people with histamine intolerance cannot tolerate dairy at all, while others tolerate small amounts. It is best to choose fresh, pasteurized, and not fermented products. There is less histamine in cheese made from pasteurized milk than in raw milk.
• Boiling may be better. Histamine levels in foods vary depending on preparation methods – boiled foods have the same or less histamine than raw foods, while frying or grilling increases histamine levels

Low Histamine Food Lists Vary Depending On What Website You Reference

It is difficult to determine the standard histamine content of foods because they are affected by cooking method, temperature and age of the food.

The SIGHI food list is a comprehensive printable guide that is commonly used.

• Fruit: blueberries, apricots, cranberries, apples, mango, peaches.
• Vegetables: Onion, sweet potatoes, asparagus, broccoli, squash, cucumbers, beets.
• Dairy: Butter, cream cheese, pasteurized milk. Eggs are safe in small amounts. The whites may release histamine. Yolks are safe
• Meats: Freshly cooked meat and poultry. Fish that is fresh or frozen
• Grains: Potatoes, corn, rice, oats
• Fats and Oils: animal fats.
• Flavor: fresh and dried herbs, salt.
• Drinks: water, herbal tea, fruit juice (avoiding citrus).
  

Many of the foods on the SIGHI  list are determined by crowd-sourcing, not scientific evidence. That being said, they are a general place to start, and everyone’s tolerance is different.

The high histamine foods on a low histamine diet are listed below. I have put an * by the most commonly problematic ( highest histamine) from the list. If this seems overwhelming, please see above for the easy start guide. Enter your email and it will be sent to your inbox.

Fruits:

• Citrus fruits (e.g., oranges, lemons, limes)*
• Strawberries*
• Bananas
• Pineapple
• Pears

Vegetables:

• Eggplant
• Avocado
• Tomatoes*
• Olives
• Beans

Dairy:

• Cheese (especially aged )*
• Yogurt
• Processed cheese products*

Proteins:

• Canned, smoked, or dried meats/fish*
• Tuna, mackerel, anchovies
• Shellfish
• Sausages, lunchmeat, and liver*
• Eggs (except in small amounts when baked into products)

Grains:

• Avoid bleached wheat flour

Flavorings:

• Vinegar
• Soy sauce
• Hot spices (e.g., chili, cayenne)

Fermented Foods:

• Beer*
• Wine*
• Pickled foods
• Kombucha
• Sauerkraut
• Kimchi

Drinks:

• Coffee
• Alcohol*
• Black tea
• Orange juice
• Lemon water

By avoiding these foods, you can help reduce the buildup of histamine in your body and manage symptoms more effectively.

A Sample Menu

• Breakfast: oatmeal with cooked apples and almond milk
• Snack: peach and almond milk smoothie
• Lunch: chicken and vegetable soup with wild rice
• Dinner: grilled frozen cod with quinoa and asparagus
• Dessert: blueberry chia pudding

It can feel challenging to embark on an elimination diet. Always try to focus on foods that you can have. There are many recipe blogs and low-histamine cookbooks available with delicious menu ideas.

The main risk is overlooking other possible causes of the symptoms.

The main risk of following a low-histamine diet is that it may overlook other potential causes of your symptoms, as there are no definitive tests to diagnose histamine intolerance (HIT). By assuming HIT is the issue, you may miss other underlying problems. It’s crucial to explore other possible causes before jumping to a HIT diagnosis and starting a low-histamine diet. For more information, check out the full article on HIT, which covers conditions that mimic its symptoms, such as SIBO.

The low-histamine diet can also be quite restrictive, which may make it difficult to follow, especially if you have other dietary restrictions (e.g., FODMAP or gluten intolerance). When you need to manage multiple dietary restrictions, ensuring proper nutrition can become a challenge. If possible, working with a registered dietitian can be a helpful way to navigate these restrictions and maintain a balanced diet.

When histamine intolerance is properly diagnosed, underlying issues are addressed, and the low-histamine diet is followed, it can be incredibly beneficial.

I’ve seen many patients eliminate symptoms like hives, rashes, and headaches through this approach. In my experience, the diet doesn’t need to be followed strictly long-term if the root causes are also treated. The ultimate goal is to regain dietary freedom while improving overall well-being.

Moreover, this diet encourages the consumption of fresh, whole foods—something that’s always a step toward better health. With a balanced approach, you’re not just managing symptoms, but paving the way for a healthier, more vibrant lifestyle.

• Histamine Intolerance: The Current State Of Art
• Comparing Histamine Intolerance And Mast Cell Disorder
• Considering Histamine In Functional GI Disorders
• Non-responsive Celiac Disease And Histamine Intolerance