The low histamine diet, similar to specialized diets like the DASH diet or the gastroparesis diet, is not designed for weight loss. Instead, it serves as a medical treatment aimed at reducing symptoms associated with histamine intolerance. Registered dietitian Amanda Igel, MS, RD, LD, sheds light on this specific eating plan.
What is the Low Histamine Diet?
To understand the low histamine diet, it’s essential first to grasp what histamine is. If you’ve ever taken antihistamines for allergies, you might already have a hint.
“Histamine is a chemical substance in your mast cells, a type of white blood cell, that helps your immune system respond to allergy triggers,” explains Igel. “When you have an allergy to a specific food, for instance, histamine is released by these immune cells to protect the body from the perceived threat.”
Histamine triggers various responses in the body to combat allergens. It dilates blood vessels while constricting the airways and gastrointestinal (GI) tract. This response can also lead to mucus production, resulting in a runny nose.
While our bodies naturally produce histamine, it is also present in many foods. Normally, enzymes like diamine oxidase (DAO) break down histamine, preventing an overload. However, people with histamine intolerance have issues with these enzymes, leading to an overabundance of histamine in the body, which can cause symptoms such as:
Diarrhea or bloating
Nausea and vomiting
Headache
Runny or stuffy nose
Shortness of breath (dyspnea)
Itching sensation
Rash, hives, or flushing
Painful menstrual periods
Low blood pressure (hypotension)
Irregular heart rate (arrhythmia)
Swelling of the lips, tongue, or throat
It’s important to note that histamine intolerance is not an allergy. It occurs when histamine levels exceed what the body can tolerate, leading to the above symptoms. Given that many conditions can cause similar symptoms, the low histamine diet should only be undertaken with medical supervision.
Diagnosing Histamine Intolerance
Histamine intolerance is considered a diagnosis of exclusion, meaning it’s identified after ruling out other potential conditions, such as inflammatory bowel disease (IBD), celiac disease, and mast cell disorders like mastocytosis and mast cell activation syndrome (MCAS). Certain medications can also cause histamine intolerance. Additionally, histamine intolerance can coexist with other conditions, like Crohn’s disease.
“The low histamine diet is about limiting foods high in histamine and those that hinder the DAO enzyme’s effectiveness,” Igel explains. “It’s not about eliminating all histamine, but rather reducing it enough to manage symptoms.”
Benefits of a Low Histamine Diet
Histamine intolerance is rare, affecting about 1% of the U.S. population, though the actual number may be higher due to the variability in histamine levels and difficulty in diagnosing the condition. The low histamine diet, when properly managed, can significantly improve quality of life by reducing symptoms such as diarrhea, heart palpitations, and rashes.
However, because the diet is complex and highly individualized, it should not be attempted without professional guidance. “People with histamine intolerance can react differently to the same foods at different times,” Igel notes. “Symptoms can also be seasonal due to environmental allergens affecting food.”
Implementing a Low Histamine Diet
A low histamine diet involves several key principles:
Opt for Fresh, Whole, Unprocessed Foods: Fermented, cured, or aged foods have higher histamine levels due to bacterial breakdown. Fresh, whole foods are preferable. Foods to avoid include alcohol, aged meats and cheeses, fermented foods, certain vegetables and tropical fruits, and non-fresh fish or shellfish.
Proper Food Storage: Minimize bacteria production by refrigerating or freezing foods. Avoid canned and shelf-stable foods.
Cook Your Own Food: Preparation methods matter. Grilling can increase histamine levels, while braising or steaming are better options. Eating out can be challenging due to the lack of control over ingredients and preparation methods.
Keep a Food Diary: Track what you eat, how much, and any symptoms. This helps identify patterns and manage histamine intake effectively.
Who Should Avoid the Low Histamine Diet
Due to its restrictive nature, the low histamine diet is not suitable for everyone, particularly those with a history of disordered eating or diagnosed eating disorders. “For these individuals, managing symptoms with medical antihistamines or topical steroids is safer,” advises Igel. The focus should be on symptom management rather than restriction, to avoid triggering or exacerbating an eating disorder.
Takeaway
The low histamine diet is a medical intervention for those diagnosed with histamine intolerance, a condition where the body’s enzymes fail to break down histamine efficiently, causing an overabundance. This diet helps reduce symptoms but must be monitored by healthcare professionals to ensure proper nutrition and avoid malnutrition.
Despite its name, histamine intolerance is not an allergy but an issue of excess histamine due to enzyme dysfunction. The diet is highly individualized and requires careful management to be effective. It’s not a weight loss plan, but a way to improve the quality of life by alleviating uncomfortable symptoms associated with histamine intolerance.