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Astute readers will note this list contains histamine-rich foods, as well as histamine-releasing foods. Diagnosing a histamine intolerance can be a bit tricky in that you can be tested for allergies, and have negative test results across the board, yet still be histamine intolerant.7 This is a case where the best method of action, is to follow a low histamine diet for a time period, and then slowly re-introduce foods which provoke a histamine response. Since your body produces histamine8 it is best to think of histamine intolerance as an ‘overflow’ type of situation.
Histamine-induced food intolerance is not IgE-mediated.14 This means again that the best way to improve a histamine intolerance is to follow a low histamine diet, which can easily be done within a Paleo Diet framework.
I have Celiac Disease and food allergies such as dairy and soy, and was still feeling sick, bloated and gassy all the time, even avoiding gluten, dairy and soy. According to the Migraine Research Foundation, approximately 18% of American women and 6% of American men suffer from migraines. Histamine causes your blood vessels to swell, or dilate, so that your white blood cells can quickly find and attack the infection or problem.
Conditions such as allergies, leaky gut, bacterial overgrowth in the intestines, fermented food and alcohol, enzyme deficiency and histamine rich foods can all cause an increase in histamine levels. When the body cannot properly break down the histamine in the bloodstream, it accumulates and eventually sets off symptoms which are easily confused with allergies. As mentioned above, the body produces it’s own histamine, but histamine is also present in foods.
In those places in the body where the concentration of histamine raises too high, symptoms will occur. As muscles need oxygen to burn fuel, excess histamine can also cause you to develop a lack of oxygen (hypoxia) with symptoms such as muscle cramps, tension-type headaches and cold hands and feet. Histamine intolerance is the intolerance towards “normal” levels of histamine in food caused by the histamine-degrading enzymes diamine oxidase (DAO) or histamine N-methyltransferase (HNMT). The decreased capacity of histamine degrading enzymes can be due to a genetic defect or could be acquired due to, for example, medicines like antibiotics and NSAIDs. Most people who are sensitive to histamine find that their symptoms will disappear or be reduced if they lower the level of histamine in their diet. Fish needs to be very fresh.Tuna, mackerel, herring and anchovies have an especially strong tendency to develop high levels of histamine when not fresh. Some probiotic strains may contain bacteria which convert the histidine in your food to histamine. Some people experience relief from eating a diet, that is not only low histamine but also includes foods that break down histamine directly (for example,foods high in vitamin C) or have mast cell stabilizing effects (high in magnesium, etc). List of bacteria in foods and probiotics that is said to cause increased histamine (to avoid): Photobacterium phospereum, Raoultella planticola.

Diamine oxidase (DAO) is the primary enzyme which metabolizes dietary histamine.3 Below is a comprehensive list detailing the kinds of foods that may cause reactions in individuals with low amine oxidase activity or commonly referred to as histamine intolerance. There are other causes of histamine intolerance, besides having low DAO activity4 including ‘leaky gut’,2,3 among other commonly exhibited symptoms as seen in the second table. Diamine oxidase cannot be supplemented; so lowering your histamine intake via food is the best method of action. But, I also have severe histamine intolerance I believe I have had my entire life, looking back at my issues. I hope that after a few solid days of a non-histamine diet, I can get things back in check and begin introducing more foods and figure out how to do Paleo with this new understanding about how my body processes food.
But, I must also have histamine intolerance because prior to going Paleo, I had so many headaches, including migraines, that I was taking Advil EVERY day to keep them at bay! The histamine buildup is what gives you a headache and leaves you feeling flushed, itchy and miserable. This happens when your body either releases more histamine than desirable or if your body has a decreased capacity of the enzymes necessary to break down histamine. In these foods the amino acid histidine is converted by bacteria to histamine, like in aged cheese, soy sauces, sausage, fish that are not completely fresh. This can be because the lining of the uterus contains mast cells which liberates histamine when it breaks down during menses. Some foods that are well tolerated are rice, carrots, pumpkin, chicken and ginger (though high in salicylics).
Also, anti-inflammatory foods can have beneficial effects when you are suffering from histamine intolerance. Other causes of histamine intolerance include: allergies, GI bleeding, and small intestinal bacterial overgrowth (SIBO). As stated in this study,15 the only effective long-term therapy for a histamine intolerance is the avoidance of histamine-containing food. Oxidative deamination of biogenic amines by intestinal amine oxidases: histamine is specifically inactivated by diamine oxidase.
Optogenetic-mediated release of histamine reveals distal and autoregulatory mechanisms for controlling arousal.
Manipulation of central nervous system histamine or histaminergic receptors (H1) affects food intake in rats.
Histamine-free diet: treatment of choice for histamine-induced food intolerance and supporting treatment for chronic headaches. Like you say, though, eating more histamine rich foods (nuts, avocados, strawberries, bacon, tomatoes, etc.) caused my levels to overflow and my body revolted.

I know that Andy Deas, who hosted the earlier podcasts with Robb Wolf, on his site, shared his story of his wife curing her migraines with a ketogenic diet. This is part of the body’s natural immune response, but if you don’t break down histamine properly, you could develop what we call histamine intolerance.
The other source of histamine is from degranulating reservoirs of histamine in the body – the so-called mast cells. Digestion of histamine or mast cell degranulators that trigger the release of histamine will cause irritable bowel. In this way symptoms of histamine overload can develop through both increased availability of histamine and impaired histamine degradation. There is nothing wrong with the hormones, just a lack of the enzymes capacity to break down histamine. Lemon sole, perch and monkfish are all low in histamine, and fresh salmon can be a good choice, because it is high in anti-inflammatory omega-3 fatty acids. For example, foods high in omega-3 fatty acids (salmon, walnuts, rapeseed oil) will produce anti-inflammatory prostaglandins in the body, whereas omega-6 rich food (ie, meat) generates inflammatory prostaglandins. Too much histamine in your bronchi causes bronchoconstriction (asthma) which reduces the amount of oxygen taken in from your lungs. Too much serotonin and also adrenaline gives way to vasoconstriction which is associated with migraines as well as anxiety.
One school of thought is that too much histamine could cause a miscarriage, so the placenta starts to produce a lot of the DAO enzyme to protect the fetus.
Unfortunately histamine intolerance is not an accepted disease by the International Classification of Diseases (ICD) and therefore not recognized by most doctors.
The headaches were reduced on the meds, but never went away and I had to be careful to avoid the migraine trigger foods, such as chocolate, onions, bananas, oranges, etc. The best way to diagnose histamine intolerance is by following an elimination diet where you remove trigger foods that are high in histamine or known to be mast cell degranulators. Then, after a period of time, you reintroduce foods and products one by one to see if you react to it. From my experience I feel histamine intolerance could be the root of many medical ailments today.

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