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Should you be following a low Histamine diet?

The entire reason I became a dietitian was to help people through complicated health issues similar to what I was experiencing and show others how to fuel their bodies correctly. So I figured it would be fitting to share my most recent health endeavors and my experience on a low histamine diet. Some of you may know that I have been healing hashimoto's for over 6 years. While diet and lifestyle changes made huge impacts on my health, I have not yet been 100% symptom free for extended periods of time, which has been really frustrating. I was beginning to think this was my new "normal". I started working with a phenomenal Functional Medicine physician to run additional labs and help get to my true root cause! We found SIBO (small intestinal bacterial overgrowth), histamine intolerance, and mold toxicity! Kind of like the Fab 3 that you don't really want {shrug}.

People tend to ask me "how did that happen?" or "what caused this?"I really don't think there is one specific event that caused this but rather an accumulation of events and missed signals since childhood. I had GI issues, anxiety, and sub-optimal nutrition since elementary school.

How this may have happened: Stress, constipation, and leaky gut is a trigger for developing SIBO and for histamine intolerance. Bacteria overgrowth occurs when food is not digested properly in the gut, causing overproduction of histamine. You need DAO enzyme to break down histamine. The same amount of DAO enzyme will not be sufficient to break down the increased amounts of histamine in your system that is produced from lack of proper digestion. Mold toxicity and leaky gut (intestinal permeability) can trigger autoimmune disorders. SIBO will most likely not resolve completely until mold toxicity is treated.

What changed?

I began experiencing breathing issues last Fall. The day after Christmas last year it got so bad I ended up spending the night in the emergency room. I was told I had bronchitis (which it wasn't) and to follow up with my family doctor (I did). Long story short, I had labs drawn, pulmonary tests, upper and lower GI series completed...the result? I was fine. BUT I couldn't breathe! I felt like I was suffocating most days and was chronically coughing. Symptoms I definitely don't want when I'm working full time, running 2 businesses and raising some kids to be good humans.

What did I do?

First, I tried the low FODMAP (low Fermentable Oligo-, Di-, Mono- saccharides And Polyols) diet for SIBO thinking that may help, but I did not see any major improvements. I dabbled with some extra eliminations but nothing strictly because my diet is already semi-restrictive.After receiving lab results that my histamine levels were elevated my physician and I decided following a Strict Low Histamine Diet for a time would be beneficial for me.

“Symptoms that I was experiencing for the last 6-7 years- that I assumed were coming from the hashimoto's- were completely resolved!"

What is Histamine?

Histamine is a chemical found in the body that helps relay messages to your brain, aids in the production of stomach acid for proper digestion, and is related to an immune response during injury or allergic reaction. We need a certain amount of histamine in the body to conduct all of these essential processes. We only run into problems when we have too much histamine in the body. This can happen in two ways- either by over production of histamine or by not being able to adequately break down histamine.

Some common symptoms of Histamine Intolerance include:


Skin issues (rashes, acne, itching etc)

Stomach problems (cramping, diarrhea, nausea)

Bolus sensation in throat (feeling something is stuck in throat)



Breathing difficulty (similar to asthma symptoms)

Nasal congestion

Chronic sinus infections


Irregular menstrual cycle

If you are experiencing any of these symptoms a trial of a low histamine diet may be beneficial for you. I have found with myself and with patient care that at least a 4-6 week trial produces the best results before introducing the high histamine foods gradually. Please reach out to me or another Functional Medicine Dietitian to help you with any obstacle, challenges, and concerns you may have navigating this diet change.

There are three main components of foods to avoid:

1. Histamine containing foods


Fermented Foods: vinegar, mustard, yogurt, kefir, sauerkraut, kimchi, tempeh, pickles, kombucha

Aged Foods: dried meats, bacon, deli meats, processed or smoked meats, jerky

2. Histamine liberators:

Vegetables: Tomatoes, Spinach. Mushrooms, Eggplant, Pumpkin

Ripe bananas

Ripe avocados

Nuts/Seeds: specifically walnuts, cashews, sunflower seeds



Dried Fruit

Canned fish: sardines, herring, tuna


Citrus fruits

3. DAO blocking foods:


Black tea

Green Tea

Energy/caffeinated drinks

In addition to types of food, in more severe cases of histamine intolerance, leftovers can also be problematic. For some people, freezing leftovers that won't be eaten within 24-48 hours can also help reduce the over production of histamine in the body.

You can include more foods that help naturally reduce histamine in the body.

Quercetin is a plant pigment and antioxidant that helps fight free radicals and helps manage immune system response to outside stressors (like toxins and food). Many studies have found that Quercetin is a natural anti-histamine. Foods high in Quercetin: Blueberries, Apples, Onions, Kale, Arugula, Parsley, Asparagus, Broccoli, Cabbage, Brussels sproutsFoods high in DAO to help break down histamine: Olive Oil, Wild Caught Salmon, Pea Sprouts, Foods to help stabilize Mast Cell response from high histamine levels: garlic, turmeric, ginger, watercress, holy basil, thyme, peaches, pomegranate seeds, peppermint

Not Just Food:

I have found both in clinical practice and personally, that reducing stress along with a low histamine diet has shown the best improvement in symptoms. If you feel like you have high stress levels and you do not handle stress well, I suggest trying different practices and techniques that may appeal to you. Choose something that can be easily implemented and won't feel like an added "chore". Stress Management techniques to try:MeditationYoga Gratitude Journal or jarBelly BreathingEFT or Emotional Freedom Techniques aka tapping

The Outcome:

After about 5 days my consistent coughing improved about 60%, then after following this diet for about 4 weeks I only had 1 episode of breathing issues! Symptoms that I was experiencing for the last 6-7 years- that I assumed were coming from the hashimoto's- were completely resolved!Once I felt symptoms improved and I was stable I started to reintroduce the higher histamine foods I was avoiding gradually and began playing with my tolerance levels. I found that on high stress days I can tolerate less high histamine foods and on very low stress days I can tolerate more histamine. I have now successfully reintroduced most of the foods I was eliminating and am finding my limits until the SIBO and mold are resolved. Have you dealt with histamine intolerance, or think you may be? Please let me know what worked for you and any questions you have below. Wishing you health and happiness always,


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