High histamine level foods: - The worst offender was the day I reintroduced tomato.

AIP and Histamine

So why is the AIP diet (autoimmune Paleo diet) such a problem for those that are histamine sensitive? Well, first of all, it doesn’t have to be. There are several reasons AIP is often high in histamine. First, this is a diet that stresses the use of fermented foods. Since ferments are quite high in histamine this can certainly contribute to total histamine levels. The other reason AIP can be so high in histamine is the emphasis on animal protein. While fresh meats and fish are not super high in histamine, as they age histamine develops. This is because all animal proteins contain the amino acid histidine. Histidine, as the animal protein ages, will then degrade to histamine. The older the meat the higher the histamine content. This brings me to the next reason AIP tends to be higher in histamine—the emphasis on whole foods typically means longer hours in the kitchen. Since most of us are so busy with work, family and other responsibilities cooking is not something we typically make time for in our lives. So, to accommodate a lifestyle that requires more homecooked meals, many (myself included) will batch cook meals enjoying leftovers all week long. While this is not a problem if you do not have HIT, for those that do this is a recipe for a histamine disaster. Finally, we live in a world were bigger is better. While traditionally fermented foods are used in small amounts as flavoring agents, many will indulge in much larger servings. A tablespoon of sauerkraut is not typically a problem, but a whole cup may be problematic.

Low Histamine Diet
High histamine foods include alcohol, fermented foods, mature cheeses, smoked foods, shellfish, nuts, chocolate, vinegar, wheat, tomatoes and citrus fruits (lemon, lime, orange, tangerine, grapefruit and pineapple). These foods may exacerbate HIT. Prepared, boxed and canned foods are also often problematic, as can be older meats that have been aged or have been sitting in the refrigerator for a few days and ground meats. Poultry skin is also high in histamine, even when fresh. Black, white and green tea, coffee and other caffeinated beverages can also be a problem. While typically, the occasional high histamine food is not overly problematic, eating lots of high histamine foods over the course of a day or two can be very problematic for those with HIT. The best course of action is minimizing the use of high histamine foods if you are histamine intolerant. Eating a vegetarian meal or two per day can be an easy way to decrease your histamine load. Try preparing meats fresh every day. When consuming higher histamine foods consider keeping portion sizes small. For example, the amount of lemon typically found in hummus is likely not a problem. However, drinking a glass of fresh squeezed lemonade could be more of an issue.

https://naturalnutmeg.com/finding-relief-with-a-low-histamine-diet/

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Low histamine level foods:

• Fresh meat (cooled, frozen or fresh)
• Freshly caught fish
• Chicken (skinned and fresh)
• Egg yolk
• Fresh fruits – with the exception of strawberries, most fresh fruits are considered to have a low histamine level (also see histamine liberators below)
• Fresh vegetables – with the exception of tomatoes
• Grains – rice noodles, yeast free rye bread, rice crisp bread, oats, puffed rice crackers, millet flour, pasta (spelt and corn based)
• Fresh pasteurised milk and milk products
• Milk substitutes – coconut milk, rice milk
• Cream cheese, butter (without the histamine generating rancidity)
• Most cooking oils – check suitability before use
• Most leafy herbs – check suitability before use
• Most non-citric fruit juices
• Herbal teas – with the exception of those listed below

High histamine level foods:

• Alcohol
• Pickled or canned foods – sauerkrauts
• Matured cheeses
• Smoked meat products – salami, ham, sausages….
• Shellfish
• Beans and pulses – chickpeas, soy beans, peanuts
• Nuts – walnuts, cashew nuts
• Chocolates and other cocoa based products
• Vinegar
• Ready meals
• Salty snacks, sweets with preservatives and artificial colourings

Histamine liberators:

• Most citric fruits – kiwi, lemon, lime, pineapple, plums…
• Cocoa and chocolate
• Nuts
• Papaya
• Beans and pulses
• Tomatoes
• Wheat germ
• Additives – benzoate, sulphites, nitrites, glutamate, food dyes

Diamine Oxidase (DAO) blockers:

• Alcohol
• Black tea
• Energy drinks
• Green tea
• Mate tea

Debatable:

• Yoghurt – depends on the bacteria culture used
• Egg white – it is a histamine liberator only when in its raw state

Other

• Yeast – even though it does not contain histamine as such, yeast serves as a catalyst for histamine generation during manufacture. There is no yeast in the end product.

Sources include:

NMI Portal für Nahrungsmittel Intoleranz, Histaminunverträglichkeit – Richtige Ernährung
Maintz L, Novak N: Histamine and histamine intolerance, American Journal of Clinical Nutrition 2007
Jarisch, R. “Histaminunverträglichkeit”, Thieme Verlag, 2nd Edition

https://www.histamineintolerance.org.uk/about/the-food-diary/the-food-list/

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What Is Histamine Intolerance?

To answer that question, first you have to know what histamines are. In the most basic sense, histamines are chemicals produced during any allergic response. When an allergen triggers the immune system, mast cells (a type of white blood cells) release histamines as part of the inflammatory immune reaction. It’s this inflammation that gives you puffy, swollen eyes or a blistery skin rash. As well as being produced during the immune response, histamines can also be absorbed from histamine-containing foods, and produced by bacteria in the gut.

In healthy people, the production and ingestion of histamines is balanced out by an enzyme called diamine oxidase (DAO), which breaks down the histamines. Some processes create histamine; others destroy it, and overall the system balances out. But some people have a deficiency of DAO, so the histamines build up in their body, and cause a wide array of symptoms.

Many of these symptoms are familiar to allergy sufferers: rashes, hives, runny nose, swelling in the throat, and itching (with or without an accompanying rash). It’s basically the same old inflammatory allergic response, only without an allergen. But an overload of histamine can also cause an enormous constellation of problems, including migraines, digestive upset (constipation and/or diarrhea), nausea, and low blood pressure.

An important point to remember about this is that even though it sometimes feels like hayfever, histamine intolerance isn’t like a regular allergy where the allergic reaction is provoked by even a little bit of the substance. It’s the buildup that matters. Think of histamine like water pouring into a sink. Most people have an emergency drain (DAO) that prevents the sink from overflowing. But people with histamine intolerance don’t have that drain, so their sink eventually overflows.

Since the symptoms of histamine intolerance look like an allergy but aren’t, researchers tend to describe the problem as a “pseudoallergy:” all the symptoms of an allergic reaction, but without any allergen there to set them off. When your body is overwhelmed with too much histamine, or can’t clear histamine quickly enough, or both, you get an “allergic reaction” that isn’t actually an allergy, often manifesting as one or more of the incredibly vague symptoms that everyone hates trying to diagnose.

Histamines and Food

If you want to try an elimination diet, the next thing to learn is what foods you’ll have to cut out. Remember from above that one of the ways to push your internal “sink” past the overflow point is by eating too many foods that contain a lot of histamine. Here’s the tricky part, though: for the most part, the biggest source of histamine in food isn’t the food itself. It’s bacteria on the food, which naturally produce histamine as part of their metabolic process. So anything aged or fermented will be big trouble for the histamine intolerant! Even leftovers can sometimes be “aged” enough to cause problems. Foods high in histamine include:

• (very high) Aged or fermented foods: kimchi, sauerkraut, yogurt or kefir, kombucha, aged cheese, alcohol of any kind, vinegar, and cured meat.
• (very high) Fish and seafood, especially canned or smoked fish.
• (medium) spinach, eggplant, mushrooms, tomatoes, canned vegetables, dried fruit, avocados, strawberries, papaya, pineapple, and leftovers.

If you want to get specific with the numbers, this chart shows a partial list of histamine-containing foods, together with the amounts found in them: as you can see, the results vary from study to study, sometimes drastically. So there’s no foolproof way to list foods from high to low histamine content, and your reaction to specific foods might vary widely: eating the fish in one restaurant might be fine, while the fish from the restaurant next door leaves you breaking out in hives.

Then there’s a second category of foods that don’t contain histamine themselves, but can cause your body to release more of it. These foods include:

• Fruits and vegetables: citrus fruit, papaya, strawberries, pineapple, tomatoes, spinach
• Meat: Fish, shellfish, and pork
• Other foods: Chocolate, nuts, and raw egg white

Individual sensitivities to these foods vary a lot. Most people only have trouble with the very high-histamine foods and don’t need to eliminate anything else from their diet. In this study, for example, a boy suffering from atopic dermatitis improved just by eliminating the foods highest in histamine and then making sure not to rely on moderate-histamine foods as his everyday staples.

Since there’s no reason to eliminate foods unless you have to, a good starting point for an elimination diet is to cut out the very high histamine foods, and then experiment with different tweaks once you can see whether it’s helping at all or not.

https://paleoleap.com/histamines/