Is a low histamine diet effective for chronic hives?

If you’ve been dealing with chronic hives, you’ve probably heard a million different theories about what’s causing them. Maybe your doctor handed you a prescription for antihistamines, told you to meditate or use “free and clear detergent” and sent you on your way. You’ve probably spent hours down internet rabbit holes, searching for a solution to your relentless itching.

Maybe you even made the same mistake I did—adding more and more fermented foods into your diet to “heal your gut,” only to have your hives flare up worse than ever.

At some point, you might have stumbled across the idea of a low histamine diet. But does it actually work for chronic hives, or is it just another internet trend?

Let’s break it down.

Disclaimer: This content is for informational and educational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease. Always consult with your healthcare provider before making changes to your diet, lifestyle, or supplement routine.

What is Histamine, and Why Does it Matter for Hives?

Histamine is a compound involved in immune responses, digestion, and brain function. It’s found naturally in certain foods and is also released by mast cells when your body thinks there’s a threat—even when there isn’t one.

If you have chronic hives, your body might be releasing too much histamine, struggling to break it down properly, or both.

Normally, an enzyme called DAO (diamine oxidase) helps break down histamine from food, while another enzyme, HNMT (histamine-N-methyltransferase), clears histamine in tissues. If those aren’t working well—or if your system is already overloaded—a high-histamine diet can make symptoms worse.

Is There Any Science Behind a Low Histamine Diet for Hives?

Many doctors will tell you there’s no evidence that a low histamine diet helps chronic urticaria (hives). But here’s the thing—I’ve seen firsthand through support groups, working with clients, and in my own journey that many people experience real, noticeable improvements when they try it.

And guess what? Research does exist—it’s just not well-known or talked about.

Studies on Low Histamine Diets and Hives

It’s not a magic bullet, but if your hives tend to flare after eating certain foods—especially leftovers, aged cheese, fermented foods, or alcohol—a low histamine diet might be worth trying.

A study published in Clinical and Translational Allergy followed patients with chronic spontaneous urticaria (CSU) who also had digestive issues. After just three weeks on a low histamine diet, 75% saw improvements, and 61% had significantly lower urticaria activity scores, dropping from an average of 9.05 to 4.23. That’s a huge shift.

Another small study of 22 adults with chronic hives found similar results. After four weeks on a histamine-free diet, participants had fewer and less severe hives, along with lower plasma histamine levels. So not only did they feel better, but there were real biochemical changes to back it up.

What about DAO?

DAO (diamine oxidase) is one of the key enzymes your body uses to break down histamine—specifically the kind that comes from food. It’s mainly produced in the small intestine and acts like a cleanup crew, clearing out histamine before it can trigger symptoms like hives, flushing, or digestive issues.

In the studies I mentioned earlier, DAO levels didn’t necessarily go up during the low histamine diet—but people still improved. That tells us something really important: simply reducing histamine intake can provide relief, even if your body isn’t making more DAO.

But here’s where it gets interesting: some people benefit from supplementing with DAO.

Can DAO Supplements Help?

DAO supplements are usually taken before meals and can help break down the histamine in the food you’re about to eat. They don’t affect histamine your body makes on its own (from mast cells), but they can be really helpful for people whose symptoms are triggered mostly by food-based histamine.

In practice, I’ve seen people use DAO strategically—like when dining out, eating questionable leftovers, or trying to reintroduce a borderline food. Some people find it gives them more flexibility and allows them to eat a slightly less restrictive diet.

Is DAO a Long-Term Fix?

DAO supplements aren’t a cure, and they don’t work for everyone. But they can be a great tool in the toolbox—especially if your own DAO production is low due to gut inflammation, nutrient deficiencies, or genetics.

If you suspect histamine intolerance is a piece of your puzzle, it may be worth experimenting with DAO supplements alongside a low histamine diet. Just remember: supplements should support healing, not cover up deeper issues long-term.

How to Tell if a Low Histamine Diet Might Help Your Hives

Not everyone with chronic hives has histamine intolerance, but here are some clues it might be part of your puzzle:

• Your hives flare after high-histamine foods (a food and symptom journal can help spot patterns).
• You have other histamine-related symptoms—like flushing, headaches, dizziness, sinus issues, or digestive problems.
• Antihistamines help, but your symptoms return as soon as you stop.
• You have a history of gut issues, such as SIBO, leaky gut, or food sensitivities.

How to Try a Low Histamine Diet for Hives

If you want to give this a try, don’t overthink it. You don’t need a hardcore elimination diet forever—just a few weeks to see if it makes a difference.

Here’s a simple way to start:

• Cut back on high-histamine foods: Stick with fresh meats, freshly cooked meals, and low-histamine fruits and veggies. Avoid aged, fermented, heavily processed foods, and alcohol.
• Store food properly: Eat leftovers within 24–48 hours. If you can’t finish something quickly, freeze it.
• Support histamine breakdown: Some people find relief using DAO supplements or nutrients like vitamin C and quercetin. These aren’t cures, but they can help support your system.
• Listen to your body: If you start to feel better, awesome! If not, it may be time to look at other root causes. For many of us, hives are part of a bigger picture—like autoimmunity or mold exposure.

The Bottom Line

A low histamine diet isn’t a cure for chronic hives, but for some people, it can be a game-changer. If histamine intolerance is part of the puzzle, reducing dietary histamine can help calm the fire. But if it doesn’t work for you, don’t stress—hives have multiple triggers, and it might take some trial and error to find your root cause or triggers.

So, Is It Worth Trying a low histamine diet for hives?
If your doctor has brushed off the idea of a low histamine diet, consider this: it’s low-cost, low-risk, and potentially high-reward. Worst case? It doesn’t help, and you move on. Best case? You finally get some relief.

Always check with a healthcare provider before making major dietary changes, especially if you have other health conditions. But don’t let anyone tell you there’s “no evidence” when there clearly is.

Your health journey is personal—and sometimes, you’ve got to be your own best advocate.

Ready to give it a try? Grab my free guide: The Low Histamine Jumpstart!
It’s packed with simple steps to help you get started without the overwhelm.

Have you tried a low histamine diet for hives? Let me know in the comments—I’d love to hear your experience!

Here are some studies to check out for more information.

• http://www.ncbi.nlm.nih.gov/pubmed/9758408
• https://pubmed.ncbi.nlm.nih.gov/10694787
• https://pubmed.ncbi.nlm.nih.gov/27624921
• https://pubmed.ncbi.nlm.nih.gov/29698966
• https://pmc.ncbi.nlm.nih.gov/articles/PMC5839887