Low Histamine Diet for Hives

If you’re dealing with chronic hives, you might be wondering about the potential benefits of a low histamine diet for hives. In this article, we’ll discuss the effectiveness of this dietary approach for chronic urticaria patients, and guide you towards resources to develop a personalized plan tailored to your needs.

This blog post will teach you to eat a low histamine diet for hives without depriving yourself of essential nutrients. We’ll explore food choices and some of the most common symptoms associated with high histamines in the body. Plus, we’ll share some low-histamine meal ideas.

You may have heard of doing the low histamine diet for hives before, but you’re not sure what it is, or maybe you have seen multiple lists and found yourself confused and overwhelmed.

There are many different low histamine diet lists, all of which involve cutting down on foods that cause an increase in histamine levels, but sometimes what is excluded or “allowed” can vary drastically. These may include alcohol, aged cheese, citrus fruits and juices, fermented products, cured meats like bacon or pepperoni, spices like paprika and curry powders, and tomato products. The idea is to cut down on these foods for 4-6 weeks so your body has time to recover and then slowly reintroduce them to see what you react to.

Following a low histamine diet for hives is challenging when you’re exhausted and run down, making it a barrier to many. I recommend that anyone suffering from severe symptoms try adjusting their lifestyle so it’s more sustainable than restrictive. It’s not all or nothing. Progress over perfection always!

Should you try the low histamine diet for hives?

The low histamine diet is not for everyone. Histamine is an important neurotransmitter and, for most people, is not something they need to think about. However, if you have an overabundance of histamines, this can cause issues with your health and well-being.

The low histamine diet could benefit anyone who has excess histamines. Histamine intolerance could be caused by a deficiency in the DAO enzyme from genetics or a leaky gut. DAO (diamine oxidase) is an enzyme in your stomach that helps eliminate excess histamines you ingest. If you are deficient in these enzymes, your body can become overburdened by the histamines you eat and drink.

Some diseases can also cause an overabundance of histamines in the body, such as a mast cell de-granulation issue like long COVID, post-vaccine injury, chronic urticaria, or mast cell activation disorder.

Because we have this overabundance of histamines in our bodies from the mast cells de-granulating, it may be helpful to reduce our overall exposure to histamines to help prevent flares. This makes a low histamine diet for hives a good place to start when attempting to reduce symptoms with diet and lifestyle changes.

Does the low histamine diet for hives reduce symptoms?

Whether to try the low histamine diet for hives is still controversial. There are few studies available about the low histamine diet and its impact on chronic hives. In my opinion, the available studies make it worthwhile to test and see if it works.

Everyone is different, and the low histamine diet for hives won’t cure your hives, but it has helped many people improve the frequency and severity of their symptoms, and some even experience remission. Medications available to treat this condition also vary in effectiveness and often come with undesirable side effects.

Doctors will often tell patients not to bother with diets, stating that there are no studies to prove it works. I was able to find a handful of studies and a lot of anecdotal evidence. That said, pharmaceutical companies fund most studies on symptom management, so unsurprisingly, dietary intervention studies (and your doctor’s knowledge in this area) are lacking.

Ultimately, it is up to you. Some people are happy to take medications to relieve their symptoms. Others, like myelf, would instead manage as much as possible with more natural remedies, including a low histamine diet for hives management.

In my interview with Dr. Marcus Maurer, head of specialty clinics for urticaria, he did not dismiss that diet does help some people. Being medically minded, he does encourage his patients to use medication to treat their symptoms and enjoy the freedom to eat whatever they want.

It’s up to you to decide what is suitable for your circumstance and quality of life. I would never shame someone for using medication to manage their symptoms. I used a combination of medication, supplements, and diet/lifestyle to manage my chronic urticaria and histamine intolerance symptoms.

What is histamine intolerance?

When you have an abundance of histamine and a reduced capacity to degrade it, this can lead to an overload of histamines in circulation. The body has a natural way of detoxifying histamine by breaking it down into less harmful compounds. However, people who don’t produce enough enzymes can risk experiencing side effects from high doses or excess levels in their systems. They won’t degrade these substances as fast, and histamine will build up. Too much buildup can cause an increase in symptoms.

My functional medicine doctor described it as a bathtub with a clogged drain. You may have heard it referred to as the “histamine bucket.” We are still processing the histamines, but our bodies can’t keep up. Eventually, the tub, or bucket, will overflow, and your body becomes overburdened with histamines, causing you to become ill. When you have chronic urticaria, your mast cells release histamine inappropriately, adding to this burden. A low histamine diet for hives can help reduce the overall burden of histamines on your body.

How are chronic hives and histamine intolerance linked?

Histamine plays a crucial role in the development of hives. Histamine causes the blood vessels in the skin to dilate, which leads to swelling and the characteristic redness of hives. Histamine also causes itching and other symptoms associated with hives.

In people with histamine intolerance, the body is unable to break down histamine properly, which leads to an excess of histamine in the body. This excess histamine can trigger symptoms.

In Chronic urticaria, our mast cells de-granulate spontaneously, causing our histamine levels to rise. This condition is usually autoimmune or auto-allergy, and there is no cure, but a low histamine diet for hives can help ease symptoms by lowering our body’s overall histamine burden.

Causes of Histamine Intolerance

Several factors can contribute to the development of histamine intolerance, including:

• Enzyme deficiency: Histamine is broken down by enzymes in the body, including diamine oxidase (DAO) and histamine N-methyltransferase (HNMT). If these enzymes are not functioning correctly, histamine levels can become elevated.
• Histamine-rich foods: these foods are high in histamine or can cause the release of histamine from mast cells, including fermented foods, aged cheeses, alcohol, and some types of fish.
• Medications: Some medications can block the action of DAO or HNMT, leading to elevated histamine levels.
• Chronic inflammation: Chronic inflammation can lead to the release of histamine from immune cells, contributing to elevated histamine levels.
• Genetics: Some people may be genetically predisposed to histamine intolerance.

Diagnosis of Histamine Intolerance

Diagnosing histamine intolerance can be challenging, as there is no specific test to diagnose the condition. However, doctors may use a combination of examinations and patient history to diagnose histamine intolerance.

Before testing for histamine intolerance, your doctor should rule out other potential causes.

Tests often used to assist in the diagnosis of histamine intolerance include:

• Histamine-restricted diet: A diet low in histamine may be recommended to see if symptoms improve. If symptoms improve on the diet and worsen when histamine-rich foods are reintroduced, this can be a sign of histamine intolerance. The low histamine diet is the most reliable test.
• Blood tests: Blood tests can measure the levels of DAO and other enzymes involved in histamine metabolism. However, these tests are unreliable and do not definitively diagnose histamine intolerance. DAO levels in plasma do not necessarily reflect the DAO in the gut.
• Skin prick test: A skin prick test for allergies to specific substances. However, this test does not diagnose histamine intolerance but may be used to rule out allergies as a primary cause of symptoms.
• Histamine blood test: This test is only a snapshot in time and could be more reliable. Ideally, the blood draw should be drawn ill within minutes of symptoms starting. Blood histamine levels will quickly degrade. Even in anaphylaxis, plasma histamine levels fall back down within 30-60 minutes.
• Urine histamine test: Instead of a blood test, urine collected over 24 hours may be tested to evaluate histamine production throughout the day.

What are the symptoms of histamine intolerance?

Histamine is found in all body tissues. Mast cells, which release histamine, are heavily located in the digestive tract, skin, joints, blood vessels, nerves, lymphatic vessels, mouth, nose, and eyes.

Histamine can cause inflammation in many parts of our bodies which results in symptoms that are incredibly vague – it could make someone nauseous or allergic sensations like itching or rash. Or it could cause cardiac symptoms, joint pain, and fatigue. If you experience these systemic symptoms you may want to consider trying the low histamine diet for hives.

Here are some symptoms of histamine intolerance:

• Anxiety
• Headache (mild to a migraine)
• Runny nose
• Bloating
• Constipation
• Depression
• Diarrhea
• Clearing throat frequently or coughing
• Fatigue
• Heartburn
• Hives
• Itchy ears, eyes, or mouth
• Joints pains or aches
• Lightheaded
• Mood swings
• Nausea
• Not able to stay asleep
• Not able to stay awake
• Rash
• Flushing
• Sneezing
• Stomach-ache
• Undigested food in stool
• Vomiting
• Wheezing or feeling breathlessness

These symptoms can occur immediately after eating high-histamine foods or can take several hours to develop. Some people may experience symptoms only occasionally, while others may have daily symptoms.

Foods high in histamines

All foods have some level of histamines but the foods listed here are typically found on high histamine food lists and can be trigger foods for those with histamine intolerance.

The foods listed here are not an exhaustive list but a general guideline to get you started. Notice how you feel when you consume these. When I implemented the low histamine diet for hives, I modified it to my needs.

Beverages

• Alcohol
• Caffeine
• Teas: Green, Black, Mate
• Energy drinks
• Soda
• Kombucha

Nuts and seeds

• Walnuts
• Cashews
• Peanuts

Fruits

• Dried fruits
• Banana
• Papaya
• Avocado
• Pineapple
• Strawberries
• Citrus

Vegetables

• Eggplant
• Spinach
• Tomatoes

Meats

• Aged meat
• Smoked fish
• Cured meats: bacon, salami, pepperoni, lunch meat, and hot dogs
• Egg whites

Other foods to avoid

Some of these foods are eliminated for a period to reduce overall inflammation and allow the gut a break from substances that can harm the gut lining.

• Leftover meats, unless frozen
• Fermented foods/drinks
• Grains
• Legumes
• Dairy
• Refined Sugar
• Soy
• Artificial flavor, preservatives, and dyes

Fresh, whole foods are always best. Remember, this is only a template and should be customized by you depending on your unique reactions/needs. When embarking on an elimination like the low histamine diet for hives, it’s important that we don’t overdo it and eliminate too many foods. Nutritional deficiencies can exacerbate symptoms. We need to find balance.

Antihistamine spices and herbs

Try to include these foods in your diet as much as possible, especially when eating foods that are higher in histamine.

• Basil (esp. Holy Basil)
• Chives
• Cilantro
• Dill
• Lemongrass
• Mint (Spearmint, Peppermint)
• Oregano
• Parsley
• Rosemary
• Sage
• Thyme
• Black Cumin (nigella sativa)
• Caraway
• Cardamom
• Cumin
• Fennel Seed
• Garlic
• Ginger
• Turmeric

Low Histamine Diet for Hives Meal Ideas:

Eating a low histamine diet for hives doesn’t have to be complicated. Choose meat, low histamine veggies, and potato, sweet potato, or other root veggies for starch. Use antihistamines and anti-inflammatory herbs and seasoning.

Use high-quality olive oil, coconut oil, or avocado oil for cooking so that you don’t end up adding more ingredients to your diet which can increase inflammation.

Here are a few quick and easy meal ideas:

• Choice of meat with roasted vegetables in the oven.
• Steak and stir-fried peppers and onions.
• Soups made with homemade quick bone broth or meat broth.
• Stir-fried veggies with stir-fried chicken breast seasoned with ginger and turmeric.

If you suffer from hives and other histamine reactions, it may be worth looking into a low histamine diet for hives. A healthy and nutritious diet is essential for anyone, but if your body reacts to certain foods, those foods are not serving your health. You must make sure that you still eat a wide variety.

Have you tried the low histamine diet for hives? Let us know how it went in the comments!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839887/

https://academic.oup.com/ajcn/article/85/5/1185/4633007

https://pubmed.ncbi.nlm.nih.gov/26242570/

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