Histamine Intolerance (Histamine Intolerance) – Causes, Symptoms & Treatment

Histamine intolerance (histamine intolerance)

Many people today suffer from food allergies. However, some people cannot be diagnosed with a food allergy and still have a wide variety of food intolerance reactions. It could be a histamine intolerance or histamine intolerance.

What is histamine intolerance?

The term histamine intolerance describes an imbalance between the histamine in the body that is ingested from food and broken down by food. In the body, the enzyme diamine oxidase breaks down histamine, which is supplied in varying concentrations through food.

If this is not produced in sufficient quantities, the body reacts with various intolerance reactions such as diarrhea, stomach irritation, tiredness, asthma, dizziness, skin rashes, nausea, etc. This is an acquired disorder, and there is no genetic evidence to date.


One of the main causes of histamine intolerance lies in the concentration of histamine-rich foods. Many foods are not naturally high in histamine, but become so through aging and fermentation.

Foods to which bacteria have been added have particularly high histamine levels, e.g. B. in smoked meat, smoked fish, red wine, cheese, sauerkraut and wheat beer. But so-called histamine liberators (foods that stimulate the release of histamine in the body) are also responsible for intolerance. These histamine liberators include strawberries, egg whites and fish.

Alcohol also promotes the release of histamine and reduces its breakdown. Medicines also affect the breakdown of histamine in the body, for example cough-relieving medicines, sleeping pills, painkillers and rheumatism medicines.

Symptoms, Ailments & Signs

A histamine intolerance manifests itself through very unspecific symptoms, the most common of which are indigestion , skin rashes and migraines . Symptoms can appear immediately after eating histamine-containing food or drink, or hours later. If the digestive tract is affected, the histamine intolerance makes itself felt in the form of abdominal pain , stomach cramps , flatulence , nausea and heartburn .

Diarrhea and vomiting are also possible. Headaches and migraines are often triggered by histamine intolerance. They are sometimes accompanied by dizziness , circulatory problems and palpitations, but these symptoms can also be signs of histamine intolerance. Skin reactions appear in the form of rashes, severe itching , swelling and wheals.

The so-called “flush” is particularly characteristic after consuming alcoholic beverages: A paroxysmal reddening of the skin extends over the neck and face, rarely also spreading over the upper body. A histamine intolerance can also affect the respiratory tract: Possible symptoms are coughing , shortness of breath and asthma-like suffocation attacks, increased sneezing and a blocked or runny nose.

Swelling of the lips and eyes is occasionally observed, and in some cases sleep disorders , depressive moods , water retention in the tissue, fatigue and joint pain can be attributed to histamine intolerance. In women, histamine can affect hormonal balance and trigger menstrual disorders.

Diagnosis & History

More and more people are affected by histamine intolerance, especially middle-aged women. Although widespread and recognizable by many symptoms, histamine intolerance is still relatively unknown.

Many people have to go from doctor to doctor before their symptoms are recognized as histamine intolerance by attentive doctors. It cannot be detected by the usual food allergy test because it is not an allergic reaction .

A diagnosis is often only possible via a blood and urine test and a reduction diet in which the intake of foods rich in histamine is restricted. A provocation test, in which histamine is intentionally added, and a food diary can also provide information.

Numerous complaints after eating histamine-rich foods can indicate histamine intolerance:


Histamine intolerance leads to many different complications and complaints that can severely limit the life and everyday life of those affected and reduce the quality of life. As a rule, the intolerance causes severe redness on the skin and itching. Nausea with dizziness also occurs and the patient suffers from severe vomiting.

Pain and cramps occur in the abdominal region, which in many cases leads to irritability and limitations in everyday life. It is not uncommon for patients to also suffer from headaches and a runny nose and runny nose. In many patients, the symptoms can also lead to psychological limitations and depression. In severe cases, histamine intolerance can also lead to breathing difficulties, causing patients to experience shortness of breath and gasping.

There is usually also relatively severe joint pain and general exhaustion. In acute emergencies, the symptoms can be treated with medication. In general, however, those affected with histamine intolerance have to avoid certain foods and are therefore restricted in their diet. However, further complications do not arise if the patient avoids these foods.

When should you go to the doctor?

If symptoms recur after eating histamine-rich foods, it may be due to histamine intolerance. A doctor’s visit is indicated if the symptoms affect well-being or cause serious complications. Symptoms such as nausea and vomiting, severe skin rashes and breathing difficulties should be examined by a doctor. Women should seek medical advice if menstrual cramps persist after eating certain foods.

People who experience shortness of breath, sweating or impaired consciousness after eating are best advised to go to a hospital. In the event of a shock reaction, the emergency services must be called. In general, those affected should have a suspicion of histamine intolerance clarified. With a medical diagnosis, the disease can be treated in a targeted manner and further complications can be avoided. Parents who notice signs of an allergy or intolerance in their child are best advised to speak to the pediatrician . In case of doubt, the medical emergency service can be contacted first. Ideally, if you have other symptoms, you should speak to a doctor immediately. In addition to the general practitioner, a specialist in internal medicine can be consulted.

Treatment & Therapy

Since histamine-rich foods are the main cause of histamine intolerance, the most important treatment method is to be aware of histamine-rich foods and to reduce or avoid them altogether if possible. The following foods are considered particularly high in histamine and should be reduced or avoided:

  • red wine
  • wheat beer
  • Mature cheeses such as Emmental, Tilsiter, etc.
  • salami, ham
  • Smoked fish, canned fish
  • Vegetables like spinach, sauerkraut
  • Restriction of histamine liberators Citrus fruits, bananas, strawberries, raspberries, pears, walnuts, chocolate, cocoa, legumes, wheat germ
  • Avoidance or limitation of preserved foods

In addition, the histamine release in the body can be stabilized with medication or antihistamines can be administered. Many doctors still try to treat complaints symptomatically because they do not put the complaints in the right context. But that doesn’t help those affected.

Outlook & Forecast

The prospect of getting the typical symptoms of histamine intolerance under control depends on various parameters and the countermeasures taken. The problem lies in the fact that various influencers are involved in histamine intolerance. Histamine is also a maturation hormone that is found in many foods. Hardly anyone can completely avoid this hormone.

Histamine intolerance is triggered either by foods containing histamine, or by histamine liberators and biogenic amines. Some foods only contain one of these triggers, while others contain two. If the latter can be avoided and if the other foods are eaten as little as possible, the prognosis is good. The avoidance of long and artificially post-ripened foods with high levels of the ripening hormone is an important measure.

Another option is the rotation diet. This can improve the prognosis with the supply of changing and low amounts of histamine. It is also possible to take an enzyme called diamine oxidase, or DAO for short. If this is taken before histamine-containing meals, the symptoms can improve. The preparation of food using special cookbooks is recommended. Visiting appropriate self-help groups can also be helpful in the case of histamine intolerance.

It becomes problematic when the histamine intolerance occurs as a result of a long-standing lactose intolerance or is accompanied by other food intolerances. In this case, the prospects of being completely free of symptoms are significantly worse.


The most important way to prevent histamine intolerance is to avoid or limit histamine-rich foods. Once the intolerance is known, it is relatively easy for those affected to recognize which foods they are particularly sensitive to.

There is no direct prevention because this disorder is acquired and depends on the histamine concentration in the body. Because the histamine concentration in canned foods is particularly high, cooking fresh can be one of the most important preventive measures.

As an affected person, you should limit or avoid preserved foods, because the histamine concentration depends on the degree of ripeness. Each person affected must find out individually what concentration is tolerated.


Those affected must absolutely adhere to the change in diet and avoid foods containing histamine and histamine liberators as part of this. In the early days, lists on which all prohibited food ingredients are noted and on which you take the time to study all the ingredients for their compatibility when shopping help.

As soon as symptoms such as headaches, skin rashes, shortness of breath or indigestion appear again, it is advisable to keep a food diary. All the food, medication and symptoms taken in are noted in this and evaluated after some time. A well-kept diary then shows parallels in symptoms and makes it easier to identify other intolerable foods.

It is important to carry a list of intolerable drug ingredients with you and to give this to every doctor treating you. Nevertheless, it is advisable to carry out a comparison with the list yourself before each prescription and injection. Pay attention to this, especially with regard to upcoming operations, but also in the case of anesthetic injections at the dentist.

Carrying an emergency card in your wallet can help in medical emergencies where you are no longer able to provide information about intolerances yourself. Such an ID card can be requested free of charge on the Internet. If you have life-threatening symptoms, you can talk to your doctor about prescribing an EpiPen for emergencies.

You can do that yourself

If a histamine intolerance has been determined, the diet must be changed. Since it differs from person to person which foods and drinks are tolerated, those affected should draw up a nutrition plan. If the typical symptoms occur after eating a certain food, it should be entered in the “red list” and avoided in the future.

In general, histamine-rich foods such as seafood, fresh fish, meat and cheese, and fermented foods such as sauerkraut should be avoided. For some people with allergies, bananas , avocados , tomatoes , spinach , strawberries , pineapples , and nuts release histamine in the body. It is advisable to eat a lot of foods with vitamin B6 , manganese and zinc , because these substances alleviate the symptoms. In consultation with the doctor, dietary supplements can be taken.

If foods containing histamine are consumed, the symptoms should be cured with bed rest and natural painkillers. The symptoms usually disappear after a few hours and no medical treatment is required. In severe cases, drug treatment with diamine oxidase preparations can also be useful. In any case, histamine tolerance should be diagnosed, as this is the only way to ensure targeted treatment.

Website | + posts

Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.