Low Histamine Diet

Low Histamines and Amines Diet Information
by Sue Kira, Naturopath & Nutritionist

 

About food chemicals

Amines

  • Different types of amines from food
  • Amines produced by the body
  • Amines in food

What is histamine?

  • Symptoms of histamine (amine) intolerance or overload
  • 12 factors that can affect histamine intolerance
  • Low histamine foods
  • High histamine foods
  • Diamine oxidase (DAO) blockers
  • Histamine liberators
  • Medications that may inhibit DAO enzymes
  • Foods with anti-histamine effect or can increase DAO

 

About food chemicals

This is not about additives, such as the chemicals added to foods to enhance flavour colour or stability etc, but rather the naturally occurring food chemicals already contained in our food.

There are different types of food chemicals that we consume in our foods every day. These include amines such as histamines and tyramines, glutamates, oxalates, phenols and salycilates, and even the nightshade family of foods could be included on this list.

Why are they called chemicals if they naturally occur in foods?

Most people aren’t aware that a chemical doesn’t have to be something that is made-made or synthetic. In truth, absolutely everything is a ‘chemical’, because a chemical is ‘any substance that consists of matter’.

Water is the chemical written as H2O, oxygen is O2, and amines are written as a bunch of atoms including hydrogen, carbon and nitrogen that are part of another chemical group called ‘ammonia’. I don’t want to get too technical here, but simply explain a little about how certain chemicals, whether natural or synthetic, can play havoc in our bodies.

For some, this can be worse than for others; this is because some of us lack certain enzymes to sufficiently breakdown these chemicals to be disposed of by the body.

Every food we eat contains chemicals, and the digestion of food creates even more chemicals. Our body can normally deal with these chemical reactions, but at times this is not always the case.

When we react to certain foods, we often think it may be a food allergy, or a food intolerance, which can be detected by immunological testing. But a food chemical reaction, called a sensitivity, does not affect the immune system in a way that builds antibodies, so there is no way to test if you are reactive to a food chemical other than by trial and error, or by an elimination diet.

An Elimination Diet involves removing suspected foods from the diet for several weeks and when your symptoms clear, then you can ‘re-challenge’ your body by gradually re-introducing various foods to determine what caused the reaction.

The biggest problem with a food elimination trial protocol is that food chemicals can take days or even a few weeks for the food chemical to build up in the body before it gets to the point of going over the ‘threshold’ and producing a symptom.

Similarly, it can take a few weeks to get these chemicals out of your system sufficiently enough to try to determine which foods suit or don’t suit you. And then the question is, “Which of the food chemicals do you react to?” It can be tricky.

However, in stating that, you can get a private blood test arranged by an integrative doctor or a naturopath to find out if you have enough of an enzyme called DAO that breaks down chemicals like histamine (more about DOA later).

 

Amines

This article mainly focuses on Amines, of which there are several types, including histamine and tyramines. No matter which name you wish to use, they all act in a similar way.

Other food chemical sensitivities can be due to salycilates, glutamates, phenols and oxalates. The recommended foods for the diets for these four categories may vary from the amine group.

However, there are some common foods that cross over the categories, which are foods that are likely to be the worst offenders for those with food chemical sensitivity.

Bear in mind that we can react to foods differently and even at different times. For example, at high estrogen times of the month, histamine can be a greater issue because oestrogen increases histamine. This can be one reason that many women can get a bad headache or migraine when their estrogen peaks.

Amines, histamines and tyramines are examples of several ‘amines’ that are a class of a naturally derived food chemical called biogenic amines. Biogenic means they are ‘produced or brought about by living organisms’. In other words, they are formed by the natural breakdown or decomposition of foods as it naturally ages and ferments.

 

This means that any food that is stale, going off, not super fresh, getting mouldy, smelly, fermented or aged in any way is going to be higher in amines than super fresh foods.

 

Normally these ‘amines’ are broken down in the body by certain enzymes, such as monoamineoxidase – A (MAO-A), diamine oxidase (DAO) and histamine N – methyltransferase (HNMT), which renders them harmless.

Any word that ends in ‘ine’ is of the amine group, but there are some compounds that contain amines that are not named that way due to changes in their molecular structure. Any word ending in ‘ase’ is an enzyme or something that breaks down another molecule.

So when we look at the word mono-amine-oxid-ase, we break this down to: mono (1) – amine (am-ine); oxid (oxidise or break down); ase (enzyme to support the break down); we can see what this substance is supposed to do. Get it?

But what can happen is that due to genetic polymorphisms (variants in our genes) we don’t always produce enough of these enzymes to help us break down these amine chemicals in foods.

You may think, like I did, “If this is because of genetics, why haven’t I always been intolerant to amines or other food chemicals”? The answer is that while we all have different glitches or defects in our genetics, it is actually our ‘epigenetics’ that determines if a gene defect is ‘switched on’ or not.

 

Epigenetics, or rather our lifestyle choices, can ‘switch on’ or ‘switch off’ (silence) a gene expression.

 

Epigenetics can be summed up as our ‘environment’ or environmental influences on our genes. This includes influences such as toxic contamination, poor food choices, vitamin or mineral deficiencies, smoking, drinking alcohol, stress, lack of quality sleep, negative emotions, infections, poor gut microbial balance, lack of self-care and so on.

This means if we reduce stress and reactive emotions, eliminate toxins, eat what is right for our bodies, take care of any microbial imbalances (in essence – take better care of ourselves) then we can heal and silence the negative impact of faulty genes. Amazing!

One thing to note is that if you have double gene defects (one from mum and one from dad), then you are more than likely to have this issue from birth (or childhood) which can explain why many kids have issues with food, behaviour and learning skills.

But even in these situations, while you may not be able to completely switch off this genetic process, a diet that suits you can make a huge difference because it can have a positive effect on your microbiota (the bacterial balance in the gut).

While on the subject of intestinal bacteria, did you know that bad bacteria and parasites can actually secrete histamine? This extra load of histamine, on top of the histamine in food, can be a huge contributor to histamine intolerance. Once these bugs are under control, then your food chemical issues may also go away. Yay! 🙂

In most cases, it’s a build-up of these food chemicals that causes the problems. Depending on the severity of reactions to foods, it may be that after a period of time to heal and clear the chemicals from the body, then many of the previous sensitive foods can be eaten in small amounts infrequently.

It is up to each person to find their own threshold and tolerance levels and discover which foods must be completely avoided (unless they are prepared to suffer the consequences).

When I compiled a list of foods for my clients to avoid, there was an issue because I found many contradictions in various lists. This means that some foods listed as being ok, may in fact not be right for you.

The variances may occur because there can be varying amounts of chemicals in a food, depending on the freshness and age of the food and if it is a local produce from your area.

For example, some say that all coconut products are safe on the low amine/histamine diet, while others say that all coconut products are not ok. This could be due to the freshness of the coconut, where it was sourced and how it was processed.

Unfortunately, there is not one single, clear, accurate list that I can give you with full confidence that it will be 100% fail-proof and you won’t react to any of the foods.

Another issue is that you may be sensitive to more than one type of food chemical. For example, if you have sensitivities to both amines and salycilates, you will need to do an elimination diet until you find the foods that you don’t react to.

I know this may be difficult, but with the guidance of a practitioner who is up to speed with food sensitivities, you can get the right list of foods for you.

It’s certainly worth being happy, healthy and vital, even if the process to get there may be arduous to start with.

 

Different types of amines from food

  • Histamine: commonly found in fermented foods and drinks like wine, sauerkraut, kefir and bacon
  • Tryptamine: is derived from tryptophan that regulates our nerves. Tryptophan is found in foods like cheese, pineapples, turkey and bananas
  • Phenylethylamine: an amine found in chocolate and was once used as a psychedelic drug (no wonder we love and can get addicted to chocolate)
  • Tyramines: amines that are found in foods like cheese and other dairy products that contain casein (the protein in dairy)
  • Other amines: putrescine, cadaverine, agmatine and spermidine are all amines that are found in decomposing fish and animal flesh
  • Any fish or meat that smells anything but very fresh is decomposing and producing one of these amines. Fish produce more amines than any other protein food as it can go off so easily. The darker the fish flesh, the more easily it can decompose, which is why it is super important to eat very fresh fish that has either been freshly caught and cooked straight away, or snap frozen at sea to maintain its freshness and prevent the formation of amines.
  • If you are very sensitive to amines you may need to avoid fish for a while. Darker fish like salmon, mackerel and tuna are best avoided initially, with the white fish being least ‘amine problematic’. The ‘fishier’ a fish smells, the more amines are present.
  • Similarly, with chicken or red meats, if they feel slimy or smell strange or pungent, then the amines are high. There should be virtually no smell in fresh flesh of any kind.

 

Amines produced by the body
Neurotransmitters are chemical messengers that communicate signals between nerve cells throughout our brain and body. To explain: think of a nerve as an electric wire, and the neurotransmitters are the electricity running through the wires.

Neurotransmitters, which are collectively called Catecholamines, are amines produced by our bodies. Here are the individual Catecholamine neurotransmitters:

 

  • Serotonin: also known as 5-hydroxytryptamine (5-HT) is a neurotransmitter (chemical messenger) that contains a monoamine (single amine) and is derived from tryptophan (an amino acid from protein). Serotonin helps to regulate sleep, mood and appetite. Serotonin is not found in food, but tryptophan is found in nuts, seeds, chicken, turkey, eggs, oats, tofu, cheese, red meat, fish, bananas, beans and lentils.
  • Norepinephrine: previously known as nor-adrenaline, is a neurotransmitter involved in attention and behaviour, sleep and wakefulness, and also a stress hormone released by the adrenal glands that regulates the sympathetic nervous system for the ‘fight and flight’ response.
  • Epinephrine: previously known as adrenaline, is an adrenal hormone released with stress and is also a neurotransmitter present in the brain.
  • Dopamine: a neurotransmitter involved in addiction, reward, motivation, behaviour and coordination of body movements. Low dopamine causes shaky hands, head etc – think of Parkinson’s disease

 

Amines in food

 

Freshness is a key factor to avoid amines.

 

Meat that is vacuum packed can be up to ten weeks old when you eat it (and still be called ‘fresh’). But studies show that vacuum packing can inhibit the growth of bacteria, but does not prevent the development of amines/histamines which increase over time.

Fish, cheese, wine, aged meats, bananas and avocados, mushrooms, chocolate and fermented foods such as sauerkraut, kefir and soy sauce are just some of the foods that are listed as containing varying levels of amines.

 

Basically, any protein food can contain amines depending on the way it is handled and how fresh it is. Remember fresh is best, when trying to minimise amines in your diet.

 

Other things to try to avoid when reducing amines are: cold tablets, decongestants, nasal drops or sprays, some pain relievers, general and local anaesthetics and antidepressants such as those classed as Mono Amine Oxidase inhibitors (MAOIs).

Because these drugs inhibit the breakdown of amines, such as serotonin which helps your mood, they can also slow down or inhibit the breakdown of amines/histamines in your food, which in some can cause serious problems such as very high blood pressure.

Speak to your doctor or health practitioner when looking at amines in drugs that are prescribed to you.

 

What is histamine?

Histamine is an amine that is a neurotransmitter (chemical messenger). It is one of the major amines that cause havoc in the body if the levels get too high.

The main job of histamines is to communicate important messages from your body to your brain, increase stomach acid to help you break down food, assist the immune system to fight invading pathogens, move your bowels, and help the blood get nutrients and oxygen to various parts of the body.

Your body needs just the right amount of histamine to do its jobs, not too much and not too little.

Some people have an imbalance of bacteria in the intestines (more ‘bad bugs’ than ‘good bugs’). These ‘bad bugs’ are bacteria and parasites that secrete histamine, which creates inflammation and irritation. In this inflamed state, the gut may be unable to create enough enzymes (DAO-1) needed to deal with the extra histamine load.

We see this in leaky gut and SIBO (small intestine bacterial overgrowth). This can create a cyclic effect of inflammation: the gut creates more histamine and higher histamine creates more inflammation.

Whether you have histamine intolerance or a histamine overload from bacterial secretion, you will find that a low histamine diet will help get your body back into balance.

 

Symptoms of histamine (amine) intolerance or overload

  • Rash or itching skin or scalp (or anywhere really)
  • Flushing, prickly heat, urticaria, profuse sweating, sensitive to heat
  • Heartburn, acid reflux or general indigestion
  • Headache or migraine – frequent or cyclic in nature
  • Strong reaction to mosquito bites
  • Runny, blocked or bloody nose
  • Gas, cramping, stomach ache or diarrhea
  • Low blood pressure, irregular or racing heart beat
  • Dry or swollen lips, cracks in corners of mouth, ulcers
  • Car sick, sea sick, any type of motion sickness, nausea
  • Muscle tremors, twitching or flickering sensations or restless legs
  • Anxiety or panic attacks
  • Insomnia or restless nights (histamines keep you awake)
  • Asthma, chest tightness, exercise induced asthma
  • Acne, psoriasis or eczema
  • Swelling or fluid retention in legs (or anywhere in body

 

12 factors that can affect histamine intolerance

 

1. Diet: high histamine foods such as fermented, aged, leftovers etc, low DAO foods, consumption of histamine liberators

 

2. Poor breakdown of histamine/low DAO and other enzymes

 

3. Bacteria and parasites that secrete histamine (SIBO, leaky gut etc)

 

4. Poor digestion of proteins creates histamine from histadine (amino acid from proteins), or overeating that leads to build-up of food which ferments in the digestive system. Can lead to digestive disorders such as IBS, IBD etc

 

5. High nutrient demand due to stress, lack of sleep or anxiety etc

 

6. Hormonal imbalances: excess estrogen or adrenal issues

 

7. Medications: especially anti-depressants of the MAOI type (mono-amine-oxidase-inhibitors) as they inhibit the breakdown of amines, but also antibiotics and antacids as they interfere with digestive health

 

8. Lifestyle factors such as alcohol, poor sleep and/or excessive exercise

 

9. Environmental factors such as dust mites, pollen, poor air quality, toxic personal care items, other allergies that already trigger histamine release

 

10. Other inflammatory factors that also trigger histamine release

 

11. Nutrient deficiencies: needed to support other factors (see below)

 

12. Genetic variants: genes that help process histamine or can be associated with issues with histamine include MTHFR, DAO, MAO, HNMT and NAT2. To see if you have any genetic variant weaknesses, you can get your gene SNPs tested with companies like 23andme or similar. Each of these genes require certain nutrient co-factors to help them to work more efficiently such as B2, B5, B6, B9 (folate), B12, copper, iron, zinc (& good digestion)

If determined that you have high histamine levels or histamine intolerance then it is important to eat foods that are low in histamine.

 

Note: there is no such thing as a totally ‘histamine-free diet’

 

 

Low histamine foods

  • Fresh meat, fish and chicken (cooled, frozen or fresh) and egg yolks
  • Fresh fruits – all except those listed below in the high histamine foods
  • Fresh vegetables – except tomatoes
  • Grains – rice, buckwheat, quinoa and corn only (some people are sensitive to all grains and seeds so be aware of any symptoms related to these foods)
  • Milk substitutes – coconut milk (some can be sensitive), rice milk. Nut milks not recommended (although some may be ok with small amounts of these, especially macadamia milk)
  • Most oils – but if rancid, do not use
  • Most leafy herbs (however, if you are also sensitive to salycilates then these are high in salycilates, so be cautious)
  • Herbal teas are ok – but not black or green tea or coffee (some can tolerate decaf coffee – not instant)

 

High histamine foods

  • All alcohol
  • Fermented, pickled or canned foods/drinks
  • Cheese, especially matured cheeses
  • Smoked meat products – salami, ham, sausages
  • Shellfish, tinned fish and fish that are not fresh
  • Beans and pulses – chickpeas, soy beans, peanuts, cashews
  • All nuts, especially walnuts
  • Chocolates and other cocoa based products
  • Citric fruits, plus kiwifruit, pineapple, plums, papaya, strawberries & tomatoes
  • Wheat and foods containing yeast as they are a catalyst to generate histamine
  • Vinegar and foods with vinegar such as mustard, mayo and sauces
  • Ready made packet meals
  • Salty snacks, sweets with preservatives and artificial colourings & additives – benzoate, sulphites, nitrites, glutamate, food dyes

Apart from high histamine foods, other things can add to the problem. These include substances that block the activity of DAO, one of the enzymes that break down histamine, and there are also histamine liberators that trigger the release of histamine.

This means that histamine in certain foods is amplified by these histamine liberators. Let’s look at these…

 

Diamine Oxidase (DAO) blockers
Many people have low levels of Diamine oxidase, the enzyme that breaks down histamine, so it is best to avoid foods and drinks that block DAO so that any DAO that is present can do its job more effectively.

Substances that block DAO include:

  • Alcohol
  • Black & green tea and coffee
  • Energy drinks
  • Mate tea

In the list above, alcohol is by far the worst thing that anyone with DAO deficiency or histamine intolerance could drink. It not only contains its own histamine and other amines, but alcohol also releases histamines from other foods as well as blocking DAO, which interferes with the breakdown of its own histamine and of the histamines found in other ingested food.

Even in people without genetic DAO deficiency, alcohol can inhibit the breakdown of histamines in the food eaten around the time that alcohol is consumed.

 

Histamine liberators
Certain foods and substances can stimulate the release of histamine from the mast cells (type of white blood cells) even if some of these foods are actually low in histamine. These are called histamine liberators. The consumption of histamine liberators alongside other histamine foods can amplify the effect of the initial histamine foods eaten, or even make a low histamine food act like a high histamine food.

 

Histamine liberator foods and food additives include:

  • Sugar of any type, including corn syrup, dextrose and other sugars
  • Sweeteners like aspartame, sorbitol and xylitol
  • Chocolate & Coffee
  • Certain fruits such as bananas, avocado, papaya, kiwifruit, pineapple, mango, fig, dates, grapes, cherries, strawberries, raspberries, blackberries, cranberries and all citrus
  • Nightshades – tomatoes, paprika, peppers(capsicum), potato and eggplant
  • Spices, such as black pepper, sweet pepper, chilli, paprika
  • Nuts and legumes such as peanuts, lentils, walnuts, hazelnuts, pecans
  • Shellfish including oysters, muscles, prawns (shrimp) and crabs
  • Other foods such as egg white, spinach, peas and pumpkin
  • Food chemicals such as preservatives, MSG, benzoates, sulphites, nitrites, nitrates, food colours such as yellow E-102 and E-110, E-123 E-124
  • High FODMAPs foods can cause fermentation in the gut in some people, especially it seems those with histamine intolerance, so a lower FODMAP diet is a helpful adjunct especially in the initial stages of correcting the imbalance and gut healing. For more info on FODMAPs visit the article about the FODMAPs Diet

If you have histamine intolerance, some prescription drugs can also have an effect by inhibiting the DAO enzyme. If prescribed any of these drugs, speak to your doctor about other options that may be available for you to use. But do not discontinue use without your doctors recommendation.

 

Medications that may inhibit the DAO enzyme

  • Acetylcysteine
  • Aspirin
  • Ambroxol
  • Aminophylline
  • Amiloride
  • Amitryptiline
  • Cefuroxime
  • Cefotiam
  • Cimetidine (Tagamet)
  • Ciprofloxacin
  • Cyclophosphamide
  • Contrast media for X-rays
  • Docein
  • Diazepam (Valium)
  • Haldol
  • Metamizol
  • Metoclopramide (Reglan)
  • Naproxen (Aleve)
  • Narcotics – Thiopental (IV med. for surgery)
  • Noscapene
  • Pancuronium
  • Prilocaine
  • Verapamil

 

Foods with an anti-histamine effect or can increase DAO
There are certain foods that have an anti-histamine action that can help subdue histamine reactions or reduce the action of other foods that either contain histamine or liberate histamine.

In other words, the addition of these foods may allow you to eat other histamine foods, if eaten together. These foods can help to reduce inflammation and stabilise mast cell activation (the cells that release histamine).

However, if you are highly sensitive to histamine then it is best to avoid combining any high histamine foods and liberators with the foods below.

Also, be aware that even these anti-histamine foods listed can be sensitive for some people for other reasons.

  • Rocket: can inhibit histamine release
  • Watercress: can inhibit histamine release
  • Pea shoots/sprouts/tendrils: contain high levels of DAO
  • Mung bean sprouts (48hr growth & fresh): inhibit histamine release
  • Lentils and chickpeas: these are tricky as they have DAO, but only when sprouted. Be careful that they don’t ferment or the histamine level will increase
  • Garlic and onions: both great pre-biotics (feeds friendly bacteria) that can lower histamine release by stabilising mast cells, but are high in FODMAPs which can be fermentable in some digestive systems. So if garlic and onion give you wind, avoid them until your digestive system has healed
  • Moringa: one of the latest ‘super-foods’, not only rich in many nutrients but also inhibits around 70% of histamine released by mast cells
  • Ginger and Galangal: both types of ‘ginger’ root can reduce the effect of allergy type reactions and stabilise mast cells release of histamine
  • Pomegranate fruit: not widely available but when it is, it can be used to reduce histamine release from the mast cells, and as a bonus can kill some parasites and bad bugs
  • Fresh herbs: certain herbs can be anti-histamine and mast cell stabilising in their action, so add them to your food, or drink as a tea to help reduce the histamine load. These include holy basil, thyme, tarragon, chamomile, peppermint, black cumin seeds and oil and my favourite, turmeric
  • Caper berries: fresh or salted only, not in vinegar or fermented.
  • Rice: black can reduce histamine release (but not brown or white rice)
  • Apples: said to inhibit histamine release, but some people can still be sensitive. Other fruits such as peaches and mangosteens can inhibit mast cell release of histamine.
  • Other foods/substances that can support DAO to break down histamine include bio-flavonoids rich kale, broccoli, asparagus, buckwheat, carrots, celery, cucumbers, olive oil, rooibos tea and certain probiotics (not L. acidophilus). LGG probiotics have been found to be helpful.

 

Note: Before changing your diet speak to your medical or health care practitioner and do not stop any medications or supplements previously prescribed unless advised otherwise.

During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.

 

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