So what CAN I eat?

Following on from yesterday’s post on new research into the histamine content of non-fermented fruit, nuts & vegetables I thought I’d break down the information contained in the paper for us mere mortals to understand.

Histamine Intolerance (HIT) is thought to be caused by low levels of two enzymes: HNMT and DAO.  DAO is an enzyme in the gut which breaks down and converts the histamine we eat in our food, and if levels are low this process isn’t effective and results in high levels of histamine in our bodies (at least, that’s the layman’s version!).  In order to keep symptoms at bay, HIT patients need to stick to a low histamine diet, which makes perfect sense and has worked miracles for me personally.

However, there is very little information on the actual histamine content of foods and the researchers found that many foods excluded from low histamine diets actually have been shown to be low in histamine and therefore are safe to eat which is fabulous news!

What constitutes a high level of food histamine is currently guesswork – we don’t know what ‘high’ is, and safe levels of histamine in food probably differs from patient to patient depending on how well their DAO and HNMT are functioning.  I’m making the assumption that ‘high’ is anything over 20mg/kg but this is a purely made-up number in the absence of any guidelines.  Based on this, then,  the only non-fermented plant foods tested in this research paper and found to be high in histamine are:

  • Eggplant (aubergine)
  • Spinach
  • Avocado is borderline at just over 20mg
  • Fresh tomato & tomato ketchup is borderline at just over 20mg & chopped tomato is fine!

So as you can see, there are less than a handful of non-fermented plant foods which are high in histamine (though of course fermented plant foods like sauerkraut aren’t included and are known to be high in histamine).  I don’t know about you but this tiny list is a massive shock!  To think I’ve been missing out on loads of foods for no good reason for the past five years is heartbreaking.

This isn’t the full picture however.  The research paper suggests that it isn’t just histamine which may be causing a problem for HIT patients.  Other biogenic amines, such as putrescine, compete for DAO and the reason that patients report issues with foods low in histamine may be that they’re high in other amines.  We have no evidence this is true though – bare in mind it’s just a theory and might be totally wrong.

The biogenic amine putrescine is found in nearly all foods to some degree, so again we have no idea what a high level is, so I’m using 20mg/kg as my figure but it’s not based on anything.  The following is a list of ‘high’ putrescine foods – if you react to any of these, none of which are high in histamine, it might be you have an issue with putrescine instead:

  • Green pepper
  • Sweetcorn
  • Tomato, fresh, concentrate & ketchup
  • Peas (fresh & frozen)
  • Soybeans, dried & sprouted (but not soya milk or tofu!)
  • Banana
  • Grapefruit, fresh (juice is borderline)
  • Mandarin
  • Orange
  • Passion fruit
  • Pear is borderline
  • Papaya is borderline
  • Pistachios
  • Wheatgerm (but not bread or other wheat based products)
  • Green beans
  • Purple beans
  • Broccoli was borderline in 1 study but fine in the others
  • Courgette was borderline
  • Cucumber was borderline in 1 study but fine in the others

I regularly eat several of the foods on this list, including bananas, passion fruit, pear, broccoli, courgette, green peppers, sweetcorn and peas and have no problems with them whatsoever.  However, you may have a totally different experience.

Tyramine, another amine, was found in some of the foods tested, though in very low levels.   So using pure guesswork and nothing else I’ve based my ‘high’ figure on foods which contain a level of tyramine of 5m/kg – it’s not based on anything though and could be way off the mark.  Foods with a ‘high’ level of tyramine include:

  • Fresh tomato
  • Avocado
  • Plum
  • Green beans are borderline

Bare in mind that tomatoes and avocado contain relatively high levels of histamine, so you may react to those due to their histamine content, but if you have a problem with plums or green beans it might be due to their tyramine content.

Cadaverine was found in some of the foods tested, though like Tyramine in very low levels.   So using pure guesswork and nothing else I’ve based my ‘high’ figure on foods which contain a level of cadaverine of 5m/kg.  These include:

  • Spinach
  • Soy milk was high in 1 study but fine in the other
  • Tofu
  • Pistachios
  • Green peppers were borderline
  • Banana was high in 1 study but undetectable in the others
  • Grape was borderline
  • Almonds were borderline
  • Sunflower seeds were high in 1 study but undetctable in the other

The biggest question people new to low histamine diets asks is, “now I know what I can’t eat, but no-one tells me what I can eat!” and this new paper helps with this.  There is a long list of plant based foods which are low in all amines including:

  • Lettuce
  • Onion
  • Red pepper
  • Potato
  • Apple, fresh & juice
  • Grape
  • Cherry
  • Guava
  • Kiwi
  • Lemon
  • Mango
  • Peach
  • Pineapple (fresh & juice)
  • Strawberry
  • Hazelnuts
  • Barley
  • White bread
  • Wholemeal bread
  • Corn-based cereal
  • Oats
  • Pasta
  • Rice
  • Asparagus
  • Yellow beans
  • Cabbage
  • Cauliflower
  • Carrots
  • Celariac
  • Chard

If you have symptoms after eating any of these foods it looks like it’s down to a problem not related to biogenic amines and therefore isn’t Histamine Intolerance.

There are some interesting foods on the ‘allowed’ list.  Bread contains yeast and yeast is banned from most low histamine foods lists, however from the research trawl I did for my Histamine in foods: the Evidence page, and from this research paper, baker’s yeast (ie the yeast used in bread) tested low for histamine, it was the yeast extract (a by-product of brewer’s yeast) found in marmite which was the problem.  Many low histamine food lists exclude nuts but most appear to be low in all amines so should be fine.  Soya beans are also excluded on all low histamine lists, yet tofu and soya milk tested low in all amines and soy beans tested low in histamine yet high in putrescine.  It’s the fruit which has shocked me the most though.  Berries, cherries, pears, plums and pineapple are all excluded from low histamine food lists yet all are low in histamine and most are low in all amines so I will be eating strawberries again before the week is out (I already eat blueberries and drink pear juice daily so knew I had no problem with them).

Although dairy foods weren’t looked at in this particular research paper milk, fresh cheeses like mozzarella (but not hard or blue cheeses!), butter, cream and yoghurt have all been found to be low in histamine, though I’m unsure of their other biogenic amine content – I’ll look into that when I’m not suffering from a sickening migraine, which I currently am :-/  Most fresh meats have also tested low for histamine, but again I’m unsure of their other amine content.  So, all in all low histamine diets don’t need to be anywhere near as restrictive as they are which really is great news 🙂

In light of recent evidence I’m going to totally re-vamp the low histamine food list on my blog when I have the time, energy and brain power.  I haven’t been following the list faithfully for a long time and am managing my HIT symptoms really well, so for me the list here on my blog is way too restrictive.  However, as I say all the time, my blog reflects my experience and yours may be totally different.

The new research paper talks about cooking methods and the fact that boiling vegetables reduced their histamine content, sometimes dramatically.  So, if you’re having an issue eating raw veg you might want to try boiling it and eating it cooked instead.

The other thing to mention while I’m on about food reactions is that Mast Cell Activation Disorder (MCAD) and Histamine Intolerance (HIT) are two distinct and separate illnesses.  Patients with HIT only have a problem with amine-related foods, while people with MCAD can react to just about anything so trying to control MCAD symptoms by a low histamine diet alone is fruitless.  The two diseases can sometimes occur together as in my own case, but many people ‘just’ have HIT and most people with MCAD ‘just’ have MCAD, so  when I talk about low histamine diets I’m exclusively talking about controlling HIT.  If people with MCAD find eating low histamine helps some of their symptoms too that’s great but it’s much more complicated than just diet for mast cell diseases.  If you’ve been religiously following a low histamine diet for more than 6 months and are still reacting to foods, or are reacting to foods low in biogenic amines, or are reacting to other things in the environment like heat or cold, your period makes your reactions worse, stress or strong emotions like excitement make your reactions worse and/or your hair is falling out, I would imagine you have more than HIT going on and it’s much more likely you have a mast cell issue.

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8 thoughts on “So what CAN I eat?

  1. Shannon Ross Watson

    Hello, I have been following your blog for just over 3 years when I chanced upon it doing my own research into histamine problems. First thank you for your tireless research, it adds just a bit more to the histamine puzzle. My problem surfaced when I was diagnosed with IBS. I was very ill with terrible symptoms for 4 years when I found a study which said using the drug ketotifen(a first line mast cell stabilizer) could help some of the IBS symptoms….. and it did. More research found lists of high histamine foods and other lists which contradicted these lists just like you have found. In the end I stopped eating leftovers, especially those with meat. Have kept my histamine cup low as possible by not eating lots of fermented foods, some cheeses, and wine of course. Tomatoes and egg plant have always given me problems as well as a group of foods in the parsley/carrot/coriander/cumin/mango pistachio plant families.Eating some of these in the past sent me to emergency. If eat too much histamine my nose plugs up and the next morning I need to pee a lot. The body gives me signs. Others in my family also suffer from histamine related problems like migraines so I believe there is a genetic component, we probably all do not have enough DAO I guess my advice would be that everyone has to do their own research and find out what works for their own bodies , you must take charge of your health and not believe everything the doctor’s tell or do not tell you. Just an added note, I live in Canada

    Liked by 1 person

    Reply
    1. Jak Post author

      Hi Shannon

      Thanks for sticking with me for 3 years – it’s lovely to hear from you 🙂

      So pleased you’ve got your histamine problem stabilized. I agree that DAO seems to be genetically low for some families, mine included.

      I totally agree that we’re all different and have to figure out what works, or doesn’t work, for us as individuals.

      I’ve always wanted to visit Canada – it’s one of the few places I didn’t get to on my travels when I was still well!

      Jak x

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  2. Catherine

    Has Stiff Person Syndrome ever come up in your searches? A lot of the crazy muscle spasms, mast cell issues, thyroid problems, drug sensitivities, etc seem awfully familiar. When my GAD 65 antibodies came up positive (along with Hashimoto’s, rheumatoid arthritis, mast cell activation syndrome, and an eclectic assortment of other possible autoimmune disorders), I was finally dx’d with Stiff Person. (In addition to all the rest.) I think way more people have it than are actually dx’d with it. Incidence of dx is 1 to 2 people in 1 million. 😲 Just curious if the symptoms sound familiar to you. I’m pretty sure I’ve had damn near every diagnosis under the sun, including pathological laziness, congenital stupidity, and terminal hypochondria. Worst symptom? Severe, rational, suicidal depression. (Thankfully, my lack of motivation works in my favor. Well, that and 6 kids. Mostly the lethargy, though.)
    Hope you are as well as can be expected,
    Catherine

    Liked by 1 person

    Reply
    1. Jak Post author

      Hi Catherine

      After all these years I thought I’d heard about every disease known to man, but admit this is a new one on me! I’m so sorry you’re having to deal with this alongside everything else.

      Jak

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      Reply
  3. atkokosplace

    I had a time where I felt everything I ate was giving me a reaction. I didn’t know what I could eat anymore. I started intermittent fasting. I was strict for two weeks. 16 hour fast a day. Smartest thing I’ve ever done. Now I fast 12-16 hours depending on my schedule/ what I have going on and I do this about 4-5 days a week. When I find myself not feeling good, I fast for a few days in a row and I find my body gets on track.

    Liked by 1 person

    Reply
    1. melody

      I just went through another reaction to something I ate–severe dizziness, diarrhea and other gastro symptoms, joint and back pain, migraine, etc. The only real cure I’ve found is to not eat for a while. I used to be pretty good at intermittent fasting, haven’t been doing it so much now that I’m older, but digesting food is such a double-edged sword! Sometimes I think we can’t live with it, we can’t live without it–those alien bits traveling through our bodies we’re trying to make part of us! I hold to the thought that it can take four days for something I ate to pass through my system, though usually a part-day fast is fairly effective. So I try to be patient and keep in mind: “This, too, shall pass!” (Gut willing) 😛

      Liked by 2 people

      Reply
      1. atkokosplace

        Intermittent fasting is really my go to. Making sure I am consuming good probiotics and pre-biotics. Whole foods and cooking for myself is a way I know what I am eating. Look in to digestive enzymes. All in good health! 🙂

        Liked by 1 person

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