Histamine & Food: The Evidence

There are 3 ways in which foods are supposed to affect histamine:

  1. By being high in histamine themselves, either naturally or through fermentation, spoiling or aging.
  2. By releasing (or liberating) endogenous histamine stored in mast cells.
  3. By interfering with DAO and/or HNMT, which means that histamine in the body isn’t dealt with effectively.

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1.   High Histamine Foods

The amount of histamine in any particular food item is, for the most part, pure guesswork. Anyone who tells you that this list or that list is the definitive low histamine food list has not got the faintest clue what they’re talking about. As you will read below, studies on the histamine content of foods are almost non-existent and those which do exist vary wildly from one study to another. This is because:

  • histamine concentrations in food are highly variable within the same family, eg hard cheese v soft cheese, porcini mushrooms v button mushrooms, and even among two samples of the same product
  • it depends how the product has been transported and/or stored, eg. frozen, refridgerated or at room temperature
  • it depends how fresh the food is, eg how long ago it was slaughtered, picked or manufactured
  • it depends on the methods used to measure the histamine (of which there are several).


The Evidence

Hardly any research has been done on the histamine content of individual foods. Most of the information I’m repeating on this page comes from a single paper16 written 10 years ago by the Department for Dermatology in Bonn, Germany.

Only a handful of companies have apparently tested a wide range of foods for biogenic amines, including histamine or histidine (the precursor to histamine). I saw references to these organisations when doing my research, but actually tracking them down took hours and was so confusing it gave me a whopping headache. They appear to include:

◊   The Nutrition Coordinating Centre at the University of Minnesota.

◊   The Netherlands based Levensmiddelen Databank which I think either incorporates, or used to be called, the ALBA databank and TNO Nutrition & Food Research (you will need google translator to read these pages, not that they tell you anything!). The information from all these sources are, I think, incorporated into the Nutrition Centre of the Netherlands’ database (the Nutrition Centre is a Government body).

In order for the information produced by these companies to be considered accurate they need to have used the same testing methods and be compared to each other.  Unless that is done no-one can rely on this information.  One thing I have found in my research, which you will see in the table below, is that different testing methods, countries and batches of foods produce wildly differing results, and we need to compare test results so that we can make an informed choice about any specific food’s histamine content.

In order to access any of the information from these companies you have to be either in the health care field or food industry, or using the information for commercial purposes eg. producing an App, and the cost of buying the data seems dependent on your purpose for needing it. If anyone has information from these databases do let me know!

Other than the databases above which I’m not privy to I’ve scoured the globe and the only items I can find which have been tested for histamine are listed in the table below:

Food table histamineNote: See end of article for information on the companies and data used in this table.

As you can see, very few foods have actually been tested for histamine. There were no foods which had been tested by all 6 sources.

The following foods were tested by 5 out of the 6 sources:

  • Blue (Roquefort) cheese: 1-2,300mg/kg (low to very high)
  • Wine & Beer: 0-30mg/kg (fairly low)

The following foods were tested by 4 out of the 6 sources:

  • Yoghurt: 0-13mg/kg (low)
  • Cheddar cheese: 0-2,100mg/kg (low to very high). How on earth can a sick person make an informed decision on whether or not to eat it based on these figures?
  • Emmental cheese: 5-2,500mg/kg (low to very high)
  • Aubergiene (Eggplant): 20-60mg/kg (average)
  • Spinach: 2-60mg/kg (low to medium)
  • Sauerkraut/pickled cabbage: 0-229mg/kg (low to high)

The following foods were tested by 3 out of the 6 sources:

  • Goat’s cheese: 0-87mg/kg (low to medium), though the Spanish Society for DAO were the only people to list the higher figure, the other 2 studies found 6.34-9mg/kg both of which are low.
  • Pasturized milk: 0-167mg/kg (low to high), again the Spanish Society for DAO were the only people to list the higher figure, the other 2 studies found 0-8mg/kg and the more recent study below found 0.3mg/kg all of which are very low.
  • Salted ham: 0-271mg/kg (low to high)
  • Fermented soy bean products (including soy sauce): 0-4,620 mg/kg (low to stupidly high)
  • Champagne: 0-670mg/kg (though I suspect the 670 is a typo on the original data, because the other 2 studies quote 67).

Most of the other foods listed were only tested by 1 or 2 studies, which cannot possibly give any guidance on the actual histamine content – one fine day does not a summer make.

A more recent paper13 which looks specifically at biogenic amine concentrations of dairy products was published in 2012. Popular foods are listed below:

  • Raw milk: 0-0.3mg/kg (low)
  • Pasteurized cow’s milk: 0.7mg/kg (low)
  • Yoghurt: 13mg/kg (low)
  • Cheese, Feta: 84.6 mg/kg (medium high)
  • Cheese, Cheddar & Emmental: 25.4mg/kg (low medium)
  • Cheese, Edam: 3.2 mg/kg (low)
  • Cheese, blue (Roquefort): anywhere from 9-376mg/kg depending on which study you look at (low to high).
  • Kefir: 1.6-4mg/kg (low)

There’s a whole section on starter cultures in cheese and yoghurt production in this paper if you can make head or tail of it, which I couldn’t 😉

In June 2010, the European Food Safety Authority EFSA published on its website a public call for data on the presence of biogenic amines (histamine, tyramine, cadaverine, putrescine, tryptamine, phenylethylamine, spermidine and spermine) in food and beverages. Member States, research institutions, academia and other stakeholders (e.g. meat industry) were specifically invited to submit data. A total number of 36,583 analytical results were collected17. The largest amount of data by far was on fish products. Second were dairy, third alcohol and fourth meat. Less than 35 results are available for vegetables and most of these were for sauerkraut. Only 7 samples were analysed for ‘cereal products’, 1 for chocolate, 1 for coffee, 5 for fruit and 3 for juices none of which were considered ‘statistically significant’ so were excluded from the research .

All this information is a lot to take in I know – I’ll tie it all together in the Conclusion at the end of the article.

What amount of histamine should we be eating?

According to the Spanish Society for DAO Deficiency, anyone with Histamine Intolerance should avoid foods with a histamine level of above 15-20mg/kg though I’ve no idea how they reached this figure. The paper written by Ladero et al10 states that “No toxicological effect is reported when food histamine levels range from 6 to 25 mg/meal. The ingestion of 75 mg of histamine, however, is reported to cause intoxication symptoms in healthy people. The ingestion of foods with a histamine concentration of 400 mg kg is considered dangerous to health and certainly the intake of approximately 1000 mg of histamine is associated with severe intoxications. An incubation period ranging from a few minutes to a few hours may be necessary.”

So from very limited evidence it looks like we should aim to eat under 20mg/kg of histamine in each meal. Most foods contain some level of histamine, so following a no histamine diet is impossible and although it’s relatively easy to look at histamine levels of specific foods one has to remember that when you have a meal you eat several foods together so you have to take into account the combined histamine load. And of course your histamine bucket fills during the day for a wide variety of reasons, which is often why I never react to my breakfast but quite often react to my dinner in the evening, so the combined total for the day should be taken into account too. In reality no-one can live like that for heaven’s sake!

Aging & Fermentation

Histamine increases with age and spoiling1,2. When you go to the supermarket to buy chicken, how old exactly is the chicken you are buying? Has it been slaughtered in New Zealand, been shipped to the UK, spent a week being transported from the docks to the supermarket and then spent 4 days in your fridge before being cooked, or did the farmer next door wring its neck, pluck it within hours and you cooked it that day? How old is the mango you’re eating? Did it sit in a hot basket in a field in Israel for hours after being picked, then be transported on a lorry for 3 days to a city, then fly to the UK, then sit at the airport, then be transported to the supermarket, then sit on a shelf for 2 days, then sit in your fruit basket for 2 days before being eaten, or did you pick it off the tree yourself and eat it there and then? Because its journey from death or picking to your plate has a humongous bearing on how spoiled it is and how much histamine it contains which is why the levels of histamine in our table of foods above varies so widely amongst the same food.

Histamine cannot be killed by refrigeration or cooking. It can, however, be stopped by freezing but this has to be done as soon as possible after the food has been killed or picked. It’s then best to cook from frozen, as the second it starts to defrost the histamine levels rise.

Bearing this in mind eat items as fresh as possible, cook frozen food from frozen whenever possible and don’t eat re-heated leftovers.

Foods which rely on aging to taste nice are always presumed to be high in histamine. Like-wise, foods which are made using fermentation are presumed to be high in histamine3,4,5,6. These include:

  • Yoghurt
  • Buttermilk
  • Cottage Cheese
  • Quark
  • Soured cream
  • Hard cheeses, eg. Cheddar
  • Aged cheeses, eg. Brie
  • Alcohol
  • Vinegar
  • Sauerkraut
  • Miso
  • Soya beans and soya products like soy sauce
  • Black and green tea
  • Cocoa powder and chocolate
  • Yeast
  • Processed meat
  • Dried fruits like sultanas.

However, there is a miniscule amount of research to back up these claims. You simply can’t make concrete decisions based on one small Norweigan research paper which has never been replicated, or one small German study which has never been replicated!

 

So, where on earth all the information you find online about histamine in food comes from is anyone’s guess. One thing’s for sure – on the whole, it’s not based on fact.

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2.   Histamine Liberating Foods

There are some foods which do not contain high levels of histamine in themselves but which are reported to liberate endogenous histamine stored in mast cells within the body. If you thought information on high histamine foods was thin on the ground it’s nothing in comparison to the lack of information on mast cell liberating foods.

The Spanish Society for DAO states on their website that the following foods liberate histamine:

> alcohol, citrus fruits, strawberries, pineapple, kiwi, tomato sauce, seafood, chocolate, fish, mushrooms, pig, cereals and egg white.

> Some food additives such as glutamate, benzoate, several colorants (yellow E-102 and E-110, E-124, amarant E-123), sulphites and nitrites can release endogenous histamine.

However there are no research citations or article links to back up this information so I have no way of checking its validity or the methods used to determine that these foods are histamine liberators.

The Department for Dermatology in Bonn’s paper lists the following foods as being capable of releasing endogenous histamine:

  • Citrus fruit
  • Papaya
  • Strawberries
  • Pineapple
  • Nuts
  • Peanuts
  • Tomatoes
  • Spinach
  • Chocolate
  • Fish
  • Crustaceans
  • Pork
  • Egg white
  • Additives (unspecified)
  • Liquorice
  • Spices (unspecified)

According to the citations, these conclusions have been reached based on a single article7 written in a British Dermatology book in 2004 (which I haven’t read), making them about as reliable as a chocolate fireguard.

This exact same food list appears in a review paper8 in the Jul-Aug 2005 edition of the Netherlands Journal of Medicine entitled ‘Mastocytosis and adverse reactions to biogenic amines and histamine-releasing foods: what is the evidence?’ The paper states that:

“Schachter and Talesnik found in 1952 that egg white releases histamine in non-sensitised animals when injected intravenously”10 so it looks like a 64 year old single animal research study is the basis for everyone excluding egg white on low histamine diets. In the same article the authors refer to unpublished data by Schachter in the 1950s on the histamine-releasing effects of strawberries but the paper was so old the authors of the review were not able to obtain a copy to verify the conclusions. Other than that the authors concluded that “We could not find any study on histamine-releasing effects of most of the foods suggested of having histamine-releasing capacities.”

Bearing this conclusion in mind, I have no idea why most papers on Histamine Intolerance cite this single paper as the source for their histamine liberating food lists when the authors state that the list they produced has no validity whatsoever!

I did an extensive internet trawl myself and could find no evidence or research for ‘histamine liberating foods’. None. Zip. Zilch.   Please let me know if you come across any.

According to Dr Joneja in her interview with the Low Histamine Chef it’s currently impossible to accurately measure histamine in urine or plasma:

“we do not have any definitive tests either for DAO function or histamine levels. What I mean here is that histamine fluctuates in the body constantly. We require histamine for brain function, it’s a neurotransmitter. We require histamine for digestion because it’s the trigger for the release of gastric acid, which is always released when we start to eat….  and we require it constantly for protection….. So, histamine fluctuates in the body constantly, and so a normal level would be different when, for example, a plasma sample is taken at different times during the day – different events during the day – and then in addition we might be able to measure DAO in blood, but it does not translate – never will translate – until we’ve got far better research into what is the importance of that level in clinical outcome”.

Dr Seneviratne, who diagnosed my MCAD and HIT, also agrees that testing for histamine isn’t ideal at the moment and better testing techniques are needed. That’s why he only uses one Lab in the entire country because he knows the results will be as accurate as they can be given the limitations of today’s testing methods.

So as far as I can find no research has been carried out on foods to see if they liberate endogenous histamine. Even if research had been carried out, if we have no way of accurately measuring bodily histamine how do we know when it’s been liberated from mast cells because of a certain food? If it’s measured after we’ve eaten how do we know that the level hasn’t increase simply through the act of digestion, rather than because of the food itself? Or if you have an obvious reaction after you’ve eaten something, how do we know why? The food could contain salicylates, tyramine or nightshades which you’re reacting to.  It could be that your DAO is low and that one food tipped your histamine bucket over the edge. It could be that the stress of worrying that you’ll react to a certain food causes mast cell degranulation and therefore histamine release (that’s happened to me more than once!).  In truth, no-one knows and the conclusion must be that it’s not currently possible to measure whether a certain food liberates endogenous histamine, so the information you read online about ‘histamine liberating foods’ is based on wild supposition rather than any kind of fact and in future I’m personally going to ignore anything relating to ‘histamine liberators’.

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3.   Foods which block or reduce DAO and/or HNMT

In Histamine Intolerance it’s the lack or inhibition of DAO and/or HNMT which allows histamine build-up and symptoms. Papers and websites on Histamine Intolerance frequently mention that there are certain foods which inhibit DAO but don’t actually list what they are, or if they do provide a list of DAO blocking foods don’t state where they’ve obtained the list from. I could find no evidence at all pointing towards foods which have been proven to inhibit DAO levels or affect DAO function.  None.  Zip.  So in future I’ll be ignoring anything to do with DAO blocking foods too. Please let me know if you find anything to change my mind!

Dr Joneja in her interview with the Low Histamine Chef states “we do not have any definitive tests either for DAO function or histamine levels”, so if we can’t accurately measure DAO how can we measure if a certain food affects it?

The evidence that alcohol causes significant symptoms for some people is fairly indisputable, but the mechanism is still open for debate. Maintz and Kovak’s Histmaine Intolerance paper12 states:

“alcohol, especially red wine, is rich in histamine and is a potent inhibitor of DAO. The relation between the ingestion of wine, an increase in plasma histamine, and the occurrence of sneezing, flushing, headache, asthma attacks, and other anaphylactoid reactions and a reduction of symptoms by antihistamines has been shown in various studies. However, among the multitude of substances contained in wine,other biogenic amines such as tyramine and sulfites have been supposed to contribute to symptoms summarized as “wine intolerance” or “red wine asthma”. In DBPC wine tests with healthy persons and in patients with chronic urticaria and wine intolerance, the histamine content did not influence wine tolerance. In the latter group, an increase in plasma histamine could be shown, paradoxically, after ingestion of the histamine-poor wine. In these patients, the ethanol metabolite acetaldehyde has been discussed as a histamine-releasing substance. However, the high percentage of responses to the placebo (87%) could be responsible for the absence of an effect in this study.”

In other words it’s known that alcohol causes allergic-type reactions for some people but quite why is currently anyone’s guess. I personally have always flushed after drinking alcohol of any description and my anaphylactic reactions began with white wine back in 1996 (not recognizing that’s what it was at the time) so any kind of alcohol is a definite no-no for me.

Drugs which block DAO is a topic I’ll cover on the Histamine & Drugs page.

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Other Possible Histamine Releasing Foods

Dr Joneja, in her interview with the Low Histamine Chef, says sulphites release histamine and should be avoided and benzoates release histamine and should be avoided.  I could only find one paper written by Dr Joneja which was a 2001 study9 on the effect of a low histamine diet on her patients with symptoms suggestive of histamine overload. On the subject of sulphites and benzoates, Dr Joneja states:

“Food additives that have been implicated as potential factors in the release of histamine….include: tartrazine, salicylates, and preservatives such as sulphites, benzoates, BHA and BHT”    (although benzoates and sulphites are also naturally present in foods) which is why she excludes all these kinds of foods from her low histamine diet.

There is no dispute that people react to all kinds of things, sulphites, salicylates, lactose, gluten, nightshades and if one were to exclude everything you could potentially be reacting to from your diet you’d be living off fresh air! Not only that, the research cited in Joneja’s paper was all carried out more than 20 years ago in single studies which doesn’t exactly overwhelm me with confidence in its accuracy.  In fact, in her conclusion she states:

“does the effectiveness of the diet used in this study depend on its low level of histamine, or are the symptoms reduced because of the exclusion of other factors, such as antigenic molecules that trigger a hypersensitivity reaction other than a type 1, IgE-mediated response….or a non-immunologically mediated food intolerance caused by amines other than histamine (tyramine for example) or other intolerance-triggering chemicals?”

A paper published in 201514 which reviewed the evidence for food additives, amines and salicylates causing illness found that some research studies found links, particularly to symptoms like migraine, while others did not. The jury is still out as to which foods cause problems, at what concentrations and by what mechanisms.

Let me make this clear, I am not saying there is no such thing as intolerance to food additives etc. All I’m saying is that there’s no concrete evidence to say what foods contain which substances, particularly benzoates and salicylates, or whether these and/or additives contain or affect histamine.

You could get so obsessed with trying to link your symptoms to something you ate you could become petrified to put anything in your mouth – something I don’t intend to do.

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Conclusion

Accurate data for the histamine content of foods is almost non-existent. Most studies to date have concentrated on fish, seafood and aged or fermented products like blue cheese, soy sauce and sauerkraut because these have been proven to produce serious symptoms in the healthy population. There is also data on alcohol because the world is obsessed with booze despite the fact we can all live very well without it.

Popular foods from online lists which claim to be high in histamine, or liberate histamine, such as tomatoes, citrus fruits, berries, stone fruits, black tea, chocolate etc. have not been tested by any source I could find and I have absolutely no idea on what basis they are included in low-histamine diets. The same can be said for spices and additives.

In the Jul-Aug 2005 edition of the Netherlands Journal of Medicine a paper8 was published entitled ‘Mastocytosis and adverse reactions to biogenic amines and histamine-releasing foods: what is the evidence?’ which concluded:

“Despite the widespread belief that biogenic amines and histamine-releasing foods may cause allergy-like, non-IgE-mediated symptoms in certain patients, the role of diets restricted in biogenic amines and histamine-releasing foods in the treatment of mastosytosis remains hypothetical but worthy of further investigation. There is some evidence for adverse reactions to alcohol in mastocytosis.”

The authors looked for scientific evidence in the literature on diets restricted in biogenic amines and histamine-releasing foods in the treatment of mastocytosis (not histamine intolerance or mast cell activation disorder) and no studies were found.

Dr Joneja carried out a study9 in 2001 on a low histamine diet in 44 patients in her clinical practice who presented with “food intolerance” (though it doesn’t state how this diagnosis was reached, which foods they were intolerant to or whether they had a confirmed diagnosis of mast cell disease or histamine intolerance). 61.4% showed ‘significant improvement’, 18.2% showed ‘some improvement’ and 20.4% showed ‘no improvement’. Which implies that a low histamine diet works to varying degrees for 80% of patients – not a bad statistic though I’ve no idea how it relates to MCAD or HIT as we don’t know if the study participants had either disease. However, the author concludes that a double-blind randomized controlled trial is needed to prove the results weren’t due to bias or chance and in the intervening 15 years this trial has sadly not taken place.

In 2004 a critical review paper was written18which looked at research papers on the biogenic amine contents of foods from 1945-2003. The report states:

“ Since identification of the ‘‘cheese reaction’’ hypertensive crisis induced by dietary tyramine with monoamine oxidase inhibitors(MAOIs) drugs, numerous articles have addressed the biogenic amine (BA) content of foods. The objective of this review is to explain why many published analyses are no longer valid. Clinically significant BA levels from literature published between 1945 and 2003 were reviewed and compiled and are presented in common units. Clinical recommendations based on newer reports about foods and drugs are offered. Reliance on case reports without chemical analyses led to unnecessary dietary restrictions. Extrapolation of analysis from one food to a similar food led to lengthy lists of banned foods. Early analyses are no longer valid for several reasons: better methods to accurately identify these amines, better packaging methods, recognition of critical processing points in prevention of BA formation, better storage and handling procedures, and substitution of cultures less likely to form amines have reduced the risks of these Food–drug interactions”.

This is why I’m cautious about studies more than 10 years old. Food production, handling and storage have come on a long way in recent years. When I was a kid the only foods which were kept in our fridge were milk, fish, meat and butter. Everything else was put in the pantry. These days eggs, opened tins and bottles, fruit, veg, jam, water, spreads and just about everything else is kept refrigerated and what’s more it was probably packed only hours after picking or production and reached the supermarket in refrigerated lorries not on the back of an open truck in 30 degrees of heat. For the most part it’s age and storage which produces histamine so if your food is fresh there’s no issue, regardless of the type of food.

SO WHAT SHOULD I AVOID?

From the limited data available, research shows that foods with over 20mg/kg of histamine and best avoided for those with histamine diseases are:

Dairy

  • cottage cheese
  • sheep’s cheese
  • hard cheeses, eg cheddar
  • blue cheeses
  • parmesan

You can eat everything else including yoghurt because the data on histamine in cultures is also non-existent. Edam cheese came out low on one study, as did Kefir.

Fish

  • Any fish which isn’t fresh, or frozen shortly after capture.
  • Tinned, smoked, salted or preserved fish, eg. tinned tuna, anchovies, smoked mackerel.
  • Seafood, as it isn’t gutted.

You can eat any other fresh, or freshly frozen, fish. The odd study seems to suggest that some species of fish are higher in histamine than others, but there just isn’t enough data to say for certain which. I eat freshly frozen wild salmon and never have an issue with it.

Meat

  • Sausage
  • Cured meats, eg. salted ham, bacon, pepperoni

You can eat any fresh meat. Don’t eat leftovers or reheated meat.

Fruit

There is no evidence for the histamine content of fruit of any variety.  None.

Vegetables

  • Aubergine (eggplant)
  • Spinach
  • Sauerkraut/pickled cabbage

Other than that, there is no evidence on the histamine content of vegetables.

Other

  • Soya and fermented soy bean products
  • Vinegar varies wildly in studies depending on whether it’s red wine, balsamic, malted etc so it’s a grey area.

Citric acid in the only study I found came out very low in histamine. I include small amounts in my diet just because it makes my life easier as it’s a widely used preservative. Bakers yeast came out low in 1 study. ‘Yeast extracts’ whatever they are, came out high. I can’t decide what to do about yeast if I’m honest. There’s no evidence for wheat, rice, legumes or much of anything else!

 

So there you have it – the shocking truth about the histamine content of foods.

 

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REFERENCES

 

Histamine in Food Table Source Information

Column 1: Information taken from the Spanish Society for DAO’s website though it doesn’t state who carried out the testing. The Society is a not-for-profit organisation accredited by the Medical Association of Barcelona.

Column 2: Information taken from the Failsafe Diet website. Original data from:

Souci SW, Fachmann W, Kraut H., 2000. Food composition and nutrition tables 6th edn. (eds), CRC Press.
Kovács A, Simon-Sarkadi L, Ganzler K., 1999. Determination of biogenic amines by capillary electrophoresis. J Chromatogr A. 1999 Mar 26;836(2):305-13. [PubMed]
Voight MN, Eitenmiller RR, Koehler PE, and Hamdy, MK., 1974. Tyramine, histamine and tryptamine content of cheese. J. Milk Food Technol. 37:377-381.
Badria FA., 2002. Melatonin, serotonin, and tryptamine in some egyptian food and medicinal plants. J Med Food. 2002 Fall;5(3):153-7. [PubMed]
Jalón M, Santos C, Rivas JC, Mariné A., 1983. Tyramine in cocoa and derivatives. J. Food Sci. 1983 48 (2), 545-547 [Blackwell Synergy]
McCabe BJ., 1986. Dietary tyramine and other pressor amines in MAOI regimens: a review. J Am Diet Assoc. 1986 Aug; 86(8):1059-64. [PubMed]
Sullivan EA, Shulman KI., 1984. Diet and monoamine oxidase inhibitors: a re-examination. Can J Psychiatry. 1984 Dec;29(8):707-11. [PubMed] Original data x by 10 as it was in mg/100g not mg/kg

Note: the original data was in mg/100g so I multiplied each result by 10 to get mg/kg

Column 3: Information taken from a paper16 written in the American Society for Clinical Nutrition Journal in 2007: Histamine & Histamine Intolerance by L Maintz & N Novak, Department of Dermatology, University of Bonn, Germany. The paper’s authors based their information on data from the following research papers which are all now over 10 years old:

– Jarisch R, ed. Histamin-Intoleranz. Histamin und Seekrankheit. (Histamine intolerance. Histamine and motion sickness.) Stuttgart, Germany: Georg Thieme Verlag KG, 2004 (in German);
– Sarkadi L. Histamine in food. In: Falus A, Grosman N, Darvas Z, eds. Histamine: biology and medical aspects. Budapest, Hungary: SpringMed Publishing, 2004:176–85; Beutling DM. Biogene Amine in der Ernährung. (Biogenic amines in nutrition.) Berlin, Germany: Springer, 1996 (in German);
– Nordic Council of Ministers. Present status of biogenic amines in foods in Nordic countries. Tema Nord 2002:524 (ISBN: 92-893-0773-0). Cited by: Sarkadi L. Histamine in food. In: Falus A, Grosman N, Darvas Z, eds. Histamine: biology and medical aspects. Budapest, Hungary:
SpringMed Publishing, 2004:176–85 and Izquierdo-Pulido, M. Biogenic amines in European beers. J Agric Food Chem 1996;44:33159–63.

Column 4:   Information based on an article from Joan Breakey’s website which outlines histamine in certain foods according to research she has found, however the links to the research are not available.  Joan is a dietician who specializes in food sensitivities. She used to work as the Adviser in Nutrition and Dietetics to the Department of Health in Queensland, Australia.

Note: the original data was in mg/100g so I multiplied each result by 10 to get mg/kg

 Column 5:   Information based on an article from the Food Intolerance Network. Original data from:

– Jarisch, R. “Histaminunverträglichkeit”, Thieme Verlag TB
– Auflage Ekici, K., H. Coskun, 2004: Histamine Contents of Some Commercial Vegetable Pickles. Pakistan Journal of Nutrition 3 197-198
– Taylor, S.L., M. Leatherwood and E.R. Cieber, 1978: Histamine in Sauerkraut. J- Food Sci., 1030-1032 Souci-Fachmann-Kraut, Lebensmitteltabelle für die Praxis.

Note: some of the foods were divided by 100 to convert from g/kg to mg/kg.

Research paper references

  1. Silla Santos MH. Biogenic amines: their importance in foods. Int J Food Microbiol 1996;29:213–31
  2. Bodmer S, Imark C, Kneubuhl M. Biogenic amines in foods: histamine and food processing. Inflamm Res 1999;48:296–300.
  3. Beutling DM. Biogene Amine in der Ernährung. (Biogenic amines in nutrition.) Berlin, Germany: Springer, 1996 (in German).
  4. Pechanek U, Pfannhauser W, Woidich H. [Content of biogenic amines in four food groups of the Austrian marketplace]. Z Lebensm Unters Forsch 1983;176:335–40 (in German).
  5. Halász A, Baráth, Á, Simon-Sarkadi L, Holzapfel WH. Biogenic amines and their production by microorganisms in food. Trends Food Sci Technol 1994;5:42–9.
  6. Nordic Council of Ministers. Present status of biogenic amines in foods in Nordic countries. Tema Nord 2002:524 (ISBN: 92-893-0773-0). Cited by: Sarkadi L. Histamine in food. In: Falus A, Grosman N, Darvas Z, eds. Histamine: biology and medical aspects. Budapest, Hungary: SpringMed Publishing, 2004:176–85
  7. Steinhoff M, Griffiths C, Church M, Lugar TA. Histamine. In: Burns T, Breathnach S, Cox N, Griffiths C, eds. Rook’s textbook of dermatology. Oxford, United Kingdom: Blackwell Science, 2004:9.50–2.
  8. Neth J Med. 2005 Jul-Aug;63(7):244-9. ‘Mastocytosis and adverse reactions to biogenic amines and histamine-releasing foods: what is the evidence?’ Vlieg-Boerstra BJ, van der Heide S, Oude Elberink JN, Kluin-Nelemans JC, Dubois AE.
  9. Outcome of a histamine restricted diet based on chart audit’   Janice M Vickerstaff Joneja: Journal of Nutrition and Environmental Medicine (2001) 11, 249-262.
  10.  Schachter M, Talesnik J. The release of histamine by egg-white in non-sensitized animals. J Physiol 1952;118:258-63
  11.  Taylor SL. Histamine food poisoning: toxicology and clinical aspects. Crit Rev Toxicol 1986;17:91-128.
  12.  ‘Histamine Intolerance in clinical practice’: Laura Maintz, Thomas Bieber, Natalija Novak in Tsch Arztebl 2006; 103(51–52): A 3477–83.
  13.  ‘Factors Influencing Biogenic Amines Accumulation in Dairy Products’: Daniel M. Linares, Beatriz del Río, Victor Ladero, Noelia Martínez, María Fernández, María Cruz Martín, and Miguel A. Álvarez. Front Microbiol. 2012; 3: 180.
  14.  ‘Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence’: Isabel J. Skypala, M. Williams, L. Reeves, R. Meyer, and C. Venter in Clin Transl Allergy. 2015; 5: 34.
  15.  ‘Scientific Opinion on risk based control of biogenic amine formation in fermented foods’: EFSA Panel on Biological Hazards (BIOHAZ) in EFSA Journal 2011;9(10):239.
  16.  Histamine and Histamine Intolerance’: Laura Maintz and Natalija Kovak in 2007 American Society for Clinical Nutrition.
  17. Biogenic amines in fermented foods, 32 EFSA Journal 2011;9(10):2393
  18. Journal of Food Composition and Analysis 19 (2006) S58–S65.  Critical Review. Tyramine in foods and monoamine oxidase inhibitor drugs: A crossroad where medicine, nutrition, pharmacy, and food industry converge. Beverly J. McCabe-Sellers, Cathleen G. Staggs, Margaret L. Bogle USDA, ARS Lower Mississippi Delta Nutrition Intervention Research Initiative, Little Rock, Arkansas 72211, USA Received 11 February 2004; received in revised form 7 November 2005; accepted 7 December 2005

11 thoughts on “Histamine & Food: The Evidence

  1. Kierstan

    Very interesting information here and explains why there is so much variation among the lists and why I can eat some things on the lists that my friend who also has MCAS cannot. I’ve decided to just trial carefully to determine what I react to and what is safe. It would be great if more, solid research was done on histamine in foods so we’d have better direction. Thanks!

    Liked by 1 person

    Reply
    1. Victoria V.Roshchina

      Dear Drs.Ekici and Coskun,
      You publication is extremly interesting. We try to combine all scientists who work in this field in new collective monograph with chapters devoted to the presence of neurotansmitters in plants and would like to invite you in the issue.
      If you may participate I shall send you rules.
      My e.Mail:

      roshchinavic@mail.ru

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  2. Safiya

    Great article! Thanks very much! You are so right about the level of research. Do you know what it is in sausage that puts it on the avoid list? Sausages vary widely in ingredients and I have always avoided commercially produced sausages. I have a good source of locally made natural sausages from pigs reared on a traditional diet, no preservatives, addatives etc. reared, butchered and sausages made by the farmer himself.
    Thanks,
    Safiya

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    1. Jak Post author

      Hi Safiya

      Thanks for the comment. I’m vegetarian, so don’t know much about meat to be honest. However, I’d assume it’s all the additives, preservatives and the skin which excludes sausages from a low histamine diet. If it were me, I’d eat fresh sausagemeat but without the skin – your locally reared meat sounds great.

      Jak

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  3. Vivienne

    This is a very useful article, thanks. My head was swimming with all the different histamine levels in foods on various sites. I mean what do you do with 1-1200, for example? It is meaningless. I have chronic autoimmune urticaria and angioedema and am suspicious of combinations of foods, rather than one. Eg. chocolate+ red wine+cheese. I hope that there will be more research soon and a meaningful test for intolerance. Thanks again for the work you have done. Vivienne

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    1. Jak Post author

      Thanks for taking the time to comment Vivienne, it’s nice to know all the hard work is appreciated. I agree, numbers like 1-1200 are absolutely meaningless and it’s impossible to make food choices based on that. I was very shocked at how little actual research has been done on histamine in foods, yet many websites and food lists state that this or that food is high histamine like it’s fact when it’s nothing of the kind! Jak x

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  4. Borsányi István

    Hi,

    I have HIT for 17 years. I have a lot of experiences. Most of food list is confused and contains contradictious statements.

    My experiences:
    Milk: I can drink some in winter. Why winter only? The milk is perishable in hot enviromnent -> milk from cow to dairy is high of histamine. That’s all.
    Tea: Black, yellow, green tea is horrible to me. Other “tea” (from permitted herbs and fruits) is okay.
    Cinnamon: Does not cause problem to me.
    Meat: Just fast-frozen or absolutely fresh meat. Most of meat at the buther is not fresh enough.
    Cheese: every cheese is horrible to me, and every dairy product too.
    Pumpkin: I do not have any problem.
    Dates: I do not have any problem.
    Kitkat white chocolate: I can eat one piece without any problem.

    I get an injection in every month which helps a lot. I do not have any urticaria, edema now and the digestion problem and headache is better now.
    http://www.xolair.com/
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530434/

    Liked by 1 person

    Reply
  5. Angie

    This was incredibly helpful to me, EDS-H (type III) and then mast cell activation showed up after chemo and radiation therapy for lobular breast cancer (thought to be related to MCAS). I spent five years working with a molecular geneticist MD. Had to travel a lot to work out my puzzles.

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