There are several low histamine diet lists available online which all differ from one another. Alison Vickery lists the main ones on her website, so it’s an individual choice as to which one you want to follow (see this post for my thoughts on the various lists). There is virtually no evidence on the histamine content of food. Most of the lists are based on chinese whispers, guesswork and 1 single research paper which is out of date and discredited – see my page on Histamine in Food: the Evidence. However, we all have to start somewhere and having a list makes this easier.
In 2013 I was so ill that even drinking water sometimes made me pass out. Everything I ate seemed to trigger an anaphylactic reaction and I honestly thought I was going to die. Thank God Dr Seneviratne diagnosed me with Histamine Intolerance (and MCAD, but that’s another story!) and I realized I needed to follow a low histamine diet. I didn’t know which diet to choose, so decided on one from the International Chronic Urticaria Society written by histamine researcher Dr Janice Joneja because it seemed straight forward, if very restrictive. Only 4 months into the diet my anaphylactic reactions were manageable and five years later I have hardly any HIT symptoms at all, despite no longer strictly following the diet.
Dr Joneja’s low histamine diet was a life saver for me back in 2013, however as time wore on I started questioning why all the lists differed from each other and realized that none of the diet writers were testing food for histamine. It came as a massive shock that I was substantially restricting my diet based on nothing much other than guesswork. I did my own research and started re-introducing foods I discovered were actually low in histamine, even though some of the so-called low histamine diets excluded them. I saw absolutely no increase in my symptoms.
If you’re following a low histamine diet I urge you to ask the author where their information is coming from. Other patients’ experience of what brings on their symptoms is meaningless, because you have no idea if those patients have HIT, MCAD, food intolerances, actual allergies or a dozen other issues which might be affecting their immune system. For example, I react badly to apples even though they are low in histamine – that’s because I’m allergic to birch pollen and apples are related to birch. Is the list you’re using based on evidence, ie has the food actually been tested, or not? If something is listed as a ‘histamine liberator’ ask to see the research on this, because I guarantee the list author won’t be able to produce it. That’s because it’s impossible to test if a particular food liberates histamine stored in mast cells and even if it were no researchers are looking into it! I honestly have no clue where this information is coming from.
Having done a mind boggling amount of research over the last five years into the biogenic amine content of food, in January 2019 I decided to write my own low histamine food list based on evidence. Bare in mind this blog covers my personal journey with mast cell disease and histamine intolerance. I’m not advocating that you should follow the diet I follow. I can only report on the information I’ve found and how well it’s working for me.
The list below is mostly based on evidence of the actual histamine content of foods. Only a very limited number of foods have been tested for histamine, so if the food isn’t listed it hasn’t been tested. In addition, no-one can guarantee the milk you drink, for example, will have the same histamine content as the milk tested because histamine formation depends on lots of factors, including how the food was transported and stored, however we all have to have something to go on!
In brackets after each food is the range of histamine in mg/kg. No-one knows what a ‘safe’ limit is for people with HIT, so I’m using 20mg/kg as the cut off point between safe and unsafe, but it’s just a guess and not based on any kind of fact – if your DAO level is super low the cut-off point of ingested histamine for you may have to be lower. Occasionally I’ll list foods I eat regularly but which haven’t been tested, based on the fact that similar products are low in histamine – it’s up to you if you want to include them or not.
The testing sources can be found at the end of the list.
JAK’S LOW HISTAMINE FOOD LIST
(This list is copyrighted and should not be reprinted without the permission of the owner. If you wish to share, please link to this page).
Milk & Dairy
- Pasteurized milk (0-162mg/kg). I include milk because only 1 out of 4 sources showed the high figure, all the others showed that milk was very low in histamine at under 1mg/kg.
- Fresh cheese, eg. Ricotta, Mascarpone, Mozzarella (0-5mg/kg). This was cited by only one source.
- Cream (2mg/kg). This was cited by only one source.
- Quark (0-3mg/kg). This was cited by only one source.
- Yoghurt (0-13mg/kg).
NOTE: Ice cream & butter haven’t been tested by any source I could find, however I include them in my diet as they are made from pasteurized milk, aren’t fermented and I’ve never had an issue with them. I eat organic dairy whenever possible, as I don’t want chemicals in with my food – my mast cells hate chemicals!
- All hard cheese, particularly mature cheese like Cheddar and Parmesan, aged cheese like Stilton or blue cheese (0-2,500mg/kg)
- Cottage cheese (1-28mg/kg). This was cited by only one source.
- Sheep’s cheese (4-61mg/kg). This was cited by only one source.
- Goat’s cheese (1-84 mg/kg)
- Raw milk (0-389 mg/kg). This was cited by only one source.
- All pre-prepared dairy products made with restricted ingredients.
- Soured cream hasn’t been tested, but is made by fermentation so I’ve added it to the restricted list. Having said all that, I have the odd dollop every now and again and it doesn’t cause me any problems.
Breads & Cereals
- Wheat and wheat products, including bread made with yeast (0-5mg/kg)
- Barley (0mg/kg)
- Oats (0mg/kg)
- Wheatgerm (0mg/kg)
- Pasta (0mg/kg)
- Rice (0-0.8mg/kg)
- Any bread, buns, biscuits, pizza dough, crackers with allowed ingredients.
- Home-made or purchased baked cookies, pies etc. made with allowed ingredients.
- Breakfast cereals made with allowed foods including all plain grains, plain oats and oatmeal, plain cream of wheat, puffed rice and wheat.
NOTE: I try to eat organic wheat products whenever I can find them.
- Cereal products made with restricted ingredients such as cheese scones, or crackers containing parmesan.
- Mushrooms (0-1mg/kg)
- Green beans (0-2mg/kg)
- Fresh olives (0-2mg/kg)
- Lettuce (0mg/kg)
- Onion (0mg/kg)
- Green pepper (0mg/kg)
- Red pepper (0mg/kg)
- Potato (0mg/kg)
- Pumpkin (0-2mg/kg)
- Sweetcorn (0mg/kg)
- Asparagus (0-1.42mg/kg)
- Beans (purple & yellow) (0mg/kg)
- Cauliflower (0mg/kg)
- Carrot (0mg/kg)
- Chard (0-1.33mg/kg)
- Courgette (0mg/kg)
- Cucumber (0mg/kg)
- Although these are the only veg I could find that had been tested, I eat all veg apart from those on the restricted list.
NOTE: I try to eat organic veg whenever I can find them.
- Aubergine (also known as Eggplant) (26mg-100/kg)
- Sauerkraut (0-229mg/kg)
- Spinach (2-69mg/kg)
- Tomatoes and all tomato products including puree, ketchup and passata (0-25mg/kg)
- Apples, including apple juice (0-0.7mg/kg)
- Banana (0mg/kg)
- Cherry (0mg/kg)
- Grapefruit, including juice(0-1.74mg/kg)
- Kiwi (0-1.9mg/kg)
- Lemon (0mg/kg)
- Mandarin (0mg/kg)
- Orange (0-1.32mg/kg)
- Peach (0mg/kg)
- Pineapple (0mg/kg)
- Pineapple juice (0-4.61mg/kg)
- Plum (0mg/kg)
- Strawberry (0mg/kg)
- Although these are the only fruit I could find that had been tested, I eat all fruit apart from those on the restricted list.
NOTE: I try to eat organic fruit whenever I can find them.
- Avocado (0-23mg/kg)
- Grape juice (35mg/kg). This was cited by only one source.
NOTE: I can find no evidence for the histamine content of dried fruits, eg. sultanas.
Meat, Fish & Poultry
- Fish, freshly gutted and frozen after capture (0-20mg/kg)
- Fresh salmon (2mg/kg). This was cited by only one source.
- Fresh sole (0-12mg/kg). This was cited by only one source.
- Fresh veal & pork (0-1.4mg/kg)
- Fresh chicken, beef & turkey (0-6mg/kg). This was cited by only one source.
- Boiled ham (0-5mg/kg). This was cited by only one source.
NOTE: I eat frozen fish on a weekly basis, usually salmon but occasionally cod, and have no issues with it at all. I buy my wild, frozen salmon from Tesco and a friend contacted the company who told her the fish were caught, gutted and frozen on board the ship so it seems pretty safe. I haven’t eaten meat for over 25 years – this is a moral choice and nothing to do with my health.
- Fresh tuna, sardines & anchovies (0-180mg/kg)
- Fresh herring (0-35mg/kg). This was cited by only one source.
- Fresh cod (0-77mg/kg). This was cited by only one source.
- Fresh trout (333mg/kg). This was cited by only one source.
- Preserved fish: herring, anchovies (0-2000mg/kg)
- Raw tuna (9,200mg/kg). This was cited by only one source.
- Smoked mackerel (1-17,888mg/kg) Eeek!
- Tinned tuna (20,000mg/kg) Double eek! This was cited by only one source.
- Fresh pork (0-45mg/kg). This was cited by only one source.
- Fresh beef liver (65mg/kg). This was cited by only one source.
- Cured ham (0-271mg/kg)
- Sausage (10-638mg/kg)
- Bacon & salami (0-654mg/kg)
- Pepperoni (10-250mg/kg). This was cited by only one source.
- All leftover cooked meats as histamine increases rapidly over time.
- All processed meats, eg hot dogs.
Legumes (peas, beans & lentils)
- All plain legumes (0-10mg/kg). This was cited by only one source.
- White beans (0mg/kg)
- Chickpeas (0mg/kg)
- Lentils (0mg/kg)
- Peanuts (0mg/kg)
- Soybean milk (0mg/kg)
- Tofu (0mg/kg)
- Fermented soy beans and fermented soy products (0-4,620mg/kg)
NOTE: I could find no evidence for red kidney beans, which are often excluded from low histamine diets. I eat them regularly and have no problems.
Nuts & Seeds
- Almonds (0mg/kg)
- Chestnuts (0mg/kg)
- Hazelnuts (0mg/kg)
- Pistachios (0mg/kg)
- Peanuts (0mg/kg)
- Sunflower seeds (0mg/kg)
NOTE: I couldn’t find any other nuts which had been tested for histamine, but I eat cashews most days and have no problems with them.
Fats & Oils
I can find no evidence for the histamine content of fats & oils. However, raw olives are low in histamine so I use olive oil to cook with and for salad dressings.
Spices & Herbs
I can find no evidence for the histamine content of any fresh or dried spice or herb.
- Eggs, including the whites.
- Red wine vinegar (4mg/kg). This was cited by only one source.
- Cider vinegar (20mg/kg). This was cited by only one source.
- Baker’s yeast (16mg/kg). This includes bread made with yeast.
NOTE: As I don’t eat meat I eat a lot of plain Quorn microprotein, such as the mince. It is fermented, but I’ve never had any problems with it. It’s made from only 4 ingredients, including a mushroom-type fungus and eggs, both of which are low in histamine.
- Yeast extract, eg. marmite (200-2,800mg/kg). This was cited by only one source.
- Balsamic vinegar (0-4000mg/kg). This was cited by only one source.
- Pasteurized milk.
- Soy milk.
- Almond milk.
- Pure juices of allowed fruits and vegetables.
- Pure teas of allowed fruits.
- Plain and carbonated mineral water.
NOTE: I can find no evidence for the histamine content of tea or coffee.
- Wine & Beer (0-30mg/kg)
- Champagne 0-67mg/kg)
- Histamine & Food: The Evidence
- ‘Biogenic Amines in Plant-Origin Foods: Are they frequently underestimated in low-histamine diets’: December 2018
- ‘So What CAN I eat?’
This list only covers histamine, but there are several other biogenic amines. Some researchers suggest that it isn’t just histamine which may be causing a problem for HIT patients. Other 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. If you’d like to read more about this issue, please see this blog post.
Some low histamine food writers advocate following an anti-inflammatory diet as well as reducing histamine. There is about as much credible evidence for anti-inflammatory foods as there is for high histamine foods and you can find my views on the subject here (spoiler alert, I’m not convinced!).
Tags: low histamine diet, low histamine foods