Tag Archives: low histamine food lists

Jak’s Low Histamine Diet List

I spent the entire day yesterday re-vamping the Low Histamine Diet here on my blog.  It is now largely evidence based so at least you know the actual histamine content of the foods I list.  Bare in mind that hardly any food has been tested for histamine, so if a food isn’t listed it hasn’t been tested.  As far as I’m aware, this is the only free list available which gives actual histamine values of specific foods, so I hope you find it useful.

As you get your histamine bucket under control most people are able to occasionally eat high histamine foods without symptoms.  I eat chocolate now and again, some tomato puree on a pizza and fish in restaurants which I know isn’t as fresh as it should be and I cope with that OK – my wish is that this knowledge gives people who are newly diagnosed and currently reacting to everything hope.

I eat as wide a diet as I can get away with.  Not only in terms of fresh fruit and veg, but also treats like puddings and sugary snacks – my life is restricted enough without depriving myself any further.   It’s weird, but I react to lovely apples yet have never reacted to nutrionally-deficient rubbish like Starburst or Pringles in my life despite the fact they are packed with preverves and additives! (not that I’m complaining you understand, hell no 😉 )

This diet focuses on histamine alone, but that’s not the end of the story as you will read in the Further Information at the end of the List.  In addition, my MCAD complicates things further and makes me more reactive than I would be if I ‘just’ had HIT, so there are some days I simply have to accept the fact I’m having a reactive day and nothing I can do is going to help.  Having said all that it’s extremely rare these days that I react to any food and that’s solely down to following a Low Histamine Diet.

 

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.

Food Histamine Q&A

Someone obviously very new to the world of histamine in foods asked a question on my blog recently and it took me right back to when I was first really ill and totally confused and bewildered about the whole subject.  I’d barely heard of Histamine Intolerance when I was diagnosed and little of what I read online made sense.  All the low histamine food lists differed from one another and no-one seemed to be able to tell me exactly what to do or what to eat to get myself better.  So I thought I’d do a post of the questions I had 5 years ago in the hopes it helps my readers new to the world of histamine intolerance.  Bear in mind this is just my personal opinion based on my experience and research which I have read – I am not the Oracle of all things histamine and just a (still) bewildered patient alongside the rest of you.

Q. Why are all the lists different?  Why are some more strict than others?
A. All the low histamine food lists online are based mostly on the personal opinion of the Author.  No spice, food preservative, food additive, citrus fruit, chocolate, tea leaf, herb or much of anything else has been tested for its histamine content.  In fact, only a handful of foods (mainly fish, soya, sauerkraut, aubergiene/eggplant, dairy) have been tested for their histamine content, so the lists are mostly pure speculation.  I know that’s not what you want to hear, but it’s true.

Q. Is pak choi/vodka/lentils/bagels/insert-your-food-of-choice-here high in histamine?
A. I have no clue and neither does anyone else.  That’s because it hasn’t been tested for its histamine content.  Even foods thought to be high in histamine, eg. cheddar cheese, will differ depending on how it was produced, stored or transported.  A certain brand of cheddar cheese in Italy may test lower, or higher, than another brand of cheddar cheese in America.

Q. So which low histamine food list should I use?!
A. It’s entirely your personal choice.  None of them are THE definitive food list because that doesn’t exist.  My advice would be to choose a list you think you can stick to, give a go for 4-6 months and see if it helps.

Q. Does the cooking method affect the food’s histamine content?
A. There was a recent study showing that frying and grilling specific types of food increased its histamine content, whereas boiling sometimes decreased it.  However, it depended on the type of food.  Eggs, for example, showed little rise or fall in histamine regardless of how they were cooked but fried vegetables had more histamine than raw vegetables.  As with all things histamine it’s not as simple as fry or don’t fry, boil or don’t boil.  It’s not something I personally worry about.

Q. Why can’t I eat leftovers?
A. It’s the freshness of food which affects its histamine content.  The older the food, the more histamine it has.  So 2 day old leftovers are going to be higher in histamine than fresh food cooked and eaten on the day it’s bought.  At least that’s the theory, but again it’s not that simple.  Who knows whether “fresh” unripe bananas picked in the Caribbean, taken on an open truck in forty degree heat to a warehouse, sorted, repacked onto another truck to go to the docks, travel in an unfridgerated container for a week to reach England, put on another truck to a warehouse, then forwarded to Tescos in Preston, then packed in the boot of your car for an hour as you drive home, then sat in a fruit bowl for three days before you eat them are going to be lower in histamine than chicken soup you made yourself yesterday but have reheated?!

Q. Does refrigeration affect histamine levels?
A. Most of the research on this has been done on fish.  Little is known of the effect refrigeration has on eggs or carrots for example.  However, from the limited research refrigeration slows down histamine formation.  But if the food already contains histamine, eg the banana example above, it won’t reduce it.

Q. Does freezing affect histamine levels?
A. Freezing is the only thing which halts histamine formation.  However, it doesn’t destroy histamine which has already formed.  So if you freeze a week old uncooked chicken breast which already contains high levels of histamine the histamine will still be there.  My advice would be to freeze foods as soon as you buy them or freeze meals as soon as you’ve cooked them, then cook from frozen whenever possible or at least cook or eat as soon as they’ve defrosted.  I never defrost stuff for hours overnight in the fridge, preferring to defrost at room temp for 1-3 hours then cook and eat.

Q. What about histamine levels of canned foods?
A. As far as I’m aware no tinned goods have been tested for their histamine content and in any event it would probably depend on the type of food and how it had been stored and prepared prior to canning.  I guess tinned goods are on the ‘excluded’ lists of low histamine diets because they contain preservatives (which haven’t been tested for histamine either!) and because they’re considered ‘old’ and assumed to be high in histamine, but it is just an assumption.  The truth is no-one knows.  I eat tinned beans and don’t react to them in any way, but that’s just me.

Q. What about dried goods, eg. pasta.
A. Again, they haven’t been tested for their histamine content so no-one knows.

Q. What’s the deal with histamine liberators?
A. Histamine liberators are irrelevant in histamine intolerance as HIT involves DAO and HNMT not mast cell activation per se.  However, I know many people with mast cell disease also follow a low histamine diet, which is why I’ve included this question.  There is no such thing as a histamine liberating food as far as we know.  No research has been conducted that shows any particular food liberates histamine stored in mast cells.  This includes egg whites and stawberries.  Which doesn’t mean to say you don’t have a reaction to a food, but that it’s your immune system which is over-reacting to a harmless substance and nothing intrinsic in the food itself which causes a reaction.  I react badly to apples, for example, because I have a birch pollen allergy and they are related – it doesn’t mean apples are histamine liberators.  I take no notice whatsoever of information online which tells me some food or other is a “histamine liberator” and will continue to do so unless it’s proved otherwise through research.

I’m sure you’re now thinking “well what the hell do I eat and how can I know it’s low in histamine?!”.  The fact is the whole low histamine food area is a very very complex subject with so many variables it makes your head spin.  There is no easy “eat this and don’t eat that” solution, I wish there were.  The histamine content of any particular food depends on so many things including its age and the way it’s been picked, handled, transported, processed and stored.  It will differ from food to food.  A button mushroom in China may differ in its histamine content compared to a button mushroom in Wales.  Strawberries picked out of your garden will differ from strawberries imported from Israel.  And so on ad nauseum.

Nearly every article online about HIT refers to the same single research paper.  However, the paper is fundamentally flawed as explained in my Histamine in foods: the evidence page.  For example, it lists egg whites as a histamine liberator based on a worthless solitary study of animals in 1956 which was never published or replicated let alone tested on human beings.  Yet this has gone viral and now everyone treats it as fact when it is anything but.  The truth is the research evidence on the histamine content of food is poor and much of it is decades old – there were no refridgerated lorries in the 1950s.  In fact there were hardly any fridges in the 1950s.  We have come a long way in the last 70 years in how we pick, transport and store food which is why research needs to be up-to-date.

However, there is hope on the horizon.  A home testing kit is being developed in Germany which will enable us to precisely measure histamine in food.  This is the only way we will know for sure how much histamine is in the actual food we’re eating and it can’t come soon enough.

 

 

Which List Should I Use?

In light of my recently gathered information, or lack thereof, on which foods affect histamine I suppose many of you are wondering which low histamine food list to use, if any.  I have no idea is the simple answer.  I don’t give advice here on my blog because I’m in no position to – I’m just a sick girl floundering around in the dark along with the rest of you.

There is information on the most popular low histamine food lists on Alison Vickery’s website so thanks to her for putting that information together which saves me a massive job 🙂  We’ll have to agree to disagree though that any of the lists are “credible”.

I follow Dr Joneja’s list (which is the one here on my website) because it helps control some of my Histamine Intolerance symptoms some of the time.  I also have Mast Cell Disease though and the diet doesn’t help that.  There is no source data for Dr Joneja’s list, however, so I have no clue on what she bases the information or how accurate it is.

Another popular List is by SIGHI, the Swiss interest Group on Histamine Intolerance.  This List is compiled from “various sources” none of which are given, so again there is no way of knowing what information the food choices are based on or how accurate the testing of these foods was.  The List also incorporates “the experience of members” which is largely irrelevant.  I have no idea whether SIGHI’s members have HIT, MCAD or any number of other diseases, what medication they are on which could affect the foods they eat or whether they’ve been tested for actual food allergies.  One thing I’ve learned from writing my blog is that we all have vastly different reactions to foods: I tolerate wheat, you may not.  I tolerate legumes, you may not.  Apples are low in histamine and they make my lips tingle, because I have an allergy to Birch pollen and apples are related.  Whether or not you react to a particular food could be due to several factors and have absolutely nothing to do with the food’s histamine content.  The reason we have double-blind randomized controlled research trials is to eliminate all these biases and only compare ‘like for like’ results.

Another List mentioned on Alison’s page is the Failsafe Diet from the Royal Prince Alfred Hospital.  You have to buy this list so I don’t have a copy – if anyone else has a copy please let me know if the testing methods on which they base their list is included.

Low Histamine Food Apps don’t appear to be available on the Windows platform, which is the type of mobile phone I have, and you have to buy them, so based on that I don’t have access to them.  At least one of the Apps apparently lists the research sources for their information, so kudos to the company for that.  However, has anyone actually read the research?  How old is it?  How many studies is it based on? Is it just a regurgitation of the research I found online, because if it is it’s next to useless.  Any App which lists food that “liberate histamine” or “block DAO” are useless IMHO, because I found that absolutely no research has been carried out in either of these two areas.

I must sound like I’m totally anti low-histamine food lists which isn’t true.  Dr Joneja’s list literally saved my life.  I was eating huge amounts of hard cheese like Cheddar & Parmesan, which research shows is high in histamine.  Being vegetarian I was also eating loads of spinach and aubergines which research shows are moderate in histamine, and fermented soy products like soy sauce which research shows is high in histamine.  And like everyone else I bought all my sauces, mayo etc.  which contain massive amounts of malted vinegar and soya products as preservatives.  Replacing all these items helped my symptoms enormously.

I have no idea if the orange juice I drank every day contributed to my histamine problems, because I couldn’t find any research which has tested citrus fruits – huge shock there, as they are demonized in the low histamine food world.  Ditto for tomatoes and strawberries – no evidence there either because no-one has actually tested them that I could find.

I’ve found that bananas, buckwheat and cashew nuts make my brain fog worse, and apples make my mouth tingly, despite none of these foods being touted as high in histamine (I don’t know if they are or not as I could find no research on them –  I just know my mast cells obviously don’t like them much).  As I said earlier, we’re all going to have things our mast cells react to which are individual to us and nothing to do with the food’s histamine content.

I regularly eat chocolate biscuits and they give me no symptoms whatsoever.  I could find no research which had tested cocoa for its histamine content.  Just because something is “fermented” I discovered it doesn’t automatically make it high in histamine.  One study found Kefir, a fermented milk drink, to be very low in histamine, along with yoghurt another fermented product!

To be honest, I’d hoped that by delving in to the murky world of histamine in food I’d come out the other side much more informed on what I should, and should not, be eating but I’m actually more confused than ever.  As a result of my research though I am going to try re-introducing foods one at a time which I haven’t eaten in nearly 3 years and just see what happens.  The more varied and balanced a diet is the better it is for you and the more fun it is to eat!