Your dietitian or nutritionist may recommend a low-histamine diet as a way to avoid triggering mast cell activity and related systemic mastocytosis (SM) symptoms. Avoiding foods high in histamine is part of a wider approach to a healthy diet and lifestyle that has proven effective in managing SM. While symptom relief has been reported as a benefit of a low-histamine diet, more clinical research is needed on the topic.
Why is a low-histamine diet useful in SM?
Histamine plays a key role in symptom episodes and allergic reactions, leading to itchiness, flushing, hives, abdominal cramps, nausea, vomiting, diarrhea, headache, shortness of breath, low blood pressure and even anaphylaxis in severe cases.
Certain foods are common symptom triggers for people living with SM. These foods are often high in histamine, or cause mast cells to release histamine.
Some people living with SM may also have lower levels of the enzymes that break down the histamine founds in foods, meaning their bodies absorb more of the histamine.
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Why does histamine occur in foods?
Histamine in foods is generally due to bacterial activity after an aging or fermentation process. Processed and pre-packaged foods are usually higher in histamine.
While some foods are high in histamine, others are low in histamine themselves but can lead to a release of histamine in the body. These foods are called histamine liberators.
Foods low in histamine
Fresh and unprocessed foods are usually the healthiest choice when you’re looking for a low-histamine option. However, even fresh food can develop higher levels of histamine if left at room temperature for too long. Here are some low-histamine foods to consider:
- Fresh meat
- Almonds
- Potatoes
- Olive oil
- Coconut oil
- Fresh non-citrus fruits, such as apples, blueberries, mangoes and peaches
- Salmon
- Gluten-free grains, such as quinoa, rice, arrowroot and buckwheat
Foods to avoid on a low-histamine diet
Before deciding if a low-histamine diet is right for you, your dietitian will likely recommend you follow an elimination diet. This will identify the foods that trigger an allergic reaction. Knowing the foods that trigger your symptoms the most will guide them in creating a personalized low-histamine diet for you, with a meal plan, shopping list and tips for avoiding high-histamine foods in daily life.
Though everyone reacts to foods differently, your dietician may recommend limiting the following high-histamine and histamine-releasing foods:
High-histamine foods
- Alcohol
- Aged cheeses
- Cured or smoked meats, like deli meats
- Fermented food products, such as soy sauce, kefir, kimchi, yogurt, sauerkraut and wine
- Avocadoes
- Spinach
- Shellfish
- Eggplant
- Dried fruits
Histamine-releasing foods
- Alcohol
- Bananas
- Tomatoes
- Citrus
- Strawberries
- Pineapple
- Papaya
- Mushrooms
- Chocolate
- Nuts
- Wheat germ
- Beans
- Pork
- Licorice
- Egg white
- Most fish
- Food additives
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