Information on this page comes from Dietary Management of Food Allergies & Intolerances: A Comprehensive Guide, by Janice Vickerstoff Joneja. 1998. J. A. Hall Publications.
- Food Sources of Histamine
- From the Urticaria Chapter
- Allowed/Restricted Foods
- Histamine Restricted Diet for Control of Urticaria/Angioedema
Histamine occurs in food as a result of microbial enzymes converting the amino acid histidine (present in all proteins) to histamine. All foods subjected to microbial fermentation in the manufacturing process contain histamine. Included in this category are cheeses, fermented soy products, other fermented foods (e.g. sauerkraut), alcoholic beverages, and vinegars.
Foods exposed to microbial contamination also contain histamine in levels determined by the extent and rate of action of the microbes. Histamine levels reach a reactive level long before any signs of spoilage occur in the food. This characteristic has important implications in fin fish, where bacteria in the gut are particularly active in converting histidine to histamine. The longer the fish remains ungutted, the higher the levels of histamine in the flesh.
Some foods such as eggplant and spinach contain high levels of histamine naturally. In addition, a number of food additives such as azo dyes and preservatives mediate the release of histamine.
Some of these chemicals such as benzoates occur naturally in foods, especially fruits, and may have the same effect as the food additive in releasing histamine.
The histamine restricted diet excludes all foods known to contain high levels of histamine or to contain chemicals that can promote the physiological release of histamine.
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The foods most commonly reported to induce urticaria are shellfish, fish, egg, nuts, chocolate, berries, tomatoes, cheese, milk, and wheat.
Foods reported to release histamine directly from mast cells are uncooked egg whites, shellfish, strawberries, tomatoes, fish, chocolate, pineapple and alcohol.
Foods containing histamine—Aged protein containing foods and fermented foods commonly have increased histamine levels.
Foods reported to be high in histamine are fermented cheeses (e.g. Camembert, Brie, Gruyere, Cheddar, Roquefort, Parmesan), brewer’s yeast, shellfish, many fin fish, canned fish, tomato, spinach, red wine (especially Chianti), beer, unpasteurized milk (e.g., cow, goat or human milk), chicken, dry pork sausage, beef sausage, ham, chocolate, fermented soy products, and all fermented vegetables, such as sauerkraut.
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This diet excludes all:
- foods with naturally high levels of histamine
- fermented food
- artificial food coloring, especially tartrazine
- Benzoates including food sources of benzoates, benzoic acid and sodium benzoate
- Butylated hydroxyanisole (BHA) and butylated hydoxytoluene (BHT)
Type of Food
|Milk and dairy||Plain milk
|All prepared dairy products made with restricted ingredients
|Breads and cereals||Any pure unbleached grain or flour
Any plain fresh bread, buns, biscuits, pizza dough with allowed ingredients
Homemade or purchased baked cookies, pies etc made with allowed ingredients
|Products made with:
|Breakfast cereals made with allowed foods, including:
Plain crackers with allowed ingredients:
|Plain pasta||All packaged rice and pasta meals|
|All pure fresh and frozen vegetables and juices except those listed||Eggplant
Tomato and all tomato productsAll vegetables prepared with restricted ingredients
Cantaloupe (rock melon)
WatermelonFruit dishes made with allowed ingredients
Fruit dishes, jams, juices made with restricted ingredients
Meat, poultry and fish
|All pure, freshly cooked meat or poultry||All fish and shellfish
All processed meats
All leftover cooked meats
|All plain, cooked egg||All prepared with restricted ingredients
Raw egg white (as in some eggnog, hollandaise sauce, milkshake)
|All plain legumes except those listed opposite
Pure peanut butter
Nuts and seeds
|All plain nuts and seeds||All with restricted ingredients|
Fats and oils
Pure vegetable oil
Homemade salad dressings with allowed ingredientsLard and meat drippings
|All fats and oils with color and/or preservatives
Prepared salad dressings with restricted ingredientsPrepared gravies
Spices and herbs
|All fresh, frozen or dried herbs and spices except those listed opposite||Anise
Seasoning packets with restricted ingredients
Foods labeled “with spices”
Pure jams, jellies, marmalades, conserves made with allowed ingredients
Plain artificial sweeteners
Homemade sweets with allowed ingredients
Prepared desert fillings
Prepared icings, frostings
Spreads with restricted ingredientsCake decorations
Cream of tartar
Homemade relishes with allowed ingredients
|All chocolate and cocoa
Prepared relishes and olives
Most commercial salad dressing
Pure juices of allowed fruits and vegetables
Plain and carbonated mineral water
Alcohol: plain vodka, gin, white rum
Fruit juices and cocktails made with restricted ingredients
All other carbonated drinks
All drinks with “flavor” or “spices”
All other alcoholic beverages
Do not eat the following food during the 4 week trial elimination period.
- All seafood including shellfish or fin fish, fresh, frozen, smoked or canned
- Egg (a small quantity in a baked product such as pancakes, muffins, cakes is usually tolerated)
- Processed, smoked and fermented meats such as luncheon meat, sausage, weiner, bologna, salami, pepperoni
- Leftover meat: eat freshly cooked meat ONLY (side note from Jackie—After meat is cooked, the histamine levels increase due to microbial action as the meat sits.)
Milk and Milk Products
- All fermented milk products, including cheese (any milk product that is curdled rather than fermented is allowed, such as cottage cheese, ricotta cheese and panir)
- Cheese products such as processed cheese, cheese slices, cheese spreads
- Yogurt, buttermilk, kefir
Fruits and Vegetables
- Tomato sauces
- Tartrazine and other artificial food colors
- Preservatives, esp. benzoates, sulfites and BHA, BHT
Note: Many medications and vitamin pills contain these additives, especially colors. Ask the pharmacist to recommend additive-free supplements and medications.
- Chili powder
- Curry powder
- Hot paprika (cayenne)
- Fermented soy products
- Fermented food
- Tea—herbal or regular
- Chocolate, cocoa, and cola drinks
- Vinegar and foods containing vinegar such as pickles, relishes, ketchup, and prepared mustard