Foods high in histamine are those that undergo microbial fermentation, such as cheese and wine, or those that have been spoiled by microbial contamination. Upon ingestion, histamine is normally metabolized in the intestine and liver by enzymes called amine oxidases. However, certain individuals have low expression levels of these enzymes and consequently cannot properly metabolize histamine. This condition is called histamine-induced food intolerance, and it promotes allergy-like symptoms such as sneezing, flushed cheeks, headache, diarrhea and shortness of breath. Individuals who are diagnosed with histamine-induced food intolerance can relieve their symptoms by restricting foods that are high in histamine.
Dairy products that are highest in histamine consist of fermented cheeses (gouda, camembert, cheddar, brie, roquefort, emmental, swiss, parmesan), yogurt, buttermilk and kefir. Plain milk and milk products such as ice cream, and curdled cheeses like cottage, ricotta and panir, are generally well tolerated.
Meat and poultry should be pure and fresh when consumed. Processed meats like salami, jerky and sausage are high in histamine. Histamine is an indicator of food quality, because meats that are spoiled by microbial contamination can also contain high levels of histamine. All processed meats and leftover cooked meats should be restricted.
Eating spoiled fish can result in a food-borne illness known as Scromboid poisoning, which is marked by high levels of histamine. Histamine occurs abundantly in the muscle fibers of fish, and is particularly high in mackerel, herring, sardine, anchovy and tuna. Cooking temperatures do not affect this type of food poisoning, so consuming high-quality and freshly prepared fish is especially important for individuals with food-induced histamine intolerance.
Certain vegetables, like sauerkraut, spinach, eggplant, pumpkin, pickled cabbage, and tomato products, including sauces and ketchup, contain concentrated amounts of histamine. All vegetables and foods or beverages containing these vegetables should be restricted. All other vegetables, vegetable products and juices are low in histamine.
Alcohol and Vinegar
Red-wine headaches are classical indicators of food-induced histamine intolerance. White wine, champagne, beer, vinegar and cider are also high in histamine and should be restricted. The alcohols that are not high in histamine include vodka, gin and rum.