What does a low histamine diet look like?

October 18, 2025 •

4 min read

For people with histamine intolerance, a condition caused by a buildup of histamine, dietary modification is the primary treatment. A low histamine diet is an elimination and reintroduction strategy designed to determine an individual's specific food triggers and manage symptoms effectively.

Quick Summary

This guide details the phased elimination and reintroduction approach of a low histamine diet. It provides comprehensive food lists and practical advice for navigating the diet's challenges, focusing on fresh, unprocessed foods to help manage histamine-related symptoms.

Key Points

Phased Approach: The diet involves a temporary elimination phase followed by a reintroduction phase to identify your personal tolerance.
Freshness is Key: Histamine content increases as food ages or is processed, making fresh, unprocessed ingredients crucial for minimizing histamine levels.
Avoid Fermented & Aged Foods: Fermented foods (sauerkraut, yogurt) and aged products (cheese, cured meats) are primary sources of high histamine.
Cook at Home: Cooking from fresh ingredients gives you control over what goes into your food and how it's prepared, helping reduce histamine buildup.
Individualized Tolerance: Sensitivity to histamine varies widely, so a food diary is essential for learning what your body can tolerate.
Not a Permanent Fix: The diet is a short-term diagnostic tool. The long-term goal is to address root causes and gradually reintroduce foods.

Understanding Histamine Intolerance

Histamine is a natural compound involved in the body's immune, digestive, and nervous systems. Histamine intolerance occurs when there is an imbalance between accumulated histamine and the body's capacity to degrade it. This is often linked to a deficiency or reduced activity of the enzyme diamine oxidase (DAO), which is primarily responsible for breaking down dietary histamine in the gut. When DAO is impaired, histamine can accumulate, leading to a wide range of non-specific symptoms that mimic allergic reactions, such as headaches, rashes, digestive issues, and nasal congestion.

The Three-Phase Approach to a Low Histamine Diet

A low histamine diet is typically not a permanent lifestyle change but a temporary strategy to identify and manage triggers. It is best implemented with the guidance of a healthcare professional, such as a registered dietitian, to ensure nutritional adequacy.

Phase 1: Elimination This is the strictest phase, typically lasting 2 to 4 weeks. The goal is to reduce the body's overall histamine load by completely eliminating high-histamine foods and beverages. If symptoms improve during this period, it indicates that dietary histamine may be a trigger.

Phase 2: Reintroduction After the elimination phase, you will systematically reintroduce high-histamine foods one at a time. This process helps pinpoint which specific foods trigger a reaction and determine your personal tolerance level. A food and symptom diary is a crucial tool during this phase.

Phase 3: Long-term Customization Based on your personal tolerance identified in Phase 2, a long-term, customized eating plan is created. This is a more liberal version of the diet, allowing for flexibility and diversity while avoiding known triggers. The goal is to reintroduce as many foods as possible without causing symptoms.

Food Guide: What to Eat and What to Avoid

Here is a general guide to foods based on their histamine content. Always remember that individual tolerance can vary greatly.

Low Histamine Food List

Fresh Meats & Fish: Freshly cooked chicken, turkey, beef, and lamb. Fresh or flash-frozen fish like trout, cod, and salmon (if caught and frozen quickly).
Fresh Fruits: Apples, pears, blueberries, mangoes, peaches, and watermelon.
Fresh Vegetables: All fresh vegetables except those listed below. Safe options include carrots, broccoli, cucumber, sweet potatoes, and zucchini.
Grains: Rice, quinoa, oats, millet, and gluten-free breads and pasta.
Dairy: Fresh pasteurized milk, cream cheese, butter, and mozzarella.
Fats & Oils: Olive oil, coconut oil, and ghee.
Herbs: Fresh herbs like parsley, cilantro, basil, and oregano.

High Histamine & Histamine-Releasing Food List

Fermented Foods: Aged cheeses (cheddar, parmesan, blue cheese), yogurt, kefir, kombucha, and sauerkraut.
Processed & Cured Meats: Salami, sausages, bacon, and deli meats.
Certain Fish & Shellfish: Canned fish (tuna, sardines), smoked fish, and shellfish.
Certain Vegetables: Tomatoes, spinach, eggplant, and avocado.
Certain Fruits: Citrus fruits, strawberries, pineapple, papaya, and bananas.
Alcohol: Wine, beer, and champagne.
Other: Vinegar, chocolate, cocoa products, and legumes.

Fresh vs. Processed Foods: A Key Difference

This is one of the most critical aspects of managing a low histamine diet. Histamine levels naturally increase in foods as they age or undergo processing and fermentation. Therefore, relying on fresh, whole foods is central to the diet.


Feature	Low Histamine Diet	High Histamine Diet
Food Freshness	Prioritizes freshly prepared food and ingredients.	Tolerates aged, cured, and fermented products.
Storage	Encourages immediate freezing of leftovers to minimize histamine formation.	Uses refrigerated leftovers, where histamine can accumulate over time.
Preparation	Favors boiling, steaming, or baking over frying and grilling, which can increase histamine levels.	Includes cooking methods that may raise histamine levels.
Processing	Focuses on whole, unprocessed foods and avoids ready meals.	Relies on canned, processed, and preserved foods.
Flavoring	Uses fresh herbs and mild spices.	Incorporates ingredients like wine vinegar, soy sauce, and strong spices.

Managing the Challenges of a Low Histamine Diet

Following a low histamine diet can be restrictive and challenging, but several strategies can help make it manageable.

Plan Your Meals: Meal planning is essential to ensure a varied diet and avoid relying on convenient, processed options.
Shop Smart: Buy fresh food frequently and in smaller quantities to ensure maximum freshness. Freeze meats and leftovers immediately after cooking.
Keep a Food Diary: Documenting meals and symptoms is the most effective way to identify personal triggers during the reintroduction phase.
Consider Supplements: Some individuals may benefit from supplements like DAO enzyme, Vitamin C, and Vitamin B6 under medical supervision, as these support histamine breakdown.
Address Root Causes: Histamine intolerance is often linked to underlying gut issues or other health conditions. Working with a doctor to investigate and treat these causes is crucial for long-term symptom management and dietary freedom.

Conclusion

Ultimately, what a low histamine diet looks like is a temporary, diagnostic eating plan tailored to an individual's unique sensitivities. It prioritizes fresh, unprocessed, and carefully prepared foods while temporarily eliminating or limiting aged, fermented, and known high-histamine items. With a structured, phased approach and professional guidance, it is a valuable tool for identifying triggers, managing symptoms, and working toward a more diverse diet in the long term. A balanced approach that combines dietary changes with addressing underlying health concerns is the most effective path to a healthier life.

For more detailed information, consult the resource from the London Clinic of Nutrition, which offers extensive food lists and recipe ideas.

Frequently Asked Questions

Histamine intolerance is a condition resulting from an imbalance between the body's histamine load and its capacity to break it down, often due to a deficiency in the DAO enzyme. This can cause various non-allergic, allergy-like symptoms when high-histamine foods are consumed.

No, a low histamine diet is generally considered a short-term diagnostic and management tool. It is used to give the body a 'reset' and identify specific food triggers. The long-term goal is to address any underlying causes of histamine intolerance with the help of a medical professional.

Common high histamine foods include fermented foods (sauerkraut, cheese, yogurt), cured and processed meats (salami, bacon), certain fruits (citrus, strawberries, bananas), specific vegetables (tomatoes, spinach, eggplant), and alcohol.

To minimize histamine, prioritize eating fresh food as soon as possible after purchase. Freeze leftovers immediately instead of storing them in the refrigerator for extended periods, especially meats and fish.

Freshness is crucial because histamine levels in food increase over time. Freshly cooked meals and recently purchased ingredients contain significantly less histamine than aged, fermented, or leftover foods.

Some people benefit from supplements like DAO enzyme capsules, Vitamin C, Vitamin B6, or quercetin. However, these should be used under the guidance of a healthcare provider and alongside dietary changes, not as a replacement for addressing the root cause.

The initial elimination phase typically lasts for 2 to 4 weeks. If symptoms subside, you can then begin the reintroduction phase to test your personal tolerance to individual foods.