What is histamine intolerance?
Histamine is a natural compound produced by the body and found in many foods and drinks. It plays a crucial role in the immune system, but for individuals with histamine intolerance, the body cannot break it down effectively. This is often due to a deficiency in the enzyme diamine oxidase (DAO), which is responsible for metabolizing dietary histamine. When dietary histamine intake exceeds the body's ability to process it, it can lead to a variety of symptoms that mimic an allergic reaction, such as headaches, hives, digestive issues, and nasal congestion.
The fermentation and aging connection
The primary reason certain drinks contain high levels of histamine is the process of fermentation and aging. During fermentation, microorganisms convert the amino acid histidine into histamine. The longer a food or beverage is fermented or aged, the higher its potential histamine content. This is why fresh, unprocessed drinks are generally lower in histamines compared to their aged or fermented counterparts.
Alcoholic beverages high in histamine
Alcohol is a significant trigger for histamine intolerance because it contains high levels of histamine and can also inhibit the function of the DAO enzyme.
- Red Wine: This is often cited as one of the highest histamine drinks, with levels significantly greater than white wine. The prolonged contact with grape skins and the fermentation process contribute to this high concentration.
- Beer: Dark beers, ales, and wheat beers generally contain higher levels of histamine than light lagers or pilsners. This is due to the fermentation process, yeast, and longer aging periods.
- Champagne and Sparkling Wines: These can also contain elevated histamine levels, and the carbonation may even enhance its absorption in some individuals.
- Aged and Dark Spirits: Whiskey, bourbon, and rum, which are aged in barrels, tend to accumulate more histamine than their clear, unaged counterparts like vodka or gin.
- Cider: Like other fermented beverages, cider is high in histamine and can act as a histamine liberator.
Non-alcoholic drinks high in histamine
It's not just alcohol that can pose a problem. Several non-alcoholic beverages are also high in histamine or can trigger its release.
- Fermented Beverages: Kombucha and kefir are highly fermented and therefore high in histamine.
- Coffee: While not all coffee is high in histamine, low-quality or improperly stored beans, as well as mold, can cause a reaction in sensitive individuals. Decaffeinated coffee may be a better option.
- Certain Teas: Black tea, green tea, and mate tea can block the DAO enzyme, making it harder for the body to break down histamine. Fresh herbal teas are generally safer.
- Aged Juices: The histamine content in fruit juices, especially citrus or tomato juice, can increase over time. Freshly squeezed juice is a better alternative.
- Energy Drinks: These can be high in histamine and also act as histamine liberators.
Drinks that act as histamine liberators
Some beverages don't contain high histamine levels themselves but can trigger the body to release its own histamine, leading to symptoms. Alcohol is a primary example of this. Other common liberators include citrus juices and energy drinks.
High vs. Low Histamine Drinks
| Drink Type | High Histamine Examples | Low Histamine Examples |
|---|---|---|
| Wines | Red wines, rosé, fortified wines (port, sherry), champagne | Dry, young white wines (Sauvignon Blanc, Pinot Grigio), low-histamine tested wines |
| Beers | Dark beers (stouts, porters, wheat beer, ales), heavily hopped IPAs | Light, filtered beers (lagers, pilsners), some gluten-free varieties |
| Spirits | Aged spirits (whiskey, bourbon, rum) | Clear spirits (vodka, gin, 100% agave tequila, white rum) |
| Fermented | Kombucha, kefir, cider | Freshly brewed herbal tea |
| Other | Aged citrus or tomato juice, commercial energy drinks | Water (filtered, sparkling), freshly squeezed non-citrus juices, herbal teas (ginger, peppermint) |
What to drink instead on a low-histamine diet
For those sensitive to histamine, a low-histamine diet is recommended, which includes careful consideration of beverages. Here are some alternatives:
- Water: Plain, filtered water is always a safe choice. Carbonated or sparkling water is also suitable.
- Herbal Teas: Teas made from low-histamine herbs like ginger, peppermint, and rooibos are generally well-tolerated.
- Fresh Juices: Freshly pressed juices from low-histamine fruits and vegetables like apples, pears, and carrots are good options.
- Milk Alternatives: Coconut milk, almond milk, and other non-dairy milks are typically low in histamine.
- Cocktails: Clear spirits like vodka or gin mixed with plain soda water and fresh lime can be a lower-histamine alcoholic option.
Practical tips for minimizing histamine from drinks
- Prioritize Freshness: Choose fresh foods and juices over aged or processed ones to minimize histamine content.
- Read Labels: Be mindful of food additives like artificial colors and preservatives, which can act as histamine liberators.
- Moderation with Alcohol: All alcoholic beverages can impair the DAO enzyme, so moderation is key even with low-histamine choices.
- Experiment and Observe: Every individual's tolerance is different, so pay attention to your body's reactions and keep a food diary to identify your personal triggers.
Conclusion
For individuals with histamine intolerance, understanding what drinks have the most histamine is a critical step toward managing symptoms and improving overall well-being. The fermentation and aging processes in beverages like red wine, beer, and aged spirits are the primary culprits for high histamine levels. Other drinks such as kombucha, kefir, and certain teas can also be problematic due to high histamine or their effect on the DAO enzyme. By opting for fresh, less processed alternatives like filtered water, fresh juices, and select herbal teas, sensitive individuals can significantly reduce their histamine load. While the histamine content in food can be difficult to predict, choosing fresher options and observing personal tolerance are the most effective strategies.
For more information on histamine intolerance and its management, consult the Cleveland Clinic guide on the low-histamine diet.
