TREATMENT OF HISTAMINE INTOLERANCE

low-histamine diet
A strict low-biogenic amine diet should be observed as a matter of principle, followed by a re-introduction phase,
with the establishment of a permanent diet at a later stage.

 Avoid matured cheese (hard cheese). Use cream cheese, mild cheese
and cottage cheese instead. Izobiraj se trdega sira. Bolje je kremni, čisto lahki sir.

 Avoid alcoholic beverages. Izogibaj se alkoholnim pijačam.

 Avoid raw and cured sausage products such as salami. Use cooked ham and cooked sausage instead.
Izogibaj se salamam in klobasam. Raje kuhana govedina ali hrenovke.

 Avoid processed fish products. Use freshly caught fish and seafood instead. Izogibaj se procesiranih ribjih
produktov (konzerve). Jej sveže ujete ribe.

 Avoid tomatoes, pickles and citrus fruits. Use other fresh fruits and vegetables instead. Izogibaj se
paradižniku, kumaricam in citrusom.

 Avoid chocolate. Izogibaj se čokoladi!

 Avoid nuts Izogibaj se oreščkom.

 Avoid products made with yeast and yeast extracts. Izogibaj se hrane, narejene iz kvasa.

 Avoid soy sauce and fermented soy products. Izogibaj se soji.

 Avoid black tea and green tea. Izogibaj se črnemu in zelenemu čaju.

 Avoid energy drinks and coffee. Izogibaj se energijskim pijačam in kavi.

It is very important to coordinate this precisely with your doctor and your registered dietician!

Enzyme products
An enzyme product containing Diamine Oxidase (DAO) breaks down ingested histamine. DAO is available
worldwide under the brand name "DAOsin" and can be bought online. It was acknowledged by the U.S. Food and
Drug Administration in 2008 and is also available in the U.S.
Vitamins and Histamine Intolerance
Some sources recommend taking supplements of Vitamin B6 and Vitamin C.

Vitamin C
 Promotes the degradation of histamine

 Substitution is useful

 Recommended daily dosage: 0,5-1g

Vitamin B6
 Important for the synthesis of DAO

 Substitution is only useful if a Vitamin B6 deficiency has been established

 Recommended daily dosage: 1,2mg

Anti-histamines / emergency pack

It is recommended that you carry an emergency pack (speak with your doctor about this!) with you at all times.
The pack should include some form of anti-histamine and maybe an asthma pocket inhaler (if you had asthmatic
symptoms previously).

The emergency pack is not a replacement for the diet!

Some drugs enhance the intolerance symptoms! If you are already taking medication for any other health reason,
ask your doctor about their effect on the histamine intolerance! There are a lot of substances used in different
drugs that have a negative effect on the DAO enzyme. So do not change your medication before you have talked
to your doctor, as otherwise you may seriously harm your health.

HIT: WHAT CAN I EAT?

The most important measure to take is to observe a low-histamine diet.

There are a couple of basic rules that you should keep in

mind:
 No preserves, canned or bottled food products

 No over-ripe foods (matured cheeses, alcoholic beverages, products produced with yeast, less than fresh
fish...)

 Histamine levels can vary! Depends on the maturation/ripening stage and hygienic condition of the product.

 No alcohol, especially not before, during or after meals.

 Always make sure to tell any physicians treating you that you have histamine intolerance. This applies
especially when you undergo surgery under anaesthetic!

 Always keep your emergency set with you (as prescribed by your doctor)

 Certain medication should be avoided. (Ask your doctor! )

 Always eat food directly from the refrigerator; don’t take it out of the refrigerator to let it warm up before you
eat it.

The following foods should be avoided in general:

 Alcoholic beverages

 Hard (matured) cheese

 Salami

 Nuts

 Tomatoes

 Fish (except for very fresh fish)

 Tuna (even when it’s fresh)

 Shell fish

 Sauerkraut

You can find a more detailed list of tolerated and not tolerated foods here, and here in the histamine table.

The following table is ranked according to the degree of

tolerance.
well tolerated | sometimes tolerated – individual testing during the test phase recommended | poorly
tolerated | ED = elimination diet (first weeks after diagnosis) | PD = permanent diet

Food ED PD Food ED PD

Potato Celeriac

Lettuce Grapes

Rice Onions
 Food ED PD Food ED PD

Courgettes Pork

Chicken (without skin) Coffee

Endive Fruit teas, fresh

Lamb’s lettuce Mushrooms

Blueberries Savoy cabbage

Pumpkin (Hokkaido) Garlic

Dandelion leaves Bell peppers (green)

Carrots Chanterelle mushrooms

Sweet potatoes Plums

Watermelon Porcini (Ceps)

Broccoli Corn (tinned)

Chicory Bamboo shoots

Chinese cabbage Red cabbage

 Food ED PD Food ED PD

Fennel Green beans

Cucumber Peas

Fresh corn, cooked Hoseraddish

Asparagus Raisins

Sugar melon Pears

Beef Chickpeas

Apple Tuna, fresh

Cauliflower Sodas, diet

Redcurrents Aubergine

Prickly pear Avocado

Peach Banana

Leek Dates, dried

Radish Lima beans

 Food ED PD Food ED PD

Beetroot Mandarin / Tangerine

Gooseberry Soy beans

Egg White cabbage

Apricot Malt beer

Artichoke Figs, dried

Blackberry Limes

Sweet chestnuts Spinach

Pomegranate Lemons

Kaki Cocoa powder

Cherry Spirits, distilled

Lohlrabi Pineapple

Lychee Strawberries

Mango Pickled cucumber

 Food ED PD Food ED PD

Okra Grapefruit

Black salsify Kiwi

Salt water fish (not tuna!) Orange

Fresh water fish Tomato

Honey Beer

Figs Energy drink, sugar-free

Raspberries White wine

Coconut milk Tuna, tinned

Mangold Energy drink with sugar

Papaya Sauerkraut

Parsnip Wheat beer

Rhubarb Red wine

Brussels sprouts