Skærmbillede 2014-03-15 kl. 09.47.55By Mariska de Wild-Scholten
– If you experience frequent headaches and migraines or for no apparent reason feel nauseous and tired it can be caused by too much exposure to histamine, fragrances from food or the environment. This happens when your body either releases more histamine than desirable or if your body has a decreased capacity of the enzymes necessary to break down histamine.

The foods highest in histamine are those which contain fermented or even spoiled proteins. In these foods the amino acid histidine is converted by bacteria to histamine, like in aged cheese, soy sauces, sausage, fish that are not completely fresh. The other source of histamine is from degranulating reservoirs of histamine in the body – the so-called mast cells.

Histamine liberation from mast cells can be caused by allergic or non-allergic reactions. Antibodies to allergens like pollen or house mites are easy to detect in the blood. However, this is not the case for non-allergic reactions to fragrances, friction on the skin, too much heat, sun, or exercise. Some known fragrances in perfumes, cosmetics, and food that may cause non-allergic histamine liberation are citral in the rind/peel of citrus fruit, cinnamal in cinnamon. Salicylates are also known to cause mast cell degranulation.

In those places in the body where the concentration of histamine raises too high, symptoms will occur. Examples of skin reactions are eczema, redness, and itch. Digestion of histamine or mast cell degranulators that trigger the release of histamine will cause irritable bowel. Too much histamine in your bronchi causes bronchoconstriction (asthma) which reduces the amount of oxygen taken in from your lungs. See table showing causes and symptoms.

As muscles need oxygen to burn fuel, excess histamine can also cause you to develop a lack of oxygen (hypoxia) with symptoms such as muscle cramps, tension-type headaches and cold hands and feet. Finally, hypoxia can decrease the production of dopamine and serotonin which leads to difficulties starting a task, or in the worst case to depression. See for a complete list of potential symptoms from hypoxia.

The oxygen in the blood of your finger can be measured easily with a continuous pulse oximeter. If you experience hypoxia, your body will try to increase the oxygen supply by increasing adrenaline with rapid heartbeats and breathing as a result. Then, when oxygen supply is restored, a sudden peak in the production of dopamine and serotonin occurs. Too much serotonin and also adrenaline gives way to vasoconstriction which is associated with migraines as well as anxiety. This makes it very important to get enough fresh air. Have a walk every day and remember to ventilate.

Build up and breakdown
Histamine intolerance is the intolerance towards “normal” levels of histamine in food caused by the histamine-degrading enzymes diamine oxidase (DAO) or histamine N-methyltransferase (HNMT). At the same time mast cell degranulation can be excessive and in this way cause different kinds of mast cell activation disorders, like MCAD. In this way symptoms of histamine overload can develop through both increased availability of histamine and impaired histamine degradation. Underlying conditions for increased availability may be histamine overproduction caused by allergies, mast cell degranulation, bacterias, parasites, gastrointestinal damage (leaky gut, inflammation..), or increased ingestion of histidine or histamine by food.

Women experience more migraines around the start of their period. This can be because the lining of the uterus contains mast cells which liberates histamine when it breaks down during menses. There is nothing wrong with the hormones, just a lack of the enzymes capacity to break down histamine. During pregnancy many migraine sufferers say their migraines disappear. One school of thought is that too much histamine could cause a miscarriage, so the placenta starts to produce a lot of the DAO enzyme to protect the fetus.

The decreased capacity of histamine degrading enzymes can be due to a genetic defect or could be acquired due to, for example, medicines like antibiotics and NSAIDs. The tranquilizer diazepam and antidepressant Amitriptyline are DAO inhibitors. Some other medicines are mast cell degranulators: ie. Codeine and morphine. Unfortunately histamine intolerance is not an accepted disease by the International Classification of Diseases (ICD) and therefore not recognized by most doctors.

New diet
Most people who are sensitive to histamine find that their symptoms will disappear or be reduced if they lower the level of histamine in their diet. Some foods that are well tolerated are rice, carrots, pumpkin, chicken and ginger (though high in salicylics). It is sometimes best to boil your food, so soups are ideal. Please note that it is rare to react to every food appearing in all the lists. Everybody have their own sensitivities. The best way to diagnose histamine intolerance is by following an elimination diet where you remove trigger foods that are high in histamine or known to be mast cell degranulators. Then, after a period of time, you reintroduce foods and products one by one to see if you react to it.

The following list gives a summary of foods, medicines and physical triggers that are often not tolerated:

Food needs to be fresh, so canned, smoked and fermented foods and yeast should be avoided

Fish needs to be very fresh.Tuna, mackerel, herring and anchovies have an especially strong tendency to develop high levels of histamine when not fresh. Fermented fish sauces are definitely not fresh. Lemon sole, perch and monkfish are all low in histamine, and fresh salmon can be a good choice, because it is high in anti-inflammatory omega-3 fatty acids.

Shellfish is often not tolerated. Shellfish is not -gutted like bigger fish

Meat needs to be very fresh. Minced meat degrades relatively fast. Also, cured sausages are not fresh and contain nitrates

Aged cheeses are higher in histamine and other biogenic amines then young/fresh cheese like mozzarella

Some probiotic strains may contain bacteria which convert the histidine in your food to histamine.

Raw egg white is a mast cell degranulator

Fermented soy sauces can be very high in histamine

Some vegetables and fruits can be problematic, i.e. tomato, spinach, avocado, eggplant, onion, garlic, strawberry, pineapple, ripe banana, citrus

Rancid fatty acids in oils, nuts and seeds

Nitrates and sulphites

Alcohol, vinegars made with wine (or wine based vinegars)

Foods with fragrances/aromas: spices! One example is cinnamon

Many additives, e.g. the aspartame metabolite formaldehyde may cause mast cell degranulation

Sweets with cacao, additives…

Wheat-lectins (Wheat Germ Agglutin = WGA) and gluten can damage gut lining thereby increasing intolerances. Also WGA attacks cartilage in your body which in turn, causes joint pain

Physical triggers
: friction (coarse wool or labels in clothes), heat, sun, exercise and stress

Certain personal products and cleaning agents

Some people experience relief from eating a diet, that is not only low histamine but also includes foods that break down histamine directly (for example,foods high in vitamin C) or have mast cell stabilizing effects (high in magnesium, etc). Also, anti-inflammatory foods can have beneficial effects when you are suffering from histamine intolerance. For example, foods high in omega-3 fatty acids (salmon, walnuts, rapeseed oil) will produce anti-inflammatory prostaglandins in the body, whereas omega-6 rich food (ie, meat) generates inflammatory prostaglandins.

Mariska de Wild-Scholten has a defect gene for the Histamine N-methyltransferase-enzyme. She studied geochemistry and hosts the website

Supplements without additives
Mineral supplements from WaterOz are pure minerals and pure water – nothing else. TOO MUCH MAG have tested iron, magnesium, selen, zink, potassium, vanadium from WaterOz and have not experienced side effects.

Supplements that is said to address histamine intolerance
The probiotic strain L. rhamnosus GG, black seed oil (Nigella sativa), lactoferrin, quercetin, magnesium, vitamin C and E, nigella sativa, boswellia, butterbur, nettle, reishi, mango steen, turmeric, holy basil

List of bacteria in foods and probiotics that is said to cause increased histamine (to avoid): Photobacterium phospereum, Raoultella planticola. L acidophilus, L helveticus, L casei, L fermentum, Lactococis lactis, L arabinose, L delbrueckii, L bulgaricus, L reuteri, Enterococcus faecialis, Escherichia coli, Streptococcus thermophilus, Enterococcus faecium

Lists for histamine and biogenic amines, DAO and HNMT enzyme inhibitors
The book “Understanding Histamine Intolerance & Mast Cell Activation” by Mariska de Wild-Scholten,
The iPhone App “Histamine Intolerance” by Ostec
The App “Food intolerance” from Baliza, guide you to several intolerances
Histamine potential of foods and additives

Other resources
“Histamine and histamine intolerance”, by Laura Maintz and Natalija Novak
Histamine Intolerance in Clinical Practice“, by Laura Maintz, Thomas Bieber and Natalija Novak
“Histamine intolerance as a cause of chronic digestive complaints in pediatric patients”, by Rosell-Camps A, Zibetti S, Pérez-Esteban G, Vila-Vidal M, Ferrés-Ramis L.

Histamine Intolerance (with Genny Masterman)
Histamine Intolerance (with Yasmina Ykelenstam)
Mastocytosis and Mast Cell Disorders-Integrative and Holistic Approach