Histamine Intolerance : Which Food List Should You Use?
When I was first diagnosed with histamine intolerance I just wanted to know what I needed to do so I could just do it. I wanted a list.
But it was not that simple.
There were a number of histamine intolerance lists from a number of credible sources. The problem was that no one list was the same and they contain conflicting information.
If you are new to histamine intolerance, then here are some of the lists that are commonly used, and my own experience with them:
Dr. Janice Joneja
Dr. Joneja is a registered dietician and holds a Ph.D. in medical microbiology and immunology. She has over thirty years of experience, nearly half as the head of the Allergy Nutrition Program at the Vancouver Hospital and Health Sciences Centre.
Dr Janice Joneja’s list eliminates histamines and tyramines.
This list is simple to follow, and gives general groups of foods, which makes logical choices easier. Personally, I found it a good place to start, as it gave me time to get my bearings, but it quickly proved inadequate.
RPA Allergy Unit List
The Royal Prince Alfred Hospital’s list not only eliminates histamines but also salicylates, amines, glutamates, sulphites, food colourings, and other artificial additives.
The diet is based on extensive ongoing trials within a renowned hospital allergy unit. The RPA Allergy Unit is considered a world expert on salicylates which in my experience are relatively rare.
The diet introduces the concept of histamines in food being primarily related to quality and age of food not the food itself. This had a dramatic impact on my histamine tolerance levels.
It also emphasises that this is not about eliminating all histamines but finding your tolerance level. The lists provide comprehensive lists of foods divided into low, moderate, high and very high levels.
Unfortunately the lists are by all excluded chemicals (not just histamines which makes them impractical if you do not have salicylate intolerance).
This failsafe diet is very heavy on sugar, carbohydrates, and processed foods. I don’t do well on them. That said carbohydrates and processed foods tend to be low in salicylates and glutamates.
It is also a highly restrictive elimination diet which is difficult to follow and in my opinion unnecessary if you don’t have salicylate intolerance.
I comprehensively failed this failsafe diet. The reason I failed was that the grains and legumes (which were such a large part of the failsafe diet). That lead me to Dr Moneret-Vautrin’s list.
Dr Moneret-Vautrin is a French Professor of Medicine specialising in allergies and immunology. She is highly published in the area of histamine intolerance but relatively unknown in english speaking countries.
Dr Moneret-Vautrin’s diet is similar to Dr Joneja’s with one exception.
It introduces the idea of foods that result in histamine synthesis in the gut (such as grains and legumes).
Removing grains and legumes dramatically increased my tolerance levels allowing me to eat a broad range of foods and in my experience many (but not all) benefit from this approach.
The Swiss Interest Group
The Swiss Interest Group is a not for profit group run by volunteers.
The benefit of this list is that it is based on a survey of around 600 real people. It means that the foods are likely to have come from a variety of sources, and also tested by eating them rather than in a lab.
The downside of this app is also that it is based on real people whom may have different underlying health conditions. At best therefore the histamine classifications are averages.
The app also does not allow you to personalise the list based on your own experience.
Food Intolerances App By Baliza
The Food Intolerance app uses published research as the source of its information. The research is referenced with a hyper-link.
The app is impressive. It allows you to filter foods into low, medium, high, and very high, for not only histamines but also a wide range of macro-nutrients. Got lactose intolerance? There’s a filter for that. Got glucose issues? There’s a filter for that too. Fructose intolerance. Yep.
Even more importantly, the app allows you to alter the individual ranking of foods, and make personal notes, based on your own bio-individuality. What you end up with is a personalised, portable, food list.
Histamine Intolerance by Ostec App
ALBA, Allergen dataBAnk, and TNO Nutrition & Food Research, have all conducted laboratory experiments, testing the precise level of amines within foods.
The ALBA list appears to be used in the Histamine Intolerance app by Ostec.
The app allows you to filter foods based on whether they are a DAO inhibitors, vitamin B6 antagonist, HNMT inhibitors, mast cell degranulator, or that have lectins, gluten, or lactose.
The reason why this distinction may be important is because histamine intolerance can be caused by either a DAO mutation (that degrades extra-cellular histamine) or an HNMT mutation (that destabilises intra-cellular histamine). Personally, I did not find that I needed to go to this level of detail to get answers.
When you do go into each food you can see the actual amount of each type of amine (not just histamine). This may be useful if your problem is not so much with histamines but with other amines. My problem was with histamines so I did not need this level of detail.
The downside of the app is its usability. You need to go into each food in order to see the amine level of the food (that is that it does not contain a traffic light system nor does it allow you to filter by type of amine). This at best makes the app an advanced “troubleshooting” resource.
The Insider’s Guide to The Low Histamine Food List
This is my own list which you can download for free.
The list attempts to draw on the advantages of the various lists and address their shortfalls. It has been compiled by categorising foods by degree using:
- Scientific Test Results – from the raw ALBA data (from a paid scientific database),
- Clinical Experience – the SIGHI and RPAH Allergy Unit data has been used to verify these results, and
- Differences – where there were differences between the scientific data, and the clinical experience, an underlying cause was identified, and resolved with reference to the scientific literature.
An optional auto-immune protocol list has been provided. This recognises that the auto-immune paleo diet excludes many common food intolerances, and certain foods that can cause histamine synthesis in the gut.
Other food intolerances have not been considered. In my experience, there is such a high divergence in other food intolerances, such that it is confusing and impractical to consider them all.
Which List Should You Choose?
So which list should you choose? The answer is paradoxically any one of them, as they are all credible sources, and at the same time none of them.
Their value is in using the list as a framework to observe your own body and develop your own bio-individual list. So pick the one that resonates with you and start there.
If you need help figuring this out I am now working jointly with a leading naturopath, and a functional doctor, to provide evidenced based solutions. If you want to find out more about the Living Health Clinic, you can schedule a FREE appointment to find out about working with us.