Histamine Intolerance : Which Food List Should You Use?

August 6, 2014  |  Blog, Histamine Intolerance

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

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 Swiss Interest Group Histamine Intolerance (SIGHI) list is also available as a histamine intolerance app.

histamine intolerance App by Escaleto

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

food intolerances iphone 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.

Histamine Intolerance IPhone 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.

sidebar-histamine-foodlist

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.

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  • Dot SLady

    I appreciate having this comprehensive list, including sources I’d not heard of (Dr. Moneret-Vautrin). I would have REALLY appreciated this at the beginning of my journey, so those just learning: this is so helpful! I think I could use a FODMAP, low-histamine app.

    • Hi Dot thanks for stopping by and reminding me about FODmaps. I think this area of “fermenting” foods is a link missing from much of the debate. I want to do a post on FODMaps, SCD, and GAPS and how it fits into HIT. Thanks for sharing.

      • Dot SLady

        Excellent, I look forward to your thoughts!

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  • Emily

    Just learned about histamine intolerance this week and strongly wonder if this is my and my child’s issue. We have environmental and food allergies/intolerances, I’ve dealt with anxiety/panic attacks, fatigue, brain fog, depression. Went low carb and felt better bc realized had food intolerances… Then did paleo… Now on SCD to heal gut but need a good low histamine list!! Too many contradictions! :/ Emily

    • Hi Emily it certainly is worth trying a histamine elimination diet for 2 weeks to confirm. I will also shortly be offering testing options. In terms of lists I suggest that you just pick one and start working with it. Fingers crossed you get your answer.

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  • Shelley

    This was wonderful! I wish it was easier to navigate which list to use, but I have been so impressed by your research on this site, I think I will start with yours. I just discovered this week that my and my children’s issues are histamine intolerance (my son and I have had 23andme testing and are both homo for MAO A). All three of us have very obvious symptoms, but all manifesting very differently. Imagine my relief to realize they all stem from one problem! We ate a 75% histamine diet, with lots of leftovers, bone broth, crock pot meals, and fermented veggies! Poor kids! I can’t wait to begin feeling well!

    • Thanks Shelley much appreciated; been there done that myself too! The best list is our own body. Go well.

  • Shelley

    Question… I notice the absence of mineral water (still or sparkling). Is there a link between mineral water and histamine? I ask because when I drink it, I seem to have a reaction. I have the same reaction with red salt (Real salt, himalayan). Thank you!

    • spring water (sparkling) is on the list as moderate. I would wonder though if something else is going on (like a mineral issue).

      • Shelley

        I know… I am trying Celtic sea salt to see if it gives the same reaction as the pink salts.

      • Shelley

        I have discovered that our issues are stemming from a moldy house (in the AC, not black mold so we could not smell it) and then a new construction house with all new furniture+clothing+textiles (1 year ago). I believe the salt/mineral sensitivity started in the old house, but has become worse in the new. This will require more thought and research…

        • mould can be a huge trigger, as can the chemicals in furniture and textiles.

  • Deepa Garge

    Hi Alison, can you share your copy of the list with me?

    • HI deepa; just hit “yes Please” at the top of the page and you will get emailed it. Hope it helps!

  • pixie.tanner

    When you list currants as Medium histamine, do you mean the dried Corinth grapes that are sold under the name currants, or redcurrants and blackcurrants?

    • hi pixie, I mean redcurants, black currants, white currants etc. Hope that helps.

  • Janice Taylor

    I chose the Food Intolerance App by Bali since I am negative for gluten MH, lactose. I am positive for beta 11 prostagladins, and reacted to soy, soy lecthins. I sign up up but not getting emails to confirm

  • Trish Tambellini

    Hi, I wanted to check in on the mention of broccoli in your high list. On most other lists it’s written up as low. Wondering if it was just one that set of reactions in your personal experience? Also, do you find the apple cider vinegar that’s raw and unpasteurized is okay? I’ve seen arguments for both so wondering your thoughts on this one. Thanks so much!

  • Katherine Arbuckle

    Hi Alison,
    I understand that leftover protein can be high histamine, but what about leftover cooked vegetables, like leftover sweet potatoes, squash, and green beans kept in the frig?? Also, are herbal teas like chamomile and peppermint low or high histamine? The lists out there are confusing! Thanks

    • Cooked vegetables are usually not so much of a problem. It is the bacteria and protein that generates histamines. It is best to use fresh herbs if possible. They are nutritionally much more dense and anti-histamines/mast-cell stabilisers. Peppermint and Chamomile are very easy to grow also. I believe the reason that purchased ones can be not so well tolerated may be due to mould or chemical treatments on either the herbs or the bags. Eating fresh organic foods will always in my opinion be the safest route.

      • Katherine Arbuckle

        Thank you, that helps a lot!

        • yes as avocado (like a few fruits) has natural chemicals and is not derived from bacterial decomposition.

          • Katherine Arbuckle

            Thank you again, Alsion. You are a valuable resource! I am very appreciative.

          • my pleasure

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  • Miren Hary

    Again awesome, I am up to this part of the connection between histamines and salycilates, Thank you 🙂

    But where do i get a list?

  • Miren Hary

    Hi Alison, after going through different layers of eliminations, hmmmm i am thinking that I am histamine, salicylate intolerant and sensitive oxylate and don’t do well on purines. eek ,, have you even heard of someone like this.

    • Of course but it is my opinion that this is something that points to an underlying issue that can be resolved through functional testing.

  • Miren Hary

    yes, but isn’t salicylate intolerance a gene variant. I look around my large family gruop and i am seeing signs loud and clear now. I was not so ready buy into the salicylates until a number of really “wow” events where refiled in my mind and suddenly make more sense with in that context.

  • Eva Platts

    Alison-i signed up too but did not get the list, could you help me? We do have sal, amines, oxalates,histamine and sulphite issues here plus many allergies (peanuts, walnuts, hazelnuts,soy, wheat, corn ,sesame, legumes)…MCAD -is causing frequent ANA episodes,leaky gut,POTS,EDS,Mold injury that triggered MCAS, Hashimoto -my son is 10. Than my daughter is almost 8 but my son is more severe.

    Wonder about liver involvement at this time.

    I wonder about SIBO,PKU,H pylori, C diff. Also Thyroid/hormone.adrenals cause high histamine if troubled. Than we have MTFHR issues too.I

    enjoy reading your site.

    You mentioned functional testing to resolve underlying issues as we have, did you mean an ND?
    Thanks, Eva

    • Hi eva
      Can I suggest you check your junk folder? It is automatically emailed out straight afterwards and it is typically sitting there.

      I now use functional testing as my sole means of working. You can get the functional testing through me or any doctor that works in a functional medicine model. I have a systematic way of working now along these lines. I am not sure what country you are in but many countries have databases of practitioners who work in this model.

  • Becky

    I am unable to open the Dr Moneret-Vautrin link. It says it doesn’t exist; is this true, or can I not access it in the states?

    • Oh thanks Becky they seem to have updated the link. Ill need to find where it has moved to and update it when I can. Thankyou for drawing it to my attention.

  • Fredrik

    Hello! I see that you have mozzarella on your list as “high”. How come? I’ve personally never had any problems with it and i thought it was a fresh cheese? Thanks 🙂

    • Hi Frederik mozarella cheese is aged, but not as long as parmesan. There is also the thresshold issue to consider. If you can tolerate it then eat it.

  • Becky

    Alison, you have cinnamon under a seeds list and rated it high. Is the spice included in that rating?

  • John Davies

    Thanks for the tour of the possibilities. Conflicting lists are a regular problem for HI people, and this helps.

    I wonder if the main reason you did well on the no grains & legumes list was that they have high lectins, which release histamine from mast cells?

    • Of course that can be an issue with mast-cell activation but I believe there is a secondary issue which has to do with carbohydrate fermentation also per the research which I find shows up on testing on an organic acids test.