Histamine in Food and Hives: Why Itching Without a True Allergy?

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Table of Contents

  1. What is Histamine and What Role Does It Play in Our Body?
  2. What is Histamine Intolerance? – How It Differs from True Allergy
  3. Foods High in Histamine
  4. Key Symptoms of Histamine Intolerance
  5. Diagnostic Methods and Role of Professionals
  6. How to Manage Histamine Intolerance?
  7. Freedom Through Diet, Reclaiming Healthy Skin


 Due to changes in modern diets and lifestyles, the number of people suffering from histamine intolerance is gradually increasing, but it is still not widely known, causing many to suffer from unknown causes. Today, we will learn in detail what histamine in food is, what histamine intolerance is, how it is diagnosed, and how to manage it. We hope you regain freedom from unknown itching and hives and reclaim healthy skin.


1. What is Histamine and What Role Does It Play in Our Body?

Histamine is a type of biogenic amine that is naturally produced in our bodies or consumed through food. It performs various physiological functions and is particularly closely related to immune responses.

  • Concept:

    Histamine is a chemical substance stored in mast cells or basophils in the human body and released by specific stimuli. It is also produced during the fermentation or decomposition of food by bacterial action.

  • Role in the Body:
    • Immune Response and Allergies: It is a key substance in the immune response to foreign invaders (allergens). When histamine is released, blood vessels dilate and vascular permeability increases, leading to inflammatory responses and allergic symptoms (itching, runny nose, sneezing, hives, etc.).
    • Gastric Acid Secretion Regulation: It also plays a role in promoting gastric acid secretion in the gastrointestinal tract to aid digestion.
    • Neurotransmitter: In the brain, it acts as a neurotransmitter, influencing the sleep-wake cycle, appetite, and cognitive functions.


2. What is Histamine Intolerance? – How It Differs from True Allergy

Histamine intolerance is not an 'allergy' to histamine, but rather a condition that occurs when the body accumulates excessive histamine due to a deficiency of enzymes that break it down.

  • Concept:

    Normal individuals rapidly break down and excrete histamine consumed through food or produced in the body using an enzyme called 'DAO (Diamine Oxidase)'. However, if the function of the DAO enzyme is reduced or deficient, even a small intake of histamine can lead to an excessive accumulation of histamine in the body, causing various symptoms.

  • Main Causes:
    • DAO Enzyme Deficiency or Impaired Function: The most common cause, genetic factors, intestinal diseases (such as Crohn's disease, celiac disease), chronic inflammation, and certain medications can interfere with DAO enzyme production or activity.
    • Gut Health Issues: Imbalances in gut microbiota (such as leaky gut syndrome) can lead to excessive histamine production in the gut or inhibit DAO enzyme production, exacerbating the problem.
    • Certain Medications: Some medications (e.g., antidepressants, diuretics, certain antibiotics) can inhibit DAO enzyme activity, causing or worsening histamine intolerance symptoms.
  • Differences from Allergy:
    • Mechanism: Allergies involve the immune system recognizing a specific substance (allergen) as harmful, producing antibodies, and triggering an overreaction. In contrast, histamine intolerance is not an immune reaction but a 'metabolic disorder' due to a deficiency of histamine-degrading enzymes.
    • Symptom Onset: Allergies show immediate and strong reactions to small amounts of a substance. In contrast, histamine intolerance symptoms appear proportional to the 'amount' of histamine consumed, and sometimes symptoms can be delayed for several hours after consumption.
    • Diagnosis: Allergies are diagnosed through blood tests (IgE antibody tests) or skin prick tests, while histamine intolerance is not diagnosed by these tests but primarily through an 'elimination diet'.

3. Foods High in Histamine

If you have histamine intolerance, you should be careful when consuming the following foods. Histamine content is particularly high in aged or stored foods and processed foods.

  • Aged or Fermented Foods:

    Cheese (especially aged cheese), yogurt, sauerkraut, kimchi, soy sauce, miso, vinegar, beer, wine (especially red wine), champagne, etc.

  • Processed Meats:

    Sausages, ham, bacon, salami, and other processed meats.

  • Certain Fish:

    Oily fish like tuna, mackerel, saury, sardines (histamine content rapidly increases as freshness decreases).

  • Some Fruits & Vegetables:

    Spinach, tomatoes, eggplant, avocado, strawberries, citrus fruits (oranges, lemons, etc.), kiwi, bananas.

  • Chocolate, Cocoa:

    Can be high in histamine or promote histamine release.

  • Others:

    Yeast extract, food additives (some colorings, preservatives), black tea, etc.


4. Key Symptoms of Histamine Intolerance

Histamine intolerance can cause a wide range of systemic symptoms, often making diagnosis difficult.

  • Skin Symptoms:

    Hives (welts), itching, skin rash, flushing (especially on the face and neck), worsening of eczema, etc.

  • Digestive Symptoms:

    Abdominal pain, diarrhea, constipation, nausea, vomiting, abdominal bloating, heartburn, etc.

  • Respiratory Symptoms:

    Runny nose, nasal congestion, sneezing, worsening of asthma, shortness of breath, etc.

  • Neurological Symptoms:

    Headaches, migraines, dizziness, difficulty concentrating, fatigue, insomnia, anxiety, etc.

  • Cardiovascular Symptoms:

    Palpitations, arrhythmias, hypotension, or blood pressure fluctuations, etc.

  • Other Symptoms:

    Muscle pain, joint pain, worsening of menstrual cramps, edema (swelling), etc.

5. Diagnostic Methods and Role of Professionals

There is no standardized diagnostic method for histamine intolerance yet, but it is primarily diagnosed through an 'elimination diet'.

  • Diagnostic Methods:
    • Elimination Diet: This is the most important and effective diagnostic method. Maintain a strict diet avoiding high-histamine foods for 2-4 weeks and observe changes in symptoms. If symptoms improve, reintroduce foods one by one to identify which foods trigger symptoms. This process must be conducted under the guidance of a professional.
    • Blood Test: A test to measure DAO enzyme activity in the blood is available, but it is still in the research stage and not applicable to all patients.
    • Genetic Test: A test to check for variations in the DAO enzyme gene is also available, but a genetic variation does not necessarily mean symptoms will appear, so it is used as a supplementary diagnostic tool.
  • Role of Professionals:
    • Doctor (Dermatologist, Allergist): Provides an accurate diagnosis to rule out other conditions (true allergies, autoimmune diseases, etc.) and may consider prescribing medication for symptom relief if necessary.
    • Dietitian/Nutritionist: Plans the histamine intolerance diet, helps supplement potentially deficient nutrients, and provides practical advice on food alternatives and cooking methods. This is essential for patients to maintain a healthy diet without nutritional imbalance.

6. How to Manage Histamine Intolerance?

The core management strategy for histamine intolerance is diet control and lifestyle modification.

  • Maintain a Low-Histamine Diet:

    Restricting high-histamine foods is paramount. Since individual thresholds vary, it's crucial to accurately identify and manage the foods that trigger your symptoms through an elimination diet.

  • Consume Fresh Foods:

    The less fresh food is or the longer it's stored, the more histamine is produced. Therefore, it's best to buy fresh ingredients and consume them immediately after cooking.

  • Consider DAO Enzyme Supplements:

    If needed, taking DAO enzyme supplements before meals can help break down histamine in food. (However, always consult with a professional before taking supplements.)

  • Manage Gut Health:

    Gut health is closely related to histamine intolerance. Consume foods rich in probiotics and prebiotics, and improve conditions like leaky gut syndrome to maintain a healthy gut environment.

  • Stress Management:

    Stress can promote histamine release in the body. It's important to find and practice stress management methods that suit you, such as meditation, yoga, or regular exercise.

  • Review Medications:

    Check if any currently taken medications contain ingredients that inhibit DAO enzyme activity, and if necessary, consult your doctor to consider medication adjustments.

7. Freedom Through Diet, Reclaiming Healthy Skin

If you have suffered from unknown itching and hives for a long time, consider histamine in food and seek professional help. By carefully observing how your body reacts to things and continuously striving to improve your diet and lifestyle, you will surely regain freedom from food and reclaim healthy, comfortable skin. Knowledge is power. Now, start your new journey to health right from your dining table!