Histamine intolerance


A histamine intolerance, also known as histamine intolerance, represents an intolerance to histamine, a certain food component. It is assumed that histamine intolerance is not a congenital disorder, but arises in the course of life from as yet unknown causes.
The intolerance to histamine is scientifically controversial. The mechanism by which this intolerance develops has not yet been clarified. However, there are some scientific theories on the subject. It is assumed that histamine intolerance is not a classic food allergy, but an impaired breakdown of histamine.

What is histamine?

Histamine is absorbed by humans through certain foods. Different foods differ in their histamine content. After the histamine has been absorbed, it is reabsorbed with the other food components via the intestine and from there converted into other substances by enzymes.

This breakdown of histamine is disturbed in the case of histamine intolerance. This explains that affected people feel discomfort, especially after eating foods with a high histamine content. Therapy for histamine intolerance consists of avoiding foods with a high histamine content.

Histamine is a substance that occurs naturally both in the body and in a number of different foods. In the body, histamine is known for important processes in the transmission of information Neurotransmitters in action.

Histamine also plays an important role in the defense function of the immune system as well as in the production of gastric acid and digestion. Histamine is also responsible for opening small vessels and has positive effects on the heart. For this reason, a certain amount of histamine in the body is essential for everyone.


The symptoms of histamine intolerance mainly occur after eating histamine-containing foods and can be varied and individually very different. However, there are typical symptoms that are associated with the disease.

The main focus is on symptoms that affect the skin. This is due to the fact that histamine is involved in inflammatory reactions and the widening of the small vessels, among other tasks in the body. This results in a so-called "Flush symptoms“With a reddening of the face and chest area and possibly occurring skin problems. These include, for example, reddening of the skin (especially on the face and chest area), hives, rashes and itching.
Please also read our article on this Flush syndrome

General complaints such as tiredness and headaches are also very common. Other symptoms include gastrointestinal complaints (abdominal pain, digestive problems, nausea). In severe cases, there may be breathing problems, often with a "runny nose" or sore throat being the foreground. Water retention, heart and blood pressure disorders, confusion or sleep disorders can also occur.

The symptoms typically occur after consuming certain histamine-containing foods, such as Tomatoes. This is why the term tomato allergy is also known.

Learn more at:

  • You can recognize histamine intolerance by these symptoms
  • Tomato allergy


Diarrhea is a classic symptom of histamine intolerance. The increased level of histamine in the body leads to a contraction of the muscles in the gastrointestinal tract. On the one hand, stomach cramps develop. On the other hand, the stool is transported through the intestine much faster and not enough fluid can be absorbed. This then leads to diarrhea.

Symptoms around the eyes

The symptoms in the eyes are not as typical for histamine intolerance as, for example, the skin rashes. Nevertheless, reactions to the intake of histamine can also be seen in the eye region. This can lead to water retention in the eyelids, which makes them swell and it may no longer be possible to close the eyelids.

Furthermore, the intake of histamine can lead to conjunctivitis (Conjunctivitis) to lead. Conjunctivitis is characterized by reddening and itching in the eye. In addition, there is an increased production of tears.

The conjunctivitis is initially triggered solely by the reaction to the histamine. In the course of the disease, an infection, for example with bacteria, can also occur. The conjunctivitis can then turn into a purulent infection, which should be treated by a doctor in order to avoid consequential damage.

What does the rash look like if I have histamine intolerance?

The rash caused by histamine intolerance can take different forms and forms. On the one hand, simple reddening can occur on various skin areas. These are usually accompanied by itching. On the other hand, symptoms of hives can develop. The skin also reddens in this reaction and wheals develop. Wheals are point-like or flat elevations on the skin.

Read more on the subject below: Rash with wheals

These bumps are caused by water retention in the skin, which is triggered by the histamine. Hives are also associated with itching. The third possible skin rash with histamine intolerance is eczema. Eczema go through different phases with different degrees.

At the beginning there is a reddish rash, which can form blisters in the course. These blisters then become encrusted and a scaly rash appears. A so-called flush can occur in the area of ​​the face. The flush is a medical term for facial skin flushing. As a result of the reaction to the histamine, the blood vessels in the face expand and the skin becomes more reddened.


The exact cause for the development of a histamine intolerance is not yet known. It can be assumed that the activity of the so-called Diamine oxidase (DAO) is reduced in affected people and thus after eating foods containing histamine Histamine cannot be broken down, this builds up in the body and causes the known symptoms.

The reason for the reduced activity of the enzyme is not yet known. Since the symptoms usually appear in the course of life, it is assumed that it is not a congenital intolerance, but rather that it only appears in the course of life. There is evidence that Tobacco smoke has an effect on the development of histamine intolerance, although sufficient evidence is lacking to make a clear statement about this.

The symptoms that arise as part of the disease can be explained by the natural role of histamine in the body. The reduced breakdown leads to a so-called pseudo-allergic reaction which due to the histamine is too typical for a Symptoms of allergy leads.

Can histamine intolerance be triggered by stress?

It is unlikely that histamine intolerance is triggered by stress alone. It is known that the body's own histamine is released during stress. However, these are rather small amounts which should not normally trigger any symptoms. However, stress can be an aggravating component.

The cause of histamine intolerance is the insufficient presence of the enzyme diamine oxidase (DAO). This deficiency is based on a metabolic disorder and cannot be caused by stress. But if people with a deficiency of this enzyme consume histamine, it cannot be sufficiently broken down and symptoms can develop due to the too high concentration of histamine.

Stress can then exacerbate this situation as it leads to further histamine release.

What do you have to consider when doing sport?

When exercising, the body gets into a stress reaction, especially when it is overexerted. The body's own histamine is then released. As the blood vessels widen, the histamine can spread well and possibly lead to symptoms.

On the other hand, exercise helps to reduce everyday stress and has a positive effect on the entire body. Therefore, one should not forego sport, but simply make sure to avoid excessive overexertion.How much sport the body can tolerate varies greatly from person to person and must be tried out.

Test for histamine intolerance

There are various methods of determining histamine intolerance, but there is no uniform recommendation for a specific test procedure. The tests are best done in consultation with a doctor.

The most common method, and probably with the least effort, is the so-called elimination diet with the following provocation test, if applicable. Food with a high histamine content is avoided for some time. After some time, a provocation, in this case controlled eating of foods containing histamine, can be used to determine whether histamine intolerance is present.

Alternatively, the activity of the enzyme can be tested, which is normally responsible for breaking down histamine and which may be impaired in the case of histamine intolerance. This can be done with the help of a blood test or by examining the small intestine using a biopsy.

Tests that examine the stool or urine for histamine or its breakdown products are less meaningful.

Medical care should be available for all tests and careful attention should be paid to whether it is desirable to dispense with histamine-containing products for the selected test or whether the result may be falsified.

More on this: This is how you can test for histamine intolerance

Is there a blood test for histamine intolerance?

If the doctor suspects that there is a histamine intolerance, histamine and the enzyme diamine oxidase (DAO) are determined in the blood. The diagnosis can then be made or ruled out by looking at these two blood values ​​together. If the blood level of the enzyme DAO is below 3 U / ml (units per milliliter) one can assume a histamine intolerance.

If the blood level is above 10 U / ml, the diagnosis is unlikely. With all values ​​between 3 to 10 U / ml, histamine intolerance is likely, but it should also be clarified by further tests, such as histamine abstinence. It is important that histamine is not specifically avoided in the days before the blood sample, as this can falsify the blood value.


The treatment of histamine intolerance depends on the severity of the complaints and the problems that exist despite not eating foods that typically contain histamine. It should be noted that there is no causal therapy for histamine intolerance. This means that all therapeutic approaches can only treat the symptoms of the disease and the The cause of the emergence of the intolerance cannot be treated. The complaints, however, are usually beyond the various available therapy options very easy to get to grips with.

In many cases that is enough Avoiding certain foods off to a complete freedom from complaints to get. Tables with a list of problematic foods can help here Diet plan to create. Over time, personal experience can help to filter out particularly problematic foods and thus further narrow down the nutrition plan.

If not eating foods that contain particularly histamine is enough to relieve symptoms, other therapeutic approaches can be undertaken. So can so-called Antihistamines which can usually control the symptoms caused by histamine very well. The same effect can be achieved by taking Cromoglicic acid to reach. These medications can be taken if food containing histamine has been consumed and symptoms occur despite known histamine intolerance.

Another controversial therapy option is the Administration of vitamin B6, which is supposed to stimulate the body's own production of the enzyme, which is disturbed in people with a histamine intolerance.

Which doctor treats histamine intolerance?

Histamine intolerance can be treated by your family doctor or an allergist. The family doctor is usually the first point of contact in case of complaints. If he is familiar with the histamine intolerance and can prove it with a blood test, you do not necessarily have to be referred to a specialist in allergology.


Foods like red wine contain a lot of histamine - if you do without them, the symptoms are alleviated

Histamine intolerance is an intolerance to histamine, which enters the body through diet. The symptoms are probably caused by the insufficient breakdown of histamine due to an underactive enzyme. The nutrition is therefore an important factor in the Detection and therapy histamine intolerance.

Since different foods have different levels of histamine, people who suffer from histamine intolerance should avoid certain foods in particular. Foods that are affected by a bacterial fermentation have a high histamine content. Such are special products like certain ones Cheeses such as smoked meat and fish such as beer and red wine rich in histamine. Histamine can also be used in Breakdown of certain products arise, which is why certain foods can cause problems even with a relatively low histamine content.

alcohol can also increase the effects of ingested histamine.

Food tables

There are a number of different tables that list foods that are typically high in histamine. Not only that direct concentration of histamine, but also the Effect of certain food ingredients in the body for one increased amount of histamine can worry, foods with relatively low levels of direct histamine often appear in the tables.

Although the tables often provide a good overview of foods with a high histamine content, there may be individual fluctuations, which often come with the Storage and age of the food correlate. So help Empirical values about problematic foods in individual cases much better than tables to keep the individually occurring symptoms under control.

Can hair loss be triggered by histamine intolerance?

Hair loss is an atypical symptom of histamine intolerance. So far, no connection between histamine intolerance and hair loss has been scientifically proven. So in the case of hair loss, other causes should be investigated.

Weight gain due to a histamine intolerance

Weight gain from histamine intolerance alone is rather unusual. Histamine intolerance triggers various gastrointestinal complaints such as flatulence, stomach pain, increased stool frequency and diarrhea. The diarrhea in particular causes you to lose a lot of fluids, and you tend to lose weight temporarily as a result of the fluid loss.

Depression due to a histamine intolerance

There is a connection between histamine intolerance and mood swings, as well as a depressive mood. This can lead to increased tiredness and exhaustion. If you have a sleep disorder caused by histamine intolerance, you may feel upset, which can also be depressive.

Additional symptoms may include increased nervousness and confusion. Suspicion of histamine intolerance should be clarified, especially before drug therapy for depression.

Medicines such as amitriptyline, which is a commonly used preparation, inhibit diamine oxidase (DAO) in the body. Instead of improving the depressive symptoms, the further increase in histamine can also lead to a deterioration.

Histamine intolerance due to alcohol

Histamine is found in foods that have been fermented by bacteria. This also includes beer and red wine. They are both extremely intolerant to people who are histamine intolerant. In red wine, the histamine content depends on the degree of ripeness. Dry white wine or sparkling wine is better tolerated.

Nevertheless, one should be careful when consuming alcohol, as not only the histamine in alcoholic drinks can cause problems. Alcohol also leads to the release of the body's own histamine. At the same time, the alcohol makes the intestinal wall more permeable, so that more histamine can be absorbed.

The enzyme diamine oxidase (DAO), which is not present in sufficient numbers in the case of histamine intolerance, is additionally inhibited by the alcohol. As a result, the histamine can hardly be broken down and the typical symptoms develop. This can also be increased when alcohol is consumed because the blood vessels are widened by the alcohol. This promotes blood circulation and contributes to the intensification of symptoms.

Caution is also advised with mixed alcoholic drinks. Here the additives can also contain significant amounts of histamine.

Histamine intolerance from coffee

Coffee naturally contains varying amounts of caffeine. The caffeine is also the component to which people with a histamine intolerance are sensitive. Caffeine releases histamine in the body and, like alcohol, inhibits the enzyme diamine oxidase (DAO). As a result, the increased histamine in the body cannot be broken down and those affected develop symptoms.

Since caffeine alone is responsible for the increased concentration of histamine in the body, decaffeinated coffee can be drunk as an alternative. No increase in the body's own histamine is to be expected during consumption and is therefore well tolerated. Another alternative to classic coffee can be grain coffee.

However, it does not always have to be necessary to completely avoid caffeine. In the time after the diagnosis, you should avoid all foods containing histamine if possible. This is the so-called waiting period. Gradually, you can then test how much caffeine can be tolerated by the body. The individual limit can be very different.

It is also recommended to prepare the coffee or espresso in an espresso maker, as there is less risk that histamine residues will remain in the boiler, which would then flow into the next coffee.

Also read our article on the subject below: Caffeine

Further information

Further information on the subject of histamine intolerance can be found here:

  • Vitamin B6
  • Antihistamines
  • nutrition
  • Lactose intolerance
  • Gastrointestinal disorders

You can find an overview of all information on internal medicine under Internal Medicine A-Z.