10 Signs You Have Histamine Intolerance

Do you have a really odd mix of symptoms? Wondering whether you might have histamine intolerance or a mast cell disorder? While it’s certainly true that histamine issues manifest differently from person to person, there are certain signs of histamine issues that show up time and time again. Here are 10 signs to watch for.


Skin issues are probably one of the most common ways people discover they have histamine issues. Hives after eating too many strawberries or other high histamine foods are a quick indicator that histamine levels are high. Flushing is another common symptom — say, after a glass of wine. A histamine response can be either acute or chronic. Dealing with chronic itching, skin lesions or sores (mastocytosis), overreaction to insect bites, and slow healing can be some chronic skin-related histamine symptoms.


Any type of inflammation can potentially have a histamine connection. This can show up in the form of redness and swelling (with or without pain) and may show up as an enlarged liver or spleen, or liver/spleen/bladder/kidney pain that just doesn’t seem to go away.  The 5 classical signs of inflammation are pain, heat, redness, swelling, and loss of function. When these occur together, you can be pretty sure you’re dealing with inflammation.


Histamine intolerance can also cause weird and random cardiovascular symptoms. You could have tachycardia (racing heart), arrhythmia (irregular heartbeat), palpitations, sudden drops in blood pressure, and even chest pain. You may also find you have unexplained bruises on your body and bleed easily. Learn more about how histamine affects your heart here.


Histamine can also make it difficult for your body to self-regulate and stay in a state of homeostasis. This can lead to episodes of low body temperature, overheating with severe sweating, and an overall sensitivity to heat and cold. Read more about how histamine affects body temperature on this post.


Thanks to the chronic inflammation that goes with histamine intolerance, you may also deal with chronic pain. This could come in the form of bone or joint pain, general all-over body pain, specific tissue pain, headaches, and migraines. Here are some histamine migraine fixes and here’s a recipe for a painkiller in a glass.


Do you deal with gluten intolerance? Are you sensitive to scented candles, perfume, gasoline? Those of us with histamine intolerance don’t do well with a lot of foods or scents/odors. It’s as though anything that stimulates our senses puts us over the top. You can have sensitivities that impact any or all of the five senses: sensitivity to sunlight (eyes), scents (nose), sounds (ears), foods or medications (mouth), and even overreaction to touch. You might swell up like crazy in reaction to an insect bite/sting, and even go into anaphylaxis. You may have an intolerance to medications and even have weird, unexplained reactions to pharmaceutical drugs. You can find a selection of histamine lists here.


This is a big one. The ways histamine can affect your digestive system are seemingly endless: gastrointestinal pain, bloating, persistent diarrhea, chronic constipation, GERD/acid reflux, nausea, vomiting, mouth sores/canker sores, IBS, leaky gut, Inflammatory Bowel Disease, malabsorption contributing to vitamin and mineral deficiencies (for example, iron deficiency or B12 deficiency — anemia), and more. Here are 4 Top Gut Histamine Digestion Tips.


Complete exhaustion. Persistent fatigue, unexplained weakness, shortness of breath, fainting… All these can accompany histamine intolerance and can make it difficult to exercise or even just walk up one flight of stairs. Brain fatigue can also go along with histamine issues causing a general feeling of cognitive impairment/brain fog.


Some of the weirdest symptoms of histamine intolerance have a nerve connection. You could have numbness or tingling in your face, hands, or feet. Your skin may feel like it’s literally on fire. You could have neuropathic pain without being a diabetic. You might have unexplained anxiety… or all these other symptoms could cause you anxiety!


Histamine can really mess with your hormones. Thyroid issues are common. Read this post to find out about the oxalic acid connection. Estrogen dominance plays a huge role in histamine issues. Women may have difficult periods with lots of pain and bleeding. Menopause may even bring on histamine intolerance.


You could have immune system problems, enlarged lymph nodes, recurrent infections, vertigo, tinnitus or hearing problems, eye problems, hair loss…  The list behind this post comes from Mastocytosis Canada’s website. You can also check out http://www.mastcellmaster.com for more information.


Mast Cell Activation Syndrome

What is Mast Cell Activation Syndrome?
Mast cells, a type of blood cell, play an important role in the body’s immune system. They reside in all body tissues and form part of the body’s initial defense system. Mast cells react to foreign bodies and injury by releasing a variety of potent chemical mediators, such as histamine, when activated. In a healthy person these chemicals will act beneficially to protect and heal the body, but in a person with MCAS these same chemicals are inappropriately triggered and released and have a negative effect on the body. Among the triggers are a variety of different foods, exercise, chemicals, fragrances and stress. Many sufferers struggle to identify their triggers and continue to discover new triggers for many years after diagnosis.

MCAS forms part of a spectrum of mast cell disorders involving proliferation and/or excessive sensitivity of mast cells, it has been identified since 2007. It features inappropriate mast cell activation with little or no increase in the number of mast cells, unlike in Mastocytosis*. MCAS causes a wide range of unpleasant, sometimes debilitating, symptoms in any of the different systems of the body, frequently affecting several systems at the same time. The onset of MCAS is often sudden, affecting both children and adults, sometimes in family groups, mimicking many other conditions and presenting a wide-range of different symptoms that can be baffling for both the patient and their physician. Often there are no obvious clinical signs since MCAS confounds the anatomy-based structure underpinning the traditional diagnostic approach. Very often Mast Cell Activation Syndrome is hiding in plain sight.

MCAS presents through a wide range of symptoms in multiple body systems, ranging from digestive discomfort to chronic pain, mental health issues and anaphylaxis.

Some key aspects of MCAS are:

  • The symptoms impact more than one body system.
  • People often experience a dramatic step change in symptoms after, perhaps, years of mild symptoms.
  • The symptoms are often episodic or cyclic and wax and wane with varying degrees of intensity, sometimes worsening over time.
  • There is often histamine involvement and will therefore include typical allergy symptoms such as itching, rashes, swelling, inflammation and vomiting.
  • The triggers are many and varied some easily recognized some not, among them environmental chemicals, foodstuffs, heat, cold and exercise.
  • MCAS can present simultaneously in patients who have Ehlers Danlos Syndrome (EDS) a connective tissue disorder, and/or Postural Orthostatic Tachycardia Syndrome (POTS).

The available treatments for MCAS stabilize the mast cells and mitigate the effects of the chemicals they release, e.g. anti-histamines and mast cell stabilizers. Avoiding triggers is also a key part in coping with this illness. See Support and Resources for publications.

There is a wide range in the variety of patients’ response to treatment. It can often take some time to work out what the best medication and dosage are. An added complication is that many patients suffer adverse reactions to the drugs themselves or to the fillers, colouring and preservatives. With a trial and error approach many patients are successful in moderating their symptoms although quality of life can still be affected.



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Hidden food intolerance: Histamine


When the body does not break down histamine from foods, and it leaks through the intestinal lining, it enters the bloodstream and can cause an immune response.

A person’s allergic response symptoms are likely to be more severe the more histamine they have accumulated in their bloodstream.

People with histamine intolerance tend to have a variety of symptoms that can make it difficult to determine the source.

What are the symptoms?

The symptoms of histamine intolerance vary but tend to mimic those of other allergic reactions.

Common symptoms include:

  • diarrhea
  • chronic headache
  • flushing, especially of the head and chest
  • irritable bowel syndrome or IBS
  • congested, runny, or itchy nose
  • red, itchy, or watery eyes
  • sneezing
  • shortness of breath
  • hives or red, raised, itchy, burning bumps
  • very itchy skin
  • unexplained anxiety
  • stomach cramps or pain
  • chronic constipation
  • nausea and vomiting
  • gas or bloating
  • unexplained exhaustion
  • dizziness
  • very dry, patchy, or scaly skin (eczema)
  • irregular or increased heart rate
  • severe menstrual pain

Less common symptoms include:

  • low blood pressure
  • sleep problems
  • swelling around the lips, eyes, and occasionally the throat
  • tremors
  • loss of consciousness

How does diet play a role?

Citrus fruits are high in histamines.

Most people associate histamine with immune responses in the body.

But almost all foods and drinks contain some level of histamine, and these usually increase as the food ages, spoils, or ferments.

Some foods and drinks also contain compounds that help release histamine in the body or block the production or effectiveness of the enzymes DAO and HMNT.

Researchers are still working out how much histamine is in most foods and drinks, as well as precisely how some nutrients impair DAO and HMNT activities.

According to the current research, everyday foods and drinks rich in histamine include:

  • alcohol
  • aged cheeses
  • canned, pickled, and fermented foods
  • smoked products, such as sausage, ham, bacon, or salami
  • legumes, such as chickpeas, soybeans, and lentils
  • vinegar
  • many prepared meals
  • yogurt
  • salty snack foods
  • sweets with preservatives
  • chocolate and cocoa
  • green tea
  • most citrus fruits
  • pineapple
  • canned fish, such as mackerel and tuna
  • peanuts
  • spinach
  • tomatoes
  • bananas
  • eggplant
  • strawberries
  • cherries
  • chili powder
  • cinnamon
  • cloves

Foods that may trigger the release of histamine include:

  • most citrus fruits
  • cocoa and chocolate
  • tomatoes
  • wheat germ
  • additives, preservatives, and dyes
  • beans and pulses
  • nuts

Foods that may interfere with DAO and HMNT levels or actions include:

  • alcohol
  • energy drinks
  • green tea
  • black tea
  • mate tea
  • raw egg whites
  • some yogurt, depending on bacteria type

Many kinds of bacteria, especially common food contaminants, can also produce a type of histamine in the gut. If these bacteria colonize the gut and multiply, they can generate enough histamine to cause symptoms.

People who may have histamine intolerance or are looking to reduce or reverse the condition will often need to go on a low-histamine diet. Usually, this means limiting the intake of histamine-rich foods rather than excluding them entirely.

People with histamine intolerance should also focus on increasing their intake of foods and drinks low in histamine.

Foods and drinks with low levels of histamine include:

  • skinned fresh chicken
  • cooked egg yolk
  • fresh or flash-frozen meat and fish
  • most fresh vegetables except tomatoes and eggplants
  • most fresh fruits and berries besides citrus fruits, strawberries, and cherries
  • fresh, pasteurized milk and milk products
  • whole-grain noodles, breads, crackers, and pastas
  • coconut and rice milk
  • cream cheese
  • butter
  • most non-citrus based juices and smoothies
  • most herbal teas except black, green, and mate tea
  • most leafy greens except spinach
  • most cooking oils

Several vitamins and minerals are necessary for the proper activity of DAO. So, people with histamine intolerance may benefit from including more foods and drinks rich in these nutrients in their diet.

People can take supplements if it is too difficult to get some nutrients because of low-histamine diet restrictions or availability.

Vitamins and minerals that may be good for people with histamine intolerance include:

  • vitamin B-6, which helps DAO break down histamine
  • vitamin C to help lower histamine blood levels and help DAO break down histamine
  • copper, which helps raise DAO blood levels slightly and helps DAO break down histamine
  • magnesium that can raise the allergic response threshold
  • manganese that can enhance DAO activity
  • zinc to help DAO break down histamine (it may also have anti-inflammatory and anti-allergic properties)
  • calcium to help reduce hives and skin flushing
  • vitamin B-1
  • vitamin B-12
  • folic acid

How is it tested?

There is no single, conclusive way that doctors can diagnose histamine intolerance. Ruling out all other potential medical causes is how they diagnose most people.

An allergist or immunologist will often begin by testing someone for food allergies and intolerances if they suspect they may have histamine intolerance.

A specialist called a gastroenterologist might test people with chronic intestinal symptoms for intestinal conditions, such as:

People with suspected histamine intolerance are also often asked to keep a food diary for at least 2 to 4 weeks so a doctor can identify symptom and diet patterns. Doctors can also request a blood test to check people’s DAO levels and enzyme activity levels.

Lastly, researchers have proposed a skin-prick test for diagnosing histamine intolerance, but it is not widely used and has not been proven repeatedly reliable.

In most cases, making dietary changes, as well as taking anti-histamines or enzyme supplements, may help manage histamine intolerance within a few weeks.

But to keep symptoms at bay, most people need to limit or avoid histamine-rich foods for a few months. People recovering from histamine intolerance will also generally need to avoid or limit the use of medications known to trigger histamine release for a similar time.

Focusing on fresh, non-packaged or prepared foods is also crucial if someone is recovering from histamine intolerance by limiting histamine levels found in everyday foods.