Is a Low-Histamine Diet Really Necessary for You?

If you've scrolled through wellness TikTok lately, chances are you've seen creators touting the low-histamine diet as a cure-all for bloating, hives, anxiety, and more. Their advice? Cut out aged cheese, wine, fermented foods, and other histamine-rich staples, and you’ll feel like a new person. But how much of this viral trend is grounded in science and who, if anyone, really needs to be avoiding these foods?

We spoke with a board-certified allergist and a registered dietitian to unpack what histamines actually are, who might be sensitive to them, and when a low-histamine diet might be worth exploring (and when it’s probably not).

What Are Histamines, Really?

Histamines are naturally occurring chemicals in the body that play several important roles. “Histamines are released by the immune system during allergic reactions,” explains Purvi Parikh, MD, a board-certified allergist and immunologist with the Allergy and Asthma Network. They're what cause symptoms like hives, itching, or swelling in response to an allergen.

But their role doesn’t stop there. According to registered dietitian Marlee Hamilton of Ignite Nutrition, histamines also help stimulate stomach acid, support the immune response, and act as neurotransmitters, influencing communication between the brain and the body.

While everyone has histamines in their system, some people have a harder time breaking them down often due to low levels of diamine oxidase (DAO), the enzyme responsible for histamine breakdown. Others might have overactive mast cells (immune cells that release histamines), which can lead to symptoms even in response to relatively low histamine exposure.

Symptoms of Histamine Intolerance May Include:

• Hives or itchiness

• Headaches or migraines

• Digestive issues

• Nasal congestion or sneezing

• Flushing or low blood pressure

• Anxiety or fatigue

This sensitivity is often called histamine intolerance, though experts caution that it’s not always clearly defined or easy to diagnose.

What Makes a Food High in Histamines?

The histamine content in food generally increases as it ages, ferments, or spoils. This means foods that are cured, smoked, fermented, or stored improperly tend to contain higher histamine levels.

Common high-histamine foods include:

• Aged cheeses

• Cured meats

• Fermented dairy (like kefir or yogurt)

• Kombucha

• Wine and alcohol

• Tomatoes, spinach, and eggplant

• Smoked or canned fish

• Sauerkraut, miso, soy sauce

Hamilton also notes that some substances can block DAO activity, such as alcohol and black or green tea, which may worsen symptoms in people who are already sensitive.

Who Might Benefit From a Low-Histamine Diet?

According to Dr. Parikh, a low-histamine diet may help individuals who experience:

• Chronic hives

• Allergies or asthma

• Mast cell activation syndrome (MCAS)

• Autoimmune diseases

• Symptoms of long COVID

However, research on this diet remains limited, and most evidence is anecdotal. Hamilton agrees, noting that while some of her clients see improvements in symptoms after cutting back on histamines, others notice no change at all.

“Histamine intolerance works like a bucket,” she explains. “You can usually tolerate small amounts, but if your bucket overflows, symptoms show up.”

14 Low-Histamine Foods to Try

If you’re working with a healthcare provider and trying a low-histamine diet, Hamilton recommends focusing on fresh, minimally processed ingredients. Here are some options to include:

• Fresh meat and poultry

• Fish that is frozen immediately after purchase

• Eggs

• Carrots

• Zucchini

• Leafy greens (except spinach)

• Blueberries, apples, pears

• Rice and quinoa

• Whole wheat bread

• Oats

Proper food storage is crucial freezing leftovers is more effective than refrigerating when it comes to slowing histamine formation.

The Risks of Over-Restricting

While there may be benefits for some people, experts caution against embracing the low-histamine diet without guidance. “Fermented foods like kimchi and yogurt offer probiotics that are key for gut health,” says Hamilton. Cutting them out without replacing those nutrients can affect digestion and immunity.

Also, restrictive diets may increase your risk of nutritional deficiencies or disordered eating patterns if not done properly. “If symptoms don’t improve within three to four weeks, it’s time to re-evaluate,” Hamilton advises.

Bottom Line: Is a Low-Histamine Diet Worth It?

For most people, no. "Like many diet trends, the low-histamine diet is often exaggerated on social media,” says Hamilton. While it may help people with histamine intolerance or mast cell-related disorders, it is not a one-size-fits-all solution and it certainly won’t solve every case of bloating or inflammation.

If you suspect histamines could be behind your symptoms, the best course of action is to consult a registered dietitian or healthcare provider. They can help you test a low-histamine approach safely, without compromising your long-term nutrition or relationship with food.

Share this article or subscribe to our newsletter for more science-backed nutrition insights.