For the diagnosis of histamine intolerance The presence of two or more of the typical symptoms is assessed: itchy and runny nose, redness on the skin, vomiting, diarrhea, headaches… A low histamine diet should reverse all symptoms.

When you eat foods high in histamine, it reacts with your bacteria and considerably increases its levels in your blood. In a person without problems, the DAO enzyme, which is the main enzyme responsible for catabolizing histaminereturns normal histamine levels in the blood. If there is a decrease in the quantity or quality of this enzyme, this is when the symptoms of excess histamine occur.

Some medications increase your blood histamine levels

Before starting a low histamine diet you should do an initial fast of 48-72 hours and then, once improvement was achieved, progressively introduce foods allowed.

Allowed foods:

• The starches: potatoes, rice, pasta and cereals.
• The vegetables: lettuce, cauliflower, broccoli, chicory, corn salad, cucumber, carrot, garlic, pumpkin, thistle, peppers, mushrooms, radish, rhubarb, asparagus, zucchini and onion.
• The fruit (peeled when possible): apple, pear, peach, plums, cherries, melon, blueberries, citrus, kiwi, strawberries, pineapple and papaya.
• Vegetable oil and vinegar.
• olives.
• dried fruits: skinless and unroasted.

Foods to avoid:

• Fish in general and canned.
• Seafood.
• Meat.
• Birds.
• Sausages.
• Eggs.
• Alcohol.
• Dairy (especially mature cheeses).
• Fermented like sauerkraut.
• Soy derivatives.
• Chocolate.
• Vanilla.

After 5-6 days of changing the diet, people usually respond and notice improvement. It should be kept for at least 4 months and then reintroduce the eliminated foods one by one. In general, it is advisable to choose fresh foods and preserved, processed and highly elaborate dishes are discouraged.

Medications not recommended

If the symptoms are associated with a medication, it should be avoided and alternatives should be sought; some medications block the DAO enzyme.

• Painkillers: morphine, pethidine, NSAIDs, ASA and metamizole.
• Anesthetics: thiopental.
• Local anesthetics: prilocaine.
• Antiarrhythmics: propafenone.
• Antibiotics: cefuroxime, isoniazid, pentamidine and acid. clavulanate, chloroquine.
• Antidepressants: amitriptyline and MAOI.
• Antihypertensives: verapamil, alprenolol and dihydrazine.
• Antihistamines: cimetidine.
• Bronchodilators: aminophylline.
• Cardiotonics: dobutamine and dopamine.
• Cytostatics: cyclophosphamide.
• Diuretics: amiloride.
• Mucolytics: ambroxol and acetylcysteine.
• muscle relaxants: pancurorium, alcuronium and D-tubocurarine.

Always read the leaflet. Sometimes, after a while, you can take that medication again, but with caution, in case the symptoms return.