What Is Histamine Intolerance? Symptoms and Treatment Tips

What Is Histamine Intolerance? Symptoms and Treatment Tips

If you’ve ever had a runny nose or itchy eyes when spring rolls around, you’re probably familiar with the term “histamine.” But what about histamine intolerance? Just like we can be sensitive to allergens in the air, we can also be sensitive to histamines taken in through the diet—this is called histamine intolerance, and it’s what we’re talking about today.

Histamine itself is a chemical messenger that plays many roles in the body, including immune defenses and gastric acid secretion. Histamine is released by the immune system (specifically mast cells and basophils) in response to allergens, such as those from the environment or foods.

Histamine is essential in controlled amounts in the body. However, when histamine levels rise, uncomfortable symptoms can occur. Allergy symptoms range from itchy, runny nose and eyes, to more severe reactions like anaphylaxis (which is a medical emergency and should not be taken lightly). Learn more here.

But histamine intolerance is less understood. Let’s dive into what it means, what symptoms to look for, and how to go about treating it.

What Is Histamine Intolerance?

Histamine intolerance is poorly understood overall, but can best be explained by malfunctioning histamine breakdown pathways in the GI tract.

Histamine is broken down by 2 main enzymes in the body, and the most active one is called diamine oxidase, or DOA. If DOA function is altered, histamines can build up in the body. Since histamine is created and released by the body, and taken in through diet, if DOA function is not working up to par, it can be common for your “histamine bucket” to overflow. This is when you’ll start to feel symptomatic after being exposed to allergens or high-histamine foods (more on what to look for in your medicine cabinet or your fridge if you’re trying to avoid high-histamine substances here).

Who is Susceptible to Histamine Intolerance?

Women with high estrogens may have a hard time with DOA enzyme function. Certain medications also alter the breakdown of DOAs, including NSAIDS and pain medications. Alcohol also alters the breakdown of histamine. Other factors that can impact DOA activity include genetic variants and microbiome imbalances. 

Symptoms of Histamine Intolerance

When the body does not break down histamine from foods, it can leak through the GI lining and enter the bloodstream, causing GI symptoms and sometimes systemic symptoms, like itchy skin.

How to Diagnose Histamine Intolerance

Histamine intolerance is very challenging to diagnose and unfortunately, some of the best foods are higher on the histamine scale, such as chocolate and aged cheeses. There is no way to avoid histamines through diet at 100%, however if you are someone who tends more towards allergic symptoms and have not found success with any other treatments, reducing high-histamine foods for a period of time and seeing how you feel would be a good place to start.

For those who struggle with chronic allergy symptoms or GI concerns with no other found cause, it is worth talking with your provider about the possibility of histamine intolerance. 

How to Reduce Symptoms of Histamine Intolerance

Reduce allergen exposure at home

Being aware of how to reduce your allergen exposure from the environment is a great place to start. To reduce indoor allergens, try:

  • wet dusting,
  • vacuuming,
  • washing curtains and bedding weekly,
  • and opening windows can help reduce allergens in indoor air.

While it might sound counterintuitive to open windows when being outside is what people with allergies often fear, indoor air is actually much more polluted than outdoor air.

Mast Cell Stabilizers

Instead of blocking histamine receptors by taking antihistamines, there is also the option using mast cell stabilizers to stabilize the cells in the body that release histamine, therefore preventing the release of histamine in the first place. A few examples of mast cell stabilizers are the herb nettle, and nutrients like vitamin C, quercetin, and NAC. More of a deep dive on supplements to consider adding to your routine for histamine intolerance can be found here.

DAO support

Supplementation with an animal-derived supplement containing the enzyme DAO can help break down histamine in the GI tract in those who have poorly functioning DAO pathways. DAO is quite expensive as a supplement and isn’t indicated in everyone with general allergy symptoms,, so working with a provider to figure out if this is the best option for you is recommended. Book an appointment with us here to see if this is a good fit for you.

Learn More About Histamine Intolerance

Learn more about histamines with this informative video.

For more info about histamine-containing foods, check out this list.

Ask Me Anything with Dr. April Jones

Ask Me Anything with Dr. April Jones

In our newest series, you’ll get a chance to ask one of our practitioners alllll the questions on your mind. We sourced these initially from Instagram, so keep an eye out for the next round to get your question answered by an MIMC staff member, and check out Dr. Cassie’s AMA here.

Q: What’s the best way to reduce stress?

Q: I’ve been hearing a lot about beef liver as a supplement. Should I take it?

Q: Do you ever tell patients to 100% cut out a food from their diet, if they’re not allergic?

Q: Do you have any sleep tips / hacks?

Q: I’m exhausted and anxious, but I’m sleeping and recovering. What could be potential culprits?

What Supplements Should I Take?

What Supplements Should I Take?

There are a few supplements that stand out when thinking about what supplements I recommend most to patients. However, I do not believe that there are supplements that “everyone” should be taking.

Why? It’s at the core of what we practice at MIMC—personalized medicine! Everyone has their own unique biochemical makeup, which means just because a supplement totally changed one person’s life, doesn’t mean it will benefit the next person. People often think of supplements as harmless since they are available over the counter, but many contain potent amounts of nutrients or botanicals that require medical guidance to properly administer and reap the benefits.

How to choose high-quality supplements

When shopping for supplements, it is also important to be confident that the product you are purchasing actually contains what it says it does, as the supplement industry is not well-regulated. For this reason, I recommend sticking with supplement brands that are third-party tested for safety and purity.

While this can be difficult to navigate initially, most companies who perform this kind of testing are very transparent about their quality standards. Companies who are not are the ones I recommend avoiding. Learn more about how to evaluate supplement brands here.

What supplements should I take?

If I had to choose 3 different supplements that would benefit most people, I would recommend vitamin D3, omega-3 fatty acids, and probiotics. Let’s dive into how each of these can help.

Vitamin D3

A large percentage of the population is deficient in vitamin D, especially those who live in the midwest. Vitamin D is a fat soluble vitamin that plays a role in so many different bodily processes, including immune and mental health.

To figure out how much vitamin D3 is right for you to supplement with, I recommend having your vitamin D levels checked during a standard lab draw. While this used to be more of a specialty lab, it is becoming more commonplace because of the increasing evidence to support the importance of vitamin D in human health.

It is crucial to note that too much vitamin D can be toxic, so I recommend supplementing with no more than 4,000IU per day without knowing your personal vitamin D levels, which is the established tolerable upper intake level that is unlikely to cause harm. 

Read more about how vitamin D can help here.

Omega-3 Fatty Acids

Since so many of us are not eating the recommended weekly intake of fatty, cold-water fish per week (3x/week), a high-quality omega-3 fatty acid supplement can benefit most for a few reasons. The standard American diet is SUPER HIGH in omega-6 fatty acids and low in omega-3s, and this is problematic because omega-6s are inflammatory while omega-3s are anti-inflammatory.

Though both omega-6 and omega-3 fatty acids play a role in the body, the ratio should be close to 2:1, and it’s somewhere around 20:1 with the standard American diet. This doesn’t mean that you can balance the standard American diet out just by taking an omega-3 supplement. BUT, supplementing can help bring down the ratio while you are working on dietary changes.

Omega-3s are also critical during pregnancy (specifically DHA) for fetal brain development. When choosing an omega-3 supplement, it is important to make sure you are purchasing one that is free of heavy metals. Nordic Naturals is a brand that I commonly recommend for this reason. 


Though the preferred way to support the gut microbiome is through eating a diet full of fiber and fermented foods, incorporating a well-formulated broad spectrum probiotic can be beneficial for those looking to improve GI health. I typically recommend cycling through a few different types of probiotics every year as maintenance for those who do not struggle with GI concerns.

For those who are symptomatic, advanced GI testing can help guide what type of probiotics would be best (remember that personalized medicine thing? learn more here).

While supplements are often a foundational part of treatment plans with patients, there is not a one-size fits all approach to recommendations. These are a starting place if you’re looking to support your system, but it’s merely a jumping off point. Your body might need more or less than these and the best way to figure that out is to get a full workup with a doctor you trust.

If you’re looking for a new practitioner, give us a try—we’re trained to partner with you to get to the root cause of your symptoms and create a plan that’s tailored to you.

23 Healthier Holiday Recipes to Bookmark For Your Gathering

23 Healthier Holiday Recipes to Bookmark For Your Gathering

pork chops on a bed of mashed sweet potatoes with cranberry relish

Looking for healthier holiday recipes? You’re in the right place! In preparation for Thanksgiving gatherings, we have compiled a list of recipes so you can still enjoy the holiday classics while focusing on including nourishing foods in your diet and avoiding food intolerances! Each section is labeled for different dietary needs. 

Healthier Roasted Turkey

If possible, support local and purchase a turkey from a farm near you. Co-ops and finer grocery stores often have organic or pasture raised turkey options as well!

Full turkey

Whole 30 friendly turkey

Turkey breast only

Gluten free turkey gravy

Healthier Mashed Potatoes

Mashed potatoes are a staple during Thanksgiving dinner. Check out the healthier mashed potato recipes below, including a few mashed potato alternatives. 

Healthier Green Bean Casserole

In the Midwest, a casserole is a must-have for a holiday meal. These options give you the comfort-food hit you need without the heaviness. Enjoy!

Healthier Cranberry Sauce

Cranberry sauce is super simple to make homemade. Ditch the usual sugar-heavy recipes and try one of the recipes below! 

Healthier Desserts

Pumpkin, apple, and sweet potato desserts just scream fall. All of the recipes below are refined sugar free and be modified to be gluten or egg free, if that’s one of your food sensitivities. Any and all of these will make great additions to your holiday meal!

Wondering if you have a food allergy or sensitivity? Check in with our dietician to learn more about the food that fuels you!

3 Healthy Warming Drinks for Good Digestion

3 Healthy Warming Drinks for Good Digestion

cassie sips a hot cup of tea.

You feeling that chill in the air? It’s FALL, and things are only gonna get chillier. With colder weather, digestion slows down, so giving your belly a kick start with warming foods can keep you from feeling sluggish and frigid.

Exercise, sauna, and warm epsom salt baths can help too, but let’s start with these 3 warming beverages for good digestion, with my favorite recipes.

Fire Cider

Fire cider is a traditional folk recipe that contains ingredients known to support immune function, decrease inflammation, and aid in digestion. It is made by combining aromatic superfoods with apple cider vinegar and allowing it to stew for about a month, before straining it for use. It can be taken as needed with a little bit of water or used in recipes in place of vinegar.

Fire cider gets its medicinal properties from:

  • anti-inflammatory ingredients like garlic, turmeric, and ginger.
  • circulation boosting ingredients like peppers and horseradish.
  • digestive tract stimulation with bitter apple cider vinegar and citrus.

Two recipes to try:

*Unfortunately, if you are someone who suffers from acid reflux, it may be best to avoid fire cider all together. Consult with your provider about what is best for you! 

Golden Milk

If you are looking for a delicious and nourishing tonic to enjoy this fall, look no further than golden milk. Golden milk is made with turmeric, an anti-inflammatory superfood that is soothing to the digestive tract and aids in improved  circulation, which is especially nice on cold autumn nights. 

Recipe to try: Downshiftology’s Dairy-Free Golden Milk

Bone Broth

Learning how to make homemade bone broth will elevate your fall cooking game. It is made by simmering bones with filtered water and vegetables/herbs of your choosing, along with a splash of vinegar to help extract the collagen from the bones. Bone broth is rich in protein, including the amino acid glycine, which is very healing to the gut lining. 

There are countless ways to use bone broth, but these are a few of my favorites:

  • Pour bone broth over quinoa and top with avocado and a pasture raised egg as a savory way to include a warming breakfast to your routine.
  • Use bone broth instead of water when cooking grains to boost up the protein content and add flavor.
  • Sip a cup before bed as a protein rich snack to keep blood sugar stable throughout the night.

Here’s my favorite simple recipe on how to cook bone broth either on the stove top, crock pot or instant pot: Wholefully’s Bone Broth.

Have you tried these go-to drinks for healthy digestion?