13 Tips for Following a Low Histamine Diet

Even with lot of motivation— in my case, pain— it can be really hard to follow a restrictive diet. I won't lie to you; the initial phase of an elimination diet for histamine intolerance can seem impossible to stick to, even if you've been on a diet before.

Yet even though the first week can be a struggle, once you start feeling relief from whatever symptoms were ailing you, your motivation will likely see a resurgence.

But just in case you're still not sure where to start with a low histamine diet or how to stick to it, below I've compiled a list of tips for following a low histamine diet. All of these recommendations come from my personal experience in following the diet.

The purpose of any elimination diet is to discover your unique triggers for whatever symptoms you're experience, so I'd be negligent if I didn't highly recommend that you seek the care of a physician before undertaking any type of diet change.

If your current doctor is unfamiliar with Mast Cell Activation Diseases and other histamine issues, you can also search for a functional medicine doctor using the Institute for Functional Medicine's directory.

That said, most any low histamine diet will be quite healthy as long as you're not overly-restrictive. Any version of the diet will have you cut out aged, fermented, and overly-ripe foods, as well as processed, highly-sweetened, and most pre-packaged goods.

Even in the first ten days or so of the diet, you can still get the proper amount of fat, fiber, carbs and protein on a low histamine diet. So to help you get through those first few tough weeks, here are over a dozen tips that really helped me get through my first month or two of eating low histamine (and the last two years on and off the diet)

Try to have natural antihistamines and over-the-counter histamine blockers on hand in case of a reaction. It’s okay to still be having a bad reaction and a bad day during the elimination phase; that doesn’t mean the diet isn’t working.

It’s okay to still need an antihistamine on Day 3 or Day 4, as your body won’t recover from long-term inflammation overnight. If you're still having reactions after a couple of weeks, you may need to tweak your approach to the diet and look into other potential sensitivities.

Focus on the foods you can tolerate right now, and what you can create with them. You can check out all my low histamine recipes for inspiration, or just start with the Level 0 recipes, which are those with the lowest possibility of triggering a reaction, regardless of histamine content.

Lingering on the foods which cause you pain or discomfort will not make them more tolerable, and will just make it harder to stick to the diet. For the vast majority of people, eating low histamine is only temporary.

On a related note, remember why there are so many different low histamine foods lists and diet plans out there— every body is different. You will actually have to choose a diet plan to follow, unless your doctor gives you one (AND seems to understand histamine intolerance), so you'll have to decide which list or plan to put your faith in.

Educating yourself about histamine intolerance is your number one defense against incorrect information, of which there is a lot out there. Do your own research and decide whose food list to follow, as all of them directly contradict each other in one way or another.

On a related note, be very careful with what meat you buy. Beth O'Hara from MastCell360 has a great post on meat handling for histamine intolerance, but the gist is: buy the freshest meat you can find, preferably frozen immediately after slaughter.

Histamine content is a result of the degradation of the amino acid (i.e protein) histidine, so meat is particularly susceptible to histamine build-up. If you want to chop, slice, or grind your meat, it's best to do so at home right before cooking with it.

I absolutely understand that food is life: keep all your high histamine food as out of sight as possible, and put ALL the foods you're currently able to tolerate on one shelf in the freezer and then one shelf in the fridge & pantry.

This way you’re not even tempted to look at off-diet options. Something that's helped me has been keeping a notecard with the list of meals I'm eating that day somewhere on the outside of my fridge, right at eye level.

I even include my snack options for the day. If thinking about food during this time initiates cravings, work on distracting yourself and do as much meal prep as you can ahead of time. This will also help you make sure you're eating a balanced diet insofar as fat, carbs, and protein.

Listen to your body, and eat when you're hungry. If you let your symptoms go on as long as I did (several years), you've probably developed an unhealthy fear of food in general. Everything seems to trigger you. But I promise that there is a root cause for your issues, and diet will probably play a large role in managing it.

So try to be cognizant of anytime you're undereating or overeating just because you're frustrated by symptoms or by what you can't eat. For example, I realized pretty early on in the diet how badly sweets made my stomach hurt, and how much more I craved them when I wasn't "allowed" to have them.

It honestly took a big mindset shift to not think about them whenever I was bored or frustrated, but after a month or so of no added sugar, I was able to tolerate some sweets again and eat them in moderation.

Most people who follow a low histamine diet will eventually be able to tolerate some amount of high histamine or inflammatory foods again, but it's all about lowering your overall inflammation levels and finding your personal limits.

Despite being my final tip (in this post!), supporting your gut really is key in any type of diet. For the most part this just means making sure that you eat a balanced amount of fats, carbs, and proteins in each meal, but some people may need more support through supplements or extra servings of certain foods.

A good friend of mine with MCAS has found luck with a rotation diet, but make sure your doctor also tests you for food allergies and other potential causes for your symptoms, such as SIBO or leaky gut.