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Sugar Guide: Low Histamine Sweeteners

When you’re on a low histamine diet, sugar can become a huge headache (literally), as it can exacerbate your body’s reactions to high histamine levels. Fluctuations in blood sugar are bad for your system in general, but high blood sugar levels are also linked to high histamine levels, which is why sugar is classified as an inflammatory food. As Beth from Mast Cell 360 says in this blog post, all sweeteners foods which affect your glucose levels have the potential to start a reaction.

This doesn’t mean just avoiding white sugar, either, but limiting sweeteners in all of their many forms. Yes, even fruit.

You can see a full chart of sweeteners and their Glycemic Index (GI) ranking here, but for the purpose of understanding sweeteners for a low histamine diet, first you need to know what’s approved (or not). Then you need to learn how to use those substances to sweeten food without spiking your blood sugar. I can only speak extensively of my own experience, but even having a large piece of fruit starts to give me a stomachache, if it’s not eaten with other foods. We’ll start with what to avoid.

Worst Sweeteners For Histamine Intolerance

Most sweetening substances are a no-no on a low histamine diet, but some are markedly more inflammatory than others. This includes sugar alcohols, like those used in no-calories sweeteners such as splenda or lakanto. In part this is because they’re fermented, but also because your body doesn’t properly process them, which can lead to an even more unhappy gut.

I never use sugar alcohols at home, so you’ll never see any in my virtual pantry or my recipes. Before I realized that they were to blame for my continued stomachaches, I even tried using some of the lower-GI rated sweeteners below. Unfortunately, most of these sweeteners are by-products of fermentation, and this can increase the inherent levels of histamine in a dish, in addition to raising your body’s inflammation level.

But it’s also because of which gut bacteria each of these sweeteners feeds, i.e. the bad bacteria, so even stuff that sounds healthy, like brown rice syrup, should be avoided because of how equally your body treats all sugars. Below are some of the worst & most common sweeteners out there. I’ve listed them in order of Glycemic Index ranking, and added any other common names in parentheses.

  • 105: Maltodextrin {used as a thickener, stabilizer, and/or preservative}
  • 100: Glucose {pure}
  • 90: Corn Syrup {high fructose or otherwise}
  • 65: White Sugar (Table Sugar) {note that cane juice is a related sweetener and not exactly as impactful as traditional sugar, but still not recommended on a low histamine diet}
  • 58: Honey {only exception is Manuka Honey; see below}
  • 50-65: Distilled Syrups (includes Golden Syrup, Blackstrap Molasses, Maple Syrup, and Sorghum Syrup)
  • 45: Lactose (Milk Sugar)
  • 35: Maltitol (Sugar Alcohol)
  • 15: Agave Syrup
  • 12: Xylitol {bad only in large amounts}
  • 4: Sorbitol
  • 1: Erythritol, Yacon Syrup, and Inulin
  • 0: Aspartame and Sucralose {both artificial sweeteners}

Is Honey Low Histamine?

You’ll note that honey is not mentioned on either the list above or below. That’s because honey is a special case for people on a low histamine diet. Normal honey (like the kind in a teddy-bear-shaped container) falls into the same category as syrups and molasses, but Manuka honey falls into a category of its own.

Manuka honey is a special type of honey harvested from bees who only gather nectar from the Manuka flower. These are the flowers of Leptospermum scoparium, a tree native to New Zealand which blooms just 2-6 weeks per year. The honey is prized due to its uniquely active antibiotic properties, which apply whether you use it topically or consume it. Honeys of all types taste sweeter than table sugar, so you can use less of it in recipes, though I don’t usually bake with it (see below).

Rather I choose to always consume Manuka honey at room temperature or stirred into a warm beverage (like my morning coffee). If you also choose to use honey on a low histamine diet, make sure it’s raw or minimally processed. Remember that all honey has a GI rating of around 50 no matter the type or origin, so only take Manuka honey once you’ve approved it with your doctor. Especially during the first month or so of your diet, the sugar rush may be too much for your system (& your gut in particular).

Low Histamine Sweeteners

A variety of factors will lead you to burying the white sugar even deeper in your pantry, but it might have surprised you to see things like xylitol and agave on the no-no list. Though note that the difference between those & these isn’t necessarily about the GI of any of them, because you shouldn’t be eating many sweets anyway. But the latter is off-diet because of the effect it has upon your blood sugar levels, which again, when raised, will also raise overall histamine levels.

Xylitol and other sugar alcohols are bad only in amounts larger than you’d find in a piece of gum, and are known to cause upset stomachs even as they feed good gut bacteria. Once you’re more aware of your own personal microbiome’s needs and limits, you can add in more sweetener options like xylitol, but it’s important to count it towards your bucket. Here are the best sweetener options for low histamine diet adherents:

  • 0: Monk Fruit/Luo Han Guo and Stevia {either in any form, as long as they’re pure}
  • 35: Coconut Palm Sugar
  • 47: Date Syrup and Date Sugar

Keep in mind that the histaminic impact of many of these sweet substances lies in the blood sugar component. Some blood sugar-stabilizing foods to keep around include ginger, milk thistle, fenugreek, and bitter melon, all of which you’ll find in the most reputable herbal remedies for such. Also remember that when using “safe” sweeteners like those above, your main concern is really whether you need solid or liquid sweetness, and how much you can substitute the bulk of sugar for a powder like monk fruit or stevia.

Baking Low Histamine Desserts

I have a fair number of low histamine desserts on the site already, but when I’m developing a recipe, there are a few standard questions I ask myself & a few standby sweeteners I use. Here’s the cheat sheet, for your own reference.

  • Monk Fruit Extract: powder. Can add an off flavor to baked goods when used in too-large quantities, which is why most of my sweets recipes use monk fruit in conjunction with either coconut or date sugar.
  • Stevia: powder. Similar to monk fruit, stevia has a reputation for adding an off flavor to baked goods when used in too-large quantities (unlike with monk fruit, I tend to taste that weird flavor more so in stevia, which is why most of my sweets recipes use the monk fruit blend detailed below).
  • Coconut Sugar: crystals. The innocent crystalline structure of coconut sugar belies its toasty, molasses sweetness, one I associate mainly with coconut-based scents and sweets. This is my go-to replacement for table sugar in anything that’s not overly fruity; it’s basically equally as sweet as white sugar, but it has a caramel kick to it.
  • Date Sugar: crystals. Though it may not look like it, date sugar is just dehydrated dates, granulated but not completely separated from their nutrients (as white sugar has been). If you’re unfamiliar with date sugar, it smells a lot like raisins and tastes like very concentrated sugary sweetness; it’s better for fruit-based baked goods.
  • Date Syrup: liquid. The products of dates, a shriveled fruit produced by the metric ton in California and the Middle East, date syrup is a plant-based, whole food sweetener that can be used as 1-to-1 replacement for honey and other liquid sweeteners.

None of these sweeteners have been aged or fermented, and while some have been heated, none have naturally high histamine levels nor do they release histamines in the body. They’re all nutrient-dense, natural alternatives to processed sugars whether you’re on a low histamine diet or not.

But there are some other things to remember— if your recipe calls for a powdered sweetener, I recommend a coconut sugar blend. I keep a mix of coconut sugar and monk fruit powder in a small jar on the counter, as well as in a larger container in my pantry (sweetener recipe below). You can easily blend up the mixture in a tabletop grinder to make the particle size smaller, even as small as a typical powdered sugar.

Just keep in mind that if you use coconut sugar, your dish will always come out with a toasty caramel undertone. For recipes needing a liquid sweetener, I use date syrup, or in a pinch I’ll use low-level manuka honey. Like coconut sugar, date syrup has a caramel-like molassesy flavor that you’ll be able to taste in your final dish, but they both tend to work very well with fruit!

Date fruits

My Favorite Low Histamine Sweeteners

I’ve been using this Monk Fruit Extract for about a year now, though I found this one to be good as well, and I’m keen to try this liquid monk fruit once I run out of my current stash. Stevia In The Raw is a similar sort of sweetener in that it can be either liquid or powder, but more people seem to report a chemical aftertaste, so consider yourself warned.

This coconut sugar is the first one I tried & I’d still recommend, had I not found a similar option in my local grocery store. Pro tip, if you like coconut sugar: buy a local brand of coconut sugar, but refill this brand’s container with the new sugar (which usually comes in a flimsy bag).

The final category is date-based products. I bought a large container of this Date Syrup that I keep in my fridge (to prevent it form fermenting, which it definitely can) and use for most tart crusts and smoothies. This Date Sugar is the same one I have in my cabinet, and I mostly rely on it for sprinkling on top of fresh fruit with coconut cream, as I’ve recently found that it blends in & sort of melts much better than coconut sugar.

Low Histamine Sugar Recipe

This sounds kind of strange, but I actually make my own sugar. For basic uses— usually beverages— in which I don’t want to use honey or need a solid sweetener, I keep a table blend of coconut sugar and monk fruit. The reasons for this come down to glycemic load and flavor; the coconut sugar is used in a ratio that masks the somewhat strange undertone I taste in pure monk fruit.

Here’s my ideal ratio: 1/4 cup of coconut sugar + 1/2 teaspoon monk fruit.

You can also use this blend in some baking recipes where you need to cut down the sugar ratio but keep some of the bulk that sugar adds. Keep in mind that just like white sugar, if your low histamine sugar blend is left unsealed for more than a day or so, it will probably start to harden. Even kept in a sealed container, the coconut sugar’s natural tendency to clump can take over. For those reasons, I tend to blend just enough for one month at a time, which isn’t that much.

Low Histamine Sweeteners FAQ

Is sugar high histamine?

Like most other sweeteners, cane sugar isn’t directly high or low in histamine, but the spikes in blood sugar that sweeteners can cause can raise your body’s overall histamine levels, as a response to the inflammation.

Does sugar contain histamine?

Everything contains some level of histamine, but cane sugar is relatively lower in histamine. Keep in mind, though, that any raise in blood sugar can cause a spike in histamine release.

Does sugar increase histamine?

Sugar doesn’t directly release histamine, but sugar can cause a histamine reaction by increasing the level of inflammation in the body.

If this post on low histamine sugar & sweeteners helped you, please leave a comment below!


    1. Hey, Deanna! I did a bit of research into allulose back when I tried keto, and while it’s thought to be a somewhat unique sugar alcohol in that it may have some anti-inflammatory effects, I’m not going to be trying to add it into my diet for the moment. It should still be used in relatively small quantities in recipes, as you’d still have to watch out for any stomach upset with it (one of my main histamine toxicity symptoms), so it’s not worth it for me to take the risk for now. But if you do try it and don’t have any reaction, please let me know!

        1. Darn. I get stomachaches with erythritol so allulose is not on my list to try anytime soon, but that sorta seals the deal. I’m sorry it doesn’t work for you, but hopefully you can still have monk fruit or stevia!

    1. I would only use regular local honey, either bought from a trusted local shop or directly from the apiary. There is SO much fake honey out there that the regulation of manuka honeys just makes them safer (in addition to the amazing antimicrobial properties)!

  1. When replacing your sugar recipe for the sugar in a baked good recipe is it equal to a 1/4cup? It seems like it would be sweeter-maybe equivalent to 1/2 cup?

    1. It would definitely be much sweeter. I haven’t made many baked goods recently, but when I use the blend I replace it 1 to 3, meaning that it’s equivalent to about three times as much sweetness as a table sugar would be. This is because 1/2 teaspoon of pure monk fruit is equal to the sweetness of about 1/2 cups of table sugar, while 1/4 cup of coconut sugar is just slightly less sweet than 1/4 cup of table sugar. Therefore you have 3/4 cups of sweetness in a 1/4 cup measure.

      If you’re using this in a recipe with precise measurements, however, be sure to replace the sugar it calls for with only coconut sugar + a pinch of monk fruit. Baking is a precise science, and using 1/3 the volume of sugar in most recipes would be disastrous. Good luck with your baking!

    1. I had only ever heard that term used as an adjective to describe something overly-sweet, but after a bit of googling I found some explanations of it as an artificial sweetener. I tend to stay away from those as a general rule, due to a strong family history of cancer and the fact that I find monk fruit and other fruit-derived sugars to be perfectly fine, but I haven’t looked into them in regards to HIT. My inclination would be, however, to avoid them for the first few months of going low histamine, just in case of stomach upset or other reactions. I wouldn’t want anyone to derail their recovery due to one ingredient, but definitely always do your own experimenting, as every body is different!

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