Genetic Risk for Histamine Intolerance


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Histamine intolerance, a condition where there is an excess of histamine in the body, may be more common than we previously thought. Its symptoms, such as headaches, skin issues, digestive problems, and even nervous system disorders, can easily be mistaken for a food allergy. However, it is an imbalance in the body's ability to break down histamine - a compound involved in our immune response and neurotransmission - and not an allergic reaction. In this article, we will discuss the role of genetics in histamine intolerance, the foods and beverages that are high in histamine, and the available therapeutic approaches.

Histamine intolerance is a relatively rare condition, affecting about 1-3% of the global population. However, it is often misdiagnosed as other conditions, such as food allergies, irritable bowel syndrome, or chronic fatigue syndrome. As a result, the actual prevalence of histamine intolerance may be higher than 3%.

The Genetic Underpinnings of Histamine Intolerance

Our body typically manages histamine levels using two crucial enzymes: diamine oxidase (DAO) and histamine N-methyltransferase (HNMT). However, variations in the genes encoding these enzymes could affect their activity and contribute to histamine intolerance.

Certain single nucleotide polymorphisms (SNPs) within the DAO gene have been linked with histamine intolerance. These genetic variants could lead to lower DAO levels and subsequently result in a build-up of histamine in the body.

A specific SNP within the HNMT gene also produces a slower-acting HNMT enzyme. While this variant has been associated with conditions involving histamine, its precise role in histamine intolerance remains a topic of ongoing research.

Foods and Beverages High in Histamine

Histamine is naturally present in various foods and beverages, particularly fermented ones. Some common high-histamine food items include:

  • Fermented alcoholic beverages like wine, champagne, and beer
  • Fermented foods such as sauerkraut, vinegar, soy sauce, kefir, yogurt, and kombucha
  • Vinegar-containing foods like pickles, mayonnaise, and olives
  • Cured meats, including salami, ham, and sausages
  • Certain vegetables and fruits like avocados, eggplant, spinach, tomatoes, and most citrus fruits
  • Aged cheeses, nuts, dried fruits, and smoked fish

Remember that histamine content can increase over time, so fresher foods typically have less histamine than leftovers.

Symptoms of Histamine Intolerance

Common symptoms include skin reactions such as flushing, hives, or itching. Individuals might also experience gastrointestinal symptoms like abdominal cramps, bloating, and diarrhea. In more severe cases, other symptoms can include nasal congestion, sneezing, headache, and even difficulty breathing. As histamine also acts as a neurotransmitter, its excess can lead to anxiety, dizziness, irregular menstrual cycle, and difficulty regulating body temperature.

Treatment Options for Histamine Intolerance

The primary approach to managing histamine intolerance is dietary modification. This includes limiting the intake of histamine-rich foods, such as certain fermented foods and beverages, aged cheeses, and specific fruits and vegetables. A healthcare professional can help develop a personalized low-histamine diet plan, which can significantly alleviate symptoms in many individuals.

Besides dietary changes, supplements that aid histamine breakdown may be recommended. These are usually centered around DAO, the primary enzyme that breaks down histamine in foods. DAO supplements can be particularly useful for those with DAO deficiency due to genetic factors.

Some healthcare professionals may also recommend a regimen of vitamins and minerals that support DAO activity and histamine breakdown. This can include vitamin C, vitamin B6, copper, and zinc.

As emerging research is beginning to suggest a link between gut health and histamine intolerance, probiotics and other gut-supporting supplements might also be suggested. These can help rebalance the gut microbiota, potentially aiding in better histamine regulation.

Finally, medications like antihistamines may sometimes be prescribed. While they don't prevent histamine release, they can block its effects and relieve symptoms.

It's important to note that while these treatment options can help manage histamine intolerance, what works best can vary from person to person. Ongoing communication with healthcare professionals is crucial in successfully navigating this condition.


As we learn more about the role of genetics and dietary influences in histamine intolerance, we can make strides towards personalized management approaches and improved overall well-being for those affected. If you suspect you may have this condition, it's important to consult with a healthcare professional for accurate diagnosis and treatment.

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