November 29, 2021 9:00 pm

histamine intolerance, mast cell activation, low histamine diet, elimination diet, histamine intolerance threshold, Alison Vickery, Health, Australia

One of the most widely misunderstood areas with histamine intolerance is food reintroduction.

Firstly, follow a low histamine elimination diet for 2 – 4 weeks to confirm histamine intolerance.

However, if it does not resolve key symptoms, stop the elimination diet altogether instead of adding more food restrictions.

Conversely, if it resolves symptoms, slowly proceed with reintroducing foods to find your unique histamine threshold.

Importantly, the aim is not to eat only low-histamine foods. Rather, the aim is to keep as many nutritious foods in your diet as possible, with as much variety as possible.

Finally, here are some food reintroduction guidelines.

Food Reintroduction

Step-by-Step Guide to Food Reintroduction

Histamine intolerance is not an allergy but a threshold issue. Therefore, we must establish our threshold by food reintroduction until we determine our sensitivity level.

To do this, I recommend introducing small quantities of medium and high histamine foods as condiments or in soups, salads, or smoothies.

If you have not already done so, please download The Insiders’ Guide To The Low Histamine Food List. This list classifies foods by relative histamine content to assist in titrating histamine levels.

Typically, histamine-sensitive people can:

  • Tolerate any amount of low histamine foods
  • Consume 1 serving (1/2 cup) of moderate histamine foods daily
  • Include 1/10 serving of high histamine foods (as an alternative to moderate histamine foods) daily
  • Rarely tolerate very high histamine foods, if at all

Moreover, many people can tolerate more and increase their threshold well beyond these limits.

Food Reintroduction, Histamine Intolerance Histamine Producing Gut Bacteria

Symptom Monitoring During Food Reintroduction

Next, monitoring symptoms during food reintroduction is crucial.

Identify your main symptoms to use as definitive reactions. This helps you adjust your food reintroduction process effectively.

Specifically, minor reactions do not necessarily mean reaching your threshold during food reintroduction. Often, reactions settle with time, so it is safe to continue with that threshold level.

Additionally, do not get sidetracked by minor tolerable reactions.

For example, my minor reaction might be incidental urticaria on my feet, while my significant reaction is chronic insomnia. Everyone’s reactions will be different. What are yours?

Cumulative Reactions

Histamine is a threshold issue that can be cumulative with food reintroduction.

Initially, we may only begin to react adversely after several days of exceeding our threshold.

One of the biggest mistakes I see is relying on a handful of “safe” foods, which can lead to eating those foods in high quantities, causing a loss of sensitivity even to the safe foods.

This is why food reintroduction is so essential to rotate foods.

Moreover, if there are no adverse effects after two weeks at a particular threshold during food reintroduction, we can increase our histamine load again.

Definitive Reactions

During food reintroduction, it we experience a definitive reaction, we do not need to return to a low histamine diet. We can return to the previous level for a few more weeks before continuing the food reintroduction process.

Elimination Diet, Food Reintroduction

When To Seek Professional Advice

If you cannot tolerate low histamine foods or even small amounts of moderate histamine foods during food reintroduction, consider that you may not be histamine intolerant.

Indeed, stress plays a vital role in our tolerance of foods during food reintroduction.

Furthermore, not all reactions, including mast cell activation, are caused by food.

Interestingly, clients with mast cell activation frequently have a high histamine threshold, as food is not the underlying cause of their symptoms.

Furthermore, when histamine intolerance exists, an elimination diet supports restoring histamine regulation. However, an underlying cause still needs to be identified. The diet is not the root cause.


In conclusion, I have helped hundreds of people with food reintroduction and reverse their histamine intolerance.

Firstly, following a low histamine diet is crucial in rebalancing the histamine system.

However, a low histamine diet merely manages symptoms.

Additionally, we need to address the underlying cause to restore histamine balance.

In my view, there are three root causes: a leaky gut, autoimmunity, and mast cell activation.

You can learn more in my FREE Course, The Roadmap To Resolution of Histamine Intolerance and Mast Cell Activation.

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