HISTAMINE INTOLERANCE : WHICH FOOD LIST SHOULD YOU USE?

When I was first diagnosed with histamine intolerance, I just wanted to know what I needed to do so I could just do it. I wanted a list.

But it was not that simple.

There were several histamine intolerance lists from several credible sources. The problem was that no one list was the same and contained conflicting information.

If you are new to histamine intolerance, then here are some of the lists that are commonly used, and my own experience with them:

Dr. Janice Joneja

Dr. Joneja is a registered dietician with a Ph.D. in medical microbiology and immunology.

She has over thirty years of experience, nearly half as the head of the Allergy Nutrition Program at the Vancouver Hospital and Health Sciences Centre.

Dr. Janice Joneja's list eliminates histamines and a second amine (tyramine).

This list is simple to follow and gives general food groups, making logical choices easier.

It was an excellent place to start, giving me time to get my bearings, but it quickly proved inadequate.

RPA Allergy Unit List

The Royal Prince Alfred Hospital's list eliminates histamines, salicylates, amines, glutamates, sulfites, food colorings, and other artificial additives.

The diet is based on extensive ongoing trials within a renowned hospital allergy unit. The RPA Allergy Unit is considered a world expert on salicylates. 

The diet introduces the concept of histamines in food primarily related to the quality and age of food, not the food itself. This had a dramatic impact on my histamine tolerance levels.

It also emphasizes that this is not about eliminating all histamines but finding your tolerance level. The lists provide comprehensive lists of foods divided into low, moderate, high, and very high levels.

Unfortunately, the lists are by all excluded chemicals (not just histamines which makes them impractical if you do not have salicylate intolerance).

This failsafe diet is heavy on sugar, carbohydrates, and processed foods. I don't do well on them. That said, carbohydrates and processed foods are low in salicylates and glutamates.

It is also a highly restrictive elimination diet that is difficult to follow and unnecessary if you don't have salicylate intolerance.

I comprehensively failed this failsafe diet. I failed because of the grains and legumes (a large part of the failsafe diet). That lead me to Dr. Moneret-Vautrin's list.

Dr. Moneret-Vautrin

Dr. Moneret-Vautrin is a French professor of Medicine specializing in allergies and immunology.  

She is highly published in histamine intolerance but is relatively unknown in English-speaking countries.

Dr. Moneret-Vautrin's diet is similar to Dr. Joneja's, with one exception.

It introduces the idea of foods that result in histamine synthesis in the gut (such as grains and legumes).

Removing grains and legumes dramatically increased my tolerance levels allowing me to eat a broad range of foods, and in my experience, many (but not all) benefit from this approach.

The Swiss Interest Group

The Swiss Interest Group is a not-for-profit group run by volunteers.

The Swiss Interest Group Histamine Intolerance (SIGHI) list is also available as a histamine intolerance app.

The benefit of this list is that it is based on a survey of around 600 real people. It means that the foods are likely to have come from a variety of sources and also tested by eating them rather than in a lab.

The downside of this app is that it is based on real people who may have different underlying health conditions. At best, therefore, the histamine classifications are averages.

The app does not allow you to personalize the list based on your experience.

Food Intolerances App By Baliza

The Food Intolerance app uses published research as the source of its information. The research is referenced with a hyperlink.

The app is impressive.

It allows you to filter foods into low, medium, high, and very high for histamines and a wide range of macro-nutrients. Got lactose intolerance?

There's a filter for that. Got glucose issues? There's a filter for that too. Fructose intolerance. Yep.

Even more importantly, the app allows you to alter the individual ranking of foods and make personal notes based on your bio-individuality. What you end up with is a personalized, portable food list.

Histamine Intolerance by Ostec App

ALBA, Allergen dataBAnk, and TNO Nutrition & Food Research have all conducted laboratory experiments, testing the precise level of amines within foods.

The ALBA list appears to be used in the Histamine Intolerance app by Ostec.

The app allows you to filter foods, whether they are DAO inhibitors, vitamin B6 antagonists, HNMT inhibitors, mast cell degranulation, or that have lectins, gluten, or lactose.

This distinction may be necessary because histamine intolerance can be caused by either a DAO mutation (degrading extra-cellular histamine) or an HNMT mutation (destabilizing intra-cellular histamine). I did not find that I needed to go to this level of detail to get answers.

When you go into each food, you can see the amount of amine type (not just histamine). This may be useful if your problem is not so much with histamines but with other amines. My problem was with histamines, so I did not need this level of detail.

The downside of the app is its usability. You need to go into each food to see the amine level of the food (that is that it does not contain a traffic light system, nor does it allow you to filter by type of amine).

This, at best, makes the app an advanced "troubleshooting" resource.

The Insider's Guide to The Low Histamine Food List

This is my list which you can download for free.

 The list attempts to draw on the advantages of the various lists and address their shortfalls. It has been compiled by categorizing foods by degree using:

  • Scientific Test Results – from the raw ALBA data (from a paid scientific database),
  • Clinical Experience – the SIGHI and RPAH Allergy Unit data has been used to verify these results, and
  • Differences – where there were differences between the scientific data, and the clinical experience, an underlying cause was identified and resolved concerning the scientific literature.

Other food intolerances have not been considered. In my experience, there is such a high divergence in other food intolerances that it is confusing and impractical to consider them all.

Which List Should You Choose?  

So which list should you choose?

The answer is paradoxically any one of them, as they are all credible sources, and paradoxically none of them.

Their value is in using the list as a framework to observe your own body and develop your bio-individual list. So pick the one that resonates with you and start there.

 

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