The role of histamines in fermentation and how some people may need to address gut imbalance first in order to fully enjoy the benefits of these traditionally cultured foods without symptoms such as breakouts.
We have known since the 1930s that beneficial bacteria, especially Lactobacillus acidophilus found in fermented foods, can help heal intestinal permeability.
This condition is better known as leaky gut. The research clearly shows that foods rich in probiotics are an essential component in maintaining clear skin and avoiding problems with acne.
But what about those with histamine intolerance?
This condition, in fact, might be an important caveat to watch out for with regard to the consumption of fermented foods and those prone to skin breakouts.
Histamine Intolerance and Fermented Foods
Histamine is a chemical your body produces as a result of an allergic reaction. The release of histamine frequently can express itself on the surface of the skin through a number of symptoms, including but not limited to urticaria (hives), eczema, rosacea, and acne.
Interestingly, the histamine molecule along with the amino acids tyrosine and arginine all have an effect on vasculature (blood flow), and have been linked to contribute to migraine headaches. Too much tyramine in the diet can increase blood pressure, whereas too much arginine reduces blood pressure.
Fermented foods are one of the biggest sources of histamines.
Those who have yet to see an improvement with other suggestions and diet changes to address their acne, may have a histamine intolerance and benefit greatly from avoiding histamine and histamine-releasing foods.
The enzyme DAO (Diamine Oxidase) metabolizes histamine, and research shows that those who are sensitive to foods high in histamine may produce low levels of this enzyme.
In addition, people with low levels of DAO typically have other digestive concerns too, such as intestinal permeability, SIBO (small intestinal bacterial overgrowth), and possibly other gut-related symptoms and conditions.
Although there is not direct evidence linking acne to foods high in histamine, there are studies that show improvement of Atopic Dermatitis when a low histamine diet is adopted.
Furthermore, I have personally experimented with a diet low in histamine, arginine, and tyrosine and have experienced reduced irritation in the skin and minimizing of breakouts. This same improvement was noted with several of my clients with difficult-to-eradicate acne issues.
Acne and Possible Diet Link
Any form of stress causes inflammation, and eating foods promoting inflammation can certainly cause acne, even without exposure to acne-causing bacteria.
This is why traditional ways to are not always effective. When inflammation occurs, stress hormones trigger the release of histamine, which in turn can irritate the skin for those with histamine intolerance.
For some tougher acne cases, this may be the body’s way of expressing its reaction when consuming foods high in these substances.
High Histamine Foods to Avoid
There are many foods containing a mixture of histamine and tyrosine, and that’s because histamine induces tyrosine production, which specifically includes foods that are aged, cured, smoked, and fermented.
I’m a big proponent of self-experimentation when it comes to diet and what works for an individual. A typical elimination diet would exclude the most common food suspects and sensitivities.
However, if you haven’t noticed an improvement in your skin after doing this, the following foods on the list below are worth avoiding as well.
Note that histamine intolerance is a wide spectrum. Hence, it would be common for sufferers to find some of these foods below irritating while others produce no issues.
Beverages
Avoid teas, regular coffee, sodas, beer, wine, cider, kombucha, and even milk.
Fruits
Citrus fruits, pineapple, peaches, nectarines, cranberries, strawberries, raspberries, avocados, dates, raisins, plums and papaya, olives, bananas, and tomatoes.
Vegetables
Cabbage, nightshades like tomatoes and eggplant, pickles, spinach, and fermented vegetables such as sauerkraut.
Dairy
Aged cheeses, such as cheddar, gouda, brie and blue cheese (think smelly cheeses), and fermented dairy such as yogurt, kefir, and cultured buttermilk.
Spices
Ceylon cinnamon, cassia cinnamon, anise, curry powder, hot paprika and nutmeg. Watch out for fermented condiments too like traditional soy sauce and coconut aminos.
Nuts and seeds
Peanuts, almonds, hazelnuts, cashews, and walnuts are the highest sources of histamines in these foods.
Smoked or cured meats
Watch out for mahi mahi, tuna, sardines, cured meat like bacon, ham, deli meat, sausages, hot dogs, jerky, and pepperoni.
Miscellaneous
Consider avoiding chocolate, cocoa powder or chocolate-derived ingredients, artificial additives/ flavors/ dyes, natural soy sauce, wheat germ, vinegar of all kinds, miso paste (both light and dark) and other foods made by fermenting soy, ketchup and mustard.
Probiotics Can Fill the Gap
Many of the foods on the list above are fermented. This means that they can provide good bacteria in order to strengthen gut and immunity health.
Thus, a probiotic supplement is an appropriate choice for people who have a histamine intolerance or sensitivity.
This article details how to choose the best probiotic for your situation, histamine intolerant or otherwise.
Complete avoidance of these foods is difficult to do and not necessary forever. Eliminating them for at least a month should give you a good idea as to whether your body is being affected.
At a later time, you can reintroduce these foods back into your diet slowly. It’s important to note and keep in mind that some people will react more specifically to histamine.
Others may be affected more or equally by tyrosine or arginine, or possibly have no reaction at all.
Be patient, listen, and see how you’re body responds. Observation is the ultimate test to know what will bring you the results you’re looking to achieve both in your skin and overall health.
References
(1) Risk factors for sebaceous gland diseases and their relationship to gastrointestinal dysfunction in Han adolescents
(2) Histamines in Migraine and Brain
(3) Treatment of Atopic Dermatitis with a Low Histamine Diet
(4) Histamines and Histamine Intolerance
(5) Oxidative deamination of biogenic amines by intestinal amine oxidases: histamine is specifically inactivated by diamine oxidase
More Information
Taking Probiotics for Maximum Benefit
Interesting. Yogurt triggers eczema in my youngest daughter. However, the worst reaction she had came after taking a probiotic supplement which seems contradictory to what you shared. Your post did shed a bit of insight into our trying to figure this all out though.
I eat most of the foods on this list! I follow the Weston A Price diet, and I have had bad acne for 2.5 months after 2 years of clear skin. I’m 30. I also have itchy skin. In the last 2.5 months, I have also had 3 times where I had a sore throat and thought I was getting a cold, including now– I think it may be part of the histamine reaction. I drink a lot of tea– I’m going to try removing tea and fermented food for a week and see if I notice any improvement. I eat all the foods listed regularly– what should I be eating instead?
A story like this can trigger more fear than insight. Some perspective would be helpful.
One study in AJCN estimates approximately 1% of the population has histamine intolerance, and 80% of those patients are middle-aged. http://ajcn.nutrition.org/content/85/5/1185.full
Cashews are considered safe to eat in relation to amines. The RPA hospital allergy unit includes them in their elimination diet which deals with salicylate, amine and glutamate sensitivities.
how about FERMENTED cod liver oil? Is there something comparable to still get vitamin A and D?
Yes, plenty of natural A and D in fermented cod liver oil in the proper synergistic balance. Very good choice.
Fermented Cod Liver Oil is high in histamines, just like any fermented food.
What about fermented foods causes the problem? If you cook the fermented foods after, does it eliminate the problem (as long as the food is not one of the highest in histamine and histamine releasing foods)?
The histamine in fermented foods is what people typically react to. Cooking fermented foods would defeat the purpose of consuming them in the first place (the enzymes and probiotics are heat sensitive).
I’m in India right now and breaking out more than I have in years. Much of the food of south India is fermented and much of that is cooked: fermented rice and lentil (pancakes of sorts) called Idli and dosa + many more foods. Most of the meals I’m eating except for lunch, which is rice and with dal or curry, is fermented. NOT to mention the yoghurt – which they call curd. It’s fermented over night, every day in the home. It’s delicious and eaten after every meal here to cool down the spicy food. Not a fan of eating it because you ate spicy food. I’m now really cutting back on it. Also buttermilk is daily. The dairy in India is of exponentially higher quality and flavor than US, almost entirely due to the overbreeding and corruption of US cows to be more milk machine than cow.
On top of the food; its spring time now and I get powerful springtime allergies that are symptomaticly more like the flu than sneezes and itches.
Thinking of factors for: why this severe of ance and why now?
Two weeks ago I was in Singapore eating unfermented noodles and rice + not going through spring allergies – my skin was very clear. I’m thinking histamines…
Actualy Natasha Campbell McBride advises about cooking fermented vegetables for people that have problems with them. Apparently even from cooked bacteria do provide some benefits and prepare with time to try them raw.
Thanks for this article. Some people feel that foods fermented in an anaerobic jar with an airlock, such as a Pickl-It, have substantially lower amounts of histamines. Also, fermenting foods for much longer and cooking bone broths and stocks for a shorter time may be helpful. Ultimately the goal is to heal the gut so that it doesn’t over-produce histamine.
It is not true that a ferment made in an airlock jar will have less histamines. Histamine levels are related to the stages of bacterial growth and are therefore impacted by fermenting times. To reduce the histamines in your fermented vegetables ferment them longer. Fermenting vegetables go through several stages. Histamines are produced by the bacteria active in the earlier stages (spike during 0 to 15 days) then reduced by the bacteria in later ones. The bacteria that produce histamines do not utilize oxygen whether it is present or not so an open or closed fermentation vessel will have no impact on the amount of histamines produced. Depending on temperature, vegetable ferments should be fermented 4 to 6 weeks at room temperature before refrigeration to reduce histamines. Sauerkraut that reaches a ph of 3.4 would be fully fermented. Brined vegetables typically take a little less time to reach full fermentation than sauerkraut.
Actually, you’re mostly right about this ~ except the reason that anaerobically fermented foods have less histamine is not only because of the full fermenting time that is recommended for a complete ferment (follow instructions at ProbioticJar.com) but also because the bacteria responsible for destroying histamine compounds are not active until the very late-stage at cool temperatures (below 55ËšF). Temperature is very important, and most ferments need to be moved out of room temperature into cool temperature to complete because the microbes that flourish vary at different temperatures. Also notable is that the final stage of fermenting is not ever reached in the presence of oxygen, where these histamine-destroying microbes are most active.
Hopefully in time lab studies will prove this directly on fermented foods, but until then, we have thousands of people who are able to eat fermented foods done in a seals-every-time Probiotic Jar, but have nasty reactions to other methods used. As always, it is recommended to start out slowly and increase slowly, when trying a new food (for people who have food sensitivity problems).
It’s a shame that so many people who really need fermented food to heal don’t know this vital information, and “throw the baby out with the bathwater” when it comes to probiotic food.
Living.Powerful.Food
Other than avoidance what is the solution? Can you heal yourself from high histamine? I have been struggling with this for years and now I believe my 4 year old is having severe reactions secondary to histamine intolerance. Thank you for the article! I have been waiting for someone to write about the connection to migrains, acne, foods, and histamine. I usually read a lot from the Low Histamine Chef:)
Yes, healing the digestive system, inner ecosystem, and your immune system may ultimately help you overcome this, although it may not as well. Some people may just have an overactive immune issue, whether autoimmune or not.
Thank you:) Small amounts of fermented foods do not give me headaches. The biggest issue I have noticed is fermented drinks giving me a headache-water kefir and kombacha.
We eat a lot of bone broth and I put gelatin in my teas. This has really helped I believe based off a IgG panel of 6 food reactive of 88.
Thanks for the help!
There is a typo – tyramine instead of tyrosine: “Interestingly, the histamine molecule along with the amino acids tyrosine and arginine all have an effect on vasculature (blood flow), and have been linked to contribute to migraine headaches. Too much
tyramine
in the diet can increase blood pressure, whereas too much arginine reduces blood pressure.”
Thank you..yes, you are correct!
Is body itching a sign of a histamine problem? I have minor acne and eat many of the foods on that list. I also have itching on my lower legs, forearms, upper back (those are the most common areas that repeat) most days. Some days I have none and its increased in the last two months. I’m 35.
The itching sounds like eczema. We have nailed down our son’s histamine intolerance. It is very difficult to keep him away from these foods but he starts itching all over his body with a tendency to itch into a visible rash around the base of his neck. We do garlic enemas and the itching is typically gone and rash gone by the next day. We supplement with probiotics as well. Before we knew of the histamine connection he had gotten quite bad. The rash was over most of his body. Thank god it never really jumped to his face.
Yes Alicia. I had those symtoms and now are gone after I found out I am histamine intolerant and changed my diet.