The Use of Low Histamine Diet – A Review

Introduction: Histamine is a biologically active amine involved in inflammatory, immunological, neurological, and gastrointestinal processes. Impaired degradation of histamine, may lead to histamine intolerance and multisystem symptoms. The low-histamine diet is interesting strategy as a non-pharmacological recommendation for managing histamine-related disorders. Background: There are many disorders which symptoms may be associated with the level of histamine, for instance: chronic spontaneous urticaria, inflammatory bowel disease, recurrent headaches, gastrointestinal manifestations in hypermobile Ehlers–Danlos syndrome, and anaphylaxis-like reactions. Although dietary histamine restriction is frequently recommended, the consistency between online dietary advice and scientific evidence could be misleading. Methods: Scientific articles adressing the use of low-histamine diet were identified through an analysis of databases. Secondly, five publicly accessible websites identified through search phrases related to the low-histamine diet were analyzed. Afterwards, five scientific studies from literature databases were reviewed to compare publicly accessible information to recommendations in scientific articles from literature databases. Key findings: Analyzed articles suggest that impaired histamine degradation can result in multisystem symptoms, which may improve after implication dietary histamine restriction. The analysis of low-histamine diet recommendations revealed inconsistencies between internet-based information and literature from scientific databases. Conclusions: A low-histamine diet may provide clinical benefit in selected patients with histamine-related disorders. However, dietary recommendations are often inconsistent with scientific evidence. Implementation of the diet should be individualized and evidence-based. Further studies could be beneficial to establish clear and standardized dietary guidelines for histamine related conditions.