Histamine-free diet: treatment of choice for histamine-induced food intolerance and supporting treatment for chronic headaches

Clin Exp Allergy. 1993 Dec;23(12):982-5. doi: 10.1111/j.1365-2222.1993.tb00287.x.


Histamine-induced food intolerance is not IgE-mediated. Skin-prick testing and specific IgE to food allergens are typically negative. Food rich in histamine or red wine may cause allergy-like symptoms such as sneezing, flush, skin itching, diarrhoea and even shortness of breath. The suspected reason is a diminished histamine degradation based on a deficiency of diamine oxidase. As diamine oxidase cannot be supplemented, a histamine-free diet was implemented to reduce histamine intake. Forty-five patients with a history of suffering from intolerance to food or wine (n = 17) and chronic headache (n = 28) were put on the diet over months to years. Fish, cheese, hard cured sausages, pickled cabbage and alcoholic beverages had to be avoided. Complaint intensity and drug-use per week prior to and 4 weeks after a histamine-free diet were compared. After 4 weeks on the diet 33/45 patients improved considerably (P < 0.01), eight of them had total remission. In 12/45 patients, however, no changes in symptoms were observed. Symptoms of food or wine intolerance significantly decreased (P < 0.02; treatment of choice), headaches decreased in frequency (P < 0.001), duration and intensity. After eating histamine-rich food symptoms were reproducible and could be eliminated by anti-histamines in most patients. These data indicate the role of histamine in food and wine intolerance and that histamine-rich food causes a worsening of symptoms in patients suffering from chronic headaches. Results obtained support the hypothesis of a deficiency of diamine oxidase in patients with intolerance to food or wine.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Amine Oxidase (Copper-Containing) / deficiency
  • Animals
  • Cheese / adverse effects
  • Child
  • Combined Modality Therapy
  • Female
  • Fishes
  • Food Hypersensitivity / diet therapy*
  • Food Hypersensitivity / drug therapy
  • Food Hypersensitivity / etiology
  • Headache / diet therapy*
  • Headache / drug therapy
  • Headache / etiology
  • Histamine / adverse effects*
  • Histamine H1 Antagonists / therapeutic use
  • Humans
  • Male
  • Meat Products / adverse effects
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications / diet therapy
  • Pregnancy Complications / drug therapy
  • Pregnancy Complications / immunology
  • Wine / adverse effects


  • Histamine H1 Antagonists
  • Histamine
  • Amine Oxidase (Copper-Containing)