Objective: To evaluate the evidence regarding the disease concept of histamine intolerance as a state of inadequate histamine inactivation.
Methods: Keyword-based systematic screening of the scientific literature and of public websites focusing on diagnostic and therapeutic procedures.
Results: Histamine intolerance is commonly diagnosed based solely on subjective reporting of symptoms instead of following systematic diagnostic procedures based on objective laboratory and physical parameters. The only effective long-term therapy is avoidance of histamine-containing food.
Conclusions: The concept of histamine intolerance as a metabolic disease is in need of more experimental and clinical evidence and affected patients will benefit from a clear, evidence-based diagnostic and therapeutic regime.