Dr Joneja's Guides to Histamine Intolerance

Dr Janice Joneja, a world expert on histamine intolerance, has published two books on histamine intolerance:

A Beginner's Guide to Histamine Intolerance – read more about it here.

Buy the paperback from Amazon here; buy the e-book from Amazon here.

Histamine Intolerance: The Comprehensive Guide for Healthcare Professionals – read more about it here.

Buy the ebook from Amazon here.

You can buy all of Dr Joneja's books here in the UK or here in the US.

Histamine levels in food and their relevance to histamine intolerance
Food is not the only source of histamine nor will any one food cause symptoms of histamine intolerance to appear. Dr Janice Joneja explains.

Exogenous histamine (from outside the body) will come from several sources, including:

  • Foods and beverages naturally high in histamine, typically as a result of ripening processes of fruits and vegetables
  • Those in which microbial activity has converted histidine in the protein component of the food to histamine as a result of incorrect processing; this is seen mostly in fish, poultry and meat and of course, over-ripe and rotting vegetation
  • Those in which histamine results from the manufacturing process (principally fermented food and beverages)
  • Those containing additives, mainly benzoates, sulphites, azo dyes (especially tartrazine) and other factors (some unknown) that result in the release of histamine within the body
  • Medications that reduce the activity of the enzymes (mainly diamine oxidase (DAO)) that break down excess histamine. 

Histamine also arises from the activity of micro-organisms within the large bowel that convert the histidine in residual protein into histamine, which is then absorbed, thereby increasing the body’s total level of histamine. 

A list of histamine levels in different foods and beverages will only provide information about the first two items in the above list.  Even then, the results are far from helpful. Histamine levels reported from different labs depend on several variables, including the methods used for analysis and, more importantly, the source of the food or beverage under test.  For example:

  • Fruits and vegetables will contain varying levels of histamine depending on the conditions under which the plants were grown and the ripeness of the fruit
  • Manufactured products will have levels of histamine as a result of the process used in their production, usually the degree of fermentation involved and the types of fermentation methods used
  • Proteinaceous foods such as fish and meat will have levels of histamine dependent on the method used in their processing: completely fresh will likely contain no histamine, but the longer the product remains in contact with micro-organisms (for example, in an ungutted fish), the higher the histamine is likely to be. 

Consumers are familiar with the concept that each food they purchase will have specific levels of nutrients.  For example, lists of the level of proteins, fats, carbohydrates, vitamins and minerals in foods are available.  However, histamine is not a nutrient and as the list above demonstrates, the biogenic amine is present in foods and beverages as a result of a variety of factors, most of which are not by any means constant.

It is often difficult for people to understand that histamine intolerance, as a result of an excess level of histamine, is not a single event.  No single food will cause symptoms to appear! As I have so frequently indicated, it is like a bucket filling up with water.  When the total level reaches the top of the bucket, the water overflows.  It is this overflowing that triggers the symptoms of histamine intolerance.  The total comes from sources both inside and outside the body.  Merely avoiding foods with reportedly high levels of histamine will not avoid the symptoms if other sources of histamine combine to fill the “histamine bucket”. 

Furthermore, histamine is not like an allergen; consuming a food with high histamine will not trigger an immediate response unless the person’s histamine bucket is already overfull. Histamine builds up over an extended period of time and it is not unusual for a histamine-intolerant person to experience symptoms several hours after consuming foods high in histamine.  Symptoms will not appear until the total level of histamine exceeds the person’s limit of tolerance.

It is important for a person with histamine intolerance to follow a low histamine diet to reduce all sources of dietary histamine. Please see the second half of this article. Supplemental diamine oxidase (DAO), the enzyme the breaks down histamine, will take care of any residual histamine in the diet and prevent this source of histamine from entering the body. Please see this article for more information on DAO.

You can buy DAO supplements here in the UK or here in the US. You can buy all of Dr Joneja's books here in the UK or here in the US.

September 2016

If you found this article interesting you can find a number of other articles on histamine intolerance both by Dr Joneja and others here, reports on histamine research here and a Q & A section on histamine with Dr Joneja here.

For many, many other articles on every type of food allergy and intolerance click here; for coeliac disease and other food related conditions, go here.

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Dr Janice Joneja, Ph.D., RDDr. Janice Joneja is a researcher, educator, author, and clinical counsellor with over thirty years of experience in the area of biochemical and immunological reactions involved in food allergy and intolerances. Dr. Joneja holds a Ph.D. in medical microbiology and immunology and was a registered dietitian (RD) – now retired. 

She has been a member of the faculty at several Canadian universities, starting her career as an Assistant Professor in the Department of Microbiology, Faculty of Science, and in the Faculty of Dentistry, at the University of British Columbia, Vancouver. Since 2001 Dr. Joneja has been a faculty member in the School of Biomedical and Molecular Sciences, at the University of Surrey, in England, teaching in the M.Sc. course in Nutritional Medicine.  For 12 years she was head of the Allergy Nutrition Program at the Vancouver Hospital and Health Sciences Centre.

Dr. Joneja is the author of six books and a dietetic practice manual on food allergy, a textbook on Irritable Bowel Syndrome, and several distance education courses. Her most recent books include “The Health Professional’s Guide to Food Allergies and Intolerances”, “Dealing with Food Allergies”, and “Dealing with Food Allergies in Babies and Children”.  Dr. Joneja’s work has been published in peer-reviewed scientific and medical journals, as well as in popular magazines.  She is a respected lecturer at universities, colleges and hospitals internationally, and regularly appears on television and radio call-in shows as an expert in her field.

Dr. Joneja is President of Vickerstaff Health Services, Inc., a practice that provides counselling for people suffering from all aspects of adverse reactions to food, and resources for the professionals and care-givers who support them.

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