If you think a low histamine diet may help, it is important to try it systematically.
Many people follow a low histamine diet, on-and-off, without really knowing if it is helping. A systematic trial will help you decide if the diet is helping. Here are a few things to keep in mind.
- The low histamine diet is a guideline based on an educated guess, not a precise diet based on fact. Please read Histamine Intolerance for a further discussion.
- The low histamine diet should be the only change. For example, if you start a low histamine diet at the same time as new medications, and feel better, you would not know which change was responsible for the improvement.
- Eating a healthy diet is just as important as following the restriction. Consider booking an appointment with a registered dietitian to ensure you are eating nutritiously during your restricted diet trial.
- The low histamine diet encompasses a few different theories, and it is good to test these parts separately. Ideally, you should not restrict your diet anymore that necessary. If your symptoms improve at any stage, continue with the restriction and add the next restrictions to see if you experience further benefit. If a restriction is not helpful, discontinue it, but try the next restriction.
- Step 1 (one week): Cut out alcohol, because it is the most common symptom trigger.
- Step 2 (two weeks): Eat your regular diet, but follow “Minimize Histamine Formation during Food Storage.” After two weeks, if these changes have not helped, you do not need to continue with them. Leftovers are not a concern for you!
- Step 3 (two weeks): Restrict fermented foods – such as aged cheese, yogurt, kefir, kombucha, kimchi, sauerkraut, tempeh, natto, aged sausage, etc.
- Step 4 (three weeks): Follow the full low histamine diet – either my version (Wendy’s Low Histamine Diet Guidelines) or a different one. Change your diet gradually over a few weeks. For most people, sudden dietary changes are hard on the body. Note: if any of the above restrictions were not helpful, follow the low histamine diet guidelines, but ignore that restriction. For example, if minimizing histamine formation was not helpful, follow the low histamine diet, but don’t worry about leftovers.