Is histamine a protective friend or inflammatory foe?


As Keren Brynes MacLean marks 25 years of herbal practice, she reflects on changed times and how modern life has led to a rise in inflammatory, auto-immune and allergic conditions

A quarter of a century of clinical experience has seen significant changes since I joined the National Institute of Medical Herbalists in 1996. Back then, things were very different. 

Herbal Medicine was going through a revival – and, thankfully, still is.  Echinacea and St John’s Wort were hero herbs, while Ashwaganda and Rhodiola weren’t available in the UK and nobody had heard of probiotics or the microbiome.


Twenty-five years on and health conditions seem much more complex.  There are a rising number of inflammatory, auto-immune and allergic conditions causing multi-system illnesses that can be difficult to diagnose and manage.

These allergic inflammatory complaints are gaining momentum at incredible speed.  Allergic conditions are growing at 5% per annum, which means they are growing on an exponential trajectory. 

Back in the 90s, the only time we considered anti-histamine herbs was for hay fever, eczema, insect bites or asthma. But this excitatory chemical is a trigger for more than just the classic allergy problems. 

Histamine can trigger a whole cascade of other chemical mediators and, as the inflammatory initiator, may exacerbate conditions such as endometriosis, irritable bowel syndrome and interstitial cystitis.

Keren Brynes Maclean at Health Food and More

Histamine may even play a role in Covid severity and longevity. 

Mast cells are an important part of our immune system.  They help protect our bodies by guarding the boundary between us and the outside world and they release histamine very readily. 

The idea is that we flush out what has caused the irritation and the job is done.  

Inflammation is part of this healing process and only really becomes a problem when it gets out of control, or chronic, and then it can cause extensive unresolved tissue damage.  

Instead of histamine being a protective friend, it has the potential to become an inflammatory foe. 

But, just as your body has the capability to produce and release histamine, it can break it down and eliminate it too. 

By cutting back on the amount of histamine being produced and released – combined with clearing it from the body quicker – you effectively increase your histamine capacity. 

Your histamine bucket gets bigger and your symptom severity might lessen.

How to spot if histamine is a problem

You should look for gut dysfunction, but other symptoms can be varied and could include symptoms in other mucus membranes such as rhinitis or cystitis. 

You may have skin rashes, pimples, flushing or hives.  Palpitations, dizziness, headaches and joint discomfort are common. 

There may be a strong family history of allergies and I often see a family trait of hypermobility too.

Women may have hormonal imbalance and there may be issues with mood and sleep. 

Clients often tell me they feel foods are making them ill, but it’s difficult to pinpoint which foods are the trigger.

This is because it’s the histamine, not the food itself, that’s the problem – and reactions can vary depending on overall histamine burden in the body when the food is consumed. 

In the back story, we might find a history of antibiotic use and a dysbiotic bowel, almost certainly some stress, nutritional imbalance and often a disconnect from nature.  

Compared to our ancestors, who lived in harmony with nature, we live in a sterile, synthetic stressful world. 

Instead of appropriate exercise, rest and digest, which increases vagal tone we tend to run in a sympathetic adrenalin fuelled mode which switches on inflammation. 

What’s the answer?

A simple first step would be to follow a low histamine diet for two to three weeks and look for an overall improvement in your symptoms. 

Two or three weeks of a low histamine diet isn’t going to fix your health, but it’s a good indicator that histamine is a problem you need to address at a deeper level. 

If it does look like histamine is a player for you, you may have a deficiency of Diamine oxidase (DAO), the enzyme that degrades and breaks down histamine. 

You can’t measure histamine levels, but you can check for DAO deficiency and supplement accordingly. 

And you can take other positive steps that might include addressing underlying infections, correcting nutritional imbalance, reducing stress levels and using supplements and herbs to help “reset” your system to a lower histamine state. 

There’s a lot of information out there and dealing with histamine issues is not an exact science.

But, armed with good information and the support of a naturopathic-minded practitioner, you have the potential to get back in the driving seat instead of histamine driving you. 

Top 5 anti-histamine herbs

Reishi Mushroom is excellent for treating hay fever and other allergies and can help reduce auto-immune inflammation.

Reishi mushroom

Lactobacillus rhamnosus gg could reduce food intolerance and atopic tendencies in young children, as well as IBS, skin problems and allergies. But not all probiotics are good for histamine problems, so research them thoroughly first.

Quercetin is naturally found in fruit and veg, but daily supplements could help  dramatically reduce histamine and inflammation.


Nettle helps calm histamine and alkalise the body – hence it’s useful forfor hayfever and eczema. Nettle is also nutritional powerhouse rich in essential minerals and vitamin C.

Schisandra, a Chinese berry, is a natural adaptogen which supports optimum liver function, supports the breakdown of histamine and boosts adrenal function.


Low histamine foods

It’s worth researching histamine foods in detail and keeping a diet dairy noting symptoms and foods eaten.

Everyone has their own unique histamine threshold.

The idea behind treatment for histamine related problems is to reduce histamine triggering foods and at the same time increase histamine tolerance by correcting underlying issues such as gut dysbiosis, nutritional imbalances and DAO deficiency.

Over time, potentially more histamine foods can be eaten as tolerance increases.

It’s important to remember that it’s not one particular food that’s a culprit, but the cumulative effect of eating too many in any one day and literally “filling” the histamine bucket until you get overspill and symptoms.

Some foods are thought to be high in histamine and should be reduced or avoided. These include alcohol, pickled and fermented foods, aged foods such as cheese or processed meats, chocolate and nuts.

Some foods are thought to liberate histamine and should be reduced or avoided. These include chocolate, peanuts, citrus fruit, tomatoes, pineapples and kiwi fruits.

Some foods are thought to block the action of DAO, the enzyme that breaks down histamine. These too should be restricted and include black tea, alcohol yeast extract and energy drinks.

Although restrictive a low histamine diet can still be healthy. Fresh meat, fish, eggs and milk are all low histamine foods.

Most green vegetables and root vegetables are also low in histamine and there are still fruits that can be consumed without impacting histamine levels.

Any low histamine diet is not intended as a long term management, it helps pinpoint whether histamine is an issue and can help you to determine what your own unique tolerance threshold is. 

Keren Brynes Maclean is a consultant medical herbalist at Health Food and More in Kirkcaldy. To find out more, or to book a consultation, visit the website.

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