DEAR DR. BLONZ: I have an unfortunate tendency to develop hives and was told that a low-histamine diet can help in some cases. I have been having difficulty finding a list of foods showing histamine content. -- S.S., San Diego, California
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DEAR S.S.: Hives also goes by "chronic spontaneous urticaria," which relates to annoyingly itchy raised skin of unknown origin that can appear in unpredictable ways and places on the body. Considering whether what you eat plays a role makes sense, but seeking a low-histamine diet is a bit misleading, as pre-formed histamine is not found in foods to any appreciable degree. (Read more about hives at b.link/649b2je.)
Histamine is involved with inflammation, a reaction that can bring about a localized increase in blood flow that the body uses to facilitate tissue repairs and the elimination of foreign materials. The body makes its own histamine from histidine, an essential amino acid in all complete proteins, and it stores its histamine in reservoirs called mast cells, which are distributed throughout the body.
Histamine has its dark side. In addition to doing good things, histamine is responsible for cold and allergy symptoms, such as sneezing, itchy eyes, runny nose and, in your case, hives. When under the throes of such effects, we often turn to antihistamines to provide symptomatic relief. Check the MedlinePlus video on histamine at b.link/gxef5uy. It may not be a case of seeking a diet low in histamine as much as it is identifying foods that cause histamine to release in your body.
As histamine is involved in allergic-type reactions, the first foods to consider would be suspects often associated with allergies or hypersensitivity reactions. That list includes shellfish, eggs, cheese, hard sausage, sauerkraut, chocolate, nuts, tomatoes, berries, wine and beer.
Other lists recommend the elimination of food additives such as sulfites, benzoates, nitrites, salicylates, artificial colors, preservatives and tartrazines, as well as other foods such as milk, citrus, cola, cinnamon, strawberries, peas, beans, eggs, pork and wheat.
The next foods to check would be those with unusually high concentrations of free histidine, an essential amino acid. Free histidine in foods poses a potential problem because enzymes can change histidine into histamine. Foods with high levels of free histidine include fish such as tuna, bonito, mackerel, blue marlin, sardines, herring and anchovies. (Note: This is not an issue with the histidine that's part of complete proteins.)
We all differ in how we react to foods, so it is best to find out what is going on rather than following a bunch of "avoid" lists. Testing is available; be sure to discuss this with the health professional focused on this aspect of your care.
Send questions to: "On Nutrition," Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.