TREATMENT OF HISTAMINE INTOLERANCE

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1 TREATMENT OF HISTAMINE INTOLERANCE low-histamine diet A strict low-biogenic amine diet should be observed as a matter of principle, followed by a re-introduction phase, with the establishment of a permanent diet at a later stage. Avoid matured cheese (hard cheese). Use cream cheese, mild cheese and cottage cheese instead. Izobiraj se trdega sira. Bolje je kremni, čisto lahki sir. Avoid alcoholic beverages. Izogibaj se alkoholnim pijačam. Avoid raw and cured sausage products such as salami. Use cooked ham and cooked sausage instead. Izogibaj se salamam in klobasam. Raje kuhana govedina ali hrenovke. Avoid processed fish products. Use freshly caught fish and seafood instead. Izogibaj se procesiranih ribjih produktov (konzerve). Jej sveže ujete ribe. Avoid tomatoes, pickles and citrus fruits. Use other fresh fruits and vegetables instead. Izogibaj se paradižniku, kumaricam in citrusom. Avoid chocolate. Izogibaj se čokoladi! Avoid nuts Izogibaj se oreščkom. Avoid products made with yeast and yeast extracts. Izogibaj se hrane, narejene iz kvasa. Avoid soy sauce and fermented soy products. Izogibaj se soji. Avoid black tea and green tea. Izogibaj se črnemu in zelenemu čaju. Avoid energy drinks and coffee. Izogibaj se energijskim pijačam in kavi. It is very important to coordinate this precisely with your doctor and your registered dietician! Enzyme products An enzyme product containing Diamine Oxidase (DAO) breaks down ingested histamine. DAO is available worldwide under the brand name "DAOsin" and can be bought online. It was acknowledged by the U.S. Food and Drug Administration in 2008 and is also available in the U.S.

2 Vitamins and Histamine Intolerance Some sources recommend taking supplements of Vitamin B6 and Vitamin C. Vitamin C Promotes the degradation of histamine Substitution is useful Recommended daily dosage: 0,5-1g Vitamin B6 Important for the synthesis of DAO Substitution is only useful if a Vitamin B6 deficiency has been established Recommended daily dosage: 1,2mg Anti-histamines / emergency pack It is recommended that you carry an emergency pack (speak with your doctor about this!) with you at all times. The pack should include some form of anti-histamine and maybe an asthma pocket inhaler (if you had asthmatic symptoms previously). The emergency pack is not a replacement for the diet! Some drugs enhance the intolerance symptoms! If you are already taking medication for any other health reason, ask your doctor about their effect on the histamine intolerance! There are a lot of substances used in different drugs that have a negative effect on the DAO enzyme. So do not change your medication before you have talked to your doctor, as otherwise you may seriously harm your health. HIT: WHAT CAN I EAT? The most important measure to take is to observe a low-histamine diet. There are a couple of basic rules that you should keep in mind: No preserves, canned or bottled food products No over-ripe foods (matured cheeses, alcoholic beverages, products produced with yeast, less than fresh fish...) Histamine levels can vary! Depends on the maturation/ripening stage and hygienic condition of the product. No alcohol, especially not before, during or after meals.

3 Always make sure to tell any physicians treating you that you have histamine intolerance. This applies especially when you undergo surgery under anaesthetic! Always keep your emergency set with you (as prescribed by your doctor) Certain medication should be avoided. (Ask your doctor! ) Always eat food directly from the refrigerator; don t take it out of the refrigerator to let it warm up before you eat it. The following foods should be avoided in general: Alcoholic beverages Hard (matured) cheese Salami Nuts Tomatoes Fish (except for very fresh fish) Tuna (even when it s fresh) Shell fish Sauerkraut You can find a more detailed list of tolerated and not tolerated foods here, and here in the histamine table. The following table is ranked according to the degree of tolerance. well tolerated sometimes tolerated individual testing during the test phase recommended poorly tolerated ED = elimination diet (first weeks after diagnosis) PD = permanent diet Food ED PD Food ED PD Potato Celeriac Lettuce Grapes Rice Onions

4 Courgettes Pork Chicken (without skin) Coffee Endive Fruit teas, fresh Lamb s lettuce Mushrooms Blueberries Savoy cabbage Pumpkin (Hokkaido) Garlic Dandelion leaves Bell peppers (green) Carrots Chanterelle mushrooms Sweet potatoes Plums Watermelon Porcini (Ceps) Broccoli Corn (tinned) Chicory Bamboo shoots Chinese cabbage Red cabbage

5 Fennel Green beans Cucumber Peas Fresh corn, cooked Hoseraddish Asparagus Raisins Sugar melon Pears Beef Chickpeas Apple Tuna, fresh Cauliflower Sodas, diet Redcurrents Aubergine Prickly pear Avocado Peach Banana Leek Dates, dried Radish Lima beans

6 Beetroot Mandarin / Tangerine Gooseberry Soy beans Egg White cabbage Apricot Malt beer Artichoke Figs, dried Blackberry Limes Sweet chestnuts Spinach Pomegranate Lemons Kaki Cocoa powder Cherry Spirits, distilled Lohlrabi Pineapple Lychee Strawberries Mango Pickled cucumber

7 Okra Grapefruit Black salsify Kiwi Salt water fish (not tuna!) Orange Fresh water fish Tomato Honey Beer Figs Energy drink, sugar-free Raspberries White wine Coconut milk Tuna, tinned Mangold Energy drink with sugar Papaya Sauerkraut Parsnip Wheat beer Rhubarb Red wine Brussels sprouts

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