Do kale and lettuce have low histamine levels?

Kale and Lettuce in Low-Histamine Diets

Yes, both kale and lettuce are considered low-histamine foods and are generally safe for individuals with histamine intolerance. These leafy greens typically contain minimal amounts of histamine and are not known to trigger histamine release in the body.

Understanding Histamine Intolerance

Histamine intolerance occurs when there is an imbalance between accumulated histamine and the body's capacity to degrade it 1. This condition typically results from:

• Reduced activity of diamine oxidase (DAO), the main enzyme responsible for metabolizing ingested histamine
• Excessive consumption of histamine-rich foods
• Consumption of foods that release histamine or block DAO activity

Symptoms of Histamine Intolerance

Histamine intolerance can manifest with various symptoms affecting multiple organ systems 2:

• Gastrointestinal: diarrhea, abdominal pain, nausea, vomiting
• Dermatologic: flushing, urticaria, pruritus, angioedema
• Respiratory: wheezing, shortness of breath
• Cardiovascular: hypotension, tachycardia

Low-Histamine Foods vs. High-Histamine Foods

Low-Histamine Foods (Generally Safe)

• Fresh leafy greens including kale and lettuce
• Fresh non-citrus fruits
• Fresh meats (not aged or processed)
• Fresh fish (not canned or smoked)
• Eggs
• Grains like rice and quinoa

High-Histamine Foods (Should Be Limited)

• Fermented foods (unanimously excluded in all low-histamine diets) 3
• Aged cheeses
• Alcoholic beverages
• Processed meats
• Certain vegetables like tomatoes, eggplants, and spinach (which can contain histamine levels of 0.8-34.2 mg/kg) 4
• Citrus fruits and bananas (contain putrescine which may interfere with histamine degradation) 3

Important Considerations for Histamine Intolerance Management

1. Dietary Management: A low-histamine diet is the gold standard for managing histamine intolerance 5

2. Individual Variation: There is significant heterogeneity in food tolerance among individuals with histamine intolerance 3

3. Scientific Limitations: Current low-histamine diets show considerable disparity in their food exclusion lists, with only 32% of excluded foods having documented high histamine content 3

4. Beyond Histamine Content: Some foods with low histamine may still trigger symptoms through histamine-releasing mechanisms, though these mechanisms are not fully understood 3

Clinical Approach

For patients with suspected histamine intolerance:

1. Consider a trial of a low-histamine diet that includes kale and lettuce as safe options
2. DAO enzyme supplementation may be beneficial for those with intestinal DAO deficiency 5
3. Second or third-generation H1 antihistamines may be used for time-limited symptom management 5

Remember that food intolerance is distinct from food allergy, which involves an IgE-mediated immunological response to food components 6. Proper diagnosis requires ruling out other conditions with similar symptoms.