Is coffee a low histamine food?

Coffee and Histamine Content: Implications for Histamine Intolerance

Coffee is not considered a low-histamine food and should be avoided by individuals with histamine intolerance due to its potential to trigger histamine-related symptoms.

Understanding Coffee's Histamine Profile

While coffee itself is not specifically identified as containing high levels of histamine in the available guidelines, several factors make it problematic for those with histamine intolerance:

• Coffee contains bioactive compounds including phenolic compounds (caffeoylquinic acids, p-coumaroylquinic acids, feruoylquinic acids) that interact with histamine metabolism 1
• Coffee is frequently excluded in low-histamine diets recommended for histamine intolerance management 2
• The caffeine in coffee may act as a histamine liberator in sensitive individuals, potentially triggering symptoms even without containing high histamine levels itself

Histamine Intolerance: Clinical Context

Histamine intolerance results from an imbalance between accumulated histamine and the body's capacity to degrade it, primarily through the enzyme diamine oxidase (DAO) 3. When considering coffee consumption in this context:

• Symptoms of histamine intolerance can mimic allergic reactions, including headache, rhinoconjunctival symptoms, asthma, hypotension, arrhythmia, urticaria, pruritus, and flushing 3
• Even modest amounts of histamine (75mg) can provoke both immediate and delayed symptoms in susceptible individuals 4
• The histamine content alone is not sufficient to predict tolerance of a food; other factors like histamine-liberating properties must be considered 5

Therapeutic Approach for Histamine Intolerance

For individuals with suspected histamine intolerance, the following approach is recommended:

1. Implement a low-histamine diet: This is considered the gold standard for diagnosis and treatment 6

   • Eliminate fermented foods (universally excluded in all low-histamine diets) 2
   • Avoid coffee and other potential histamine-liberating foods
   • Maintain the diet for at least 4 weeks to evaluate effectiveness

2. Consider DAO supplementation: May be helpful as an adjunctive treatment for those with intestinal DAO deficiency 6

3. Use antihistamines judiciously: If needed, prefer second-generation H1 antihistamines over first-generation due to fewer side effects 7

Important Considerations and Caveats

• The diagnosis of histamine intolerance requires a complex, time-demanding multidisciplinary approach 6
• Individual responses to histamine-containing or histamine-liberating foods can vary significantly
• A good response to a low-histamine diet is considered confirmatory of histamine intolerance 6
• Coffee has beneficial effects in healthy adults without histamine intolerance, including decreased risk of various cancers, cardiovascular disease, and type 2 diabetes 1

For those with suspected histamine intolerance experiencing symptoms after coffee consumption, a trial elimination of coffee for 4 weeks, followed by careful reintroduction, may help determine individual tolerance.