Are onions and bell peppers safe for a low histamine (histamine intolerance) diet?

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Onions and Bell Peppers in Low Histamine Diets

Onions and bell peppers are generally safe for consumption on a low histamine diet, as they are not considered high-histamine foods and are not typically excluded from low histamine dietary protocols.

Understanding Histamine Content in Foods

Histamine intolerance results from an imbalance between accumulated histamine and the body's capacity to degrade it, primarily through the enzyme diamine oxidase (DAO) 1. When considering foods for a low histamine diet, it's important to understand which foods actually contain significant histamine levels.

According to a comprehensive review of low-histamine diets, only certain plant-origin foods contain significant levels of histamine 2:

  • Eggplant
  • Spinach
  • Tomato
  • Avocado

Notably, onions and bell peppers are not included in this list of high-histamine plant foods.

Scientific Evidence on Onions and Bell Peppers

Research specifically examining low-histamine diets found great heterogeneity in the foods excluded across different dietary protocols 3. The only foods unanimously excluded were fermented foods, which neither onions nor bell peppers are. Only about 32% of foods excluded in low-histamine diets could be justified by their actual histamine content 3.

A study on biogenic amines in plant-origin foods confirmed that onions and bell peppers are not among the plant foods with significant histamine content 2. This supports their inclusion in a low-histamine diet.

Practical Dietary Recommendations

When following a low-histamine diet:

  1. Focus on freshness: Consume onions and bell peppers when they are fresh, as biogenic amine content can increase with storage time 2.

  2. Consider cooking method: Boiling vegetables can help reduce their biogenic amine content 2.

  3. Be aware of individual variations: While onions and bell peppers are generally considered safe for low-histamine diets, individual tolerance can vary 4.

  4. Watch for other biogenic amines: Some foods may contain other biogenic amines like putrescine that can compete with histamine for degradation by DAO 2. However, onions and bell peppers are not noted for high levels of these compounds.

Beyond Dietary Management

While diet is important, comprehensive management of histamine intolerance may include:

  • DAO enzyme supplementation to support histamine degradation 4
  • Second-generation H1 antihistamines when indicated, as recommended by the American Academy of Allergy, Asthma, and Immunology 5
  • Avoiding medications that may increase histamine levels 5

Caution and Considerations

Despite the general safety of onions and bell peppers on a low-histamine diet, it's worth noting that:

  • The diagnosis of histamine intolerance requires a complex, multidisciplinary approach 4
  • A good response to a low-histamine diet is considered confirmation of histamine intolerance 4
  • Individual responses to foods can vary, and some people may have idiosyncratic reactions even to foods not typically high in histamine 6

In conclusion, current scientific evidence supports that onions and bell peppers can be included in a low-histamine diet, as they are not significant sources of dietary histamine. However, individual tolerance should always be monitored, and freshness and proper preparation remain important factors in minimizing biogenic amine intake.

References

Research

Histamine and histamine intolerance.

The American journal of clinical nutrition, 2007

Guideline

Histamine and Sexual Dysfunction

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

[Debating histamine intolerance: are adverse reactions to histamine-containing foods fact or fiction?].

Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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