A Tolerance Kitchen article.
The below content has been created with the input of a range of dietitians and sources. Following a low histamine diet should always be done alongside a qualified dietitian. Your own unique intolerances may make you more susceptible to certain foods than others, and long term adherence can lead to deficiencies in other important nutrients. You can find a list of trusted histamine dietitians here, all of whom offer 1:1 online sessions to help you get started and work with you to create a personalised diet.
When you first start exploring a low histamine diet, food often takes centre stage. You learn to swap aged cheese for fresh, tinned fish for freshly caught, and spinach for kale. But what are you drinking with these meals? Beverages can be a significant and often overlooked source of histamine, and making the right choices can be a key part of managing your overall load.
We like to think of it using the 'histamine bucket' analogy. Everyone has a bucket of a certain size, and when it overflows from a combination of triggers, reactions can occur. The drinks you consume can either fill your bucket quickly or add very little, leaving more room for other things. This guide will walk you through the most common types of drinks, explaining why some are better choices than others.
We're focusing here on non-alcoholic drinks only, but you can read more about histamine in wine in another of our articles here.
Why Do Drinks Contain Histamine?
The histamine content in drinks, much like in food, is often related to a few key processes: fermentation, ageing, and specific ingredients. Fermentation, used to make drinks like kombucha and black tea, involves microbes that can produce histamine as a byproduct. Similarly, certain fruits and additives used in drinks are naturally high in histamine or can trigger your body to release its own internal supply.
Your body's primary tool for breaking down histamine from food and drink (external histamine) is an enzyme called Diamine Oxidase (DAO). When you don't have enough of this enzyme, a condition known as DAO deficiency, you may find it difficult to process even moderate amounts of histamine. You can learn more about the science of how DAO works here.
Your Morning Brew: Coffee and Tea
That first warm drink of the day is a non-negotiable ritual for many, so let's look at the options.
Coffee
The topic of coffee and histamine intolerance is complex. The coffee beans themselves are not considered high in histamine. However, caffeine can be a 'histamine liberator' for some people, meaning it may encourage your body's mast cells to release their own stored histamine. Furthermore, poorly processed or instant coffee may contain trace elements of mould, which can also be a trigger.
If you love your coffee, you might not have to give it up entirely. Some people find they can tolerate it by:
- Choosing high-quality beans: Opt for freshly roasted, single-origin beans, as they are less likely to have issues with mould
- Brewing fresh: Avoid letting brewed coffee sit for long periods
- Limiting intake: Pay attention to how you feel and find the amount that works for you
- Trying alternatives: Chicory root coffee provides a similar roasted flavour without the caffeine and is generally well-tolerated
Tea
With tea, the key difference lies in how the leaves are processed.
- Low Histamine Teas: Most herbal teas are a safe bet. Peppermint, chamomile, ginger, and rooibos (also known as red bush tea) are excellent choices. Always check the ingredients however, as some blends contain dried citrus peel or other high-histamine flavourings
- Moderate to High Histamine Teas: Black, green, and white teas all come from the same plant, Camellia sinensis. The difference is the level of fermentation and oxidation. Black tea is the most fermented, and therefore typically the highest in histamine. Green tea is unfermented but can still be problematic for some. Matcha, made from the whole, powdered leaf, is a concentrated source and is often best avoided during an elimination phase
Navigating Plant-Based Milks
Finding a low histamine plant milk can feel like a challenge, as many contain gums, thickeners, and preservatives that can be triggers. The golden rule here is to read the label carefully.
- Generally Lower Histamine: Oat milk, rice milk, and coconut milk (the drinking kind, not the tinned variety) are often tolerated well. The best options are those with the fewest ingredients, ideally just the plant itself, water, and perhaps a little salt
- Potentially Problematic: Soya milk is made from a legume and is a fermented product, placing it firmly in the high-histamine category. Almond milk can be a grey area; while almonds themselves are moderately high in histamine, the low concentration in the milk may be tolerable for some. It's a case of individual sensitivity
Fruit Juices and Smoothies
When it comes to juice, freshness is everything. Histamine levels in fruit increase as it ripens, is processed, and is stored. We have an article on histamine in fruit here.
- Low Histamine Choices: Freshly made juice or smoothies using low-histamine fruits are your best option. Think apple, pear, mango, or blueberries. You can find a full list on our Low Histamine Diet & Food List
- High Histamine to Avoid: Steer clear of citrus juices (orange, grapefruit, lemon), as citrus is a well-recognised histamine liberator. Tomato juice, pineapple juice, and most pre-packaged, long-life juices should also be avoided due to their high histamine content and potential for preservatives
Water: The Safest Choice
Plain, filtered water is always the best and safest choice for hydration. If you find it uninteresting, you can infuse it with low-histamine ingredients:
- Slices of fresh cucumber
- A few fresh mint leaves
- Slices of a crisp apple or pear
- A single blueberry or two
Avoid adding lemon or other citrus slices, and be wary of commercial water enhancers, which often contain artificial sweeteners, colours, and citric acid.
Managing Your Beverage Choices
Understanding which drinks are lower in histamine gives you the power to make choices that support your body. By opting for a peppermint tea over a black tea, or fresh apple juice over orange juice, you are helping to keep your histamine bucket from overflowing.
Remember, this is about building a toolkit, not a rigid set of rules. The goal is to find a balanced and enjoyable diet that works for you. If you are just starting out, our Beginner's Guide to Histamine Intolerance may be a helpful resource.
This article is for informational purposes only and does not constitute medical advice. Please consult a qualified healthcare professional for advice specific to your situation.