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.
Understanding Dairy and Your Histamine Bucket
Navigating the world of dairy when you have histamine intolerance can feel like walking through a minefield. Cheese is both a dietary staple as well as one of the ultimate treat foods, so when you develop a histamine intolerance and have to remove a lot of it from your diet it can be genuinely disheartening.
The good news is that not all dairy is created equal when it comes to histamine.
The key factors that determine the histamine content in dairy are fermentation, ageing, and the types of bacteria involved in its production. In this article we'll explore how histamine is produced in dairy products, what to watch out for, and which options you might be able to tolerate even with a histamine intolerance. Remember, everyone experiences histamine intolerance differently, so we always recommend managing your diet alongside a dietitian, and keeping an accurate histamine diary to understand your own unique tolerance levels.
Why is Some Dairy So High in Histamine?
The high histamine content in certain dairy products comes down to microbiology. Histamine is a biogenic amine, which is a compound produced by living organisms. In foods like cheese and yoghurt, specific bacteria are used to ferment the milk. Some of these bacterial strains convert an amino acid naturally present in milk protein, called histidine, into histamine.
The longer a food is fermented or aged, the more time these microbes have to produce histamine. This is why a 24-month-old Parmesan will have a significantly higher histamine content than a fresh, unripened mozzarella. It is not the milk itself that is the primary issue, but what happens to it during processing. You can learn more about this process in our article on histamine in food and drink.
Remember, almost all dairy products will contain some level of histamine, so our overarching advice is to always approach with caution, and manage your overall histamine levels in your histamine 'bucket'.
Navigating Cheeses: From Aged to Fresh
We understand that giving up cheese can be one of the most challenging aspects of a low histamine diet. However, you may not need to eliminate it entirely. The key is to focus on fresh, unaged varieties.
High-Histamine Cheeses to Approach with Caution
These cheeses are known for their high histamine levels due to long ageing and fermentation processes. They are generally best avoided, especially during the initial phases of a low histamine diet.
- Hard, aged cheeses: Parmesan, mature Cheddar, Gruyère, Comté, Manchego, among others
- Blue cheeses: Roquefort, Stilton, Gorgonzola, Danish Blue. The moulds used to create these cheeses are significant histamine producers
- Processed cheeses: Sliced or spreadable cheeses can contain a mix of aged cheeses and additives that may be problematic
Lower-Histamine Cheeses to Try Carefully
These fresh cheeses have undergone minimal fermentation and no ageing, meaning the bacteria have had very little time to produce histamine. Many people find they can tolerate these in moderation.
- Very fresh cheeses: Ricotta, cottage cheese, mascarpone, cream cheese (check for additives)
- Soft cheeses: Mozzarella (the fresh kind, packed in water), young goat's cheese (chèvre), feta (rinse before eating to reduce brine)
When reintroducing cheese, it is always best to start with a very small amount and monitor your own reaction. Remember to check our comprehensive Low Histamine Diet & Food List for more guidance.
Milk, Yoghurt, and Other Dairy Products
Beyond cheese, other dairy products also vary in their histamine potential. Overall, plant-based milk and yoghurt alternatives will generally always be lower in histamine than dairy products, so (assuming no underlying allergies to these ingredients) could be a better option for you.
Milk and Cream
Freshness is paramount. Freshly pasteurised milk and cream are generally considered low in histamine and are well tolerated by most people with histamine intolerance (assuming no underlying lactose or casein issues). Conversely, fermented milk products like buttermilk or sour cream are high in histamine and should be avoided.
Yoghurt and Kefir
This is a particularly tricky area. Both yoghurt and kefir are fermented, which means they contain histamine-producing bacteria. Kefir, with its wider range of bacteria and yeasts and longer fermentation time, is typically very high in histamine.
Yoghurt is a grey area. Individual tolerance varies significantly depending on the specific bacterial strains used in its production. Some studies suggest certain probiotic strains may even help degrade histamine, but this is not guaranteed for commercial products. If you choose to try yoghurt, opt for a plain, full-fat variety with no added sugars or fruit purees, and start with a very small portion.
Butter and Ghee
Good news. Butter is primarily milk fat, with very low levels of the protein (casein) and amino acid (histidine) needed to create histamine. For this reason, many people find they can tolerate butter better than other dairy products. Ghee, or clarified butter, has had the milk solids removed, making it an even safer choice for many.
Non-hydrogenated margarines are still an even safer choice than butter for a lot of people managing a histamine intolerance.
Could Something Else Be Going On?
It is worth noting that sometimes a reaction to dairy may not be solely due to histamine. The symptoms of other conditions can overlap, and it is a good idea to discuss these possibilities with your doctor or dietitian.
- Lactose Intolerance: A difficulty digesting the sugar (lactose) in milk, causing symptoms like bloating, gas, and diarrhoea
- Casein Sensitivity: An immune or digestive reaction to the protein in milk. Some research suggests differences between A1 and A2 casein proteins, but this is an emerging area
Distinguishing between these conditions can be difficult, which is why working with a professional is so important. You can find a list of dietitians specialising in this area on our about page.
A Practical Approach to Dairy
Managing dairy with histamine intolerance is about prioritising freshness and minimising fermentation, and in many cases, finding alternatives where possible.
Ultimately, navigating your relationship with dairy is a personal journey. By choosing fresh products, listening to your body, and seeking expert guidance, you can build a diet that feels sustainable and enjoyable, not restrictive.