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Histamine Intolerance and Its Role in POTS: Diet Recommendations

  • Kayla Jane
  • Jan 21, 2024
  • 4 min read

Updated: Jul 5, 2024

Explanation of the Connection between POTS and Histamine Sensitivities


By Kayla Jane

Benefits of low histamine diet for POTS patients

POTS patients often struggle with a range of uncomfortable and debilitating symptoms. I've found that one potentially effective tool in managing symptoms is implementing a low histamine diet. I am dedicated to providing in-depth knowledge and support to those looking to explore this option. Here is a breakdown of the reasons behind high histamine levels and offer solutions to help you find relief from your symptoms.


I recognize the impact histamine levels can have on POTS symptoms and here I offer resources on how to manage them.


Explore POTS and Histamine Sensitivities


It is a good idea to start with an elimination diet. Depending on the individual, it can serve as a confirmation of histamine sensitivities. I know how frustrating it can be to constantly battle with symptoms of histamine intolerance. That's why I suggest trying a low histamine diet for three weeks. It's a budget-friendly option that can serve as a confirmation to histamine intolerance if your symptoms improve.


Here's a list of low-histamine food options [3]:


  • Fresh meat

  • Certain fresh/frozen fish – hake, trout, cod, or salmon

  • Chicken

  • Egg

  • Fresh fruits – with the exception of bananas, citrus fruit, cherries, or pineapple

  • Fresh vegetables – with the exception of tomatoes, eggplant and spinach

  • Grains – also products such as rice noodles, white bread, rye bread, rice crisp bread, oats, puffed rice crackers, millet flour, pasta

  • Fresh pasteurized milk and milk products

  • Cream cheese, mozzarella, and butter

  • Olive oil

  • Most leafy herbs

  • Most fruit juices excluding ones containing citrus fruits


The good news is that it doesn't necessarily mean you will need to permanently change your diet.


Histamine Intolerance (HIT)


Those who suffer from histamine intolerance often times do not realize it. Histamine intolerance is not an allergic reaction to histamine, but rather an insufficient histamine breakdown.


Histamine Intolerance causes a wide variety of generic symptoms [1]. Histamine symptoms may include the following symptoms:



Here I will share with you the potential reasons for histamine intolerance [3]. It may be due to one or more of the following reasons:

  • DAO and/or HNMT enzyme deficiencies

  • Allergies can effect levels of histamine. Detection of allergies through an allergist running IgE/IgG4 panel, can serve as a reduction of histamine levels

  • Deficiencies in Vitamin C, folic acid, and vitamin B12 can affect levels of histamines

  • Deficiencies in trace elements (Zinc, copper, manganese & lead) can affect levels of histamines

  • Methylation issues. Doctors can check for MTHFR gene which can be another cause of histamine buildup

  • High levels of estrogen. Estrogen can activate mast cells to release histamine


"80% of sufferers are female, 80% have hypermobility of the joints and 30% have interstitial cystitis." – Dr. Tina Peers [2]

Reasons for DAO Enzyme Deficiencies


As stated above, DAO deficiencies can be a substantial contributor to histamine intolerance [3]. Potential reasons for a decrease in DAO Enzyme production are the following but not limited to

  1. High histamine food/drink consumption

  2. Body is making too much histamine

  3. Impaired DAO activity due to histamine intolerance, genetics, medical conditions, and medicines

  4. Inflammation in the gut or poor gut health can reduce DAO production


Importance of Addressing Potential POTS Contributors


All of these reasons mentioned above can serve as contributors to POTS flares. POTS is difficult to manage, but through process of elimination, it is possible to address some of the main contributors. Some of the POTS contributors can eventually cause more debilitating health issues in the future if not addressed in a timely manner.


Histamine Intolerance and Mold Toxins: POTS Contributors


As mentioned previously allergic reactions can be behind histamine intolerance. The immune system can overreact to mold spores. Over time histamine intolerance due to mycotoxin Exposure or mold toxins, can result in additional debilitating diagnoses if left untreated over time. These include MCAS, CIRS, Chronic Fatigue, Chronic Lyme, MS, Chronic Pain, Chronic Brain Fog, and IBS. For a more in depth explanation on how mold exposure is related to histamine intolerance visit The Impact of Mycotoxins on POTS: Understanding Mold Exposure.


Another Step Toward Healing


Histamine intolerance can be a factor in the severity of symptoms POTS patients experience. It is important to address as soon as possible because excess histamine responses can cause the body to develop new allergic reactions and food sensitivities.


If the low histamine diet is successful it will be beneficial to see a doctor to discuss the potential reasons behind your histamine sensitivities. Everyone is different but the list of reasons shared for insufficient histamine breakdown would be a good starting point for your doctor to check. Take this as another step toward healing in your journey with POTS.





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