Alcohol

Alcohol is notable for histamine, tyramine, gluten and salicylate. Clear on FODMAPs, lactose, fructose, oligosaccharides, sorbitol, sucrose, nickel and oxalates.

Yes — Alcohol is high in histamine. Alcohol is a problem even when the drink carries no histamine of its own: ethanol directly inhibits DAO, the enzyme that clears histamine, so whatever you eat alongside it hits harder. That is why a meal that is normally fine can trigger symptoms when there is a drink with it. This is the source the whole axis rests on, and alcohol is one of the two things it names directly: Maintz and Novak describe histamine intolerance as a disequilibrium between accumulated histamine and the capacity to degrade it, with DAO the main enzyme for what is eaten, and alcohol and some drugs either releasing histamine or blocking that enzyme. The authors add their own caveat, which belongs here too: further double-blind placebo-controlled provocation is needed.

Alcohol contains moderate levels of tyramine. Alcohol as a category is on MAOI lists for what it comes in rather than for the ethanol: tap beer is the one the modern review still restricts, and the fortified and aged wines - sherry, vermouth - are the older list's entries; wine and bottled beer it treats as safe in moderation, and distilled spirits leave the amines behind in the still. Shulman's assay of over 100 foods, seven years before that review, put it plainly: alcoholic beverages, Chianti included when taken in moderation, appeared to be safe.

Alcohol contains only low levels of gluten. Alcohol: whether a drink contains gluten depends on its source — beer and malt drinks contain gluten, while wine and distilled spirits are gluten-free. Check the specific drink if you are sensitive to gluten.

Alcohol contains only low levels of salicylate. Pure alcohol carries no salicylate, but it worsens the intolerance independently: it increases gut permeability and competes for the liver capacity that clears salicylate. Amounts vary by brand and recipe, so always check the label of the exact product.