Drinks and histamine: 49 foods rated

Advocaat is two triggers in one glass: egg yolk and white, and egg white is a classic histamine liberator, plus brandy, whose alcohol blocks the enzyme that would clear the result. It is also a drink that sits opened in a cupboard for months, which is a third factor the recipe does not mention.

• Maintz & Novak, Am J Clin Nutr 2007
• Zuberbier et al., EAACI/GA2LEN urticaria guideline

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.

• Maintz L. & Novak N., Am J Clin Nutr 85 (2007) 1185-1196, histamine and histamine intolerance

Beer carries histamine from its fermentation and ethanol that blocks DAO, and unlike wine it adds a third thing: it is brewed from barley malt and often unfiltered, so it carries yeast and its breakdown products too. Pasteurised bottled beer stops there; a cask or a bottle-conditioned beer is still fermenting.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020
• EFSA (2016), re-evaluation of sulfur dioxide and the sulfites, EFSA Journal 14(4):4438

Eggnog stacks the same two triggers as advocaat - egg white as a liberator, alcohol blocking DAO - and adds a third that advocaat does not have: dairy, and often cream that has been whipped and left standing. It is also traditionally made in a bowl and served over an evening, which is time at room temperature.

• Maintz & Novak, Am J Clin Nutr 2007
• Zuberbier et al., EAACI/GA2LEN urticaria guideline

Energy drinks are near the top of this axis because of what they stack rather than any one ingredient: caffeine at two or three times a cola's concentration, benzoate, azo colours and acidity regulators. Be precise about what that means - benzoate and the azo colours are documented in the PSEUDOALLERGEN literature, which is not the same as being documented liberators of histamine, and the caffeine claim is the weak one it is everywhere else. The elimination protocols remove all of these at once, and a can brings several of them cold and fast.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 10:1181 (2020)
• Zuberbier et al., EAACI/GA2LEN urticaria guideline, for the pseudoallergen elimination list

The sugar-free energy drink keeps every mechanism that put the original here - the caffeine, the benzoate, the colours - and swaps sucrose for an intense sweetener. Removing the sugar removes no histamine, and the caffeine dose per can is usually identical.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020

Kombucha is the ferment that is still working when you drink it: the culture is alive in the bottle and keeps producing acids and amines on the shelf and in your fridge. A bottle opened and left for a week is a different drink from the one you bought. Refrigerate it and drink it soon.

• Comas-Baste et al., Biomolecules 2020
• McCabe-Sellers et al., J Food Compos Anal 2006

Kvass is fermented from bread, and the fermentation is what builds the histamine - the bread itself carries nothing. Unpasteurised bottles keep fermenting on the shelf, so age matters as much as recipe.

Wine hits all three routes at once, which is why it is the classic trigger. Fermentation builds histamine (red wine holds roughly 20-30x more than white — barrel time and malolactic fermentation add more), the alcohol itself blocks DAO so you clear histamine slower, and the sulfites pile on. A histamine-sensitive person often reacts to a glass of red and not to a glass of white.

Almond milk is mostly water with a few per cent almonds, so the nut's own liberator standing arrives heavily diluted - the additives are the larger part of the answer here. Check for flavourings and long shelf life rather than for the almonds.

• Maintz & Novak, Am J Clin Nutr 2007
• Zuberbier et al., EAACI/GA2LEN urticaria guideline

Champagne ferments twice, and the second time is IN THE BOTTLE, on the lees - the dead yeast stays in contact with the wine for twelve months at the least, and the bottle may not leave the cellar before fifteen months in all; a vintage waits three years. That contact is exactly the condition that produces amines, and it is the difference between champagne and a still white. The bubbles are the visible part of a process that also does this.

• Champagne appellation rules for the lees and cellar minima
• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020

Coconut milk splits into two products with different histamine: the tinned cooking milk, which is coconut and water and little else, and the carton drink, which is mostly water with stabilisers and gums. The tin is the shorter ingredient list of the two, and on this axis the ingredient list is the whole question.

• Maintz & Novak, Am J Clin Nutr 2007
• Zuberbier et al., EAACI/GA2LEN urticaria guideline

Coffee holds no meaningful histamine. It is here because caffeine is widely said to slow DAO - a claim repeated in almost every food list on this subject and supported by remarkably little: reliable studies are hard to find. Treat it as an open question rather than a mechanism, test it on yourself, and note that what people feel after coffee is caffeine doing what caffeine does.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 10:1181 (2020)

Cognac is distilled twice and then aged in oak for at least two years, often far longer - and the wood is where a clear spirit and a brown one part company: barrels are not sterile, and years of contact put back some of what the still took out. Alcohol blocking DAO remains the larger effect.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020

Cola's caffeine is widely said to slow DAO - the same claim the coffee entry carries, repeated in nearly every food list on this subject and supported by remarkably little. What the bottle adds is not one mechanism but a stack of elimination-list items: caramel colour, phosphoric acid, often benzoate. The volume is what makes it count - nobody drinks 30 ml of cola, and a caffeinated drink taken by the half-litre is a different exposure from a coffee.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 10:1181 (2020)
• Zuberbier et al., EAACI/GA2LEN urticaria guideline, for the pseudoallergen elimination list

Sugar-free cola removes the sugar and changes nothing that matters here - the caffeine, the caramel colour and the benzoate are all still there, and an intense sweetener is added on top. The diet version is not the gentler version for histamine; it is the same drink with one ingredient swapped.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020

A dry white has fermented to completion - the yeast ate all the sugar - which means the fermentation ran its full course and so did everything that goes with it. Dry does not mean less fermented; it means more, and fermentation is what builds histamine. What dry does buy you is less residual sugar, which matters on other axes and not on this one.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020
• EFSA (2016), re-evaluation of sulfur dioxide and the sulfites, EFSA Journal 14(4):4438

Gin is a neutral spirit redistilled with botanicals, so the distillation happens twice and nothing amine-bearing gets through either time. What it carries instead is juniper and a dozen other plant extracts, and the tonic beside it brings quinine and sugar. The ethanol blocking DAO is still the mechanism.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020
• EFSA (2016), re-evaluation of sulfur dioxide and the sulfites, EFSA Journal 14(4):4438

Lemon juice is the citrus liberator in its most concentrated everyday form - a bottle is the juice of many lemons, and it is used freely because it reads as an acid rather than as a food. The histamine content of a lemon tells you nothing; the reaction comes from the release. Citrus is on the elimination lists as a liberator, but the current review attributes its symptoms to its other amines — putrescine above all — competing for the enzyme that clears histamine.

• Maintz & Novak, Am J Clin Nutr 2007
• Zuberbier et al., EAACI/GA2LEN urticaria guideline
• Comas-Basté O. et al., Biomolecules 10:1181 (2020), section 5.4.1, attributing the symptoms of citrus to its other amines, putrescine above all, competing for DAO

Lemonade is lemon juice diluted and sweetened, and the dilution is real - but so is the volume, because a glass of lemonade contains more lemon, and more of its histamine, than most people would squeeze onto a plate. Commercial versions add citric acid and flavourings on top of the fruit.

• Maintz & Novak, Am J Clin Nutr 2007
• Zuberbier et al., EAACI/GA2LEN urticaria guideline

Oat milk is made by treating oats with enzymes to break the starch into sugar - which is why it tastes sweet with no sugar on the label - and that enzymatic step is the one thing distinguishing its histamine from the other plant milks. The base is low; the stabilisers and the rapeseed oil are what the ingredient list is for.

• Maintz & Novak, Am J Clin Nutr 2007
• Zuberbier et al., EAACI/GA2LEN urticaria guideline

Rice milk is the plainest of the plant drinks - rice, water, oil and usually nothing else - and it is the one to reach for when the additives are what you are avoiding. The base carries no histamine and rice is not a liberator, so what is left is whatever the brand added.

• Maintz & Novak, Am J Clin Nutr 2007
• Zuberbier et al., EAACI/GA2LEN urticaria guideline

Rum is distilled from molasses that has been fermented, sometimes for weeks with wild yeast - a process that produces plenty of amines, all of which stay in the still. What can come back is the ageing: a dark rum spends years in oak, and barrels are not sterile.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020
• EFSA (2016), re-evaluation of sulfur dioxide and the sulfites, EFSA Journal 14(4):4438

Soy is a recognised histamine liberator rather than a source — it contains little itself but can prompt release. Fermented soy (soy sauce, miso, tempeh) is a different story and does carry real histamine.

Sweet rosé is stopped part-way through fermentation, usually by chilling and sulfiting - and that second word is the point: a wine whose fermentation was halted chemically carries more sulfite than one allowed to finish. Sulfite is a sensitivity of its own rather than a mechanism on this axis, so what it adds here is a second question rather than more of the first. The first is the alcohol, which the reviews do describe as a DAO inhibitor, and the histamine the fermentation made before it was stopped.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020
• EFSA (2016), re-evaluation of sulfur dioxide and the sulfites, EFSA Journal 14(4):4438
• Reg. (EU) No 1169/2011 Annex II for the 10 mg/kg declaration

Tequila is distilled from agave that has been COOKED before fermenting - roasted in ovens or steamed - and cooking a plant for a day before fermenting it is not a step the other spirits have. It changes the flavour and not the answer here: the still removes the amines, the ethanol blocks the enzyme.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020
• EFSA (2016), re-evaluation of sulfur dioxide and the sulfites, EFSA Journal 14(4):4438

A fortified, aromatised wine: it starts with wine's own histamine, then adds alcohol that blocks DAO and botanicals on top. It behaves like wine, not like a clear spirit.

• Maintz L. & Novak N., Am J Clin Nutr 85 (2007) 1185-1196, the DAO framework: alcohol among the agents that slow the enzyme

Vodka is distilled to the highest purity of any spirit and filtered afterwards, so it carries essentially nothing but ethanol and water - no histamine survives a still. The ethanol is the whole problem: it blocks DAO, so the vodka is not the source, it is the handbrake on everything else in the meal.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020
• EFSA (2016), re-evaluation of sulfur dioxide and the sulfites, EFSA Journal 14(4):4438

Whisky is aged in oak for three years at minimum and commonly ten or more, and unlike cognac it is often matured in casks that previously held sherry or bourbon - a second history in the same barrel, and more time for the amines. Longer in wood is more of what the distillation removed, on top of the alcohol.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020

White wine carries less histamine than red as a rule - the skins, where much of it forms, are removed before fermentation - but it usually carries more sulfite, because white wine needs more protection from oxidation. Sulfites are a separate sensitivity rather than a DAO mechanism, but they travel with the same drinks. The two effects work against each other, which is why white wine is not the safe choice it is often taken for.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 2020
• EFSA (2016), re-evaluation of sulfur dioxide and the sulfites, EFSA Journal 14(4):4438

Alcohol-free beer removes the ethanol but not the brewing - the yeast worked and left what it left. What it does remove is the bigger problem: alcohol inhibits DAO, the enzyme that clears histamine, so a beer normally loads the system twice.

Black tea contains no histamine, and it is here for the third route on this axis: tea polyphenols inhibit DAO, the enzyme that breaks histamine down in the gut. Drinking it alongside a histamine-rich meal is worse than drinking it alone. Brückner infused 14 black teas among 21 and detected no histamine in any of them; two of the black teas carried no measurable amine at all, and tyramine across the set ran 16 to 431 micrograms per litre of infusion. The histamine half of the case is measured and empty. What keeps black tea on this axis at all is the other half — the enzyme that clears histamine — and that has not been measured.

• Brückner H et al., Amino Acids 42 (2012) 877-885, biogenic amines in tea infusions

Green tea is naturally low in histamine, and that is the whole of its case here. Two claims often made for it do not hold. Coffee is not an established inhibitor of DAO - the claim is repeated in every food list on this subject and supported by very little - so “better than coffee because coffee blocks DAO” rested on nothing. And green tea is not caffeine-free: whatever the caffeine argument is worth, it applies here too, at a lower dose. The catechins, EGCG above all, do damp mast-cell activation in laboratory work, which is interesting and is not the same as an effect in someone drinking tea. That is now measured rather than assumed: Brückner infused five green teas among 21 and found no histamine in any tea of any kind, with the authors expecting no health risk even from large quantities. Green tea is not gentler than black on this evidence — neither carries histamine at all.

• Maintz & Novak, Am J Clin Nutr 2007
• Comas-Baste et al., Biomolecules 10:1181 (2020)
• Brückner H et al., Amino Acids 2012, biogenic amines in tea infusions

Hazelnut milk is a small fraction of nut, blended with water and strained. Diluted is not absent: the hazelnut is moderate in histamine, and a dilution of it is low. The practical difference is the glass: nobody eats 200 g of hazelnuts, and 200 ml of hazelnut milk is an ordinary serving.

• Gobbi L et al., Beverages 2019, biogenic amines in plant milks
• Swain A et al., Friendly Food (RPAH elimination diet)

Malt beer is brewed but barely fermented, and it is the fermentation that makes amines. Being low in alcohol, it also spares the DAO enzyme that stronger drinks block.

Rosé sits far below red wine on histamine and close to white. The reason is malolactic fermentation: it is standard in red winemaking and it is where the bacteria that produce biogenic amines do their work. Published surveys put red anywhere from about 60 to 3800 micrograms per litre and white between roughly 3 and 120, with rosé alongside white rather than red. The alcohol itself is a separate issue - it slows the DAO enzyme that clears histamine, so any wine adds to the load twice over.

• Marcobal A et al., Food Res Int 38 (2005) 387-394, biogenic amines in wine
• De Borba B et al., J Chromatogr A 1155 (2007) 22-30
• Emer CD et al., Aust J Grape Wine Res 27 (2021) 26-33, malolactic fermentation
• Maintz & Novak, Am J Clin Nutr 2007

Tea is the entry that covers both black tea and green tea, and its answer here is theirs. Brückner infused 21 teas — 14 black, 5 green, one Oolong, one instant — and detected no histamine in any of them; tyramine ran 16 to 431 micrograms per litre of infusion, and in three teas no amine was found at all. The authors expect no health risk even from large quantities. That settles the histamine question and not the other one: this axis also covers what slows the enzyme clearing histamine, and that has not been measured.

• Brückner H et al., Amino Acids 42 (2012) 877-885, biogenic amines in tea infusions

Tonic water contains no histamine and does not liberate any. It is on the scale because it is a mixer - what it is mixed with is where the question usually lies.

Walnut is the nut the histamine elimination lists name, and walnut milk is a dilution of it. It is the same dilution argument as the other nut milks and it lands in the same place: low, not absent. Walnut oil goes rancid faster than any common nut's, and a walnut milk is an emulsion of that oil in water - a reason to buy it cold and finish it, though rancidity is a question of freshness rather than of this axis.

• Gobbi L et al., Beverages 2019, biogenic amines in plant milks
• Swain A et al., Friendly Food (RPAH elimination diet)