Are amines or histamines in chocolate and/or red wine triggering your headaches or migraines ?
Many people notice that they can have a migraine after eating significant amounts of chocolate.
Many people notice that dark chocolate is worse.
What are Amines or Histamines?
JOIN THE COMMUNITY: BRAND NEW Dietitian led Facebook group: Amines, Salicylates and Glutamates: The Food Intolerance Dietitian for great information and community support.
Amines are a group of chemicals that you find in a whole range of foods and they tend to add flavour to foods. Chocolate is a great example!
Some foods may naturally be low in amines but over time develop significant amounts of amines. Meat is a great example- very fresh chicken or lamb or beef is naturally low in amines but as it gets closer to its expiry date, there is a noticeable increase in amines.
Other foods that may be low amines but can develop amines through processing are fermented foods. Cabbage is low in amines, but the fermentation process to produce sauerkraut causes a big spike in amines. Enough to cause an issue if you are amine sensitive.
Foods contain many different types of amines, and experience shows that if you are amine sensitive then you may react to one type of amine but be fine with another type.
Many people have heard of the amine: histamine that is found in many foods.
Other well known amines are serotonin, dopamine and noradrenaline.
Lesser well known food amines are tyramine, tryptamine (cheese) , and phenylethylamine (chocolate), which together with histamine can cause food issues.
Amines are found often together, although some amines may be more dominant such as phenylethylamine in chocolate.
Are amines or histamines bad for you?
For amine sensitive people, the amounts of amines found in foods that are normally tolerated for others can cause issues if you are amine or histamine sensitive.
Amines are sometimes called biogenic amines and their impact on the body is due to the fact that they are biologically active in the body. They can be absorbed across the gut wall and enter the body where they can play active roles in the body's chemical processes.
Biogenic amines may act as neurotransmitters, be involved in local immune responses (such as the inflammation produced by histamine release), or regulate functions of the gut.
The classic amine neurotransmitters serotonin, dopamine, and noradrenaline are all essential to proper brain function. Imbalances cause problems such as depression and anxiety.
Local symptoms can also occur in the gut including nausea, diarrhoea, and irritable bowel syndrome (IBS), as well as triggering symptoms elsewhere in the body, such as headaches, migraines, asthma, and hives.
As in all areas of food chemical intolerance, evidence is sparse but there is some limited low level evidence (case series) for amines causing migraines.
Personal experience of food chemical sensitive people also suggests that other naturally occurring food chemicals such as salicylates, glutamates and food additives can also trigger headaches and migraines.
Foods Containing Amines or Histamines that can Trigger Headaches or Migraines
If you feel you may be histamine or amine sensitive, then you may react to some of the following amine/histamine rich foods*:
PORK
MINCED MEAT: minced meat can be low in amines but if not 'managed' porperly can be very high and often noticed to be a trigger
OVERBROWNED MEATS
SLOW COOKED MEATS
LEFTOVER MEATS BEYOND 24 HOURS
CHOCOLATE: the darker- the higher the amines
FERMENTED FOODS EG Kombucha
OVER RIPE BANANA (hate the smell of banana?)
MUSHROOMS
AVOCADO: especially if ripe
EGG PLANT
EXTRA VIRGIN OLIVE OIL
PEANUT PASTE
MANY CHEESES (except the non fermented cheese such as ricotta or cream cheese)
VINEGAR
Meat does not need to be avoided at all, just a review of the meat management is important when reducing amines in the diet. This becomes even more crucial when it comes to fish and seafood.
Many amine rich foods also contain salicylates and glutamates which have been found to cause issues in sensitive people.
Amine Sensitivity Diagnosis
The diagnosis of sensitivity to the food amines is usually made through a thorough history and dietary exclusion of the different amines found in foods.
Salicylates as well as glutamates and some food additives MAY also be excluded, if doing the full Royal Prince Alfred Hospital (RPAH) elimination diet, as it can be hard to know if issues are being caused by amines or by salicylates.
If symptoms can be improved then food trials can help confirm if amines are causing your headaches/migraines following by working to bring back smaines into the diet u to your tolerated level.
If you think your headaches or migraines may be related to what you eat then food amines may be your issue.
I work with many many people around Australia and overseas with amine issues- book in to see how I can help you gain control of your amine or histmine intolerance.
*The Royal Price Alfred Hospital allergy unit have 2 handbooks (RPAH Elimination Diet Handbook) which lists foods low, moderate, high and very high in amines, and goes through the elimination, challenge and re-introduction process. This handbook online from the Royal Prince Alfred Allergy unit.
Updated 18/3/24
REFERENCES
1. Wöhrl S, Hemmer W, Focke M, Rappersberger K, Jarisch R. Histamine intolerance-like symptoms in healthy volunteers after oral provocation with liquid histamine. Allergy Asthma Proc. 2004;25:305–311.
2. Wantke F, Götz M, Jarisch R. Histamine-free diet: treatment of choice for histamine-induced food intolerance and supporting treatment for chronic headaches. Clin Exp Allergy. 1993;23:982–985. doi: 10.1111/j.1365-2222.1993.tb00287.x.
3. King W, McCargar L, Joneja JM, Barr SI. Benefits of a histamine-reducing diet for some patients with chronic urticaria and angioedema. Can J Diet Pract Res. 2000;61:24–26.
3. Böhn L, Störsrud S, Törnblom H, Bengtsson U, Simrén M. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol. 2013;108:634–641. doi: 10.1038/ajg.2013.105.
4. Smit AY, Engelbrecht L, du Toit M. Managing your wine fermentation to reduce the risk of biogenic amine formation. Front Microbiol. 2012; 3():76.
5. RPAH elimination diet handbook: with food and shopping guide. Anne Swain, Velencia Soutter, Robert Loblay, 2019 (revised edition).
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