The migraine trigger you probably haven

The Migraine Food Trigger You’ve Probably Never Heard Of

I went from having a migraine attack every time I ate (no exaggeration) to having only a few a week. The explanation of how I did it is long and involved. Here’s the at-a-glance summary and the details follow. Please don’t stop reading at the word “histamine” if you don’t have allergies – this has nothing to do with allergies!

  • Histamine can be a migraine trigger, even if a person has absolutely no allergies.
  • Some foods contain histamine.
  • Histamine is also always released as part of the digestive process.
  • A digestive enzyme called diamine oxidase (DAO) processes histamine, both what’s in food and what’s released as part of digestion.
  • Some people do not produce enough DAO.
  • Taking DAO as a supplement before eating and/or eating a low-histamine diet can reduce the frequency, severity and/or duration of a person’s migraine attacks.

In most people’s minds, histamine is inextricably intertwined with allergies, but it does a lot more in the body than allergic and immunological responses. For example, histamine is a fundamental part of digestion. It’s what tells your stomach to start producing gastric acid, which is key to digestion. Histamine is also contained in or released by numerous foods, like tomatoes, citrus, chocolate, spinach and aged meats and cheeses.1 The phrase “histamine intolerance” is often used to describe people who have trouble with dietary histamine.

Diamine oxidase (DAO) is an enzyme that’s present in your body, primarily in your kidneys and digestive tract.2 DAO allows your digestive tract to process the histamine that’s released as part of digestion or is in contained in or released by certain foods. At least, this is what’s supposed to happen. (More on this in a minute.)

Is histamine a known migraine trigger?

Histamine has been suspected to play a role in migraine for many people since the 1950s. Recent research also supports the idea that histamine can be a trigger.3,4 I began to unravel histamine’s role as a trigger for me after the first prescription migraine preventive to give me any relief was an antihistamine called cyproheptadine (Periactin).

If histamine is problematic for you – and it can be even if you’ve tested negative to every possible allergen (food and otherwise) and have no allergy symptoms at all – the histamine that’s part of digestion or is in certain foods could be a migraine trigger.


Is dietary histamine a trigger for you?

The best place to start is to trying to find out if dietary histamine is a trigger for you is to eliminate foods that contain histamine from your diet. This list of foods containing histamine and tyramine* (a relatively well-known potential migraine trigger), is a great place to start. Keep in mind that you do not necessarily have to eliminate all these foods permanently, but you need to establish what your baseline is like without them. (If you search online, you’ll find many conflicting lists of foods that contain or liberate histamine. You’ll drive yourself wild trying to follow all the lists, so I recommend starting with only the one I shared. It’s the most reliable list and I trust the science behind it.)

What if an elimination diet isn’t enough?

For many people, avoiding histamine in foods is sufficient for their bodies to deal with the histamine that’s released as part of digestion. For others, it’s not. This is the category I fall into. It doesn’t matter what I eat, whether it contains histamine, tyramine or is the least potentially triggering food ever, I get a migraine.

Yes, you read that right: the very act of eating is a migraine trigger for me. That’s because my body is unable to process even the amounts of histamine that are released as a necessary part of the digestive process. With a lot of sleuthing, I’ve discovered that I appear to produce such small amounts of DAO, that I can’t process even my own body’s histamine release. Add histamine-containing foods and my migraine severity skyrockets.

Does DAO deficiency connect to migraine?

About 25% of the population has a DAO deficiency and one study found that 87% of participants with migraine did not produce sufficient DAO.5 In a study tested a low-histamine diet for chronic headaches (migraine or not). On the low-histamine diet, 73.3% of patients “improved considerably,” according to the researchers, and eight had no headaches at all.6 There are also anecdotal reports from migraineurs who have the same experience. I much prefer science to anecdote, but the science for this is in the very early stages.

Is there a way to supplement DAO?

Fortunately, there is a digestive enzyme that is made with DAO from pig kidneys. (Pigs are currently the only source for supplemental DAO.) You can take DAO up to 15 minutes before eating and it will degrade the excess histamine in your digestive tract. It has shown to be highly effective a recent study.7

Several different companies sell DAO supplements. Histame has the fewest additives, but is also the lowest dose at 4,000 HDU (histamine digesting units) per capsule. All the others, including HistDAO, Histamine Block and DAOsin contain 10,000 per capsule. I started with Histame, but the dose was insufficient. I now take HistDAO. I’ve found that one capsule is sufficient for about 400 calories.

Is DAO safe?

I can’t point you to hard data on the safety of DAO. My naturopath and a leading dietician on the subject have both assured me that it is very safe and does not remain in the body. They tell me that DAO, like food, gets processed and eliminated quickly. It is rare that I take something without definitive proof of it’s safety, but I feel so much better taking DAO that I’m sticking with it.

Can DAO levels be tested?

There is a blood test to check your DAO levels, but most practitioners consider the test to be a waste of money. The levels of DAO in your blood do not necessarily reflect the amount in your digestive tract. Also, there’s no known range of “normal” levels of DAO in a person’s blood. Without knowing the range, there’s nothing to compare a number to. Ultimately, the test is unnecessary because trying a DAO supplement is likely to give you all the information you need.

Want to learn more?

You can learn tons more about migraine, histamine and DAO on my blog, The Daily Headache. That link takes you directly to the histamine page, which I continue to update. Be sure to read “Histamine Intolerance & DAO: Anwers to Your Questions,” which responds to some of the numerous questions I’ve been asked.

The American Journal of Clinical Nutrition published a comprehensive article on histamine and histamine intolerance (the full text is available for free). It might take some time to wade through, but it is worth the effort.

There’s not much about histamine and migraine online, but there’s good basic information on histamine intolerance. Use “histamine intolerance” as your search term to find general information.

Why am I sharing this?

Writing about an unproven treatment for which there’s little data isn’t my style, but I couldn’t keep this information to myself. Taking DAO has literally changed my life in so many positive ways. I hope that reading my story will help someone else find the missing piece of their migraine puzzle.

*This document includes some foods that contain tyramine, but it is not an exhaustive list.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. Maintz, L., & Novak, N. (2007). Histamine and histamine intolerance. The American journal of clinical nutrition, 85(5), 1185-1196.
  2. McGrath, A. P., Hilmer, K. M., Collyer, C. A., Shepard, E. M., Elmore, B. O., Brown, D. E., ... & Guss, J. M. (2009). Structure and inhibition of human diamine oxidase. Biochemistry, 48(41), 9810-9822.
  3. Alstadhaug, K. B. (2014). Histamine in Migraine and Brain. Headache: The Journal of Head and Face Pain, 54(2), 246-259.
  4. Levy, D., Burstein, R., Kainz, V., Jakubowski, M., & Strassman, A. M. (2007). Mast cell degranulation activates a pain pathway underlying migraine headache. Pain, 130(1), 166-176.
  5. Keller, D. Migraine Attacks Shortened by Diamine Oxidase Supplements. Medscape, Oct. 1, 2013. Retrieved from http://www.medscape.com/viewarticle/811920 Jun. 27, 2014.
  6. Wantke, F., Götz, M., & Jarisch, R. (1993). Histamine‐free diet: treatment of choice for histamine‐induced food intolerance and supporting treatment for chronical headaches. Clinical & Experimental Allergy, 23(12), 982-985.
  7. Naila, A., Flint, S., Fletcher, G. C., Bremer, P. J., Meerdink, G., & Morton, R. H. (2012). Prediction of the amount and rate of histamine degradation by diamine oxidase (DAO). Food chemistry, 135(4), 2650-2660.

Comments

View Comments (16)
  • Dan S
    2 months ago

    Hi, very interesting article. I suspect it applies to me. Unfortunately the link “foods containing histamine and tyramine*” did not work (for me on my computer at least, Dec.1 2018). Is there another way to get that same list?
    Thank You

  • tucker
    3 years ago

    Wow, I stumbled on this in my email. I seem to get a migraine almost every day at work. I thought it was “work” and the environment. But most days I make this really healthy smoothie with this crazy concoction of stuff in it. Aside from the avocado and spinach and variety of fruit, I have spices like cinnamon and anise and nuts and other things mixed in. So if this could be an issue for me, my “healthy” food of the day is hurting my body…. Sigh (and it’s one of the few things I can handle with my chronic nausea).

    It might also explain the whole, you have no celiac markers (in the blood panel), but why my gut just rejects bread and pasta.

    Thanks so much for this info!

  • JRain
    3 years ago

    Thanks for the great article. This information needs to get out there!
    I’ve been suffering from migraines since my late teens (I have aura with mine) and I recently was finally able to stop one after experiencing aura with 1 Benedryl and 1 Advil Migraine. This is amazing, as nothing else I’ve tried has ever stopped a migraine after the aura (visual disturbance) has happened. I am still researching this: I started taking DAO supplement and trying to eat lower histamine foods (at the very least I avoid the foods with the highest amounts: spinach, wine, cinnamon, citrus, etc.). I am glad to feel that at the least I’m no longer flailing around in the dark looking for specific triggers, when the trigger is the more pervasive histamine.

  • Joanna Bodner moderator
    3 years ago

    Hi JRain – We are happy to hear that this article resonated with you! Thank you for sharing and we LOVE hearing that you are experiencing some relief! Truly hope it continues and great job as well with all your hard work in taking the time to research & track the endless amount of possible triggers! Wishing you MORE pain free days ahead! Joanna (Migraine.com Team)

  • Jojiieme
    3 years ago

    I’m late to the discussion!
    Been on a version of this, which later became refined into the FODMAPS diet, since the late 1980s, in Australia. And specifically for migraines! Amazing what difference it makes to your overall well being, isn’t it?
    After 7 years, I was able to slowly reintroduce some low-level histamine foods (things like cinnamon and pawpaw, occasional hard cheese, mushrooms); after a little while longer I started drinking fresh coffee again but not with real milk (dairy remains a problem). Fermented foods are a challenge, but a tablespoon once in a while is OK.
    Your rescues are interesting: I was always taught that unbuffered Vit C would be good for a reaction to something alkali, and to have sodium bicarbonate (baking soda) in water if reacting to an acid. If it’s a bad reaction, Phenergan or epipen and ambulance.
    For me, Benadryl would actually create an allergy-like reaction!

  • Jojiieme
    3 years ago

    That should read: NOT specifically for migraines.

  • Patty
    4 years ago

    Hi Kerrie,
    Thank you for the article. I have been on a low-histamin diet for three years now and have found it to be helpful in reducing the frequency of migraine. I pay attention to my histamine load through out the day, for example, if I have something with a bit of histamine (one of the low foods listed) for breakfast I make sure my lunch only safe histamine foods, etc. I avoid all meat as I have found it is one of the worst migraine triggers.

    I would also like to mention that stress releases histamine into the body so people that are intolerant must be hyper-aware of what they eat when stressed. I have also discovered through research and my own experience that menstrual period increases the level of histamine in my body.

    Finally, reducing my levels of histamine by adhering to a diet similar to the one linked from this article has helped more than any medication or therapy I’ve tried (and I tried a lot over the past 20 years!). Good luck everyone.

  • stacysillen
    4 years ago

    Amazing timing for me!! I just got re-tested for allergies and to my great surprise I have none! Years of draining sinuses, clogged noses and itchy skin, always popping antihistamines, because if I let myself get stuffed up it seems to bring on a migraine. I just had my nose inspected by a specialist and it’s fine. Thank you, now I have something else to explore.

  • Kelly Hibbert
    4 years ago

    I have had migraines for over 25 years now. I have them daily, with a fairly high pain level from when I open my eyes to when I close them again. The ONLY thing that helps me, even just a little bit, is I.V. benadyl. I have known the histamine trigger for such a long time and I’m fairly surprised more people don’t know about. I tried over the counter, IM injection and gratefully, my doctor agreed to put in a port-a-cathereter in for IV benadryl. It can make an 8 pain level go to a 6 but I can also have days when it doesn’t help much. I’m grateful for a doctor with and open mind and taking a chance on this treatment. I urge you to discuss this with your doctors. It doe not make my headaches go away, but it usually brings me to a level where I can participate in Life and have fun with my family again.

  • headacheslayer
    4 years ago

    Hi Kerrie!! Don’t know if you remember me, but I’m so happy you are doing much better, in so many ways!! This is a really interesting idea for me. My son has food and environmental allergies, and migraines. And I’m still having constant headaches and migraines. I have environmental allergies, and many drug allergies, almost all antibiotics.

    I know you said it wasn’t about allergies, and I can’t say either of us get migraines after eating, but it’s something to think about. Thank you for sharing, this may be something I look into. Too bad the pig supplement can’t be in the form of bacon lol. My son would be on board 😉 yes I know bacon can be a trigger. Just a joke 😉

  • B. Morebello
    4 years ago

    Thank you so much for posting this! I have severe asthma and allergies, I’ve never had any food allergies until my migraines got worse, but I’ve never even heard of a histamine allergy.. very interesting..

  • art lover
    4 years ago

    Kerrie-thanks for this! I too am finally trying to alter my diet after a lifetime of migraines and this will certainly help my efforts. I also highly recommend a book I read that got me on the path, The Migraine Miracle by Dr. Josh Turknett,a neurologist who also had migraines,who had great success when he gave up-you guessed it-wheat, dairy and sugar! But the histamine part will help some even more, especially knowing the main foods that are problematic. I encourage all migraine sufferers to educate themselves on going the diet route. For years it seemed both too complicated to try and too simple of an answer, but it really seems to be helping me. Good luck!

  • Jules2dl
    4 years ago

    I have tried various types of diets over the years in hopes of helping my migraines. Most recently I went gluten free for a year because my cousin, who had daily migraines, has been migraine free since she gave up gluten. No such luck for me however.
    I’ve been on the tyramine free diet many times, to no avail. I’ve given up caffeine, sugar, alcohol, sausage and lunch meat, msg. I haven’t been able to pin down any dietary triggers, but I’ve never heard anything about histamine, so I’m going to look into it. Thank you Kerrie!

  • clemmie
    4 years ago

    Thanks for this article, Kerrie. Very interesting–will check out the link and hope to learn which foods require more histamine, and try out the low-histamine diet.

  • Sarah Hackley
    4 years ago

    Fantastic article, Kerrie! Thank you for sharing.

  • Lorraine Yearling
    4 years ago

    Thank you for this article Kerrie! I have recently discovered that histamine intolerance has been a big culprit in my migraine attacks.

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