Some people may react to histamine in food, wine or beer. This may be misinterpreted as being a food or wine allergy.


Clinical features triggered by an ingestion may include:

(1) sneezing

(2) flushing

(3) skin itching

(4) headache

(5) diarrhea

(6) asthmatic symptoms with wheezing and dyspnea

(7) often negative tests for food allergy such as skin prick or RAST


A provocation test can be performed with red wine, champagne or any wine known to be high in histamine. Choosing a wine low in sulfites can help to exclude sulfite sensitivity as the cause of the reaction.


Provocation test:

(1) Draw a blood sample for baseline serum histamine level.

(2) Administer a glass of wine.

(3) A histamine-intolerant person should experience symptoms within an hour of ingestion (usually in less than 30 minutes).

(4) Draw a blood sample for histamine level during peak symptoms.


A patient who is histamine intolerant should show an increase in serum histamine from baseline.


Differential diagnosis:

(1) allergy to fermentation products

(2) allergy to sulfites


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