hivesDie off and histamine issues are encountered by most people while on GAPS (Gut and Psychology Syndrome) by Dr. Natasha Campbell-McBride. However when you progress in a certain rhythm, according to Dr. Natasha’s protocol, histamines are not an issue.

A histamine or die-off response, is your body talking to you, telling you what is happening in the gut. It’s a good sign. The more severe the gut damage the more sensitive to certain fermented foods you will be – this does not mean you should avoid fermented foods, this means you need to start with gentle probiotic foods slowly, increasing and advancing as healing takes place. This also means probiotic foods are  the very thing that your body needs to heal in order to rebuild the good flora in the intestinal tract.

{We are taking a leap of faith and have added a donate button instead of using advertisers. Advertisements have been removed from this page to make your reading uninterrupted. If you learn something here, please donate so we can keep offering these posts. This post contains affiliate links, which sometimes pay for this site}.

Histamines can accumulate in your body and then have a resulting explosive reaction often times through a raised red rash that resembles a burn. Histamine responses can be flushing of the face and body, nausea, burning in the mouth, headache, feeling faint, blurred vision, abdominal cramps, gas, diarrhea, wheezing, respiratory issues, cold-like symptoms, flu-like symptoms, swelling or inflammation, hives, eczema or other similar responses.

When dealing with GAPS the intestinal tract is loaded with pathogenic bacteria which is killed off by probiotic foods and capsules. When too many pathogens are killed off the patient experiences what is called die-off. Die-off symptoms are a raised red rash that resembles a burn, flushing of the face and body, nausea, burning in the mouth, headache, feeling faint, blurred vision, abdominal cramps, gas, diarrhea, wheezing, respiratory issues, cold-like symptoms, flu-like symptoms, swelling or inflammation, hives, eczema, acne, red ant type looking bites, exhaustion, irritation, anger and short temper. Notice the similarity in symptoms. This is because the two are related.

Often times people who experience histamine issues remove probiotic healing foods to avoid the histamine reaction. According to Dr. Natasha’s protocol when histamine issues are evident it is vital to go back a step and begin healing with more gentle probiotic foods like unpasteurized whey and kraut juice and give the intestinal tract time to heal. Build the flora up and slowly progress into the fermented probiotic foods that caused the die-off or histmine issues, including sauerkraut eventually but adding it in slowly.

Those with the worst gut damage sometimes start with one drop every three days, pushing through histamine and die-off symptoms, building up from there progressively.

Dr. Judy Safrir, MD says, “FODMAPS and Histamine Intolerance are not primary conditions, but rather secondary manifestations which have resulted from gut inflammation and damage via dysbiosis.

Dr. Natasha recommends introducing fermented foods and probiotics slowly to avoid these uncomfortable die off symptoms. It is best to add probiotics until you feel die-off, then step back a small amount on the dosage and maintain that level for at least a week before you increase your dosage. Increasing in small amounts is vital if you experience die-off or histamine responses.

Eating properly made meat stock will seal the gut allowing the properly supported body to rebuild mast cell and amino acids. This is what GAPS does in the early stages. Once you are sealed histamine issues are often confused with die off from too much probiotic. 

DSC04303Click here to read more about fermented probiotic foods vs over-the-counter probiotics for purchase like this affiliate link, or this one. Most probiotics purchased in the store are filled with ingredients not conducive to gut healing but instead feed bad bacteria in the gut making the matter worse. The above linked probiotics are GAPS approved and recommended.

The only way to know how much probiotic your body should take is to try some and see how your body responds. If you have great gut damage, a reflection of pathogens taking over the gut, Dr. Natasha recommends starting with a very small dose of probiotics which for some is a drop of kraut juice each day. This would be true for anyone with an autoimmune disease, a growing number of food allergies, depression, bipolar disorder, autism and other issues reflective of gut dysbiosis.

People who have mild gut damage can tolerate larger doses of fermented foods. It is more beneficial to take smaller amounts of probiotic foods like kraut juice or whey throughout the day than it is to take one large dose and encounter histamine issues or die-off. Kraut juice and whey are both good introductory probiotic foods for damaged guts, especially those that experience these symptoms.

There are two different locations for GAPS FAQs, click here or here to see them in depth.

On page 29 of GAPS FAQs Dr. Natasha clearly answers the histamine issue:

*Is the GAPS Diet appropriate for someone with histamine intolerance?

Yes! I believe that people with this condition have an overgrowth of particular species of microbes in the gut which produce histamine and block the enzyme (diamine oxidase), which is supposed to process histamine. DSC04239GAPS Program will allow you to change your gut flora and remove this condition permanently. In the initial stages avoid all the culprit foods: all alcohol, black tea, canned and smoked foods, leftovers (you should eat everything as fresh as possible), beans and lentils, fermented vegetables, mature cheeses, cocoa, nuts, etc. All fresh foods prepared at home, including freshly fermented yoghurt and kefir will be fine for you. It will be best if you follow the GAPS Introduction Diet.

On page 14 of GAPS FAQs she goes into a deeper explanation.

*Your book has a single chapter on sauerkraut saying it is ready in 5-7 days, but other research has shown that in the first 2-3 weeks histamines are released which can cause major reactions which are not a problem at the end of a longer 6 weeks fermentation process. Does fermenting vegetables longer decrease the histamine levels in the food?

In the majority of my patients following the recipe in my book works. For people who are particularly sensitive to histamines it may make sense to ferment their vegetables longer.

On page 19 of FAQs:

*How long will it take to heal histamine intolerance and how long will it take before fermented veggies can be introduced? Are there any specific supplements you suggest to help with this intolerance?

It is very individual how long it takes to heal. Keep testing if you are getting more tolerant by trying to eat tomato, eggplant or spinach before trying to eat fermented vegetables. I believe that it is the abnormal flora that produces excessive amounts of histamine and also impairs enzymes which break the histamine down in the body.

Patricia Allen, Certified Nutritional Therapist and Certified GAPSPractitioner in Atlanta says, “The pathogenic microbes continually produce toxins from their life cycle. They flood the brain with toxins and can cause people to feel drunk. They produce a group of substances called amines and produce too much histamines.”

Allen goes on to say, “Some amines produced by pathogenic microbes from amino acids like choline, lecithin, methylamine, lysine, arginine, ornithine, and tyrosine have been shown to cause intellectual regression, behavior and emotional issues, and withdrawal symptoms.”


*Nourishing Plot is written by Becky Plotner, ND, traditional naturopath, GAPS who sees clients in Rossville, Georgia. She works as a Certified GAPS Practitioner who sees clients in her office, Skype and phone. Since her son was delivered from the effects of autism (Asperger’s syndrome), ADHD, bipolar disorder/manic depression, hypoglycemia and dyslexia through food she continued her education specializing in Leaky Gut and parasitology through Duke University, finishing with distinction. This is not a news article published by a paper trying to make money. This blog is put out by a mom who sees first hand the effects of nourishing food vs food-ish items. No company pays her for writing these blogs, she considers this a form of missionary work. It is her desire to scream it from the rooftops so that others don’t suffer from the damaging effect of today’s “food”.

GAPS™ and Gut and Psychology Syndrome™ are the trademark and copyright of Dr. Natasha Campbell-McBride. The right of Dr. Natasha Campbell-McBride to be identified as the author of this work has been asserted by her in accordance with the Copyright, Patent and Designs Act 1988.


Other sources:



Tagged with:

Probiotic Foods vs Commercial Probiotics

GAPS, Stage by Stage, With Recipes

Joyous Song, The Proverbs 31 Woman

The Fontainebleu Miami

Ocean Drive Guidebook

%d bloggers like this: