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.

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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.

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26 Responses to Histamine Issues While On Gaps

  1. Sheila says:

    This is the best post I have found so far on histamine issues while on GAPS. Thank you, thank you, thank you!

  2. Betsy Branstetter says:

    Please explain the staement about eating tomato, eggplant. or spinach before fermented vegetables. I am allergic to nightshades.

  3. Melody Moon says:

    My son had been eating fermented foods for about six months when he began to have a seizure after he would eat them. We are trying to heal his gut by using the fermented foods….we believe his gut has been damaged and is the reason for the seizures….just my thoughts….I have wondered if the fermented foods were causing histamine and his body was not able to tolerate it anymore….I would LOVE to have some insight into this situation…

    • Becky Plotner says:

      dr natasha campbell-mcbride says seizures are caused by the toxin state of the body reaching a state of such toxicity that it releases the seizure as the body’s natural way to do mass toxin elimination. that’s why most people are more lucid just after a seizure. she says the source is a compromised gut. it sounds like you are already on this path but fine tuning would help. fermented foods could be causing the die off for sure, meaning you should back off to eliminate the inflammation from the die off. it sounds like you are a fabulous mother!!!!!!! removing inflammation causing foods as well as pathogen feeding foods (sugars, starches, grains, intolerances) is a vital part of the healing process. GAPS would be the best choice for this. for some people who are highly toxic, which may be her case if she is suffering seizures, dr natasha advises people start on the full gaps diet first (which is a huge list of options) allowing the body to detox a bit. if you are very toxic (those with firbro, schitzophrenia,etc) and just into gaps phase 1 you will suffer major detox and for those highly toxic it can be too much on their sytems. starting with full gaps for about a year allows some of those toxins to release on their own gently.

  4. Paulina R. says:

    It’s good to see writing about this issue, because it is frightening and can deter people when we start to get these symptoms as a response to fermented foods. The difficulty I have found personally is in the recommendation to go to tiny amounts of fermented foods and build up slowly – excellent advice in itself, but where can we buy tiny amounts of fermented food so that we are not constantly throwing stuff away? When we drain off the (relatively small amount ) of whey from fermented vegetables, what do we do with the vegetables, assuming we have no family who are willing to use them up? Or if we expend lots of our limited energy on making our own ferments, how do we console ourselves as we throw away what we can’t use in the time they are ok for ? I haven’t managed to solve this problem yet, so I am presently making and taking small servings of kefir daily while trying to find a means of attenuating the symptoms to a manageable degree – I live on my own so there is no-one to take over if I put myself out of action. I would love to know if other people have found ways of dealing with this, or have given up because it was too difficult(and expensive) way to go about things.

  5. Renvia says:

    Thank you for this post. My husband’s skin look like the pictures above. He then takes antihistamine as they get quite severe. So aside from taking a step back re fermented food and be strict with GAPS diet, should we avoid using antihistamine when skin flares up again? Thanks

    • Becky Plotner says:

      No. You should be working with a GAPS practitioner who follows GAPS thoroughly. Before settling in on a practitioner you should ask them questions to decide their comprehension of the protocol as a lot get certified to increase their customer base. A case like this is reflective of deep damage in the gut which requires specifics steps listening to the body and following what it says.

  6. Danika says:

    Hi there,
    I have a question as to what you actually eat if you have histamine intolerance and FODMAPS intolerance. I was on the GAPS diet for months and it gave me such a bad face rash I didn’t leave my house for 4 months…looking back, this was all before I knew that I had these intolernaces…I have severe gut damage, have Lupus as a diagnosis. I know that the GAPS diet is what I need to do but I can’t even tolerate the broth. So if you can’t have the broth or the ferments GAPS seems impossible….where would you even start with what to eat? Would love any insight. Thanks so much or your post!

    • Becky Plotner says:

      When you are on GAPS your body speaks to you telling you how deep the damage in the gut. This tells you which mast cells are effected as well as which pathogens are growing out of control depicting which probiotic routes to pursue and at what level. Your body was speaking to you. With this type of damage it is easy to not read what is happening and get the impression it’s not working or I’m getting sicker when in fact your body is guiding you where to go. For a situation like this it would highly recommended to work with a qualified GAPS practitioner who can read these tells. It doesn’t have to be me it should just be someone. Most do Skype and phone consults from a distance if needed.

  7. Priscilla says:

    My 17 mo old son had a histamine looking reaction after pork stock but hasn’t had any reactions with fermented foods. Would that mean it isn’t a histamine reaction but maybe a reaction to what the pig ate? Thoughts? Thank you!

  8. Tasha says:

    I’ve been on the GAPS intro diet for six days. Three days in, I started to get hives on my feet. They have been increasing every day although I have not taken a probiotic in two days and the probiotics I’ve been using did not cause an allergic reaction before I started the intro diet. Do you have any knowledge of people who are allergic to chicken broth? I’ve started to dread eating because of the hives that have been popping up following my meals. If I read your article correctly, I should wait this out and try a drop of probiotic every three days but I’m not sure this is the problem.

    If you have any advice, I would really appreciate it. I started GAPS after ten years of increasing food allergies and as much as I want to believe the hives are a result of the diet killing pathogenic bacteria, I’m quite discouraged.

    Thank you very much,

  9. i hear that even broth/stock is high histamine. i can handle having very small fermented stuff and building up gradually (starting with small kraut juice) but how do you avoid broth on a gut healing diet like gaps? i just started working with a gaps practitioner by the way, he was the one who told me i have histamine issues. i am awaiting an email response from him as well but just wanted to see your take on that. thank you!! love your blog

    • Becky Plotner says:

      If your Certified GAPS Practitioner tells you to stay away from meat stock to repair a histamine issue you need to say thank you and quickly find another GAPS Practitioner who deals with histamine issues. This is by the most misunderstood thing I see.

    • Andrew N says:

      I thought I was allergic to broth/stock as well. What I learned was I was cooking them too long and the glutamine in the bones turns to glutimate (poisonous – think Monosodium Glutimate (MSG)) and I had serious issues for awhile until I learned the mistake of cooking broth too long. Now I cook meat/bones under 12 hours in a slow cooker and things are fine.

      • Becky Plotner says:

        This is why GAPS meat stock is necessary for repair first.

        • Vicki says:

          I have literally no good bacteria left in my gut after 5 years of antibiotic use for Lyme disease and taking no probiotics. I have now developed a stubborn kidney and urinary tract klebsiella infection that returns every time I come off antibiotics. When I try to take any probiotic now, it actually brings the klebsiella infection back, and I have to return to the antibiotic again. It seems my body now identifies the good bacteria as being bad. Or, it seems to actually feed the klebsiella instead of kill it. Do I stand a chance on the GAPS program? Feels hopeless.

  10. Kimberley says:

    Do you have any recommendations of a GAPS practiotioner that has experience with severe histamine intolerance in adults and also very young children? We have been on the gaps journey for almost a year now and I am finally figuring out why we have gotten more and more sick instead of better….histamines. I need someone with real experience! Any advice would be wonderful. Thank you.

  11. Monne says:

    Hi Becky
    Thanks for the article.

    I know this is an old post, but I’m trying to track down the basis of Dr Natasha’s premise that histamine is reduced at the 6 week mark in fermented foods. Do you know if there is a study as I’m chasing more information.

    Kind regards,

  12. dave says:

    I just discover your blog and really appreciate your articles and dedication. IMHO taking something as an axioma will not gonna help anyone.”fermented foods could be causing the die off for sure”.

    Im also really big fan of GAPS and its PRINCIPLES – I found out that the above statement and the one about dye-off are many times taking as an AXIOMA and are over-rated IMO. I would suggest contemplating more the idea of lactic acid fermening bacteria in the gut and adding more by taking fermented food. Histamine or dye-off are not the only issues. for example i experienced many times with kefir so called dye-off which in fact were “feed-off” streptococcus and enterorococcus. sorry for my english

  13. Debbie says:

    The book I purchased on GAPS doesn’t match the pages you quoted above. I bought it because I need help with histamine issues and the book only has 2 short paragraphs. Did I purchase the wrong book?

    • Becky Plotner says:

      I’m not sure which book you have. There are several editions, each has only added new information, didn’t erase the old. If it’s the gaps book it’s true.

  14. Molly says:

    Debbie, you have the correct yellow GAPS book. You have to follow the protocol to heal and lighten your histamine reactions. The quotes you’re referring to are from the FAQ document (not the book). I’m linking the FAQ below. The questions quoted above are now found on page 164 and 170 though. Hope this clears things up.

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