About ME/CFS
SIGHI Food Compatibility Standard

Low Histamine Food Compatibility Checker & Meal Analyzer

Evidence-based food compatibility database, histamine liberator and DAO blocker identifiers, and an interactive plate calculator based on the Swiss Interest Group Histamine Intolerance (SIGHI) system.

The Microbial Histidine Decarboxylase Rule

In patients with ME/CFS and MCAS, dietary tolerance depends as much on microbial freshness as food taxonomy. Bacteria (including Morganella, Enterobacter, and Lactobacillus species) synthesize histidine decarboxylase, rapidly transforming harmless histidine into histamine even during refrigerator storage. To maintain low histamine levels, freeze freshly prepared meals immediately in individual portions and thaw rapidly prior to consumption PMID: 34209583.

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SIGHI Searchable Food Database & Meal Plate Analyzer

Search foods, filter by category or tolerance score, and click "+ Add to Meal" to compute the composite histamine and amine burden of your planned meal.

Food Name Category SIGHI Rating Biochemical Characteristics Action

🍽️ Planned Meal Plate (0 items)

No foods added yet. Click "+ Add to Meal" next to any food in the table above to analyze your meal.
Composite Histamine Load
Low Risk (Safe)
Histamine Liberators (L)
0 Detected
DAO Enzyme Blockers (B)
0 Detected
Add foods to evaluate preparation precautions, potential cross-reactivities, and diamine oxidase (DAO) enzyme requirements.

4-Phase Low Histamine Elimination & Reintroduction Protocol

Restrictive diets pose severe risks of malnutrition, micronutrient depletion, and gut microbiota loss in ME/CFS. An elimination diet must follow a structured, timed schedule rather than indefinite severe restriction:

Phase 1: Strict Washout (2 to 4 Weeks)

Consume exclusively SIGHI 0 foods. Eliminate all fermented products, aged meats/cheeses, leftovers older than 12 hours, alcohol, and tea. The goal is to clear circulating histamine and reduce baseline mast cell hyper-reactivity.

Phase 2: Systematic Single-Food Challenge (Weeks 5 to 8)

Reintroduce one isolated SIGHI 1 food every 72 hours in small quantities. Maintain a detailed food-symptom journal tracking flushing, heart rate spikes, brain fog, and GI distress for 48 hours following exposure before testing the next item.

Phase 3: Histamine Liberator Assessment (Weeks 9 to 12)

Test mild histamine liberators (e.g., fresh lemon juice in water, small amounts of strawberries) while continuing baseline H1/H2 antihistamines. Note if reactions correlate with mast cell priming or true non-IgE degranulation.

Phase 4: Personalized Maintenance & DAO Optimization

Transition to a diverse, tolerable whole-food diet. Utilize exogenous Diamine Oxidase (DAO) enzymes or natural mast cell stabilizers (Quercetin, Cromolyn) prior to occasional higher-histamine social meals to maintain dietary variety.

Peer-Reviewed References & Consensus Sources

  1. Swiss Interest Group Histamine Intolerance (SIGHI). Food Compatibility List: Histamine, Biogenic Amines and Mast Cell Degranulators. SIGHI Leaflet; 2021.
  2. Schnedl WJ, et al. Evaluation of symptoms and symptom combinations in histamine intolerance. Healthcare (Basel). 2019;7(1):24. PMID: 30791467
  3. Comas-Basté O, et al. Histamine intolerance: The current state of the art. Biomolecules. 2020;10(8):1181. PMID: 32824107
  4. Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr. 2007;85(5):1185-1196. PMID: 17490952