cheese and vegetables

Fermented Food Allergy • Reveal Hidden Causes

How do you know if you have fermented food allergy? Answer the following questions:

  • Do you get headache or migraine after drinking red wine?

  • Does fermented cheese like Parmesan, blue cheese and Roquefort trigger some reaction?

  • Have you had an allergy reaction after eating commercially fermented soy, pickles or sauerkraut?

If you said yes to one or more questions, does this mean you have fermented food allergy? Perhaps not. Allergic reactions and other side effects when consuming certain fermented foods or drinks are quite common. What’s causing fermented food allergy? And if you are indeed intolerant, does it mean that you cannot eat any fermented foods like homemade sauerkraut, fermented vegetables or yogurt?

  • Do you think that fermented food allergy or sensitivity means you cannot eat any fermented products?

I hope this post will help you to identify the specific foods causing allergy, intolerance or other adverse effects so that you can exclude them from your diet. Perhaps this information might also help you to see that you might still be able to enjoy certain fermented products.

Even though numerous factors can come into play, common triggers in fermented foods are biogenic amines. What are they? And how can you avoid them?

Biogenic amines are substances created by bacteria that break down the amino acids in food. These amines are present in some foods that are overcooked, processed, ripened, fermented or decomposed. Amines cannot be removed by boiling or any other method.

Reactions from biogenic amines often mislabeled as “fermented food allergy”

In healthy individuals biogenic amines like tyramine are normally quickly broken down by a healthy gut, intestine and liver. Enzymes in your body such as MAO (monoamine oxidase) render amines from food harmless.

However, some people are missing this enzyme MAO, or it can become sluggish or blocked; this can lead to a build up of amines in your body causing symptoms. Some drugs like antibiotics, antidepressants can also inhibit the actions of the MAO enzymes causing…

  • headache
  • migraine
  • depression
  • mental confusion
  • stomach problems
  • rash
  • itching
  • fever
  • vomiting

As you can see, biogenic amines can affect you mentally, your blood pressure, body temperature, and other body processes.

There are also different degrees of intolerance; some people are just a little sensitive while others experience adverse reactions on smaller amounts of amines. A few older studies showed that some people can get a migraine attack if they drink water containing as little as 1 mg of tyramine chloride, which is an amine.

However, many people are intolerant only to one or two specific amines (usually histamine and tyramine), while other amines might not bother them at all. But identifying the specific amines triggering your symptoms can be very hard. If you suspect biogenic amine intolerance, as good start is to keep a log of what you eat and drink. This way you might be able to discern a pattern and determine what fermented foods are linked to headache, migraine or other symptoms.

Children with behavior problems

Research suggests that about 70% of children with behavior problems are affected by salicylates, artificial colors and preservatives, compared to only about 40% affected by amines. Many mothers have reported that their child becomes silly and hyperactive on salicylates whereas amines make them aggressive. Many children who are expelled from day care centers due to aggressive behavior are often sensitive to amines as well as to other food chemicals.

A study in 2002 found that men with MAOA-L who had been badly treated as children were more likely to exhibit antisocial behavior than those who had been well treated. This shows the need for parents to approach this problem with discernment and understanding.

If you suspect intolerance/allergy to amines, try the following:

  • Keep a food diary to monitor what foods trigger symptoms; this can greatly help you to identify specific amines causing your symptoms
  • Find a specialist who knows what biogenic amines are. You can test negative for allergies but still have a biogenic amine intolerance. Be sure the doctor knows what Diamine Oxidase (DAO) and Monoamine Oxidase (MAO) are before your consult; if he doesn’t, don’t go! These enzymes are responsible for degrading two of the most commonly identified biogenic amines, histamine and tyramine.
  • A safe way to avoid biogenic amines is by consuming fresh produce and avoiding commercially fermented foods. Buy fresh, cook fresh, eat fresh.
  • Foods containing 2% salt or more are generally safe.
  • Yogurts and similar dairy products are safe if the bacteria have been chosen especially not to produce biogenic amines.
  • Making homemade yogurt and fermented vegetables is usually safe, if done properly.
  • Get a high quality probiotic supplement.

Some common biogenic amines are…

TyramineHistaminePhenylethylamineAgmatinePutrescine
CadaverineSpermidineTyptamineAdrenalineSerotonin
  • Reports indicate that histamine and tyramine are considered the most toxic of all amines

Other common substances that can cause similar symptoms are salicylates and glutamates. People who have migraines and try to avoid amine-rich foods sometimes say ‘I tried avoiding foods but it didn’t work’. Sometimes this is because migraines can be provoked by food chemicals such as salicylates and glutamates.

Fermented foods containing amines

Here’s a list of a few fermented foods that contain amines and that can cause symptoms in those with intolerance or sensitivity. Please keep in mind that in many foods there can be a wide difference of tyramine concentration in different parts of the same food. Poor quality food also tend to contain higher amounts of amines, as does food not properly stored, cleaned or prepared.

“Red wine headache”

There are many people who get headache after drinking red wine, which is a fermented drink. The symptoms can occur 15 minutes after drinking a single glass of wine and might be followed by nausea and flushing.

Some researchers believe this might be caused by tyramine and histamine present in red wine, even though other potential causes also exist (like tannins and sulfite). In one study on alcohol, red wine and Sake (an alcoholic beverage of Japanese origin that is made from fermented rice) were found to have the highest amine levels, while some beer had the lowest levels. Red wine can contain between 20–200% more histamines than white wine.

Beer

Can contain tyramine and Phenylethylamine if the malt is infected, or because of a later infection. It seem that the amine contents varies from brewery to brewery. In some studies, bottled/canned beers had the highest levels. Only 12% of tap beers had higher levels while the rest had low levels of tyramine.

The “cheese effect”

There are two main types of cheese—fermented and non-fermented. To ferment cheese you need to add live bacteria cultures. The bacteria feed on the lactose in the milk, producing biogenic amines as a byproduct. This process is often called aging. In one study they found that 18 of 26 cheeses (26%) had high levels of tyramine.

In the 1960s a British pharmacist noticed that his wife developed a headache every time she ate cheese, which is high in tyramine, at the same time she was taking MAOI antidepressants. In people who are taking certain drugs known as MAOIs (monoamine oxidase inhibitors), the enzyme is inhibited and a build up of tyramine can occur leading to high blood pressure, headaches, itchy skin rashes, heart palpitations and diarrhea. A number of MAOI patients died from strokes or heart attacks before doctors realized that patients taking MAOIs needed to avoid foods high in tyramine. There is also a rare condition where people are born without the MAOA gene and therefore lack the MAO enzyme.

Chocolate

The cocoa bean is fermented to achieve its flavor. Dark chocolate contains the chemical tyramine, which has been found to trigger migraine headaches in the majority of migraine-prone subjects tested in some studies, according to the Clemson University Extension. Phenylalanine, another component of chocolate, has been shown to trigger migraines in about half the migraine-prone subjects in another field study.

Yogurt

Much of the commercially produced yogurt can contain tyramine and sometimes phenylethylamine. However, if probiotic bacteria cultures is carefully chosen, you can make your own homemade yogurt free of tyramine. High quality starter cultures will prevent the creation of amines. One reason for this is because they are composed of probiotic bacteria strains that do not produce amines and even prevent the development of amines.

Drugs

Many drugs can contain amines, including over the counter cold tablets, decongestants, nasal drops or sprays, some pain relievers, general and local anesthetics and some antidepressants. Be sure to check labels and ask you doctor before taking new drugs.

Biogenic amines in sauerkraut

A study in 1999 aimed to determine levels of biogenic amines in 121 sauerkraut samples. They tested Austrian manufacturers, household-prepared and sterilized with brine in jars. Even though very wide variations occurred, there were generally low concentrations of amines in sauerkraut.

  • The lowest concentrations of amines were found in household-prepared sauerkraut

    Fermented food allergy from vegetables

    Fermented Vegetables

Another study made in 2011 tested levels of biogenic amines in spontaneously fermented sauerkraut, during 45 days of storage. They added three different probiotic bacteria strains to ferment cabbage, Lactobacillus plantarum, Lactobacillus casei and Lactobacillus curvatus.

After fermentation they compared amine levels in jars where probiotic bacteria had been with jars without the added bacteria. This is the result:

  • Adding probiotic bacteria created much lower biogenic amine levels in fermented cabbage. All biogenic amine levels were below the 100 ppm-threshold. Histamine and tyramine were essentially absent during 45 days of storage.
  • Fermenting cabbage without adding probiotic bacteria produced a higher amount of amines. When Lactobacillus bacteria were not added, the dominant biogenic amines created were putrescine, tyramine and histamine. The longer the sauerkraut was stored, the higher the levels of amines created.

Conclusion: Using a starter culture to ferment a vegetable mix will prevent extensive formation of biogenic amines.

This means that if you’re sensitive to amines, you might still be able to enjoy fermented vegetables, sauerkraut or yogurt.

Spoiled food packed with biogenic amines—a common cause of food poisoning

The concentration of biogenic amines in food is an indication of how much they have rotted or decomposed. High concentrations of biogenic amines can cause food poisoning no matter how healthy you are. In lower concentrations these same chemicals can trigger migraine attacks in susceptible sufferers.

Food freshness is a key factor to avoid biogenic amine side effects

The way meat is distributed in supermarkets can cause problems if you’re intolerant to amines. Most meats are vacuum packed, repacked and sold as fresh which means it can be up to ten weeks old when you eat it.

Studies show that vacuum packing can prevent the growth of bad bacteria but does nothing to prevent the development of biogenic amines.

Experience shows that if you’re sensitive to amines, you need to learn much about the history and freshness of your foods; you need to approach all possible amines-containing foods with caution.

Other foods containing biogenic amines

Certain bacteria are often used to process many commercially produced foods and as a result of this process these foods can contain high amounts of biogenic amines.

  • For example fermented soy and canned tuna are known to be very high in histamine, cadaverine and putrescine.
  • Aspartame (Nutrasweet). It is used as a sweetener in many drinks and 600 different foods. It contains phenylethylamine and can cause many problems even in healthy individuals.
  • In one study they analyzed 45 commercial fish sauces and 23 soy sauces for their biogenic amine content. They reveals that content of biogenic amines varied from 100 mg/kg to 4000 mg/kg, depending on the method of manufacture. The content of biogenic amines in soy sauces was generally much lower than in fish sauces. Tyramine was the main biogenic amine in soy sauce, fish sauces contained high concentrations of tyramine, histamine, tryptamine and others. The levels of biogenic amines in fish sauces were at a level equivalent to that found in other matured foods like matured cheese.
  • As I said before, biogenic amines are formed when amino acids in food are broken down. High concentrations can therefore be found in fish and fish-products that have not been kept according to hygiene guidelines.

Food that can cause side effects and allergic reactions if intolerant or sensitive

This table give you an idea of what foods often are responsible for side effects. The high-very high group contains 10-100 times more amines together with salicylates or glutamates than the low-medium group. Exactly what foods you could eat and how much depends on how sensitive your body is. You just have to keep a log and exclude foods causing a reaction. Generally, fresh, organic foods are much safer than processed products.

NegligibleLow-mediumHigh-Very High
Tacos
Apples
Apricots
Gooseberries
Rhubarbs
Strawberries
Cherries
Asparagus
Cabbage
Capsicum
Carrot
Celery
Corn
Cucumber
Green Peas
Lettuce
Lima Beans
Onion
Potato
Soy Bean
Turnip
Zucchini
Herbs
Pepper
Spices
Coffee
Lemonade
Milk (Goat, Cow)
Tea
Fresh Cottage Cheese
Yoghurt
Soy Milk
Tofu
Tofu Ice Cream
Emmental
Jaalsberg
Almonds
Cashews
Macadamia Nuts
Pine nuts
Pistachio
Brazil Nut
Sesame Seeds
Sunflower Seeds
Kiwifruit
Lime
Oranqe
Tanqerine
Broccoli
Cauliflower
Olives
Eggs
Beef
Chicken (No Skin)
Fish (White Meat)
Lamb
Rabbit
Sausage Casing
Turkey (No Skin)
Veal
Canned Salmon
Chicken Liver
Chicken Skin
Meat Older Than 2 Days
Frozen Chicken
Frozen Meat
Frozen Turkey
Fresh Tuna
Champagne
Blackcurrant
Grapefruit
Rockmelon
Red Wine
Dark Chocolate
Black Walnut
Spicy Flavoured Snacks
Brie
Camembert
Miso
Roquefort
Parmesan
Smoked Meat, Chicken
Chocolate Drinks
Cocoa
Spinach
Meat Pies, etc.
Pate
Salami
Sausages
Cola Type Drinks
Orange Juice
Tomato Juice
Vegetable Juice
Anchovies
Beef Liver
Brains, Kidney, Tripe
Canned Tuna
Dried, Smoked Fish
Fish Roe
Cheddar Cheese
Danish Blue
Edam
Leicester
Limberger
Mozarella
Swiss Cheese

Foods rich in histamine can trigger an allergic reaction

These foods contain different levels of histamine. Please keep in mind that consuming several foods containing histamine will increase the risk of allergy or other adverse effects. People who have low levels of the enzyme diamine oxidase cannot break down all histamine their body absorb from food containing histamine. This is histamie intolerance.

  • Alcoholic drinks as wine and beer
  • Anchovies
  • Avocados
  • Aged or fermented cheese, such as parmesan, blue and Roquefort and others
  • Cider and home-made root beer
  • Dried fruits such as apricots, dates, prunes, figs and raisins (some might eat these fruits without reaction if thoroughly washed first)
  • Eggplant
  • Fermented foods, such as pickled or smoked meats, commercially produced sauerkraut
  • Mackerel
  • Mushrooms
  • Processed meats – sausage, hot dogs, salami and others
  • Sardines
  • Smoked fish – herring, sardines and others
  • Sour cream, sour milk, buttermilk, and yogurt; especially if not fresh
  • Soured breads, such as pumpernickel, coffee cakes and other foods made with large amounts of yeast
  • Spinach, tomatoes
  • Vinegar or vinegar-containing foods, such as mayonnaise, salad dressing, ketchup, chili sauce, pickles, pickled beets, relishes, olives
  • Yogurt, most commercially produced

Histamine-Releasing Foods

Some foods might be low in histamine but they can stimulate the release of histamine in your body. The following foods are examples of this:

  • Alcohol
  • Bananas
  • Chocolate
  • Eggs
  • Fish
  • Milk
  • Papayas
  • Pineapple
  • Shellfish
  • Strawberries
  • Tomatoes

Treating fermented food allergy

First, you might want to try a low-amine diet to confirm that you are intolerant to amines.

Then you want to determine what amines are triggering your symptoms; histamine, tyramine or others.

When you have a pretty good idea of possible trigger, treatment of fermented food allergy or intolerance includes avoiding all food triggering an adverse effect.

After this, the same food should be reintroduced in your diet to confirm the intolearnce of this particular food. Otherwise you might end up with a long list of foods to avoid when in reality not all those foods will trigger your allergy symptoms.

Comments

    • Ken Silvers says

      Hi Sharon.

      Sorry to hear that you suffer from this also. My wife has had similar allergies and that’s when I started researching this subject. It can be very frustrating to deal this problem as it is quite complicated. It took a long time to research the relevant scientific studies and to gather only the most vital information in an understandable way. Much that is written on this subject is very scientific and not easy to digest. But doing it was very enlightening and did help us a lot.

      My wife is now completely free from her allergies and has not had symptoms for a long time. This is the result of life-style changes we have made like focusing mainly on a plant-based diet, fermented vegetables, intermittent fasting and regular detox.

  1. Susan says

    Wow! Such great info, all in one place!

    I just posted a question to the “side effects” (?) page, I think that I have found some more clarity here.

    I posted asking about the possibility that large doses of probiotics might be causing congestion, headache & earache. I now see that it’s probably due to amine/salicylate/glutimate/histamine sensitivity. The pro-biotics could have contained some of these.

    I get congested when I have too much milk or cheese. The biggest migraine triggers for me are red wine, dark chocolate & some cheeses. MSG and brewers yeast also gives me a headache, as can some salami, sausages, and some soy sauces. Walnuts, shrimp & cayenne pepper makes my mouth burn.

    I can have some of the above foods, but too much & I can get ratcheted up to a migraine in no time. Seems like once I already have a headache, I’m more sensitive to offending foods. When I get a migraine, I occasionally get an intense itching in one eye &/or nostril & my eye/nose runs on that side. Probably a histamine release?

    Ironically, one of the ways that I get rid of a migraine is to have a Diet Coke or Pepsi, so I’m fortunately not sensitive to phenylalanine. I have heard that it’s bad for you anyway & try to replace artificial sweeteners with the less artificial stevia. Or, take an Excedrin with caffeine. Lucky that I’m not bothered by salicylates!

    Thanks so much for listing some of the foods that can be triggers that I was not aware of yet. I often have a banana with almond butter, so will pay extra attention next time to see if I have a reaction to it.

    Do you have a list of specific bacteria that are likely to create amines? And/or conversely, ones that don’t? I would like to make my own yogurt or kefir & it would be helpful to know what would be the best starter to use.

    I don’t know if you mention specific brands on-line, as that might be considered an endorsement or not? I would like to hear from you & the other readers if they have found a specific store bought yogurt that has worked for them, or ones that they know to avoid if they are also sensitive to the above chemicals. I know that we are all different, but it might help to eliminate some bad ones!

    Thanks again! I have taken some of your lists & put them into a spreadsheet that I can keep on my phone if I’m out shopping & need help with better food choices. I think that someone should create a food diary app for smart phones so that we can keep track of our food consumption/reactions while we are out. Anyone?

    • Ken Silvers says

      Hello Susan.
      Nice to hear from you. Yes, I worked long and hard with this post. My wife suffered from allergies in the past and I was determined to understand the causes and how to deal with them. Part of my research became this post.

      A list of amine producing bacteria would be nice. I’ve not made one because it is quite a complicated question. One reason is that you’re dealing with many different foods that are fermented in many ways using all kinds of bacteria.

      However, a few histamine producing bacteria are Morganella morganii, H. alvei, Klebsiella spp., Citrobacter freundii, Enterobacter spp., and Serratia spp. The bacteria species included in starter cultures are beneficial ones that do not promote the creation of amines. In fact, research shows that such starter even oppose the creation of amines. The lowest levels of amines was found in homemade fermented vegetables.

      So a good way to avoid amines is to prepare your own yogurt (from raw milk) and fermented vegetables. It is difficult to know for sure which commercial yogurts and kefir will contain amines or not.

      Great idea to create a food app!

      About starter cultures, I make my own fermented vegetables, yogurt and kefir so I’ve tried many starter cultures and found a few that are really good. I now mostly use Body Ecology or Dr Mercola Complete Probiotics (his latest is Kinetic Culture, but I’ve not tried it yet).

  2. Susan says

    Thanks so much for responding so quickly! I’m feeling better after a couple of days. I stopped taking the massive doses of probiotics. I added back some simpler foods that I know are soothing to my belly. Drinking more filtered water. Taking psyllium product to move things out of my colon quicker. Taking only foods that I know are safe for me, as I don’t want to confound the elimination process.

    I made myself a spreadsheet (can share it with you?) that compares the different strains that are in the Mercola & BioKult brands (both of which I haven’t tried yet) along with the VitaCost 15-35 & Ultimate Flora that I was using. I don’t know if that is one that you have checked out yourself?

    VitaCost also sells the BioKult, Mercola & Ultimate Flora and many, many more! I haven’t taken the time to compare the prices that you had gathered, but I think that they are competitive? I like the fact that if you order more than $50 (not difficult!) you get free shipping & get it delivered in one day. & no, I don’t work for them.

    It’s all overwhelming. I will begin the process of adding back one product at a time & see if I get a reaction. Hopefully the spreadsheet will help me figure out if it is one bacteria in particular, or if my crisis was created by too much, too fast.

    I REALLY appreciate that the Bio-Kult tells you what probiotics are helpful for which area of the body, situation, etc., I will be looking for more of that on-line. Will continue to do research & if I find out anything about the amines or anything that might be helpful to you or your readers, I will share.

    I know that we are all individual & will have different reactions, but the more that we can figure out & share, the more that we can potential help others. I REALLY appreciate blogs like this that create a public forum.

    Thanks again!

    • Ken Silvers says

      Hello Susan.

      Nice to hear you’re feeling better. Yes, the BioKult list of bacteria was something I started doing a while back as many people want an overview. In fact, my plan was to make a separate listing the many more probiotic bacteria to have an good overview. Perhaps I should complete that project.

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