Histamine intolerance: a metabolic disease?

To evaluate the evidence regarding the disease concept of histamine intolerance as a state of inadequate histamine inactivation. Keyword-based systematic screening of the scientific literature and of public websites focusing on diagnostic and therapeutic procedures. Histamine intolerance is commonly diagnosed based solely on subjective reporting of symptoms instead of following systematic diagnostic procedures based on objective laboratory and physical parameters. The only effective long-term therapy is avoidance of histamine-containing food. The concept of histamine intolerance as a metabolic disease is in need of more experimental and clinical evidence and affected patients will benefit from a clear, evidence-based diagnostic and therapeutic regime.