Alcohol and histamine: which drinks are suitable for histamine intolerance?

October 21, 2026approx. 15 minutesby mybody®x Editorial & Expert Team

In this article

Alcohol and histamine intolerance: how are they connected?

According to the guidelines, alcohol consumed at the same time may interfere with histamine breakdown because the same enzymes are involved (DGAKI et al., 2021, paraphrased). However, it is unclear whether alcohol directly inhibits DAO.

A glass of red wine with dinner, and later your face is red and your nose is running. If this sounds familiar, the next time you have a glass, you may wonder whether it’s the wine or the alcohol in it. The answer has two parts. Drinks contain varying amounts of histamine, and the alcohol itself may interfere with its breakdown in the body (DGAKI et al., 2021, paraphrased).

The article on the basics of histamine explains what histamine is and what roles it plays in the body. This article picks up where alcohol comes into the picture: how it is broken down in the body and how much histamine is in your glass.

Which enzymes break down histamine from food and drinks?

Two main pathways for histamine breakdown are known in the human body, driven by the enzymes DAO and HNMT (Comas-Basté et al., 2020). DAO, short for diamine oxidase, is considered the main enzyme for breaking down histamine obtained from food (Maintz & Novak, 2007). HNMT, short for histamine N-methyltransferase, breaks down histamine inside cells, while DAO acts outside cells (DGAKI et al., 2021).

You can think of the two enzymes as two departments in a waste disposal company: one cleans up inside the cells, the other outside them. In the intestine, according to the guideline, HNMT may also be involved in histamine breakdown, alongside DAO (DGAKI et al., 2021, paraphrased).

What do alcohol and histamine compete for?

A review names alcohol and its breakdown product acetaldehyde as possible enhancers because both compete with histamine for the enzyme ALDH (Comas-Basté et al., 2020, paraphrased). ALDH stands for aldehyde dehydrogenase, an enzyme that, according to this review, is involved in breaking down both histamine and alcohol (Comas-Basté et al., 2020). Acetaldehyde is produced in the body when alcohol is broken down (Brooks et al., 2009, paraphrased).

An older review lists alcohol as a possible trigger of symptoms in histamine intolerance (Maintz & Novak, 2007). What stands out is how cautiously the sources phrase their claims. The guideline (DGAKI et al., 2021) speaks of possible interference with breakdown, while the two reviews (Comas-Basté et al., 2020; Maintz & Novak, 2007) refer to possible enhancers and triggers.

What does the laboratory study show about alcohol and DAO?

Online, you may read that alcohol switches off DAO. A laboratory study examined this exact question: at relevant concentrations, alcohol and its breakdown products did not inhibit the activity of genetically engineered human DAO (Bartko et al., 2016, paraphrased). The authors conclude that their laboratory data do not support direct inhibition of DAO in the body (Bartko et al., 2016, paraphrased).

This result is not a blank check. It comes from a laboratory, not from trials with humans. The guideline considers it possible that alcohol slows histamine breakdown (DGAKI et al., 2021, paraphrased).

The article what is proven about histamine explains which measures related to histamine are supported by studies and which remain more like insider tips.

How much histamine is in wine and beer?

Red wine contains a median of 1.90 mg/kg of histamine, more than white wine or beer (Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020). This median conceals a wide range.

The figures come from a table reproduced in a review article from a food safety reference work (Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020). The content is given in milligrams per kilogram, or mg/kg. The median is the middle value of the measurements. It represents the midpoint of the samples, not an individual bottle.

Median histamine levels per kilogram

Source: Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020

The highest values show just how far levels can vary. The red wine sample with the most histamine contained 55.00 mg/kg (Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020). This is a single value at the high end, not a typical glass, but it shows how far levels can be from the median.

A measurement study of 100 high-quality red wines also found a wide range: the median was 7.2 mg/l, with values ranging from 0.5 to 26.9 mg/l (Konakovsky et al., 2011). Measurements here were in milligrams per liter, or mg/l, and taken from different samples.

Levels varied widely between wines, regardless of grape variety (Konakovsky et al., 2011, paraphrased). High levels were also found in highly rated wines (Konakovsky et al., 2011, paraphrased). Of the wines tested, 34 percent exceeded a hypothetical threshold of 10 mg/l, which the authors used for comparison (Konakovsky et al., 2011). So a good reputation does not protect the wine in your glass from containing histamine.

Wine and beer are not the only sources. The article Foods Containing Histamine shows which other foods contain histamine. The Institute for Quality and Efficiency in Health Care (IQWiG) also cites red wine as an example in its glossary (gesundheitsinformation.de, accessed on October 21, 2026).

Which alcoholic drink is low in histamine?

The median histamine levels in white wine and beer are lower than in red wine (Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020). The alcohol in each of these drinks may also slow histamine breakdown (DGAKI et al., 2021, paraphrased).

In the compilation, white wine had the lowest median, at 0.45 mg/kg (Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020). That does not mean it is histamine-free. The white wine sample with the highest histamine level reached 13.00 mg/kg (Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020).

For beer, the median was 0.70 mg/kg, and no histamine was detectable in some beer samples (Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020). At the other end of the range was a sample with 21.60 mg/kg (Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020). This maximum value is higher than the highest white wine value in the same compilation.

If you are looking for alcohol without histamine, these data do not provide a definitive answer. Histamine levels vary widely from glass to glass, so the data cannot identify a drink that is guaranteed to be histamine-free. The aggregated values do not show whether a particular wine or beer contains a lot or a little.

That brings us to the second part of the answer. Even a drink low in histamine contains alcohol, which may hinder histamine breakdown according to the guideline (DGAKI et al., 2021, paraphrased). A low median is therefore a guide, not a reason to assume it is safe.

The article Tea for histamine intolerance covers non-alcoholic drinks. This article focuses on wine and beer.

What are the symptoms of a histamine reaction to alcohol?

If you have histamine intolerance, eating histamine-rich foods or drinking alcohol may cause symptoms such as headaches and flushing, or reddening of the skin (Maintz & Novak, 2007, paraphrased). Symptoms can vary widely (Maintz & Novak, 2007, paraphrased).

Among other things, the review lists these possible symptoms that may occur after eating histamine-rich foods or drinking alcohol if you have histamine intolerance (Maintz & Novak, 2007, paraphrased):

• Diarrhea
• Headaches
• Nasal and eye symptoms
• Hives
• Itching
• Flush, a reddening of the skin

Two points on the list are especially relevant to a common everyday concern: a red face after red wine—the flushing and nasal symptoms. Both are consistent with a histamine reaction, but neither proves one. Facial redness after drinking alcohol can also have another cause related to how the body breaks down alcohol (Brooks et al., 2009, paraphrased).

Because the symptoms are so varied, the authors believe histamine intolerance has been underestimated (Maintz & Novak, 2007, paraphrased). For you, that means observation is more useful than guessing.

Keep track of which symptoms occur after which drinks. These notes are a good starting point for a conversation with your doctor. If symptoms persist or recur after drinking alcohol, discuss them with a doctor rather than trying to self-diagnose.

Alcohol and Histamine: What’s True and What’s Not?

White wine is not histamine-free (Bover-Cid et al., 2014, cited in Comas-Basté et al., 2020). A red face after drinking alcohol can also occur without histamine (Brooks et al., 2009, paraphrased), and whether alcohol directly inhibits DAO is unclear (Bartko et al., 2016).

Claims about alcohol and histamine are often repeated because they sound convincing and are easy to pass on. Here are three of them, alongside what the sources actually show.

Claim and evidence

The third point leads to the most important distinction in this article. If someone turns red after a glass of wine, they may quickly think it’s histamine. But there’s another, entirely different pathway: the breakdown of alcohol itself.

Histamine Intolerance or Alcohol Intolerance: How Can You Tell the Difference?

In histamine intolerance, histamine from food or drinks is not broken down sufficiently; the main enzyme responsible is DAO (Maintz & Novak, 2007, paraphrased). In alcohol flushing, by contrast, acetaldehyde builds up because the ALDH2 enzyme is missing (Brooks et al., 2009, paraphrased).

About 36 percent of people from East Asia develop facial flushing after drinking alcohol (Brooks et al., 2009). Nausea and a racing heart can also occur (Brooks et al., 2009). Experts call this alcohol flush. It is mainly caused by an inherited deficiency of the ALDH2 enzyme (Brooks et al., 2009, in essence).

The mechanism differs from histamine. With ALDH2 deficiency, alcohol is broken down into acetaldehyde, which builds up in the body because ALDH2 activity is lacking (Brooks et al., 2009, in essence). So this is about the breakdown of alcohol itself, not histamine from the drink.

Both mechanisms can lead to the same result: a red face after drinking. The overview lists other possible symptoms of histamine intolerance, such as itching (Maintz & Novak, 2007, in essence). Nausea is also associated with alcohol flush (Brooks et al., 2009).

Evidence on histamine intolerance is limited, making it difficult to state how common it is (Comas-Basté et al., 2020, in essence). Some authors estimate that it affects 1 to 3 percent of the population (Comas-Basté et al., 2020). When reading both figures, keep in mind that they describe different groups.

The article Alcohol Intolerance and Its Test explains how alcohol intolerance manifests and how it can be investigated. The table compares the two mechanisms.

Comparing histamine intolerance and alcohol flush

For anyone who wants to know how their genes are set up to break down alcohol: the NutriCare | INFINITY DNA Test from mybody®x (MYBODY Lab GmbH) analyzes the ALDH2 gene and two other genes involved in alcohol breakdown in the “Alcohol Metabolism” report, using a saliva sample, for €269.00 (as of October 21, 2026; subject to change). The report describes a genetic predisposition, not a measurement in the body; no mybody®x test measures histamine or DAO. It can help prepare for a conversation with a doctor, but it does not replace a medical evaluation.

Alcohol and histamine: What are the limits of our knowledge?

The levels in wine and beer are pooled values from the literature. The sources and years of the individual measurements are unknown (Bover-Cid et al., 2014, via Comas-Basté et al., 2020). The finding about DAO comes from a laboratory study that did not involve humans (Bartko et al., 2016).

A study of red wine by an Austrian research group measured selected high-quality red wines (Konakovsky et al., 2011). It reports levels, not health data. Its figures come from different samples and use a different unit than the pooled values; each set of measurements stands on its own.

The laboratory study used genetically engineered human DAO (Bartko et al., 2016). The fact that it found no inhibition does not mean that alcohol is harmless for people with histamine intolerance.

The guideline’s statement that alcohol may hinder histamine breakdown is based on a single source (DGAKI et al., 2021, paraphrased). The review by Maintz and Novak (2007) predates the guideline (DGAKI et al., 2021) and takes a somewhat more supportive view of histamine intolerance. Where the two disagree, the guideline takes precedence (DGAKI et al., 2021), and the review’s authors themselves called for further carefully controlled studies (Maintz & Novak, 2007, paraphrased).

The figure on alcohol flushing describes people from East Asia (Brooks et al., 2009). The prevalence of histamine intolerance is based on estimates by individual authors, not on a survey (Comas-Basté et al., 2020).

Alcohol and histamine: What you can do now

A red face after red wine can have two causes: the histamine in the glass and the breakdown of the alcohol itself. The figures for wine and beer are a guide, not approval of any particular drink. Your notes on drinks and symptoms are the best starting point for a conversation at the doctor’s office. One glass tells you little; a pattern tells you more.

Frequently asked questions

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Sources

1. Reese I. et al. (DGAKI et al.): Guideline on management of suspected adverse reactions to ingested histamine, Allergologie select (2021) – europepmc.org
2. Comas-Basté O. et al.: Histamine Intolerance: The Current State of the Art, Biomolecules (2020), table based on Bover-Cid et al. (2014) – europepmc.org
3. Konakovsky V. et al.: Levels of histamine and other biogenic amines in high-quality red wines, Food Additives & Contaminants (2011) – europepmc.org
4. Bartko J. et al.: Recombinant human diamine oxidase activity is not inhibited by ethanol, acetaldehyde, disulfiram, diethyldithiocarbamate or cyanamide, Alcohol (2016) – europepmc.org

The claim that histamine breakdown is slowed is based on guideline [1]. The levels in wine and beer and the estimate of prevalence come from review [2], while variations between individual red wines come from measurement study [3]. The laboratory finding on DAO comes from [4]. mybody®x product information: as of October 21, 2026; subject to change.