Abstract
OBJECTIVE To evaluate the evidence regarding the disease concept of histamine intolerance as a state of inadequate histamine inactivation. METHODS Keyword-based systematic screening of the scientific literature and of public websites focusing on diagnostic and therapeutic procedures. RESULTS 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. CONCLUSIONS 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.