Avoid Eating Aged Cheeses If You Have This Little-Known Food Intolerance

Gouda, asiago, and parmesan are just a few of the various aged cheeses people with histamine intolerance will want to bypass at the grocery store. Found both in the body and in certain food items, histamine is a chemical that plays a role in nerve cell communication, gut functioning, inflammation, and more, as outlined in the 2017 textbook "International Review of Neurobiology" (via ScienceDirect).

Histamine intolerance (which is different from a food allergy) means that histamine levels have surpassed the body's means to break it down, as outlined in a 2024 scientific review published in Nutrients. This can lead to symptoms of diarrhea, constipation, headache, congestion, dermatitis, menstrual cramping, a fast heart rate, and more. For many people, gastrointestinal effects make up the bulk of symptoms, with researchers from the review citing a study in which more than 90% of participants with histamine intolerance were found to experience bloating. Experts advise that individuals with the condition stay away from aged cheeses due to their high histamine content. Here are the specific types of cheeses best avoided, and which ones may be safer for people with histamine intolerance.

Complementary and Alternative Medicine (CAM) expert Dr. John Gannage writes via Markham Integrative Medicine that people with histamine intolerance will want to steer clear of blue cheeses aged with bacteria (like gorgonzola, cabrales, and stilton), which are rich in histamine. The same is true for stinky cheeses, such as raclette or munster, that have also been ripened with bacteria. You don't want to eat moldy cheeses either, including the signature cheese board favorite: brie. This also rules out many different types of hard and semi-hard cheeses, including cheddar, romano, manchego, and Swiss cheese, amongst others. Cheese made from unpasteurized milk should also be avoided.

Researchers from a 2018 European study published in the Journal of Veterinary Research outline how temperature and storage time play a major role in the histamine content of ripening cheeses. In the study, aged cheeses stored at a temperature of 22 degrees Celsius (71.6 degrees Fahrenheit) for over 42 days had more than twice the amount of histamine than those stored at 4 degrees Celsius (39.2 degrees Fahrenheit) for 112 days. While the research article mainly focused on risk reduction for histamine poisoning in the processing of aged cheeses (not the same thing as histamine intolerance), the study demonstrates how aged cheeses can accumulate high amounts of the chemical.

For those with histamine intolerance, there's also some potential risk associated with eating plant-based cheeses, such as those made from cashews, which also have a high histamine concentration (via Markham Integrative Medicine). Soy-fermented products may also accumulate high levels of the chemical, according to 2021 research published in Nutrients. Generally speaking, the key is to stick with low-lactose or lactose-free dairy products, which tend to be lower in histamine. Minimal consumption of soft cheeses (like ricotta, mozzarella, cottage cheese, and cream cheese) is the way to go, Dr. Gannage writes. Yet it's important to note that some cheeses overlap across the low-lactose and high-histamine categories. This includes feta cheese as well as the previously mentioned parmesan, cheddar, and Swiss. For this reason, the low-lactose rule shouldn't be applied across the board. Here's an additional list of foods to eat and which to avoid if you're following a lactose-free diet.

Talk to your doctor if you're experiencing symptoms of histamine intolerance and have questions about cheese consumption. Your physician can help determine if you may be a good fit for the low-histamine diet. To learn more, here's what you need to know about a low-histamine diet. In the event of anaphylaxis symptoms, such as lip swelling, trouble breathing, or sudden decreases in blood pressure, go to the nearest hospital.