You’re histamine intolerant. Which beers can you drink?

It’s the amber nectar, the answer to the question you can’t remember, and, to quote Homer Simpson, “the cause of and solution to all of life’s problems”. Beer is a beverage enjoyed by millions, but delicious though it may be to many, it can wreak bodily havoc in people with histamine intolerance. Indeed, those who suffer often have very poor tolerance to beer, yet some consume it nonetheless. Here we take a closer look at what beer-drinkers with histamine intolerance need to consider.


Different brewing methods have different effects on histamine content

Beer is an alcoholic drink made from water, malted barley, hops, and yeast. The latter ingredient is crucial in the production process: when the barley is malted, yeast metabolizes the sugar into alcohol to form the beverage with which we are familiar. The process is called fermentation and it lasts several weeks.

Today there are two main types of yeast strains cultivated for brewing beer:
  • Saccharomyces pastorianus (bottom-fermenting yeast)
  • Saccharomyces cerevisae (top-fermenting yeast)

The choice of yeast affects the manufacturing process and therefore the content of biogenic amines.

Contrary to a popularly held view found prominently online, yeast neither contains histamine nor produces it during brewing (you can read more on this here). Histamine and other biogenic amines are actually found in beer as a result of contamination with lactic acid bacteria, especially Pediococcus spp. Whether contamination occurs depends heavily on the sanitation of the brewing conditions. One method of fermentation performs particularly poorly when it comes to restricting the level of biogenic amines produced, but more on that later.

Bottom-fermented beer

Bottom-fermenting yeast requires low temperatures – between 39 °F and 48 °F (4 °C and 9 °C) – for the fermentation process, which is why it was traditionally brewed in winter. The brewing process is relatively slow, but the cooler temperature ensures a lower probability of contamination with unwanted foreign microorganisms. Bottom-fermented beers therefore contain only small amounts of histamine and other biogenic amines.

Bottom-fermented beer
Pilsners (e.g. Budweiser, Stella Artois, Heineken), Lagers (e.g. Modelo Especial), Märzen-style beers (e.g. Shiner), German Oktoberfest beers, assorted craft beers, and their alcohol-free equivalents
Histamine content<1 mg/l
Table 1: popular bottom-fermented beers and their respective histamine content

Top-fermented beer

With top-fermented beer, the yeast used requires a higher ambient temperature of around 68 °F (20 °C). Fermentation occurs much more quickly at this temperature, but the product is more susceptible to contamination. Histamine-producing bacteria is more likely to be found in top-fermented beer, and this is reflected in its higher histamine levels. Some beers are brewed with a mixture of yeast and lactic acid bacteria – Berliner Weißbier from Germany for example – and in those cases, an increased amount of histamine is to be expected.

Top-fermented beer
Pale ale, IPAs (e.g. Sierra Nevada, Blue Moon), brown ale, porter, stout, wheat beer (e.g. German Weizenbier), many Belgian beers, assorted craft beers, and their alcohol-free equivalents
Histamine content0.1–3 mg/l
Table 2: popular top-fermented beers and their respective histamine content

Spontaneous fermentation

As well as top- and bottom-fermented beers there are also beers that are produced through spontaneous fermentation. In this case, no defined pure yeast is added to the liquid; instead, wild yeast and lactic acid bacteria fall into the brewing kettle. A high level of expertise is required to brew beer in this way, since the risk of contamination is extremely high. Histamine-producing microorganisms can find their way into the mixture, resulting in dangerous levels of histamine, and in rare cases, even healthy people can suffer bad reactions. Spontaneous fermentation is usually used for brewing specialty beers, though it is a rarely practiced method of brewing these days.

Spontaneous fermentation
Belgian specialty beers (e.g. Lambic, Framboise), Wild Ales
Histamine content0.3–12 mg/l
Table 3: beers made with spontaneous fermentation and their median histamine content


Two types of beer dominate the market worldwide today: top- and bottom-fermented beer.

Bottom-fermented beers generally contain the lowest levels of biogenic amines – usually tyramine and putrescine – instead of histamine. Histamine content is a good indicator of how beer is brewed, since a high histamine content is usually accompanied by larger amounts of other biogenic amines. Top-fermented beers contain higher levels of these amines due to their brewing conditions, while specialty beers, produced via spontaneous fermentation, can sometimes contain critical amounts of histamine, tyramine, and other amines.

Inadequately hygienic conditions during production can also lead to increased levels of biogenic amines. Large breweries tend to have better hygiene control, but in this regard, consumers remain at the brewer’s mercy. For sufferers of histamine intolerance, bottom-fermented beers are the most “tolerable”, if we consider just their content of biogenic amines. Tolerable is in quotes, because biogenic amines are only part of the story. Despite the lower histamine content, bottom-fermented beer is by no means risk-free. After all, beer contains alcohol, which can still be fatal for sufferers of histamine intolerance.

At 6% alcohol, the beer served at the annual Oktoberfest in Germany, for example, is stronger than regular beer, and one measure contains almost 60 g of pure alcohol. In the context of histamine consumption – either from the beer itself or the food a reveler might consume while drinking – that amount of alcohol can be dangerous, because it inhibits the breakdown of histamine. And this does not take into consideration other substances arising during the fermentation process that can also have negative side effects.

It pays to remember that not all beers are the same, and neither are all brewing techniques, especially in terms of hygiene control. Many of our users cannot tolerate even a small amount of beer. If you suffer from histamine intolerance and still want to drink beer, we make a cautious recommendation for bottom-fermented beer. The side effects of the alcohol can be avoided by choosing an alcohol-free option.

If you would like to know more about alcohol and food intolerances, you can find a detailed article on the subject in our app. And if you are interested in the glycemic index of beer, you can find further reading material here.

histamine-intolerance-1Our price-winning "Food Intolerances" app helps you manage your diet. Available for iOS and Android. Check it out:

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