Cod liver oil
Cod liver oil is a refined oil product, and while it carries a high rating, the histamine concern is likely lower than for fish flesh given how histamine behaves in purified oils.
Unlike eating fish directly, cod liver oil is a purified oil product, and histamine — which is water-soluble — is not expected to concentrate significantly during the refining process.
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Oil vs. flesh — the histamine concerns associated with fish relate primarily to fish tissue, where bacteria convert histidine to histamine; this process is generally considered less of a meaningful concern in refined fish oils
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Freshness still matters — rancid or oxidized fish oil is generally worth replacing regardless; products with clear sourcing and proper storage are preferable
Individual responses vary, and if you find you tolerate cod liver oil well, the histamine-specific concern may be lower than the rating suggests.
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For educational purposes only. Not medical advice. Consult a healthcare professional for personal guidance.
References
- SIGHI Food Compatibility List — SIGHI (2026)
- Histamine and histamine intolerance — Maintz & Novak (2007)
- Histamine Intolerance: The Current State of the Art — Comas-Basté et al. (2020)
- Low-Histamine Diets: Is the Exclusion of Foods Justified by Their Histamine Content? — Sánchez-Pérez et al. (2021)
- Histamine Intolerance: Symptoms, Diagnosis, and Beyond — Jochum (2024)
- Guideline on management of suspected adverse reactions to ingested histamine — Reese et al. (2021)