Tofu (fermented)

Regular tofu is already something to be mindful of with histamine, but the fermented version adds a whole extra layer.

• Fermentation builds histamine — during the aging and fermentation process, bacteria break down proteins in the tofu and produce histamine directly, meaning the food itself arrives with a higher histamine content

• Different from plain tofu — unfermented tofu has the soy liberation concern but skips the fermentation step, so it's generally considered a lower-load option if tofu is something you want to keep in rotation

Fermented tofu is used as a condiment in many dishes, so even small amounts can contribute meaningfully.