Salami is one of the highest-histamine foods. The fermentation process that gives salami its distinctive flavour also allows bacteria to produce large quantities of histamine (averaging 91 mg/kg), tyramine (~197 mg/kg), and putrescine (~143 mg/kg). Some brands exceed safe histamine levels by five times.

These biogenic amines compete with each other for the same enzyme (DAO) the body uses to break them down, creating a cumulative overload — histamine becomes significantly more potent when tyramine is also present. This synergistic effect is why a charcuterie board combining salami with aged cheese, wine, and pickles can cause a strong reaction even when each individual component might seem manageable on its own. There is no preparation method that reduces these levels.