Sauerkraut & Eczema

Eczema /

Triggers /

Sauerkraut

Fermented Foods

Fermentation creates both histamine and tyramine that compete for the same breakdown enzyme. Recommended for gut health but can worsen eczema in histamine-intolerant people. Homemade is lower risk.

🎯 Symphony Trigger Score

2/5

Summary

Sauerkraut accumulates biogenic amines during lactic acid fermentation, with tyramine typically being the dominant amine (~174 mg/kg) rather than histamine (0–229 mg/kg). This matters because both tyramine and histamine compete for the same enzyme (DAO) the body uses to break them down — when both are present together, they overwhelm the system more effectively than either alone.

Homemade sauerkraut generally has lower biogenic amine levels than commercial products, possibly because of shorter fermentation times and cleaner conditions. Sauerkraut creates a genuine tension in eczema management: it is often recommended for gut health and microbiome support, but for those with histamine intolerance it can worsen skin symptoms even as it supports the gut. Rinsing sauerkraut before eating reduces some surface-level amines.

The Details - Sauerkraut & Eczema

Reaction Timeline

Short delay (2–12 hours), Cumulative (days of repeated exposure)

Histamine effects within hours. Daily sauerkraut consumption (common in some diets for gut health) creates cumulative biogenic amine exposure.

How Much Is Needed To React?

Dose-dependent

A small forkful is different from a large side dish. Combining sauerkraut with sausage (cured meat) on a typical plate doubles the histamine load. If you eat sauerkraut for probiotic benefits, consider whether a probiotic supplement could provide the same benefit without histamine.

Does Preparation Matter?

Yes — preparation significantly changes reactivity

Longer fermentation increases biogenic amines. Household-prepared sauerkraut had lower concentrations than commercial in studies. Canned sauerkraut (pasteurized) stops fermentation but retains already-formed histamine. Rinsing sauerkraut before eating may reduce surface histamine slightly. Cooking does NOT reduce histamine. [4]

Also Watch Out For...

Kimchi — similar fermented vegetable, similar histamine mechanism
Other fermented vegetables (pickles, fermented hot sauce)
Other high-histamine foods — cumulative load matters

What To Use Instead

Fresh coleslaw (cabbage salad, unfermented)
Braised red cabbage (cooked, not fermented)
Probiotic supplements (Lactobacillus strains without the histamine vehicle)
Quick-pickled cabbage (vinegar-based, minimal fermentation — note: vinegar on trigger list)

Hidden Sources

Reuben sandwiches
Hot dogs and bratwurst toppings
German and Eastern European dishes
Some salads and grain bowls
Sauerkraut juice (health food shops)
Fermented vegetable blends

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This content is for informational purposes only and is not medical advice. Food triggers are highly individual — a food appearing in this database does not mean it will cause your eczema to flare. The information presented is drawn from published clinical research and patient community reports, but it is not a substitute for professional diagnosis or treatment. If you suspect a food allergy or sensitivity, consult a dermatologist or allergist. The gold standard for identifying food triggers remains a supervised elimination diet with oral food challenges. Symphony is a tracking tool, not a diagnostic or medical device.