Low Histamine Pizza slice

Low Histamine Pizza Recipe (and Low Oxalate, Low Lectin)

You don’t have to give up comfort foods if you have Mast Cell Activation Syndrome or Histamine Intolerance! 

But finding low histamine recipes for some of our favorite comfort foods can be a challenge sometimes.

Pizza is definitely one of those.

My husband loves to make pizza. And it was tortuous for me to smell it knowing I couldn’t eat it.

I never give in, though, because I feel too sick if I cheat. I have missed those pizza and movie kind of nights.

So I decided to get creative and see if I could make my own version of pizza. I was really excited when I came up with this Low Histamine Pizza recipe!!

Of course, tomato sauce is out for us. So are mushrooms, pepperoni, and hamburger. These are all high histamine.

When you have Histamine Intolerance and Mast Cell Activation Syndrome, it’s better to avoid those kinds of things while you are healing.

I’ve always liked the gourmet pizzas, though. The ones with a pesto or white sauce. So that’s the direction I went in this recipe.

And this Low Histamine Pizza recipe is really versatile. You can swap the toppings out with anything low histamine that you like.

For the crust, I use Otto’s Cassava Flour. It has the best taste and texture of all the brands I’ve tried. And it’s the only cassava flour product I know of that isn’t fermented.

Otto’s has been fine for my histamine levels. Other brands I tried were not.

And what’s really great is that Otto’s batch tests for quality. Because of this, I trust this company and their product!

Cassava is also lectin-free!

Otto’s is also lower in oxalates than other brands. But you should know it still has medium to high oxalates, depending on how much you eat.

(If you have severe oxalate issues or if you aren’t tolerating many foods in general, even Otto’s Cassava might be too much for your body to handle, though. This might not be the best recipe to start with if this is the case.)

For the base, I use either my Low Histamine Pesto or my Creamy Cauliflower Sauce. Both of these work great. Sometimes I really like to layer them both on!

The basil in the pesto has a lot of anti-histamine properties. And cauliflower is not only antihistamine but also helps with healthy detox.

For toppings, I use sautéed shallots and wilted arugula. Both of these also have amazing anti-histamine and detox properties.

In fact, according to Jo Merchant who wrote Eating On The Wild Side, these 4 vegetables (basil, cauliflower, shallots, and arugula) are some of the most nutritious foods you can eat!

And I really love adding some of my Low Histamine Bacon on top.

Think of the topping section of this Low Histamine Recipe as a guideline. And feel free to get creative with the toppings. This recipe has a few different steps, but it comes together quickly.

I usually make up extra creamy cauliflower sauce and pesto sauce and keep them in the freezer. That way the next time I make pizza, I can just pull those out – they are all ready to go.

I really hope you enjoy this low histamine recipe! I’d love to hear your ideas for Low Histamine Pizza toppings! You can comment in the comment box below.

Low Histamine Pizza Crust

Low Histamine Pizza Crust


Crust Directions

  1. Preheat oven to 350 degrees F.
  2. Grease a glass pie pan like one of these with ghee or coconut oil. (You can also use a pizza stone.)
  3. Mix flour and salt together. Pour in oil.
  4. Slowly add the water. The exact amount of water will differ depending on how humid your kitchen is. This can even vary day to day.
  5. Mix well until you have a solid dough. You want the dough to hold together well without being sticky.

    If it is crumbly, it needs more water. If it sticks to your hands, add more flour.

  6. Press evenly into pie plate and up the sides a little. You want a really thin crust. About 1/8 of an inch.

    (Option: roll dough out thin on a pizza stone. About 1/8 of in inch.)

  7. Bake at 350 for 20-30 minutes until dough is cooked through without burning.

The crust should be thin and somewhat crisp on the outside. It can still look “wet” on the inside. It is done when it starts to brown a little. It will not change color dramatically.

Low Histamine Pizza Sauce Ingredients (Choose 1 or both)

hand holding Low Histamine Pizza slice

(Note: Each sauce recipe below will be enough for both of the pizza crusts. If you prefer to make one with pesto and one with cauliflower, half each recipe below.)

Creamy Cauliflower Sauce



  1. Consider making a double or triple batch to freeze some for later.
  2. Steam cauliflower until soft.
  3. Put cauliflower, garlic, olive oil, sea salt into high speed blender (like Blendtec Blender or Vitamix blender) or a food processor. Add the 2 tablespoons of water if using a food processor.
  4. Blend on high in a Blendtec or Vitamix blender for a couple minutes until sauce is smooth. Or you can process in a food processor.
  5. Spread on pizza crust and freeze any leftovers.

Pesto Sauce



  1. Add the nuts to a food processor or high speed blender (like a Blendtec Blender or Vitamix blender). Blend until the nuts are finely chopped but stop before it becomes nut butter. (Just a few pulses is all you need.)
  2. Add the basil, garlic, and salt to food processor or blender and pulse until the basil is finely chopped.
  3. Add the olive oil and optional lemon or Camu Camu powder. Pulse until everything is well combined but not completely smooth.
  4. Spread on pizza crust and freeze any leftovers.

Low Histamine Pizza Toppings Options:

Low Histamine Sliced Pizza
  • Sautéed shallots or red onions
  • Wilted Arugula
  • Roasted Brussels Sprouts
  • Roasted Garlic
  • Asparagus
  • Shredded roasted pork
  • Shredded roasted chicken breast
  • Low Histamine Bacon

Low Histamine Pizza Assembly Directions:

low histamine pizza slice
  1. After the crust is cooked, spread on either the Pesto or Creamy Cauliflower base or both.

    (I sometimes like to dollop the creamy cauliflower onto a pizza with a pesto sauce base. It reminds of the the Italian pizzas with mozzarella chunks. It has a nice soft texture like cheese, too.)
  2. Add any toppings you like.
  3. Warm in a hot oven for 5-10 minutes, checking that toppings and crust don’t burn.
  4. Cut into pieces and enjoy!
  5. Be sure to freeze any leftovers.

A pizza made in a pie pan will yield about 4 average-sized slices. A pizza made on a stone will yield about 6 average-sized slices.

It’s important you know that this blog post is for informational and educational purposes. It’s not meant to treat any health condition or to be prescriptive for anyone. Always be sure to work with your healthcare practitioner.  

Before you change your diet on your own, please make sure you’re working with a healthcare practitioner who can help you with this.  

More Low Histamine Cauliflower Recipes 

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  1. Amy

    Hi Beth! Thanks for sharing! I thought Cassava flour was high oxalate. Can this be made with coconut flour?

    1. Beth O'Hara

      Hi Amy! Oxalates are really dependent on how much you eat and even differ brand to brand. Otto’s cassava hasn’t been tested yet. It depends on how sensitive you are. I am fairly sensitive, and if I stick with 1 piece of the pizza, I have no problems. I did have problems with other brands of cassava. I do also take oxalate binders with my meals. So many factors!

      I tell all my clients that ultimately, we all have to all find our own individual tolerances to foods by experimenting and keeping a food journal.

      This recipe won’t work well with only coconut flour for the dough. But you could sub a blend of coconut and white rice flour, if you aren’t bothered by lectins.

    2. Avry Bablitz

      Ok question, somewhere you said histamine and oxalates go hand in hand and I found yuca to be very high in oxalates???
      Does this sound accurate to you? Is there another solution? Almond flour? Probably no better… :/

  2. Tina

    Day 1 of this diet and first recipe tried. The cauliflower sauce was delicious and came out perfect in my just purchased refurbished Blendtec! The pizza crust was a total bust. I have been making my own Otto’s tortillas for a couple of years now so am familiar with it. However, this recipe did not work at all. I followed directions exactly, the dough was perfect (not too sticky, not too dusty), and cooked it for over an hour and a half and it barely got crusty on the outside and the entire inside was just goo. Thoughts?

    1. Beth O'Hara

      Hi Tina,
      So glad you liked the sauce!
      Sounds like your crust was too thick. I make the crust very thin. I also press it into a glass pie pan. The glass can make a difference. I bake it before adding any toppings. It won’t be thick and doughy like regular pizza crust. It is more like the tortillas. Hope that helps!

  3. Becky

    Making his recipe as we speak! The dough came together beautifully, however I wanted to let you know that it made roughly enough for 3 pie plates! I used a large rectangle casserole dish and a pie plate so as not to waste any dough.

    About to get started on the pesto! Very excited to have found your blog, as I have a severe form of eczema that seems to be affected by histamines, so my naturopath advised me to try a low histamine diet. Very few resources online seemed to be reputable, unlike you! Thank you!

  4. Becky

    Also, is it possible to pre-mix the dough and freeze it or even make the crust and freeze that?

    1. Spring

      Hey Becky, curious did you try freezing the crust? I am getting ready to make some!

  5. Allison

    This was a really nice change from my normal boring diet!
    I do wish I would have read the comments before making, haha! I do think a little more guidance on the dough could have been helpful. I wasn’t sure if it was supposed to be so thick or not. When I make it again I will definitely do the dough much thinner, perhaps it’s just personal preference. I don’t enjoy the cassava flour as much in a thick bread. I will probably use a 9×13 pan. The good news is that it will serve my family or just make a lot of leftovers to freeze! The cauliflower sauce was a delight after having been so long without anything creamy! Also the pesto was amazing! I just love pesto anyways and I’m SO thankful that Basil is so good for mast cells! I am sensitive to garlic and left that out but it was still so tasty! Thank you so much for posting these recipes! I would be lost without them!!

  6. Justin

    Followed the exact recipe and made the proper adjustments as the dough was too runny at the beginning. I formed a thin crust at no more than a 1/4″ in thickness. The bake resulted in a rubbery and raw inner crust. I have now wasted expensive flour. This recipe should be taken down.

    1. Suz, Mast Cell 360 Team

      Hi Justin,
      Thank you for your feedback. I’m so sorry to hear the results weren’t a success for you. I know how frustrating that can be. The team will take another look at this recipe over our holiday break to see if there is anything we can change as far as instructions or if there are any tweaks we can make to help yield the best results for everyone who tries this.
      Best regards,

  7. Linda

    I made this and it turned out really good! I’m glad I read the comments first. I made a really thin crust in a 10″ pie pan and another one in a smaller container.
    I still had a lot of dough left over so I froze it. I will find out soon if the dough still works after freezing.

    I baked both crusts, used the smaller pizza crust and froze the larger crust. Last night I pulled the crust out of the freezer,
    topped it with cauliflower sauce, arugula, red onion, shredded chicken, red bell pepper slices, sliced radishes, cooked and frozen zucchini and salt and pepper. So good! The crust is chewier than regular crust, but such a treat!

  8. Avry Bablitz

    Oh dear. Amy asked the same question. So there’s my answer!
    I did try almond flour & I didn’t get my usual oxolate or histamine symptoms & I REALLY pigged out!! Hadn’t had pizza in years, went a lil cra cra, ate the whole pizza! :/

  9. Kate

    I also used the brand cassava flour – you have to REALLY make it as thin as a tortilla so it isn’t gummy. Using a glass pie plate also Might make a difference, as I use a pizza pan. Might as well use a tortilla for as thin as it needs to be. That’s not my idea of a pizza, unfortunately. I would suggest mixing another flour with the cassava. In fact, I’ve never been able to make anything of substance with cassava flour as the main/solo flour.

    1. Suz, Mast Cell 360 Team

      Hi Kate,
      Yes, it has to be thin, but some people do like a thin crust pizza. I’d love to hear if you experiment with another flour and how the results are for you!


  10. Cindy Ghiglione

    Hi Justin,

    I’m just reading through these comments and read yours.

    Baking with alternative flours, can seriously be challenging. I think what went wrong with your crust, is you probably made it too thick.

    I think it would turn out much better if you had tried it at 1/8 inch thick, that had been suggested.

    Hope this helps.

    Have a Blessed Day.

  11. Lindsay| Splendiferous Mama

    I cut the recipe in half and made one large pizza. I rolled it very thin and it almost took up my entire pizza pan. After cooking, I topped it with pesto and zucchini and cooked for another 7 minutes. I made some of your sweet potato fritters and put them on top! So good! Thank you for the recipe. It turned out delicious!

  12. JenniferMay

    Hi! I’ve been reading through your site for all of the research and recommendations you have done. I’m disheartened that there’s so little to consider people who keep Kosher or similar. There are few vegetarian recipes. DAO is made with porcine and so on. For someone like me, who is not so few in number, but few in the MCAS group, the lack of resources is sad. Thank you for all your hard work. Hopefully you consider also adding more options for the rest of us. Shalom!

    1. Jamie, Mast Cell 360

      Hi Jennifer,

      Thank you so much for sharing! I will make sure to share your feedback with the content team!


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