Low Histamine Diet
What is it?
This is an elimination diet. The idea is to minimize the amount of histamine getting into your system by means of your food to see if doing so can get you feeling any better. Many people with mast cell activation syndrome already have a hefty amount of histamine in their system thanks to their mast cells spilling mediators improperly. Histamine acts as vasodilator (among many other things), and is something someone with POTS or MCAS definitely doesn’t need more of… standing is hard enough already. It’s not that the histamine you’re ingesting is causing these ailments, but instead it could be exacerbating them. This diet isn’t going to cure mast cell issues, but the hope is to help reduce them to a degree.
How much and how long?
A popular strategy is to try this at first as a strict elimination diet, so that it becomes much more obvious which foods (if any) are making symptoms worse. This way you’ll also know what foods to trust as you add more foods slowly back into your diet, making culprits more obvious. A couple doctors I’ve seen recommended trying at least 6 weeks for any elimination diet, because the benefits (if any) might take a little while to show. An important part after trying this strict diet is adding in more variety. It’s important to keep your long term diet as varied as you can, to keep your diet as balanced and nutritious as possible.
Does it help? Will I see a difference?
Results vary by person. Some people don’t see a difference at all, while others see a modest or even a significant improvement on the diet. Some fellow patients find they can add in a couple higher histamine foods most days without setting themselves back. I personally can do modest amounts of tomatoes, beans and other higher histamine foods without a problem, but the key for me is making them a MUCH smaller part of my overall diet. And of course, know each person with a mast cell disorder is unique with their specific food sensitivities (regardless of a food’s histamine content), so it’s expected that each person has their own personal list!
Which food list to use?
It’s confusing. All the low histamine food lists out there seem to be conflicting and different. Is the list only excluding foods with the highest histamine content? Are they also excluding foods that tend to trigger histamine release by your own body? Are they excluding foods with compounds that block the body’s ability to break down histamine efficiently? I found a list that accounts for all these aspects of histamine in a diet… I prefer to reference the most researched and organized list I could find, one done by the Swiss Interest Group for Histamine Intolerance: SIGHI’s detailed histamine food list.
The fact is many of these lists online aren’t well referenced, and seem based on the author’s subjective experience. The important thing is to choose a list, and have it serve as a baseline. As long as you’re drastically reducing histamine in your diet, you should have the opportunity to see an improvement if there’s any to be had. Any foods were making you feel worse before, but were flying “below the radar” before should become more obvious. No list is guaranteeing that all its foods will sit great with you, because as it’s belabored everywhere, each person has their our own personal list of sensitivities (due to the complexity of biology). I might love blueberries, but you might get completely sick from them. It’s an empirical study for each person, meaning you’ll have to learn from your own experience. A low histamine food list serves as a foundation for you to red-line and make your own. What’s great about SIGHI’s food list is that you might also find some patterns in your sensitivities too, hopefully making diet choices a little easier. For example, you might find you’re most sensitive to the foods with other biogenic amines, or foods that tend to cause histamine liberation by the body.
What if you feel worse?
Another thing to keep in mind is that many with MCAS are sensitive to salicylates, a chemical naturally occurring in many plants. If you find a lot of these low histamine foods, especially fruits and veggies, make you feel worse you might be salicylate sensitive. Read more here: Salicylate Sensitivity
Simplified Food List
Here’s a food summary I used for my attempt at an ultra-low histamine diet.. the Low Histamine Food List. It’s based off of the Swiss Interest Group for Histamine Intolerance’s detailed histamine food list, which I highly encourage you to review. I noticed that I’m generally more sensitive to the foods listed as “histamine liberators.” You might also find some patterns in your sensitivities too, hopefully making diet choices a little easier.
This Low Histamine Grocery List is to help someone kick-off their low histamine diet. No fancy recipes. Let’s keep it real… being sick is exhausting and the last thing you’re going to want to do is make fancy dishes.
This is a growing collection of FREE Low Histamine Diet Recipes. The goal here is to not feel totally deprived, though making some of these might be for more spoon-plentiful days.