Frequently Asked Questions

If you have Mast Cell Activation Syndrome (MCAS), you’ve probably heard about histamines. Your body naturally makes histamine. It is very important in the immune system, but it is also very important for digestion. It is also a part of the nervous system. 

The correct balance of histamine levels is really important for good health. But with MCAS, these histamine levels can easily get out of control. Too much histamine is inflammatory, and inflammation causes the mast cells to release even more histamine. A vicious cycle is therefore created, making it extremely difficult to manage conditions triggered by MCAS (e.g. Melasma, Rosacea, Acne, Cellulite, Abnormal Weight Gain, Some Auto-Immune conditions).

The mast cells will also release other inflammatory chemicals which further exacerbates the problem. 

Many foods naturally have histamines in them, and some foods cause the body to release histamine. Other foods block the release of the enzyme Diamine Oxidase (DAO) which is responsible for the breakdown of histamine. 

Aged, Cultured & Fermented Foods (including Leftovers): 

Any foods with bacteria in them can create high histamine. So anything that is out of date, spoiled, moldy, or not really fresh is higher histamine. This also means leftovers become higher histamine the longer they sit. 

Look out for these high histamine foods: 

  • Fermented alcoholic beverages, like wine, champagne, beer, whiskey, brandy 
  • Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc. 
  • Soured foods: sour cream, sour milk, buttermilk, soured bread, etc. 
  • Balsamic Vinegar and Vinegar foods: pickles, mayonnaise, olives, ketchup 
  • Cured meats: bacon, salami, pepperoni, luncheon meats and hot dogs 
  • Aged cheese including goat cheese 
  • Smoked fish, fish not gutted within 30 minutes of catch, anchovies, sardines 
  • Minced meat (Increased surface area increases histamines) 
  • Beef (aging process increases histamine) 
  • Smoked or processed meats: salami, bacon, ham, sausage 
  • Dried fruit: apricots, prunes, dates, figs, raisins 
  • Uncooked egg whites (histamine liberator) 
  • Leftovers (the longer they sit, the higher histamine) 

Fruits, Vegetables, and Nuts High in Histamines

There are just a few fruits, vegetables, and nuts that are the highest in histamines or release histamines. If you are eating these foods, it would be a good idea to track how they affect you. Some things to look out for as indicators that you have an issue with these foods include, itching skin, headaches, migraines, disturbed sleep, or poor sleep quality.   

Examples of high histamine fruits, vegetables, and nuts: 

  •         Walnuts 
  •         Cashews 
  •         Peanuts 
  •         Spinach 
  •         Mushrooms 
  •         Eggplant 
  •         Avocado 
  •         Pineapple 
  •         Strawberries 
  •         Most citrus (small amounts of lemons and limes are usually alright) 

Processed Foods and Additives

Avoid packaged and processed foods as much as possible. Many people with MCAS still eat lots of packaged foods. Canned foods, boxed nut milk, cookies, prepared sauces, and protein bars are higher histamine and inflammatory too. Packaged foods are highly processed to make them shelf-stable. This destroys the nutrients your body so desperately needs. Avoid sugar, additives, colourings & flavouring.  

 

Watch out for these additives that can wreak havoc with mast cells: 

  •         Carrageenan 
  •         Sodium Benzoate 
  •         Potassium Sorbate 
  •         Lecithin 
  •         MSG 
  •         Citric Acid 
  •         Sodium Triphosphate 
  •         Potassium Triphosphate 
  •         Sodium Nitrite 
  •         Maltodextrin 
  •         Guar Gum 
  •         Calcium Chloride 
  •         Xanthan Gum 
  •         Food colourings 
  •         Smoke Flavouring 
  •         Yeast Extract 

Look out for Lectins, oxalates, salicylates, sulphur and FODMAPs. 

These are types of foods beyond histamine issues that can affect MCAS.  

Lectins are proteins found in certain plants. Lectins activate mast cells. Low lectin diets can make a big difference in mast cell issues.  

A large number of MCAS patients have issues with Oxalates. Oxalates are tiny crystals that are also found in plants. People who have a genetic predisposition to high oxalates can have trouble with oxalate foods. Gut issues including leaky gut can lead to oxalate issues. 

Salicylate issues are less frequent but do occur. Salicylates are found in many plants, especially in mint. Some people start to have trouble breaking down salicylates. This can cause a variety of symptoms similar to MCAS. 

Sulphur foods can cause trouble for some people. It mostly affects people with genetic weaknesses for sulphur metabolism or those low in B6 and/or molybdenum. 

FODMAPs are a type of short-chain carbohydrates and sugar alcohols found in foods like beans, onions, garlic, broccoli, and cauliflower. Sometimes people end up with FODMAP sensitivity when their gut flora gets out of balance.

Be sure you are eating fresh, whole, nutrient-dense foods.  As produce ages, it loses nutrition. The fresher your foods are, the more vitamins, minerals, and antioxidants they have. These nutrients support a healthy immune system. They are also necessary to make histamine degrading enzymes, like DAO and HNMT. So they also have the added bonus of helping to lower histamine. Be sure to buy your produce as fresh as possible.  

Cover most of your plate with vegetables. Vegetables have nutrients and antioxidants you need to heal. These are histamine lowering, low oxalate, low lectin vegetables you can emphasize: 

  • Arugula 
  • Bok choy 
  • Broccoli 
  • Brussels sprouts 
  • Cabbage, Green, and Red 
  • Cauliflower 
  • Collards 
  • Kale (flat dinosaur or lacinato kind – curly is high oxalate) 
  • Napa cabbage / Chinese cabbage 
  • Watercress 
  • Onions – any kind 
  • Leeks 
  • Chives 
  • Scallions (green onions – especially use green parts) 
  • Carrots 
  • Radishes 
  • Daikon radishes 
  • Cilantro 
  • Asparagus 
  • Garlic 
  • Romaine, Red and green leaf lettuce 
  • Kohlrabi 
  • Mesclun 
  • Endive 
  • Dandelion greens 
  • Butter lettuce 
  • Fennel 
  • Escarole 
  • Mustard greens 
  • Mizuna 
  • Basil 
  • Mint 
  • Perilla (Shiso). 

 If you don’t have trouble with oxalates, you can also add in: 

  • Artichokes 
  • Beets 
  • Celery 
  • Okra 
  •  Parsley 
  • Radicchio 
  • Rhubarb 
  • Sweet Potatoes  

Then eat moderate amounts of clean protein.  

  • If you eat meat, protein should come from pastured meats like chicken, pork, lamb, and turkey. Be careful with beef, which is aged. Make sure the meat is very fresh.  
  • Cook or freeze meat and fish right away to prevent histamine levels from rising. I cook meat while it is still a little frosty to keep histamine levels low.  
  • Avoid slow cooking, which allows histamine levels to go up.  
  • Pasture-raised chicken, duck, or quail eggs are also a good protein source.  

Healthy fats are needed for overall health. 

Fats are necessary for healthy brain cells and to make your hormones. So add healthy fats to your vegetables to absorb the most nutrition. Healthy fat sources include: grass-fed butter, very fresh extra-virgin olive oil, virgin coconut oil, grass-fed ghee, cold-pressed flax oil, cold pressed avocado oil and unrefined palm oil. 

Avoid canola oil, corn oil, safflower oil, and peanut oil. These are inflammatory. 

Fresh nuts can be a good source of protein and fat. 

Low histamine, low oxalate, and low lectin choices are flax seeds, macadamias, pistachios, coconut, and pecans in moderation.  

If you don’t have oxalate issues, you can also enjoy almonds (blanched to remove lectins in the skin), hazelnuts, pine nuts, sesame seeds, Brazil nuts (only 3-4/day), hemp seeds, and hemp protein powder. Buy nuts as fresh as possible. 

Use lots of fresh herbs. 

Fresh herbs are some of the highest nutrient and antioxidant foods. Adding herbs to your meals will give them more flavour. Ginger, basil, chives, oregano, garlic, peppermint, rosemary are all excellent histamine lowering herbs.  

Avoid anise, cinnamon, cloves, curry powder, paprika, and nutmeg. These can liberate histamine and cause mast cell reactions.  

Eat Fruits as a dessert. 

Spikes in blood sugar (including fruit sugars) affect the mast cells. Prioritize lower sugar berries like blueberries. Tart cherries and green apples are also good choices. Lemons and limes are ok, if you tolerate them.  

If you don’t have trouble with oxalates, raspberries and blackberries are lower in sugar. Other lower histamine, low oxalate fruits are: all types of apples, fresh apricots, cherries, fresh cranberries, fresh currant, cantaloupe, fresh figs, grapes (especially black), honeydew, kiwi, mango, nectarine, peach, pear, and watermelon. These do however higher sugar levels. 

Sweeteners should be kept to a minimum.  

There are some good sweetener options that don’t affect blood sugar, though. These are stevia, monk fruit, and inulin. These come from plants, and our bodies don’t metabolize them like sugar.  

You want to be sure to avoid sugar, artificial sweeteners, and corn syrup. These are very inflammatory. 

Vegetables - Lower Histamine

  • Arugula 
  • Asparagus 
  • Basil 
  • Bok choy 
  • Broccoli 
  • Broccolini 
  • Brussels sprouts 
  • Cabbage – Chinese 
  • Cabbage – Green and Red 
  • Cabbage – Napa
  • Carrots 
  • Cauliflower 
  • Celeriac or Celery Root
  • Chives 
  • Cilantro 
  • Collards 
  • Daikon radishes 
  • Dandelion greens 
  • Endive 
  • Escarole 
  • Fennel 
  • Garlic
  • Kohlrabi 
  • Leafy greens 
  • Lettuce – Butter
  • Lettuce – Endive
  • Lettuce – Leaf Green & Red
  • Lettuce – Iceberg
  • Lettuce – Romaine
  • Leeks 
  • Mesclun 
  • Mint 
  • Perilla 
  • Mizuna 
  • Mustard greens 
  • Onions – any kind 
  • Parsley, flat 
  • Parsley Root
  • Radishes 
  • Rutabaga / Swede
  • Scallions / Green Onions
  • Shallots
  • Turnip 
  • Watercress


Fruits - Lower Histamine 

  • Apricot – fresh
  • Currant, fresh 
  • Dragon Fruit
  • Figs, fresh
  • Lemon – 1/2 tsp (not always tolerated in elimination)
  • Lime – 1/2 tsp (not always tolerated in elimination)
  • Loquat
  • Mango
  • Passion Fruit


Meat, Poultry & Fish - Lower Histamine 

All pure, freshly cooked, un-aged meat or poultry (not ground):

  • Beef (only if unaged and not ground)
  • Bison (only if unaged and not ground)
  • Chicken
  • Duck
  • Eggs, if tolerated
  • Goose
  • Lamb
  • Liver
  • Ostrich
  • Pork
  • Quail
  • Rabbit
  • Salmon (frozen) 
  • Turkey


Fats & Oils - Lower Histamine 

  • Avocado Oil – Cold Pressed (use cautiously if DAO levels are very low)
  • Butter – Grass Fed
  • Coconut Oil – Extra Virgin 
  • Flax Oil – Cold Pressed 
  • Ghee – from Grass Fed Cows
  • Lard – (If kept frozen, and thawed for individual use)
  • Macadamia Oil
  • MCT Oil
  • Meat drippings – Fresh
  • Olive Oil – Extra Virgin (use cautiously if DAO levels are very low)
  • Palm Oil – Extra Virgin (unprocessed)
  • Rice bran oil
  • Salad dressings – Homemade with allowed ingredients
  • Sesame Oil
  • Sunflower Oil – Cold Pressed – use sparingly can be inflammatory
  • Tallow – (If kept frozen, and thawed for individual use)


Spices & Herbs - Lower Histamine

  • Basil
  • Bay Leaves
  • Cardamom
  • Caraway
  • Chives
  • Cilantro
  • Coriander
  • Curcumin powder can replace turmeric if oxalates are a concern
  • Curry Leaves
  • Dill
  • Fennel
  • Garlic
  • Ginger
  • Lemongrass
  • Mint
  • Oregano
  • Parsley – Flat Leaf- (curly is high oxalate)
  • Peppermint
  • Tarragon
  • Thyme
  • Turmeric – (See Curcumin)
  • Rosemary
  • Saffron
  • Sage
  • Salt – only unrefined like Real Salt, Celtic Sea Salt, Himalayan Sea Salt
  • Shallots


Sweeteners - Lower Histamine 

These don’t affect blood sugar:

  • Coconut Sugar – Use sparingly, avoid in elimination
  • Homemade sweets with allowed ingredients
  • Inulin
  • Maple Syrup – Use sparingly
  • Monk Fruit – 100% no fillers
  • Stevia


Miscellaneous - Lower Histamine

  • Arrowroot – (medium to high oxalate)
  • Baking powder
  • Baking soda
  • Brown Rice Flour – (much higher oxalate)
  • Carob 
  • Cassava Flour – (medium oxalate)
  • Cocoa butter (white chocolate with no additives)
  • Cream of tartar
  • Homemade relishes with allowed ingredients
  • Leftovers – freeze right after cooking
  • White Rice Flour – (medium oxalate)



Beverages - Lower Histamine 

  • Coconut Water – Fresh
  • Coffee – preferably avoid caffeine. If you must drink coffee, then only lower histamine, mold free brands
  • Dandelion Root Tea 
  • Herbal teas, except those listed to the right
  • Juice – Pure freshly squeezed juices of allowed fruits and vegetables – limit fruit juice due to sugar
  • Mineral Water – Plain and carbonated
  • Water – with fresh squeezed lemon or lime (if tolerated)


Milk & Dairy - Lower Histamine 

Lower Histamine Foods

These dairy products are technically low histamine, however, if you have casein and lactose issues be cautious. 

  • Cow Milk – plain
  • Cream (from grass fed cows)
  • Cream cheese (from grass fed cows)
  • Ghee from grass fed cows
  • Goat milk
  • Grass fed butter
  • Ricotta cheese (from grass fed cows)
  • Sheep milk


Foods that can HIGHER Histamine - Limit or Avoid these!

Vegetables to limit/avoid

  • Avocado
  • Banana
  • Dates
  • Dried fruit
  • Fruit dishes, jams, juices
  • made with restricted
  • ingredients
  • Grapefruit
  • Grapes
  • Loganberry
  • Orange and other citrus
  • Papaya
  • Pawpaw
  • Pineapple
  • Plums
  • Prunes
  • Raisins
  • Strawberries
  • Tomato and all tomato products


Nuts to avoid/limit

  • Cashews 
  • Coconut – Dried
  • Peanuts
  • Walnuts 


Fats and Oils to avoid/limit

  • Fats and oils with colour and/or preservatives
  • Hydrolysed lecithin
  • Margarine
  • Salad dressings – Prepared with restricted ingredients
  • If DAO levels are very low: Olive Oil and Avocado Oil


Spices & Herbs to avoid/limit

  • Allspice
  • Anise
  • Cinnamon
  • Chili Powder
  • Cloves
  • Curry powder
  • Cayenne
  • Foods labelled “with spices”
  • Foods labelled “natural flavours” or “artificial flavours”
  • Mace
  • MSG
  • Mustard
  • Nutmeg
  • Paprika
  • Peppercorns – Black, Green, White 
  • Seasoning packets with restricted ingredients


Sweeteners and Sugars to avoid

  • Artificial Sweeteners
  • Cake decorations
  • Candies
  • Confectionary
  • Corn syrup
  • Desert fillings- Prepared
  • Flavoured syrups
  • Honey
  • Icing sugar
  • Icing & Frosting – Prepared
  • Molasses
  • Pure jams, jellies, marmalades, conserves made with allowed ingredients
  • Spreads with restricted ingredients
  • Sugar


Other Higher Histamine Foods to avoid/limit

  • Bragg’s Liquid Aminos
  • Bone Broth
  • Chocolate and cocoa 
  • Coconut Aminos
  • Collagen
  • Gelatine
  • Gherkin pickles
  • Ketchup 
  • Leftovers not frozen immediately after cooking
  • Mincemeat
  • Miso
  • Relishes and olives – prepared
  • Soy sauce
  • Vinegars, including white, champagne, and balsamic; apple cider vinegar is lowest and tolerated by some at 1tsp


Additives to avoid

  • Calcium Chloride
  • Carrageenan
  • Citric Acid
  • Food colourings
  • Lecithin
  • Maltodextrin
  • MSG
  • Potassium Sorbate
  • Potassium Triphosphate
  • Smoke Flavouring
  • Sodium Benzoate
  • Sodium Nitrite
  • Sodium Triphosphate
  • Xanthan Gum
  • Yeast and Yeast Extract


Beverages to avoid/limit

  • Beer
  • Carbonated drinks
  • Cider
  • Coconut Water – packaged
  • Drinks with “flavour” or “spices”
  • Flavoured milk
  • Fruit juices and cocktails made with restricted ingredients
  • Kombucha
  • Tea – All black, green, white, rooibos tea
  • Wine/Alcohols
  • Best tolerated alcohol: top-shelf plain vodka, gin, white rum, silver tequila 


Dairy to avoid

  • All prepared dairy products made with restricted ingredients
  • Buttermilk
  • Cheese
  • Kefir
  • Yoghurt
Sharon Izak Elaine Chat staff ) WhatsApp
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