Beth eating a mast cell activation syndrome diet

How to Do a Mast Cell Activation Syndrome Diet

Several years ago, I was pulling my hair out trying to figure out what I could and couldn’t eat. I didn’t know about Mast Cell Activation Syndrome Diet (MCAS Diet) back then.

I just knew I was reacting to most foods. I had no clue what a low histamine or MCAS diet was.   

Every time I ate, my hands and feet would swell up and get red. I’d be so itchy, I’d scratch at my hives until I bled.   

I had abdominal pain that was misdiagnosed as IBS. It was actually a bad leaky gut. 

And the number of foods I could eat without having reactions was minimal. 

I spent a lot of time studying and experimenting to figure out what was going on.  

Eventually I discovered histamine. I also learned about other types of inflammatory foods. 

Did you know: Some “healthy” foods can actually make you worse if you have MCAS?  

I figured out how to eat foods that were healing for me. And how to spot foods that would make my Mast Cell Activation Syndrome worse.  

I got my inflammation way down by making good food choices (but also along with the right nervous system work, antihistamines, enzymes, medications, and mast cell-stabilizing supplements like quercetin.) 

I was eventually able to reintroduce a lot of foods.  

In fact, I’ve reversed most of my food intolerances at this point.

I can eat strawberries without itching, insomnia, GI distress, headaches, or anxiety. I can eat in restaurants. I’ve increased my oxalates. Even FODMAPs are improving.  

I can eat rice and some pressure cooked winter squashes now. But I’ll likely not re-introduce these as a staple due to their inflammatory nature. 

These days, I eat a wide variety of healthy and healing foods. The itchy hives, sleep issues, and leaky gut are gone. And my MCAS is under control.  

Are you having reactions to foods?  

Read on to learn what to eat and not to eat for the MCAS diet.  

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.  If you have any medical condition, it is critical you work under the care and guidance of a licensed medical provider.    

What is the Mast Cell Activation Syndrome Diet?  

The Mast Cell Activation Syndrome Diet (MCAS Diet) incorporates the Low Histamine Diet.

That’s because even if you don’t have Histamine Intolerance, you may still get relief from some of your MCAS symptoms by switching to a low histamine diet.

Why is that?

High histamine foods can still trigger mast cells to release high levels of other inflammatory mediators.

But if you trial a low histamine diet for 6 weeks and don’t notice any differences with adding histamine foods back in, then you may not be sensitive to histamine.

In this case, eating anti-inflammatory, nutrient dense, and avoiding sugar, wheat, and dairy may be very helpful for you.

The MCAS diet emphasizes choosing low histamine foods that are: 

  • Anti-inflammatory – because inflammation sparks mast cells  
  • Nutrient dense – fresh, healthy foods may help calm your immune system 
  • Free of major allergens – since most are inflammatory for many   

However, those with MCAS may have specific food triggers. So be sure to test for food intolerances and food sensitivities with your practitioner.  

Let’s look at each of these factors of the MCAS Diet in more detail.  

Low Histamine MCAS Diet  

The most important part of the MCAS Diet is that it is low histamine.  

Histamine triggers the mast cells. And when mast cells are triggered, they can release more histamine. This histamine then triggers the mast cells. And on and on.  

It’s a cycle you want to break. 

And one way you can do this is to choose lower histamine foods. 

If Histamine Intolerance is your only concern, a low histamine diet can be helpful in reducing your symptoms.  

But if you also have Mast Cell Activation Syndrome, you’ll want to consider these other food factors. 

You can see my low histamine food list in this post.   

Anti-Inflammatory MCAS Diet  

An effective MCAS Diet will emphasize clean, anti-inflammatory foods. Most of these are going to be whole foods like fruits, veggies, and clean meats. 

Your food choices affect how much inflammation you have in your body. 

Inflammation triggers immune cells and mast cells to become more reactive. That means more MCAS symptoms. 

For example, trans fats are technically low histamine, but it’s inflammatory which will still raise histamine in the body.  

Our food choices also affect how much inflammation we have in our bodies. 

Inflammation triggers immune cells and mast cells to become more reactive. The more inflammation, the more immune response and MCAS symptoms. 

So you’ll want to focus on eating anti-inflammatory foods in your Mast Cell Activation Syndrome Diet.  

Similarly, the MCAS Diet is also nutrient dense.  

Nutrient Dense MCAS Diet  

The best MCAS diet is going to be full of nutrients that will help your body heal itself.  

In the MC360TM Method, we emphasize feeding and nourishing your mast cells, so they don’t release extra histamine.   

This is why our low histamine recipes list the top nutrients and their health benefits. 

Food forms the building blocks for everything in our bodies. Certain foods are healing. Other foods are damaging.  

Allergy Friendly MCAS Diet 

Lastly, the MCAS Diet avoids the major food allergies (which are usually inflammatory.) 

Many people who try eating low histamine still eat inflammatory foods and low nutrient foods (like many processed foods.)  

This can lead to them still feeling ill.  

There are different arms of the immune system that can react to food. Not all are technically allergies, but these foods still cause inflammation.  

The major allergens to initially avoid are:  

  • Gluten  
  • Corn  
  • Dairy  
  • Peanuts  
  • Soybeans  

Some of the food groups listed above are high histamine or histamine liberating. So, you’d want to avoid those anyway.

But corn, for example, isn’t high histamine. Yet, it can still be an issue. Some diary is low histamine, too. But things like lactose and casein which are found in dairy may be causing trouble for your body.

The MCAS Diet recommends low histamine foods. And it also encourages you to eat foods that won’t trigger your body to produce histamine.  

To review, the Mast Cell Activation Syndrome (MCAS) diet is: 

  • Low histamine 
  • Anti-inflammatory   
  • Nutrient dense   
  • Free of major allergens 

Mast Cell Mediators  

The best MCAS Diet emphasizes anti-inflammatory and nutrient dense because histamine isn’t the only mediator that can spark your mast cells.  

In addition to histamine, other mediators that mast cells release as part of the immune response in your body include:   

  • Leukotrienes – blood vessel constriction or dilation   
  • Tryptase – allergic responses and immunity 
  • Cytokines 
  • Prostaglandins 
  • Interleukins  
  • And hundreds of others 

When your mast cell mediators have gone haywire, all this inflammation can lead to:   

  • Allergic reactions  
  • Constipation  
  • Diarrhea  
  • Itching  
  • Bloating  
  • Cramping 
  • Rashes  
  • Hives   
  • Abdominal pain   
  • IBS   
  • Anaphylaxis  
  • Sleep problems 

Related Article: Cytokines, Mast Cells, and Mast Cell Activation Syndrome & Mast Cell Mediators and Receptors

Now that you know more about what to eat, we’ll explore more on what to avoid on the MCAS Diet.  

But first, a note on histamine food lists.  

A Note on Histamine Food Lists  

There are a number of high and low histamine food lists online. 

Here’s the problem with most histamine food lists. They were created through studies on small groups of people and were not well controlled.  

This means the researchers usually didn’t know if someone was reacting because of Histamine Intolerance or to something else. 

So what happened is that many foods that aren’t actually high histamine were put on the do not eat list. And some foods that are high histamine were mislabeled on low histamine diet lists.   

Also, many lists leave out the histamine liberators. These are foods that may technically be low histamine, but they spark the body to release histamine. 

Some examples are walnuts, citrus or certain teas. 

Before you go any further, here’s what I want you to know. Everyone is different in how foods affect them. 

If you have MCAS or Histamine Intolerance, you probably have a hard enough time finding foods you can eat. 

So do your best and know that you may need to make exceptions sometimes. 

For example, if you are down to only 10 foods and one happens to be high histamine, it’s usually better to keep that food for now. You want to get as much variety in your diet as possible. 

But generally speaking, it is important to identify the foods that are the highest histamine and replace them with lower histamine choices. 

If you aren’t sure what you might be reacting to, keep a food and symptoms journal. You can use this info to see what works best for you.    

Next up, take a look at histamines and the MCAS diet.  

Mast Cell Activation Syndrome Diet: What to Avoid   

If you have MCAS, you’ve probably heard about histamines.   

While most of the people we work with at Mast Cell 360 have histamine intolerance, not everyone with MCAS has trouble with histamine.  

You can read more about that in my post: Do You Have One or Both? Histamine Intolerance vs MCAS (Mast Cell Activation Syndrome)

Your body naturally makes histamine, which is an important mediator for digestion. It is also a part of the immune system and nervous system with receptors all over your body.  

Proper balance of histamine levels is really important for good gut health.   

But with MCAS, these histamine levels can easily get out of control. Too much histamine is inflammatory. And that inflammation causes the mast cells to release even more histamine. (You can read more about mast cells here.)  

Mast cells release over 200 other inflammatory chemicals when the receptors get stuck in this loop. It’s called degranulation when the mast cells become hyperactive.   

So it is really important to keep those histamine levels in check.  

Many foods naturally have histamine content in them. And some foods cause the body to release histamine. 

Other foods block the release of the enzyme Diamine Oxidase (DAO). This is one of the main enzymes that breaks down histamine. 

Here are the main ways histamine comes from food:  

  • Naturally in some food – eggplants, strawberries, banana, pineapple, etc. (see more below)   
  • Histamine liberators – that cause mast cells to release histamine like citrus, walnuts, cinnamon, cloves, etc.    
  • Histamine producing bacteria – in foods that give hospitable environment like being high in protein, high moisture content, or fermented 

The most common sources of histamine producing bacteria are:  

  • Ground meats 
  • Aged meats 
  • Fish that wasn’t gutted or frozen soon after catch 
  • Leftovers in the fridge  
  • Dried fruit (still has some moisture) 

Note: Fats don’t tend to harbor bacteria that grow histamine.  

And low histamine very dry foods like uncooked rice or dried sorghum pasta are okay.  

High Histamine Foods to Avoid in the MCAS Diet  

Based on what we just learned about what foods are high in histamine, here are some comprehensive lists.  

Aged, Cultured, Fermented Foods and Leftovers

Remember, any foods with bacteria in them can create high histamine. So anything that is out of date, spoiled, moldy, or not fresh is higher histamine. 

This also means leftovers become higher histamine the longer they sit. 

That rotisserie chicken at the grocery store that has been sitting all day is building high histamine levels. 

Meat in the refrigerator section increases in histamines. 

Fermenting, culturing, and aging increases histamines too. 

Most beef and bison are especially high histamine because they get aged for at least 2 weeks before going to market. 

Look out for these types of high histamine foods:  

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

Learn more about identifying high histamine foods in this blog post.

Fruits, Vegetables, and Nuts High in Histamines

There are only a few fruits, vegetables, and nuts that are high in histamines or release histamines. 

Do any of these foods bother you? Examples of high histamine fruits, vegetables and nuts:  

  • Walnuts  
  • Cashews  
  • Peanuts  
  • Spinach  
  • Mushrooms  
  • Eggplant  
  • Avocado  
  • Pineapple  
  • Strawberries  
  • Most citrus (small amounts lemons and limes sometimes ok)  

I used to always itch badly when I ate walnuts or pineapple. Spinach made me not be able to sleep. And strawberries gave me a migraine. 

Fortunately, there are still plenty of other fruits, veggies, and nuts you can enjoy that won’t cause histamine-related reactions.  

Inflammatory Oils  

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

Cold pressed sunflower oil is usually ok in small amounts.  

Herbs & Spices 

You want to avoid using dried spices that have been sitting in your cupboards for a long time. Fresh are best. 

But some herbs, even fresh, can liberate histamine and cause mast cell reactions.

Avoid or restrict:  

  • Anise 
  • Cinnamon 
  • Cloves 
  • Curry powder 
  • Paprika 
  • Nutmeg 

Spiking Your Blood Sugar  

On the MCAS diet, you’ll need to be careful with sweeteners, high glycemic fruits, and refined carbs.

This is because increases in blood sugar can cause inflammation. And inflammation increases mast cell reactions. 

You want to be sure to avoid:  

  • Sugar 
  • Artificial sweeteners (like sugar alcohols)  
  • Corn syrup 

These are all very inflammatory. 

But don’t fear! I have some sweetening solutions for you below in the what to eat section.  

Processed Foods and Additives 

You want to avoid packaged and processed foods as much as possible. Period. 

This may seem obvious, but many people with MCAS still eat lots of packaged foods. They think if the label says organic or gluten free then it must be healthy.  

Crackers, chips, cereal, and frozen dinners can be a problem. Canned foods, boxed nut milks, cookies, prepared sauces, and protein bars are higher histamine and inflammatory too.  

Packaged foods are highly processed to make them shelf stable. (Think chips from dried rice or sorghum pasta.) 

This destroys the nutrients your body so desperately needs. Avoid sugar, additives, colorings, flavorings – anything artificial.  

In addition to avoiding processed and packaged foods, 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  
  • Calcium chloride  
  • Xanthan gum  
  • Food colorings  
  • Smoke flavoring  
  • Yeast extract  

Histamine In Your Supplements  

You even need to be careful that your supplements aren’t fermented! One of the most common fermented supplements in vitamin C. 

All of the supplements I recommend across this site are low histamine. 

Check out my MCAS Supplements Course here.

Other Mast Cell Triggering Foods  

Beyond histamines, you may need to rule out other foods that are inflammatory for you. Some of the most common ones are: 

These are types of foods in addition to histamine that can affect MCAS.  

These aren’t like allergies with antibodies, but you may still react to them.  

Before you change your diet on your own, please make sure you’re working with a healthcare practitioner who can help you with this. Never limit foods unnecessarily, and always have a medical provider who is supervising your case.  

Lectins   

Lectins are proteins found in certain plants. More and more research indicates that lectins activate mast cells in the gastrointestinal tract. 

Low lectin diets can make a big difference in mast cell issues.

So you may need to consider whether lectins are affecting you. 

Oxalates   

Oxalates are tiny crystals that are also found in plants. People with dysbiosis, leaky gut,  low B1 or B6, and certain genetic predispositions can have more trouble with oxalates than others.  

Fungal species like molds and candida feed on oxalates. So people dealing with these issues can have more trouble with oxalates. You can have oxalate issues from leaky gut and Mold Toxicity as well. 

I find oxalate issues in about 50% of my clients with MCAS.  

You can order the Great Plains Organic Acid Test for yourself below, to see if oxalates might be an issue for you. 

>>> Order the Great Plains Organic Acid Test

But know that the OAT test doesn’t always catch it oxalate issues That’s because oxalates can be stored in the tissues and not excreted in the urine. 

Salicylates   

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.  

Salicylate Intolerance is very common in Mold Toxicity.  

This can cause a variety of symptoms similar to MCAS. 

Sulfurs   

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

FODMAPs  

FODMAPs are a type of short chain carbohydrates and sugar alcohols found in foods like:

  • beans
  • onions
  • garlic
  • brussel sprouts
  • cauliflower 

Sometimes people end up with FODMAP sensitivity when their gut flora gets out of balance. It can be tricky to track down sulfur and FODMAP sensitivities. These usually require elimination diets.  

If you suspect you have SIBO, here’s more on SIBO and Histamine Intolerance, and how to do a SIBO Diet.

Identifying Food Triggers in MCAS 

Be sure to think beyond histamines and consider whether you may have any other food sensitivities or iGe allergies. 

You may want to consider giving the Low Histamine Diet at least 6 weeks to see if it helps. Always talk with your doctor about any changes to your diet.   

Then do a challenge with reintroducing high histamine foods for 2-3 days and see if symptoms increase. If there is no change, then histamine may not be a problem.   

Those with autoimmunity, gut, and/or heart problems, may want to try 6 weeks low histamine and low lectin.   

Ask your healthcare provider about doing a challenge with reintroducing several servings of high histamine foods for 2-3 days and see if symptoms increase. If there is no change, then histamine may not be a problem.

After that, 2-3 days of reintroducing several servings of high lectin foods for 2-3 days to see if symptoms increase. If there is no change, then lectins may not be a problem.   

I’ve outlined the phases in more detail in this post on Lectin Intolerance. 

If there is joint pain, muscle pain (like fibromyalgia), urinary burning, interstitial cystitis, chronic UTI type symptoms with negative culture, then it may be worthwhile to explore Oxalate Intolerance.

But this needs to be done under the guidance of a healthcare practitioner. Oxalates are tricky to navigate.   

Do NOT go cold turkey off of oxalates. (Learn more about the low oxalate diet part 2 here.) It can trigger oxalate dumping and kidney stones, which are extremely painful.  

Identifying your personal food triggers can go a long way toward helping you feel better.   

What Can I Eat in a Mast Cell Activation Syndrome Diet?  

It’s not unusual to feel overwhelmed when you first start the low histamine diet. At first, you may feel like there is nothing left to eat. 

But, truly, there are so many nutritious and flavorful foods you can eat. 

It is easy to feel deprived if you just focus on the foods you can’t have. This is a sure road to feeling angry, resentful, and depressed.  

Focus on replacing food instead of removing. For example, eat arugula and lettuce, as a swap for spinach and curly kale, in salad and other dishes.  

The key is to think about how much eating fresh, nutritious foods will improve your health. Focus on choosing the foods that are healing and that you enjoy. 

Sometimes it is good to splurge on yourself. I don’t mean buying a chocolate cake. I mean by spending a little extra time in the kitchen making something healthy and delicious just for you.  

Some of my favorite low histamine treats are:  

Eat Fresh Foods on the Mast Cell Activation Syndrome Diet  

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. 

When you have MCAS, you need as many nutrients from healthy foods as you can get. 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. 

Look for these vegetables with their tops still attached:  

  • Carrots  
  • Radishes  
  • Beets (Note: Very high oxalate)  

TIP: Be sure to cut the tops off when you get home so they don’t suck any more nutrients out of the roots.  

If you can, get produce at the farmer’s market or even grow your own for the most nutrient dense options.

The book Eating on the Wild Side by Jo Robinson is a great resource on the highest nutrient varieties of fruits and vegetables. 

Emphasize Vegetables on the MCAS Diet  

Emphasize vegetables! Cover most of your plate with vegetables. 

Yes, this means lots of 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  
  • 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) 

Eat Clean Protein on the MCAS Diet   

In addition to eating lots of veggies, you’ll want to choose clean proteins. If you eat meat, look for pasture raised and organic.  

Pasture-raised chicken, pork, lamb, and turkey are a few good options to consider. 

For the lowest histamine levels, get meat and seafood that has been frozen right after slaughter or catch. 

Cook frozen meats in a pressure cooker. (I use an Instant Pot.)

The next best option is to thaw your meat in the refrigerator (not on the counter). Thaw until it is still just a little frosty. 

Finally, avoid slow cooking which allows histamine levels to go up. 

Check the sell by dates and make sure you get the freshest packages. 

You can learn more about low histamine meat handling best practices in this blog. 

Other good options for pasture raised meats are farmers markets. 

I use a local farmer as well as favorite producers:

For fish, I recommend Vital Choice and Northstar Bison.   

They both use sustainable fishing methods. Look for the low histamine fish that are frozen within 2 hours soon after catch. If you try their fish, start with a small amount first to make sure you don’t react.  

Those with both MCAS and Histamine Intolerance may still have a hard time with fish and may need to take DAO Enzyme before meals. Many wait until phase 2 of the low histamine diet to try it.  

I get my meat delivered to me frozen. Once I get it, I put it in the freezer right away to prevent histamine levels from rising. 

When I’m ready to prepare it, I thaw the meat in the fridge until it is still a little frosty to keep histamine levels low.  

Pasture-raised chicken, duck, or quail eggs are also a good protein source.  

Some people react to eggs, though. So, you’ll need to test them for yourself. 

Be sure to cook egg whites thoroughly.  

Depending on your situation, you might also use protein powder. 

Unfortunately, I haven’t found a protein powder that checks all these boxes:  

Most protein powders will be high in salicylates.   

Rice and pea protein are lectins.   

Hemp protein is high oxalate.   

Soy is high histamine.   

I’ve found one that is lower histamine with lower levels of salicylates and oxalates.  

But it does have rice and pea protein. So, it won’t be well tolerated with Lectin Intolerance.  

However, if you aren’t concerned about lectins, you can look into this one to see if it might be right for you.  

And if you don’t have trouble with oxalates, this hemp protein is one to consider.  

It tastes great in my low histamine smoothies like this cherry smoothie recipe.  

I know this list feels long but there’s still delicious foods you are able to eat on a MCAS diet.  

Legumes  

Legumes can cause histamine release and are also high oxalate and high lectin.

So, you may need to be careful with these. In the MC360TM Method, we recommend avoiding them initially on the MCAS Diet.   

Fats  

Healthy fats are needed for overall health, too. Be sure you are getting enough good fats. 

Fats are necessary for healthy brain cells and to make hormones. 

Also, some vitamins are fat soluble. This means they are best absorbed when eaten with fats. 

So, add healthy fats to your vegetables to absorb the most nutrition. 

Healthy fat sources include:  

Nuts 

Fresh nuts can be a good source of protein and fat when eaten in moderation. 

Buy nuts as fresh as possible. 

To make them more digestible, soak them overnight in salt water. Then dry in a food dehydrator or oven at 250 degrees. 

You can also make your own fresh nut butters using a VitaMix or Blendtec blender.  

The best low histamine, low to medium oxalate, and low lectin choices are: 

Keep the pecans, pistachios, and macadamias to 1/4 cup to stay low oxalate.   

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 
  • Hemp Protein Powder  

Pumpkin and sunflower seeds are lower oxalate and lower histamine, but do contain lectins.  

Herbs  

Season with a lot of fresh herbs.

Fresh herbs are some of the most nutrient-dense foods. And they are antioxidant foods. 

Cultures that use a lot of fresh herbs live longer than those that don’t use herbs. Plus, adding herbs to your meals will give them more flavor. 

If you enjoy what you are eating, you’ll be more likely to stick to making healthy choices. 

These are all excellent histamine lowering herbs: 

  • Ginger 
  • Basil 
  • Chives 
  • Oregano 
  • Garlic 
  • Peppermint 
  • Rosemary  

Fruits  

Fruits should be eaten as a dessert. This is due to higher sugar content. Spikes in blood sugar affect the mast cells. 

Prioritize lower sugar berries like blueberries. Tart cherries and green apples are also good choices. 

A squeeze of lemon or lime are ok, if you tolerate them. 

If you don’t have trouble with oxalates, blackberries are lower in sugar. 

Other lower histamine, low lectin, low oxalate fruits are:  

  • Apples (any) 
  • Apricots (fresh, not dried)  
  • Cherries 
  • Fresh Cranberries 
  • Fresh Currant 
  • Fresh Figs 
  • Grapes (especially black) 
  • Honeydew 
  • Kiwi (Golden is medium oxalate at 1/2 cup)  
  • Mango 
  • Nectarine 
  • Peach 
  • Pear 
  • Raspberries 

Large servings of fruit have higher sugar levels though. So, again, think of these as healthy, tasty desserts rather than as staples.  

However, currants and cranberries are very low sugar.  

Grains and Carbs 

Some people do better with carbs and some worse. 

Experiment to find what works best for you. I find grains increase my inflammation. I do better with lower levels of carbs. I think this is because many grains are high lectin and high oxalate.  

Too low carb keeps me from sleeping, though. Finding your own optimal carb intake takes a little trial and error.  

You might be able to use the flour of the cassava root as a carb. I use this to make cassava tortillas and pizza crusts.

If you get cassava, be sure to buy Otto’s brand. It is the only one that isn’t fermented.  

You can try these sources of low lectin, low oxalate carbs too:  

If oxalates aren’t a problem for you, then histamine-lowering sweet potatoes are a great carb choice.  

Sweeteners 

Sweeteners should be kept to a minimum.   

There are some good sweetener options that don’t affect blood sugar, though.

These are:  

These come from plants, and our bodies don’t metabolize them like sugar. Be sure you get stevia, monk fruit, and inulin without other additives.  

Often they have sugar alcohols added, which isn’t good for MCAS. So you have to check the ingredients.  

I use the 100% pure monk fruit extract from Smart Monk.

You can also use coconut sugar in moderation for a treat.  

Coconut sugar affects blood sugar more slowly than regular sugar.  

Honey, molasses, and maple syrup do have some good nutrients. They also have a big impact on blood sugar, so use sparingly.  

Handling Leftovers  

Leftovers grow histamine quickly. You’ll want to freeze your leftovers if they are going to be kept more than a couple hours in the fridge.  

I try to make a double batch of whatever I’m cooking. Then I freeze the leftovers in single serving containers. This makes it easy to pull out to take for lunch or have for dinner after a busy day.  

When I worked in an office, for lunches, I put the frozen meal in my lunchbox and put it in the fridge. By lunch time, it is usually mostly thawed. You can also thaw foods by running hot water over the container. Then reheat in a pan or toaster oven.  

Sometimes in a pinch you might have to use a microwave. I just trust that my nutrient dense foods outweigh any negatives of occasional microwave use. But you should know, I leave the room when the microwave is running and go to the other side of the house.  

I store leftovers in glass or silicone bags to avoid chemicals from plastics leaching into food.  

Still not sure what to eat?  

Sample Meal Ideas for the MCAS Diet

Here are some of my favorite low histamine meals ideas.

Mast Cell Activation Syndrome Diet Breakfast:  

Mast Cell Activation Syndrome Diet Lunch:  

Mast Cell Activation Syndrome Diet Snack:  

Mast Cell Activation Syndrome Diet Dinner:  

Mast Cell Activation Syndrome Diet Dessert:  

See all my low histamine recipes here.

Can Antihistamines Replace the Mast Cell Activation Syndrome Diet?  

A common misconception with Mast Cell Activation Syndrome is that you can just take histamine blockers to get rid of histamine in the body.  

This is a myth.  

Related Article: Mast Cell Myths   

There are some supplements that can help lower histamine levels, but reducing the amount of dietary histamine you ingest is going to be your best way to lower histamine.  

Long Term MCAS Diet   

Eating low histamine may not be forever for most people with MCAS. Your needs may shift over time as you heal. (The rare exception to this is a rare genetic disorder called Mastocytosis.) 

I can now tolerate a lot more histamine and oxalates than I used to. I still have trouble with most lectins, but I’ve found I have been able to reintroduce rice and pressure-cooked winter squashes, like kabocha squash. 

FODMAPs are still a work in progress for me. 

I can go out to eat occasionally. But when I do, I make sure to take my DAO enzyme supplement beforehand.   

Here are some more posts on how to do this MCAS Diet (aka low histamine diet):  

Healing foods are a big foundation for those recovering from MCAS. In the Mast Cell 360 clinic, we always start with a conversation about foods with my clients who have MCAS. 

This article gives you the steps to start to make good food choices for yourself.   

But if you have MCAS, food changes are rarely enough on their own. 

There are more root causes for MCAS beyond food. If you’re worried or overwhelmed about Mast Cell Activation Syndrome (MCAS), you may feel afraid that you’re never going to feel well again.   

Don’t worry, though. Figuring out the root causes underlying your MCAS will give you a road map to healing. Subscribe below to download my free guide to discover the 7 Most Common Root Causes of Mast Cell and what to do about them.   

You can get more information about these and other mast cell triggers by downloading your Free Report on the 7 Most Common Root Causes in Mast Cell Activation Syndrome here.

More Posts on MCAS 

Some links in this website are affiliate links, which means Mast Cell 360 may make a very small commission if you purchase through the link. It never costs you any more to purchase through the links, and we try to find the best deals we can. We only recommend products that we love and use personally or use in the Mast Cell 360 practice. Any commissions help support the newsletter, website, and ongoing research so Mast Cell 360 can continue to offer you free tips, recipes, and info. Thank you for your support! 

References 

Gibb, J. L. (2014). Is Food Making You Sick?: The Strictly Low Histamine Diet (Illustrated ed.). Leaves of Gold Press. 

Kullman, Pamela. Privately Compiled Notes. 

PhD, J. J. V., & Lawrence, H. (2018). Histamine Intolerance: A Comprehensive Guide for Healthcare Professionals. Berrydales Books. 

Wild-Scholten, M. D. (2013). Understanding Histamine Intolerance & Mast Cell Activation. CreateSpace Independent Publishing Platform. 

Ykelenstam, Yasmina. Healing Histamine | Histamine Intolerance Research & Recipes. (2022). Healing Histamine. https://healinghistamine.com/ 

Comments

  1. Pingback: The Mast Cell 360 Starter Low Histamine Foods List & Why you Shouldn’t use Most of the Online Histamine Foods Lists if you have Mast Cell Activation Syndrome or Histamine Intolerance

    1. Beth O'Hara

      I’m glad you found this helpful! Thanks for reaching out!

      1. Michelle

        Hi Beth!

        I have histamine intolerance to certain foods, i break out in hives if I eat avocados and others, I also have constant environmental allergies.

        What kind of testing is done to find out if you have a mold gut infection ?

        I have dysbiosis and some yeast overgrowth, but I’ve never heard of having mold in the gut.

  2. Natalina Keble

    Thankyou so much , I’ll try some of these recipes .

  3. Amanda Baker

    Thank you, this is a helpful site! I have MCA. I just bought a pressure cooker. You said to avoid slow cooking, is a pressure cooker OK? I hope so because I love making soups and veggie stews.

  4. Michelle

    Is it ok to eat frozen vegetables or should I buy fresh vegetables. I always steam them, I do not like them unless they are soft. Thank you for your help

    1. Beth O'Hara

      Hi Michelle,
      Fresh is always best, but frozen is definitely better than canned.

    2. Denise hurd

      Hi beth. I have recently developed problems with histamine intolerance a month into my taper off of valium. I don’t have a car. I can only order food on line. I bought some frozen Tyson chicken breasts and a box of minute white rice to eat for a week to see how I will react to them. Then will get frozen vegtables. With fresh vegetables and fruit how long can they be in the refrigerator, before they are considered not fresh anymore? How long does it take after you have eaten a food to know if you will have a reaction to it. It will take me around 2 years to taper off of the valium. Will I need to b on the diet most likely until I am done with my taper. I’m on a limited budget. If I listed anything that I should not eat, please let me know. Thank you

      1. Beth O'Hara

        Denise, I’m very sorry to hear you are dealing with this. Tyson chicken has a lot of chemicals. You might want to try for a natural, hormone and antibiotic free one. Unfrozen meat sitting at the grocery will be high histamine. If you can get meat that is frozen after slaughter, it will be lowest histamine. Local farmers often offer this. With vegetables and fruit, it depends on how you store the and what type of fruits and vegetables. For example, apples and turnips last longer in the fridge than lettuce. If they are losing firmness, wilting, browning, etc it will be higher histamine. they will last longer in the produce drawer of the fridge. Frozen fruits and vegetables are usually low histamine, if you select the kinds from the low histamine list. Regarding reactions, people can have reactions immediately to up to 3 days later.

  5. MK Nightingale

    Hello Beth

    Thank you so much for sharing your knowledge. I think it may have saved my bacon, so to speak!

    Have been a vegan for twelve years. Trying to move over to low histamine, low lectin diet (will play with oxalates too, in time), as well as making lifestyle and environmental changes, as the worst has happened and have found myself in a rolling state of anaphylaxis and sub-anaphylaxis where the action of swallowing water is enough to trigger an intensification of symptoms.

    At present managing only lower histamine / histamine deconstructing fruits and boiled veg, water, and rapidly losing weight.

    Am hoping very much to be able to introduce eggs from local farms, pending a peptide sensitivity test, but as I’ve previously relied on nuts, seeds, tofu and canned legumes as dietary staples, and am now reacting badly to all of the above, wanted to ask you firstly:

    Am I right in thinking soy/tofu is excluded from lists as it’s a common allergen? Does it have specific negative properties with regards MCADs itself?

    Buckwheat. So much conflicting info out there but it had been a staple for me due to gluten sensitivity the last twelve years, and am not tolerating my other staples brown rice + legume pasta at present. Where does it fall in terms of histamine, lectins, oxalates?

    Thanks so very much,
    MK

    1. Beth O'Hara

      Hi MK,
      I’m glad to hear you are finding the site helpful!
      Yes, Soy is a lectin and a thyroid disruptor. Buckwheat is low histamine, but high lectin and high oxalate. You can get rid of the lectins by pressure cooking, but it won’t get rid of the oxalates.

  6. Maria Jose Pastor

    Hi there,

    Your blog has been extraordinarily helpful! Oats were not on your list of grains, and I am wondering if oats, oat milk, or even rolled oats for oatmeal are considered safe to eat.

    Thanks and I look forward to your reply!

    Best,

    1. Beth O'Hara

      Hi Maria,
      Oats are lower histamine, but they do fall under the oxalate and lectin category. Hope this helps!

  7. Christina

    Hi,

    Is coconut flour low histamine low oxalate? I found some discrepancies between this list and your website page that is titled Low and High Histamine Foods Lists which makes me confused-specifically some of the starches if they are high in oxalates or not.

    1. Beth O'Hara

      Hi Christina,
      Fresh coconut is lower histamine than dried coconut. Think of it as being on a spectrum. Fresh and dried Coconut are lower oxalate.

  8. Ali Smith

    You suggest using cold pressed avocado oil, yet avocado’s are histamine high….I’m confused…

    1. Beth O'Hara

      Hi Ali,
      The oil isn’t as high histamine as avocados, and people usually have 1-2 tsps of avocado oil as opposed to 1/4 to 1/2 cup of avocado. Some people are extremely sensitive and may not tolerate it still, though. I hope that helps.

  9. Tonya

    Hi! Is seaweed low-histamine? Specifically dulse flakes and/or kelp powder, which I take in small amounts as a source of iodine.

  10. Candice

    Hi. Is Dairy out on a low histamine diet? I didn’t see anything here about dairy. Also can we have decaf coffee and herbal teas? Thanks.

    1. Suz, Mast Cell 360 Team

      Hi Candice,
      You will find the dairy and beverages sections near the bottom of this post: https://mastcell360.com/low-histamine-foods-list/
      Some herbal teas are fine (the list shows that black, green, white, rooibos and drinks with “flavor” or “spices” are higher histmamine. Decaf coffee like the lower histamine, mold free brands like Purity are ok.

      1. Samantha Penry

        Are Persimmons high in oxalate or histamine?

        Thank you

        1. Suz, Mast Cell 360 Team

          Hi Samantha,
          Persimmons are listed as generally well-tolerated in the histamine guide, but I’m not finding a listing for it within the resources I have on hand for oxalates. You might try the Trying Low Oxalates group on Facebook to see what resources they may be able to share. https://www.facebook.com/groups/TryingLowOxalates

  11. Samantha

    I was wondering, do you know if Sachs inchi is high oxalate or high histamine?

    1. Suz, Mast Cell 360 Team

      Hi Samantha,
      Great question. In my histamine food resources, I am unable to find a specific listing for that. You might try to check in with the Trying Low Oxalates Facebook group to see if they can get you some information about the oxalate content:
      https://www.facebook.com/groups/TryingLowOxalates

  12. Patricia

    This is awesome! However my son is 7 years old and severely histamine intolerant and extremely picky 🙁

  13. Karen Pailing

    Hi, I’m so confused as to what I can eat, please help. I have so many symptoms that I think I need to cut everything possibly bad out and then try reintroduce later. Is there a definitive list of foods that are safe to eat that do not have histamine, gluten, dairy, glutamate, lectins, oxalates etc?
    I should imagine that will leave me with very little to eat but I don’t know what else to do. I spent money seeking advice from a functional medicine Dr who gave me an elimination diet which included legumes, kefir, all nuts, potatoes, rice, oats and rooibos tea which online info says I should also avoid. It’s such a minefield! please help…

    1. Suz, Mast Cell 360 Team

      Hi Karen,
      Here is the list Beth put together which indicates higher and lower histamine foods as well as oxalates and lectins. The key also shows which foods should be best purchased organic. This list will have some gluten and dairy on it, but dairy is listed in its own category. I hope this will be of help.
      https://mastcell360.com/low-histamine-foods-list/

  14. Caroline M

    Thank you Dr. Beth for your incredible research and details on what foods/products are safe and acceptable for those of us with this challenging health issue. I have learned so very much from your posts and become a much more personally conscientious shopper. I do miss coffee, the Purity coffee suggestion was excellent, but I did manage to overdo it and results manifested in hives, so lesson learned. I do have questions about supplements that would be acceptable- currently I take glucosamine- chondroitin, krill oil and a Vitamin D supplement. The krill has been put on the back shelf because of the crustacean component. Would you be able to suggest any that I can substitute as safe together with HIT/MCAS from the regular commercial ones I’m currently taking?

    1. Suz, Mast Cell 360 Team

      Hi Caroline,
      We can’t say for sure if this will be right for you, but we use this SPM Active in the practice:
      https://us.fullscript.com/product_cards/90546/redirect?store_slug=mastcell360

      Omega 3s get processed in our bodies to SPMs – which is the activated form of omega 3s. That processing in the SPM Active makes it lower histamine. Be sure to talk with your practitioner with any questions and read all the ingredients for your needs. If you do decide to try it, start very slowly (we say drops or sprinkles) and then gradually build up if you are tolerating it. If you use the link above to register a FullScript account, you will get 15% off.

      –Suz

      1. Kekoa

        Is it safe to take n acetyl glucosamine if you have histamine intolerance?

        1. Suz, Mast Cell 360 Team

          Hi Kekoa,
          We can’t say if it will be right for you since we don’t know your case. However, we do use it in the practice sometimes. If you have any questions or concerns, please be sure to talk with your provider who knows your history. And start slow if you decide to take it if you have sensitivities. We usually recommend “drops or sprinkles” to start and then gradually build up as tolerated.
          Here is one we use in the practice. You can get 15% off your FullScript Orders if you register an account with this link: https://us.fullscript.com/product_cards/57927/redirect?store_slug=mastcell360

          Best wishes, Suz

  15. Cari Reed

    Beth, Everything has been super helpful:) Are there any tests you recommend for checking lectin, oxylate and sacilayte sensitivites?

    1. Suz, Mast Cell 360 Team

      Hi Cari,
      The best test to look at oxalate issues is the Great Plains Organic Acid Test. This is an at-home urine test you can order for yourself. You can find that here: https://www.truehealthlabs.com/Organic-Acids-Test-Great-Plains-Labs-p/gpl_organic_acids_74.htm#hw360

      For lectins, there is now a Lectin Zoomer test available through Vibrant that can help determine if you are reacting to Lectins and even which ones. This test needs to be interpreted in reference to your total IgG and IgA levels, so be sure you work with a practitioner who knows how to interpret this test for you.

      And for salicylate intolerance, the only test we currently know about is really just the aspirin test. IT IS VERY IMPORTANT NOT TO DO THIS ON YOUR OWN. Please talk with your doctor about this if you think you have salicylate intolerance. Salicylate intolerance is more rare. You can read about it more here: https://mastcell360.com/salicylates-and-salicylate-foods-what-to-know-when-you-have-mast-cell-activation-syndrome-or-histamine-intolerance/

      Suz, MC360

  16. Judy Shaw

    My husband has Alpha Gal and MCAS. He only eats chicken, turkey and fish. No dairy, red meat etc. It has become a nightmare trying to figure out what has high histamines and what doesn’t. Would working with a nutritionist be a good idea?

    1. Suz, Mast Cell 360 Team

      Hi Judy,
      It might be helpful, but you’ll want to be sure whoever you choose to work with has experience with these particular needs. Wishing you all the best!

      Suz

  17. Marina

    Thank you so much for the useful info! A question – I buy lots of leafy greens which are delivered twice a month, but now I see that they shouldn’t be kept so long in the fridge. 1) is it ok to freeze them and then eat as needed or 2) how long is it ok to keep fresh leafy greens in the fridge for? Thank you!

    1. Suz, Mast Cell 360 Team

      Hi Marina,
      Greens like lettuce don’t freeze very well. More robust greens may hold up better. If you are able to freeze your leafy greens, that is certainly one way to keep histamine levels lower. If they don’t freeze well, keep in mind that if you eat fresh produce in a reasonable amount of time, you may not need to freeze it. If foods start to brown, go soft, get slimy, or wilt, you’ll want to avoid them. And produce tends to keep longer in the produce drawer.

      Hope this helps!

      Suz, MC360

  18. Naza

    Hi there, how long can I keep fresh vegetables in the fridge before their histamine levels increase? Is it generally recommended to only buy frozen vegetables if not cooked the same day?

    And also, is it ok to fry food or is it better to boil and grill veggies?

    Thank you so much!

    1. Suz, Mast Cell 360 Team

      Hi Naza,
      One thing to remember with Histamine Intolerance is that everyone’s level of sensitivities is different. You may be able to tolerate something that someone else may not be able to tolerate. For very sensitive people who are just starting to work on their health, they may need to take some of the most precautions to keep histamine levels down while they get proper supports in place.

      Fresh is best and frozen is next best.

      With vegetables, it depends on how you store them and what type. For example, apples and turnips last longer in the fridge than lettuce lasts in the fridge. And they last longer in the produce drawer. If vegetables are losing firmness, wilting, browning, etc. that’s an indication that the histamine levels will be higher. For cut fruits and vegetables, Beth recommends freezing where possible. Once cut, the histamine levels can increase faster.
      Some foods like lettuce won’t freeze well, so you may consider things like buying smaller amounts more frequently or planning on eating things with a shorter shelf life soon after purchase.

      With frying, it’s the same in terms of histamine levels. Frying isn’t always the best option, but you may be able to tolerate it sometimes. Grilling can also be an issue for some sensitive people because of chemicals from the gas or charcoal. Boiling is usually fine. In terms of other types of preparation, just remember that the longer something cooks, the higher histamine it will be. A slow roasted pork will be higher histamine that a pork roast made with an instant pot.

  19. Sunshine

    Hello. I have recently developed GI issues due to covid, and it has developed into hormone imbalances, heavy metals in my system, mold toxicity, MCA issues and histamine intolerance. I’m going crazy trying to find what to eat your site is very helpful.

    1. Jamie, Mast Cell 360 Team

      I’m sorry to hear that you’ve been experiencing health issues lately, but that our site has been helpful. We wish you all the best on your healing journey.

Add A Comment

Recipe Rating