high fodmap foods

FODMAP Intolerance: What to Know if You Have Mast Cell Activation Syndrome or Histamine Intolerance

Eating high FODMAP foods when you have FODMAP Intolerance can contribute to your Mast Cell Activation Syndrome flares. 

Particularly gut issues. 

You may attribute gut symptoms to Mast Cell Activation Syndrome (MCAS) or Irritable Bowel Syndrome (IBS). I even hear people say, “That food just doesn’t agree with me.” 

But when foods “don’t agree” with you, there’s probably a reason for it.  

Before I knew all the health issues I was dealing with, I only knew I had (IBS). When food upset my stomach, I often thought it was an IBS flare due to something I ate.  

Like beans. 

I’ll never forget the last time I ate beans, even though it was ages ago. 

My belly was so distended. I looked 7 months pregnant. 

I had so much gas that I could barely move.  

Diarrhea kept me running to the bathroom all night.  

It was some of the worst abdominal pain I’d ever felt in my life. 

After a truly horrific night, the pain eventually subsided. 

These types of reactions are like IBS symptoms. So, I figured I’d had a severe IBS flare.  

It wasn’t until years later that I finally realized FODMAPs were causing me gut trouble. 

If you’re doing a low histamine diet and still having gut issues, read more to learn if FODMAPs might be causing your flares. 

You’ll learn: 

  • What are FODMAPs? 
  • What is FODMAP Intolerance? 
  • What causes FODMAP Intolerance? 
  • Are FODMAPs causing your mast cell flares? 
  • How lowering FODMAPs may help your gut 
  • How to tell if you have FODMAP Intolerance 
  • High FODMAP foods to avoid 
  • Low FODMAP foods & low histamine foods to enjoy 
  • Reintroducing FODMAP foods 
  • Rebalancing your gut 

Let’s start by answering the question, “What are FODMAPs?” 

What Are FODMAPs? 

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

FODMAP is an acronym that stands for

  • Fermentable
  • Oligosaccharides
  • Disaccharides
  • Monosaccharides
  • And
  • Polyols  

They are short-chain carbohydrates (sugars) found in some foods. 

And they aren’t completely digested or absorbed in your intestines.  

During the digestive process, FODMAPs move through the small intestine and attract water.  

When they pass into the large intestine, FODMAPs are fermented by gut bacteria. 

Together, this can lead to symptoms like gas and bloating, as well as abdominal pain.  For some people, they’ll get diarrhea or constipation, too. 

Not everyone has trouble with FODMAPs (FODMAP Intolerance), though. 

You are more likely to have FODMAP Intolerance if you: 

You’ll read more about what causes FODMAP Intolerance in a bit.  

But first, let’s finish looking at what the terms fermentable oligosaccharides, disaccharides, monosaccharides and polyols mean next.  

Let’s start with the easy terms.  

Fermentable 

Fermentable is the F in FODMAP. This refers to the sugars that are fermented by your gut bacteria. 

“And” is the A. 

In short, the ODMP in FODMAP refers to different molecular makeups of sugars.  

Here’s what those terms stand for. You’ll also see some examples of foods high in each of these categories. 

Oligosaccharides  

Oligo means “few,” and saccharide means “sugar”. 

Oligosaccharides are carbohydrates made up of “a few” sugar molecules linked together.  

You may also hear foods in this category called fructans, fructooligosaccharides (FOS), or galactooligosaccharides (GOS). 

Examples of foods with oligosaccharides are: 

  • Onion 
  • Garlic 
  • Wheat 
  • Rye 
  • Beans and lentils 
  • Broccoli 
  • Leeks 
  • Artichokes 
  • Yacon (a root vegetable that can be made into a sweetener) 
  • Agave 
  • Pumpkin 
  • Powdered prebiotics with FOS or GOS 

Disaccharides  

Disaccharides are “two sugars”. They are carbohydrates made up of two sugar molecules.  

There are 3 main disaccharides: 

  • Lactose 
  • Maltose  
  • Sucrose 

Examples of foods with disaccharides are: 

  • White sugar 
  • Brown sugar 
  • Milk 
  • Cheese 
  • Sour cream 
  • Cream cheese 
  • Ice cream 

Monosaccharides  

Monosaccharides are carbohydrates made up of one sugar molecule. 

Another term you’ll come across for these foods is fructose. 

Examples of monosaccharides include: 

  • Honey 
  • Apples 
  • High fructose corn syrup 

Polyols 

Polyols include sugar alcohols like:

  • Sorbitol
  • Mannitol
  • Xylitol
  • Erythritol

You’ll often find these as sweeteners in diabetic or low carb candies and other sweet treats. 

But you can find polyols in whole, natural foods like these, too: 

  • Pitted fruits like cherries, peaches, and plums 
  • Cauliflower  

You can have trouble with just 1 or 2 FODMAP categories. Or with all of them, like I did. 

But why would you have trouble with FODMAPs at all? 

Let’s look at that next. 

What Causes FODMAP Intolerance? 

Generally speaking, FODMAPs aren’t absorbed well by the small intestine. 

And numerous studies have shown that FODMAPs can be a big trigger for IBS, either IBS – C (constipation) or IBS – D (diarrhea). 

But why do some people struggle more than others? 

Why do some people tolerate eating high FODMAP foods without uncomfortable symptoms? And why do high FODMAP foods have others doubled over in pain? 

As we touched on earlier, your tolerance to FODMAPs may be affected by:  

  1. An imbalance in your gut bacteria (for example, SIBO)  
  2. Mold Toxicity
  3. Not enough enzymes to break down FODMAPs 

Let’s read more about these next. 

1. FODMAP Intolerance and an Imbalance of Gut Bacteria 

The #1 root cause of FODMAP Intolerance is an imbalance of bacteria in the gut. For instance, SIBO (Small Intestinal Bacterial Overgrowth) is often the root cause of FODMAP Intolerance.  

SIBO led to my FODMAP Intolerance.  

I suspect I actually had SIBO for years. 

But I didn’t know it earlier in my life. Like when I had that terrible reaction to eating beans. 

I had never addressed SIBO directly, but cleaning up my eating likely helped somewhat with SIBO related gut issues. 

But I don’t think it ever really went away. 

A few years ago, though, my gut microbiome was majorly upset by bacteria in a hydrogen water machine I was using. 

After a few days of drinking water from it, I started having diarrhea, bloating, and gas. 

So, I got the water tested. 

Sure enough, there was harmful bacteria. 

It dawned on me that I had SIBO. And that it was contributing to this new onset of awful gut issues. 

Then I looked at why my symptoms were flaring more when I ate. Certain foods were really setting me off. 

It finally hit me when I ate half of an apple one morning. 

My belly became massively bloated. 

I was in pain. 

The gas was embarrassing. 

And I was stuck in the bathroom with diarrhea. 

It was just like what happened years ago with beans. 

Now, it was happening with cauliflower, broccoli, and Brussels sprouts, too. 

What did these foods have in common? 

They were all foods high in FODMAPS. 

FODMAP Intolerance can be caused by SIBO. 

SIBO is when bacteria that is normally found in the large intestine starts to overgrow instead in the small intestine. This bacterial overgrowth leads to uncomfortable symptoms like gas and bloating.   

Many people are dealing with SIBO these days.  

What you might not know is that SIBO is common in people with Mold Toxicity. 

Let’s look at that next. 

2. FODMAP Intolerance and Mold Toxicity 

Mold Toxicity is the #1 root cause of MCAS that I see in the Mast Cell 360 practice. 

And Mold Toxicity can lead to food intolerances like FODMAP Intolerance. 

Related Article: How To Detox Your Body from Mold with MCAS 

Research has shown that most of the reported effects of mycotoxins are negative in terms of gut health. 

Mycotoxins can eliminate the beneficial bacteria population in your gut. And without these good bacteria, bad bacteria and bad yeast can thrive.  

When you have an imbalance of bacteria in your gut, this can lead to bad bacteria outnumbering good bacteria. This is when you’ll get SIBO. 

So, how do you rebalance your gut when you have FODMAP issues? I’ll give you a great strategy in the next section. 

Rebalancing Your Gut with FODMAP Issues 

While you’re eating low FODMAP, you’re not going to be producing as many SCFAs (Short Chain Fatty Acids) which are extremely important for healing. 

That’s where taking a SCFA supplement can help. 

There are a lot of different SCFAs such as acetate, propionate, and butyrate.  

The most important and beneficial SCFA by far is butyrate. 

Butyrate supports the gut in a number of ways such as: 

  • Improves tight junctions to promote healing in leaky gut 
  • Improves the mucus layers to promote healing in leaky gut 
  • Encourages the growth of good bacteria 
  • Helps the gut get rid of bad bacteria 
  • Keeps oxygen levels low in the large intestine (very important for gut health) 

Butyrate has also been shown to support mast cells and modulate histamine levels. AND it lowers inflammation. 

Many people will take some type of resistant starch like HI-MAIZE® for butyrate production.  

The problem with that is HI-MAIZE® is high FODMAP. 

If you don’t have problems with FODMAPs, HI-MAIZE® is fine. And it’s low histamine. 

But if you’re getting bloated from this and other high FODMAP foods, taking Hi-Maize® isn’t a good idea. 

That’s where I got a lot of help from a supplement called Tributyrin-X™.   

It helped restore my gut balance after the nasty bacterial contamination from the water machine. And it helped with my gut issues from Mold Toxicity, Mold Allergy, and Mold Colonization. 

Now, full disclosure, I had to address the mold toxins for my gut to fully improve. 

But the Tributyrin-X™ was one of the key supports I used to help get myself back on track. And I wanted to share this with you in case this will help you, too. 

Tributyrin-X™ is a butyrate supplement that doesn’t have FODMAPs. It’s a way to get in your butyrate without all the digestive upset, bloating, and gut issues FODMAPs can cause. 

Many people with Histamine Intolerance and MCAS have tried Tributyrin-X™ with success. 

Not only were they able to tolerate Tributyrin-X™… it actually helped them tolerate more foods! 

In food allergy studies, Tributyrin-X™ has been shown to help diminish allergic reactions to foods. 

That’s because it helps heal all 3 layers of the gut lining. That means reduced mast cell activation. And as the gut lining heals, food particles aren’t leaking into the bloodstream to trigger more immune reactions.  

And it turns out that butyrate has mast cell stabilizing properties, too.  

Here are a few of the common questions that come up around Tributyrin-X™, my preferred SCFA. 

How Long Until You See Results? 

You could notice some positive changes within a few days of starting. Many people notice changes within 3 days! 

After 7 days, a number of people have reported even more improvement. 

By 14 days, about 80% of people are noticing significant improvements. So, usually you’ll see marked results within 14 days. 

How Long Should You Take It? 

Most people who are wanting to heal a messed-up gut are on Tributyrin-X™ for 6 to 12 months. For some, it may be even longer. 

But the good news is that Tributyrin-X™ is a 99.9% pure tributyrin liquid. This means there are no fillers or additives that may cause Mast Cell Activation Syndrome or Histamine Intolerance reactions. 

So, even if you have to take it for a longer time, you won’t have to worry about it affecting your MCAS. 

You can read more about Tributyrin-X™ here: The Best POST-biotic Butyrate for Mast Cell and Histamine Supports 

Tributyrin-X by healthy gut

Ready to try Tributyrin-X™?

>>>Use coupon code MC36015TRX to get $15 off your first order!

Following a low FODMAP diet with the addition of Tributyrin-X™ could go a long way toward helping your gut. 

As you know from following me for a while, addressing gut health is essential when you have Mast Cell Activation Syndrome or Histamine Intolerance! 

And I’ve found in my practice that taking Tributyrin-X™ may help address FODMAP Intolerance no matter what your root cause may be. 

Gut imbalances like SIBO are the most common reason people end up with FODMAP Intolerance.  

However, it is possible to have FODMAP Intolerance without SIBO. I don’t see that as much, though.  

But there are instances where FODMAP Intolerance is related to a lack of enzymes being produced in the body. 

Read more on that next. 

3. FODMAP Intolerance and Enzyme Production 

FODMAP intolerance can also be caused if your body doesn’t produce enough enzymes to break them down. 

For example, lactase is the enzyme that breaks down lactose. You’ll remember that lactose is a disaccharide (that’s the D in FODMAP). 

Generally, if someone is only intolerant to these lactose disaccharides, we just call this Lactose Intolerance. 

Lactose Intolerance is a subset of FODMAP Intolerance, though. 

Lactose Intolerance is often genetic. Some people with Lactose Intolerance choose to take lactase enzyme supplements to break down milk sugars.  

But if you have MCAS, I usually don’t recommend eating dairy, though. 

Next, let’s look more at the relationship between FODMAP Intolerance, MCAS, and your gut health. 

FODMAPs and MCAS 

Is FODMAP Intolerance causing your mast cell flares? Yes. It certainly can. 

A huge part of your immune system is in your gut. And when your gut is disrupted, it may cause mast cell activation. 

FODMAPs can disrupt your gut by causing inflammation. That’s one way it may be contributing to your mast cell flares. 

And with FODMAP Intolerance, your body is already seeing these high FODMAP foods as a threat.  

More accurately, the bacterial fermentation that occurs with high FODMAP foods increases the number of bacteria and fermentation by products. The mast cells respond to that.  

That means temporarily avoiding higher FODMAP foods may allow the gut to recover. And calm your mast cells. 

At least to the point that gut symptoms like loose stools, hard stools, gas, bloating, and abdominal discomfort may significantly improve. 

You read earlier that Tributyrin-X can help rebalance your gut. 

But another key component to addressing gut imbalances and FODMAP Intolerance is eating a low FODMAP diet.  

Next, read more on the FODMAP elimination diet.  

You’ll learn more about some of the high FODMAP foods you may be eating. And I’ll share with you some low histamine and low FODMAP food choices you can enjoy. 

Low FODMAP Elimination Diet 

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 licensed medical provider who is supervising your case. 

Remember that elimination diets aren’t meant to be forever. But they are often used as a tool to help you regain your health. 

Working with your provider, you can eliminate high FODMAP foods to see if you start to feel better. Use this as a test. Don’t think of it as a lifestyle change you’ll make forever. 

When I stopped eating high FODMAP foods, my bloating, gas, and gut aches were dramatically better after 3 days. 

Some people have told me they noticed a difference in just 2 days. Whereas others said it took about 5-7 days. 

Again, here’s an important note: you don’t want to avoid FODMAPs forever. FODMAPs should be reintroduced gradually at some point. This is because they also help maintain a healthy gut balance. 

It’s important that you work with your provider or a dietician before making big changes to your diet. You want to be sure your nutritional needs are being met…especially when you are doing an elimination diet. 

Let’s look more at some of the high FODMAP foods you’ll remove from your diet during your temporary elimination. 

Then I’ll share with you some tips for how to reintroduce FODMAP foods into your diet. 

Now, let’s look closer at where we find FODMAPs in the diet. 

High FODMAP Foods 

FODMAPs are primarily found in plant foods. Like fruits, vegetables, legumes, and vegetables. 

But you can also get it in dairy. This is because lactose is an animal-based FODMAP. 

Honey is another animal product you may need to temporarily avoid, if you have trouble with the FODMAP fructose. (Honey is also high histamine.) 

Here are some common high FODMAP foods.  

HIGH FODMAP GRAINS & CARBS   

  • Almond meal (at ½ cup or more) 
  • Amaranth 
  • Barley (including barley flour) 
  • Bran cereals 
  • Chestnut flour 
  • Coconut flour 
  • Corn (½ cob is low, ¾ a cob is moderate, 1 full cob is high) 
  • Couscous 
  • Granola 
  • HI-MAIZE® resistant starch 
  • Rye 
  • Some gluten free breads 
  • Some gluten free pasta or crackers 
  • Spelt 
  • Wheat 

HIGH FODMAP VEGETABLES 

  • Artichoke leaves 
  • Asparagus 
  • Beets / Beetroot 
  • Brussels sprouts 
  • Butternut squash (more than ⅓ cup) 
  • Cauliflower 
  • Celery (more than ⅓ of a stalk) 
  • Escarole 
  • Garlic 
  • Leek (white bulb only, green tops are ok) 
  • Lotus root, dried (frozen is okay) 
  • Onions 
  • Scallions / Green onions (white part only, green tops are ok) 
  • Split peas 
  • Shallots 
  • Snow peas (over 5 pods) 

HIGH FODMAP FRUITS 

  • Apples 
  • Apricot 
  • Blackberries 
  • Cherries 
  • Cranberries 
  • Currants 
  • Figs 
  • Nectarines (over ⅕ cup) 
  • Peaches 
  • Pears 
  • Watermelon 

HIGH FODMAP LEGUMES  

  • Beans (all except black) 
  • Lentils (above ¼ cup), (green and red are slightly better)  

HIGH FODMAP NUTS & SEEDS 

  • Pistachios 

HIGH FODMAP SWEETENERS  

Note: some of these are high histamine, too. 

  • Agave 
  • Chicory-based sweeteners 
  • Fructooligosaccharides (FOS) 
  • Fructose 
  • High fructose corn syrup 
  • Honey 
  • Inulin 
  • Molasses 
  • Oligofructose 
  • Sugar alcohols: 
    • Erythritol 
    • Isomalt 
    • Lactitol 
    • Maltitol 
    • Mannitol 
    • Sorbitol 
    • Xylitol 

HIGH FODMAP MILK & DAIRY PRODUCTS  

  • Plain A2 cow milk 
  • Ricotta cheese (above 2 Tablespoons) 
  • Sheep milk 

HIGH FODMAP MEAT  

  • Marinated meats  
  • Sausage  
  • Salami  

FODMAPs are a concern for processed and marinated meats like sausage or salami because of added ingredients. 

You’d be avoiding these already, though, if you are eating low histamine since they are also high histamine foods. 

HIGH FODMAP HERBS & SPICES  

  • Garlic powder 
  • Garlic salt 
  • Onion powder 

Those are a lot of foods! You might be wondering…is there anything left to eat? 

Absolutely! 

There are plenty of great low FODMAP and low histamine food options.

Low FODMAP Low Histamine Foods 

NOTE: this list is primarily about FODMAP foods that are low histamine. High histamine foods have been omitted. High oxalate, medium oxalate, and lectin foods are noted. 

For more foods and details, we highly recommend the MONASH University FODMAP App – available for both iPhone and Android. 

Much gratitude and appreciation for their groundbreaking, high quality research in this area. 

Some foods are noted “s/b” for “should be low FODMAP”. We don’t have data on these but they appear to be well tolerated in my clinical experience.  

LOW FODMAP GRAINS & CARB SOURCES 

LOW FODMAP VEGETABLES 

  • Artichoke hearts – medium-high oxalate 
  • Arugula 
  • Basil 
  • Bean sprouts – lectin, medium oxalate 
  • Bok choy  
  • Broccoli  
  • Broccolini  
  • Cabbage – green / white cabbage or red cabbage  
  • Cabbage – Chinese / napa  
  • Cabbage – savoy 
  • Carrots  
  • Chives 
  • Cilantro 
  • Collard greens 
  • Cucumber – lectin 
  • Daikon radish  
  • Dandelion greens (not yet tested, but s/b low FODMAP) 
  • Ginger 
  • Italian parsley 
  • Kale – flat leaf (aka Lacinato or dinosaur kale) 
  • Kale – curly – high oxalate 
  • Kohlrabi 
  • Leek (green tops only) 
  • Lettuce – butter 
  • Lettuce – endive 
  • Lettuce – green or red leaf 
  • Lettuce – iceberg 
  • Lettuce – radicchio 
  • Lettuce – romaine 
  • Mesclun (not yet tested, but s/b low FODMAP) 
  • Mint 
  • Mizuna (not yet tested, but s/b low FODMAP) 
  • Mustard greens (not yet tested, but s/b low FODMAP) 
  • Okra – high oxalate  
  • Parsnip 
  • Perilla (not yet tested, but s/b low FODMAP) 
  • Pepper – green bell peppers – lectin 
  • Pepper – hot  
  • Pepper – red – lectin 
  • Potatoes – red or new – lectin (all other high oxalate) 
  • Radishes 
  • Rhubarb – VERY high oxalate 
  • Rutabaga / Swede 
  • Scallions / Green onions (tops only, no whites) 
  • Squash – butternut – lectin 
  • Squash – spaghetti – lectin 
  • Squash – summer – lectin 
  • Squash – yellow or winter – lectin  
  • Sweet potato / Yam – VERY high oxalate 
  • Swiss Chard – VERY high oxalate
  • Turnip  
  • Watercress 
  • Zucchini – lectin 

LOW FODMAP FRUITS 

  • Blueberries  
  • Cantaloupe / Rock melon – lectin 
  • Guava – ripe – VERY high oxalate 
  • Honeydew melon – lectin  
  • Kiwi – high oxalate 
  • Lemon – not always tolerated in elimination 
  • Lime – not always tolerated in elimination 
  • Mango  
  • Passion fruit  
  • Plantain – VERY high oxalate 
  • Pomegranate – high oxalate 
  • Raspberries – not always tolerated in elimination 
  • Rhubarb – EXTREMELY high oxalate 

LOW FODMAP LEGUMES 

  • Black beans – high oxalate 
  • Lentils – lectin (use in moderation – soaked overnight and pressure cooked) 

LOW FODMAP NUTS & SEEDS  

  • Almonds – VERY high oxalate 
  • Brazil nuts – high oxalate 
  • Chestnuts  
  • Chia seeds – high oxalate 
  • Coconut cream
  • Coconut meat, fresh  
  • Coconut milk – 100% coconut milk only, without additives
  • Flax seeds  
  • Hazelnuts – high oxalate 
  • Hemp seeds – high oxalate 
  • Hemp protein powder – high oxalate 
  • Macadamia nuts – medium oxalate at 10 nuts (keep to ¼ cup for medium oxalate) 
  • Pecans – medium oxalate at 10 halves 
  • Pine nuts – high oxalate 
  • Poppy seeds – high oxalate 
  • Pumpkin seeds – lectin 
  • Sesame seeds – high oxalate 
  • Sunflower seeds – lectin 

LOW FODMAP SWEETENERS 

I always recommend limiting sweeteners because they can spike your blood sugar and your histamine levels. They can be a mast cell trigger.  

  • Coconut sugar  
  • Pure jams, jellies, and marmalades made with allowed ingredients (mango, pomegranate, or raspberry with no sugar) 
  • Stevia 

LOW FODMAP MILK & DAIRY 

LOW FODMAP MEAT 

My favorite sources are:  

LOW FODMAP HERBS & SPICES 

LOW FODMAP OILS & FATS 

LOW FODMAP MISCELLANEOUS 

Now you know which foods to avoid and which foods to focus on.  

The great news is that making this change may also really help your gut if you struggle with bloating, gas, leaky gut, gut aches, and diarrhea or constipation! 

Do you have to avoid high FODMAP foods forever? Fortunately, no! 

Next, I’ll explain why. 

Reintroducing FODMAPs 

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 licensed medical provider who is supervising your case. 

While you may need to remove high FODMAP foods for a time, it’s not good to stay low FODMAP long term. 

After all, there’s a reason why high fiber, fermentable fruits and vegetables are recommended for a healthy diet. 

When your bacteria are living where they’re supposed to, the fermentation of these high fiber foods is actually good for you.  

The gut produces Short Chain Fatty Acids (SCFAs) when you eat FODMAP fibers. 

These SCFAs are beneficial for your body in many ways. 

They have been shown to have anti-inflammatory and antimicrobial effects. 

And research is showing that SCFAs play a key role when it comes to the maintenance of gut and immune health and balance.  

For that reason, most people want to start reintroducing FODMAP foods as soon as it’s safe to do so (under the guidance of a healthcare practitioner). 

But it has to be done methodically. 

Usually, this means introducing one high FODMAP food at a time. And giving it a couple of days to see if there are symptoms. 

So, the first thing some people do is to temporarily follow a low FODMAP diet. 

Sometimes, this is for 2-6 weeks, but sometimes people follow a low FODMAP diet for longer. 

Again, please be sure to work with your healthcare practitioner to determine what is right for you. 

A low FODMAP diet can help reduce gut irritation. And allow for the gut to start recovering. This is especially important for Mast Cell Activation Syndrome and Histamine Intolerance because the whole GI tract is lined with mast cells. 

If mast cells are triggered, that’s what can lead to unwanted reactions. Mast cell activation will also increase your histamine load. That’s because mast cells release histamine. 

But after you’ve given your gut a break and lowered gut irritation, it’s usually time to start reintroducing some of these healthy foods. 

Step-By-Step Options for Reintroducing FODMAPS 

Here is one suggestion for reintroducing FODMAPs. 

Step 1:  

Try the Low FODMAP Diet for 2-6 weeks (until symptoms improve and your healthcare practitioner recommends reintroduction). 

Use the list of low histamine and low FODMAP foods above as your guide.  

You may still want to keep a food diary of your symptoms during this phase in case you have other intolerances. This will make it easier to identify them. 

If you still don’t see improvements, talk to your healthcare specialist about these:  

I never want you to limit foods if it’s not necessary. Please work closely with your doctor. 

Step 2:  

Start reintroducing FODMAPs by challenging each FODMAP group separately. 

People normally start reintroducing foods by testing these subgroups of FODMAPs individually: fructose, lactose, sorbitol, mannitol, fructans, and GOS. 

TIP: If you have Histamine Intolerance or Mast Cell Activation Syndrome, work with a qualified healthcare practitioner to target low histamine options that have FODMAPs. 

Only reintroduce one FODMAP food from the group at a time. 

You can consider trying 1 food daily for 3 days, starting with a small amount and increasing a little each day. 

If it triggers symptoms, leave it out of your diet for now. 

If you have a flare of gut symptoms with that food, give your gut a break for 3-5 days. 

You can get a more comprehensive guide from Monash University’s FODMAP App. 

And this book has great info on FODMAP Reintroduction: 

Re-challenging and Reintroducing FODMAPs: A self-help guide to the entire reintroduction phase of the low FODMAP diet by Lee Martin MSc RD 

Step 3:  

Add back certain high FODMAP foods to create a low histamine diet that is customized to you. 

Once you’ve figured out which FODMAPs trigger symptoms and which are safe, you can add back more foods. 

As your gut improves, you may be able to add back others as well. 

Reintroducing FODMAP foods once the gut is healed helps the gut maintain its microbiome. 

I’m still working on my gut health. But I’m improving to the point where I can eat a few more FODMAPs in moderation now.  

Are you still dealing with mystery gut symptoms? Consider keeping a food diary to see if high FODMAP foods may be triggering you! 

Do you prefer to learn by watching videos or listening? Be sure to check out this presentation about mystery digestive symptoms

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More on Mast Cells and Gut Health

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References 

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Comments

  1. Rachel Reder

    I’m a little confused. I see Rutabagas listed in Grains & Carbs without any notes next to it. Then I see Rutabagas listed in Vegetables with the note about Oxalates and 1 cup. Are Rutabagas an oxalate issue? I am sensitive to Oxalates and have been eating rutabagas because I thought they were safe. I have some ongoing issues that I’m trying to trouble shoot so I’m really wondering about the oxalates in rutabagas. Thank you for your help.

    1. Suz, Mast Cell 360 Team

      Hi Rachel,
      Thank you so much for bringing this to our attention. We do our best to provide the most clear and up to date information on foods, but we do err from time to time. I apologize for the confusion this caused. I have clarified with Beth that Rutabagas are not oxalate. Thank you again for your feedback! We do have it listed under grains and carbs and veg because we get a fair amount of inquiries for a low lectin carb source.

  2. Elaine Shipman

    Dear Beth,
    I have been following your research for a year now since allergist diagnosed MCAS/HI. Last June and August had intense unexplainable rashes over my body that looked like measles & poison ivy. What’s the genesis of that?
    It was the catalyst to seeking a functional integrative MD who did lots of tests & diagnosed SIBO along with thyroid issue, malabsorption, high iron & mercury, low manganese allergy to wheat, milk, eggs and more.I must be on thyroid rx now which is helping some symptoms like sleep. Have done an elimination diet and taking supplements to heal gut diversity. He also suggests the Fodmap eating plan. More bloodwork to check progress.
    Thank you for this TIMELY blog connecting SIBO, MCAS/histamine intolerance and clear connections.
    I am grateful to have this info to be able to partner with my doc in understanding his plans for me.
    Gratefully, Elaine in PA

    1. Suz, Mast Cell 360 Team

      Hi Elaine,
      I’m glad to hear this article appeared at the right time for you!
      Wishing you all the best!

  3. Lauren

    Hi, we have been treating our young son for gut issues for a while with a functional medicine doctor and he has been diagnosed with SIBO as well as Mast Cell Activation in reaction to gut as well as some mold issues we are treating in the house. That being said, she recommended a low Fodmap and low histamine diet so I am so grateful to find your website. However, Im very confused when reading through this list at what is and is not considered high Fodmap. For example corn is listed as a high fodmap item but then also listed as a low fodmap option? I understand about the portion control factor but could you explain this further? Thank you!

    1. Suz, Mast Cell 360 Team

      Hi Lauren,
      You are correct that a factor in FODMAPs is quantity. We’ve listed corn in high FODMAP because a typical portion — one ear/cob — will be high FODMAP. It’s a really common food often served in portions that make it fall under high FODMAP. However, at just 1/2 an ear it is considered low. 3/4 is considered moderate. 1 whole ear of corn is high. Hope this helps clarify. Thanks for your question!

      Suz, Mast Cell 360 Team

  4. Mel

    Hot peppers is listed in the low histamine and low fodmap but the on the low histamine list, its listed as a high histamine???? Noticed same thing on the low salicylates list. Paprika is listed as a high histamine but then on the salicylates, its listed as a low histamine, high salicylates food.

    1. Suz, Mast Cell 360 Team

      Hi Mel,
      I’m seeing on our Low and High Histamine foods list found here: https://mastcell360.com/low-histamine-foods-list/ that hot peppers are under low histamine. I’m also seeing it as low FODMAP at 1 tablespoon.

      For paprika, on the main list it is shown as high histamine, which is correct. I see the confusion on the salicylate page and will address this. Thank you for your keen eye!

      Suz

  5. Morten

    I was reading a studie at pubmed with patients went from high to low fodmap. Histamine levels dropped 8 times? What do you think about that?

    I’m eating AIP diet. Thinks its ok for me. But if I eat oatmeal and potatoes I will be so much inflammed,.. Believe its lectins and oxalates? 😀

    And no high histamine meats. But if the levels drops 8 times with low fodmap, is that maybe more high histamine than meat aged for some days? 😉

    1. Jamie, Mast Cell 360

      Hi Morten, It’s hard to say since we don’t know what study you are referring to, but we also are unable to provide literature reviews at this time. You may be interested in the resource section at the bottom of this blog! Histamine is produced as part of the natural digestive process so if someone is sensitive to FODMAPs their body may be producing excess histamine as a result of eating such foods. When those food sensitivities are removed from the diet, it is possible that there could be a reduction in histamine.

      Oatmeal and potatoes are typically not allowed on an AIP diet because of the grains and nightshades. Lectins and Oxalates may also be an issue but since we are not familiar with your individual case we cannot say for certain. You might find the following articles helpful for determining if lectins, oxalates, or meat may be playing a role in your symptoms:
      https://mastcell360.com/low-oxalate-diet/
      https://mastcell360.com/lectins-low-lectin-foods-and-the-mast-cell-connection-for-those-with-mast-cell-activation-syndrome-or-histamine-intolerance/
      https://mastcell360.com/meat-handling-tips-preparation-cooking-and-storage-what-to-know-for-those-with-mast-cell-activation-syndrome-or-histamine-intolerance/

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