What to know about FODMAPs and SIBO if you have Mast Cell Activation Syndrome or Histamine Intolerance
Mast Cell Activation Syndrome and Histamine Intolerance are enough for anyone to deal with! And they can really affect the gut.
But did you know that something called SIBO (Small Intestinal Bacterial Overgrowth) can be a root trigger of both Mast Cell Activation Syndrome and Histamine Intolerance?
I’ve had gut issues most of my life. I was diagnosed with IBS-D (Irritable Bowel Syndrome-Diarrhea) at a young age.
I figured out early on that stress would cause severe stomach pains. And I’d be running to the bathroom multiple times a day.
But I didn’t link it with SIBO or FODMAP foods for a long time.
SIBO wasn’t really on my radar. Yet…
But, I had at least figured out I just couldn’t digest beans. Even with alpha-galactosidase enzymes (think Beano).
I still remember clearly the last time I had beans. Even though it was over 10 years ago. I was at a farm to table Mexican restaurant with some friends in Asheville.
Everything was so fresh and delicious. Especially the refried beans. I took extra enzymes, thinking I’d be ok. And ate what was on my plate.
About 6 hours later, the misery set in. Oh my! I was in so much pain. And my belly was so distending that I literally looked 6 or 7 months pregnant.
I honestly was in so much pain that I prayed to die. It was truly horrific.
Eventually, it passed (so to speak)…But I didn’t eat beans again. I can tell you that.
It wasn’t until several years later that I realized I also had SIBO and FODMAP issues.
See, I had a hydrogen water machine that I sent off for repairs. And when they returned it, it hadn’t been properly sanitized.
I didn’t know that, though. And I drank the water for 2 days. I started having significant diarrhea, bloating, and gas.
At the end of day 2, I realized it was the water. And I stopped drinking it. But the gut issues stayed with me.
I finally pieced it together when I ate half of an apple. And an hour or two afterward, my belly became massively bloated. I was in a lot of pain again.
The gas was utterly embarrassing.
And I was feeling depleted from all the diarrhea. (Some people get constipation or alternating constipation and diarrhea, instead.)
It was happening with cauliflower, broccoli, and Brussels sprouts too – many of my favorite low histamine foods. Sigh…
My Mast Cell Activation Syndrome and Histamine Intolerance had gotten much, much better up until this point. But when this all happened, I started going backwards and getting really flared.
Between the life-long bean issues and the new food issues, I put together that FODMAPs were worsening a lot of my digestive issues.
And that I couldn’t deny anymore that I had SIBO.
Many people are dealing with SIBO these days. And it’s extremely common in people with Mold Toxicity because of how they disrupt the balance in the gut.
Let’s start with looking deeper into what SIBO is…
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.
What is SIBO? What to know when you have Mast Cell Activation Syndrome or Histamine Intolerance
SIBO stands for Small Intestine Bacterial Overgrowth.
Researchers and practitioners have long thought that gut bacteria is supposed to mostly live in the large intestine. And the bacteria that’s supposed to stay in the large intestine migrates into the small intestine, causing SIBO.
But more recently, thinking is shifting away from this model. And toward the thinking that SIBO is really an imbalance of bacteria in the small intestine.
SIBO can happen from a few other problems in addition to intestinal valve issues, like:
- Gut immune imbalances that can’t keep normal bacteria in check
- Vagal nerve issues that affect motility
- Issues with the valve between the large and small intestine causing bacteria to enter the small intestine
- Low stomach acid
This imbalance of bacteria in the small intestine is one of the things that can contribute to “Leaky Gut” – damage of the gut lining. This can cause problems with nutrient absorption that mostly happens in the small intestines. And can sometimes lead to nutrient deficiencies.
When the gut lining is damaged, undigested food particles and bacteria get into the bloodstream. This activates the immune system… including mast cells.
So, this is one of the reasons SIBO can be a root trigger of Mast Cell Activation Syndrome.
SIBO is very common in Mast Cell Activation Syndrome and Mold Toxicity.
We’re going to talk about SIBO a lot more in a future blog post. But in this one, I want to talk about FODMAPs.
This is because, when you have SIBO, it can result in an intolerance to high FODMAP foods.
Let’s look at FODMAPs next…
What are FODMAPs? What to know when you have Mast Cell Activation Syndrome or Histamine Intolerance
FODMAP refers to different names of carbs in some foods that are fermentable by gut bacteria. And when bacteria ferment food, they produce gases. This is not what we want in the small intestine.
That is a big part of why they can cause bloating, gas, and gut aching. As well as diarrhea and/or constipation for some people.
Numerous studies have shown that FODMAPs can be a big trigger for IBS (either the constipation or diarrhea kind).
FODMAP is an acronym that stands for:
- Oligosaccharides (oligo – “few,” saccharide – “sugar”)
- Disaccharides (“two sugars”)
- Monosaccharides (“one sugar”)
Let’s look at what each of these are.
Oligosaccharides are carbohydrates made up of what are called “oligo” sugars. That’s “a few” sugar molecules linked together. These are in foods like:
- Onion, garlic, wheat, rye, beans, lentils
- Powdered prebiotics like Fructooligosaccharides (FOS) and Galactooligosaccharides (GOS).
- Yacon, which is a sweetener
- Agave is another sweetener that contains FOS.
- Swerve sweetener (erythritol + oligosaccharides)
Disaccharides are carbohydrates made up of two sugar molecules. Examples include:
- Regular white sugar (and brown sugar)
- Sour cream
- Cream cheese
This is a part of having lactose intolerance. Lactose intolerance is one of the most common FODMAP issues.
Monosaccharides are carbohydrates made up of one sugar molecule. Common examples include:
- High-fructose corn syrup
Polyols include sugar alcohols like sorbitol, mannitol, xylitol, and erythritol. Examples include:
- Diabetic or low carb candies or other sweets
- Mannitol and Sorbitol – artificial sweeteners
- Low carb sweeteners like Swerve
- Pitted fruits: like cherries, peaches, and plums.
- Also, cauliflower and pumpkin
You can have trouble with just 1 or 2 FODMAP categories. Or with all of them, like I did.
Now you know what FODMAPs are. And that they can cause problems for SIBO, Mast Cell Activation Syndrome, and Histamine Intolerance.
But, why exactly is that? And which low histamine foods do we need to watch out for?
That’s up next…
High FODMAP Foods: What to know when you have Mast Cell Activation Syndrome or Histamine Intolerance
If you have Mast Cell Activation Syndrome or Histamine Intolerance, you probably know the gut plays a major role.
FODMAPs impact the gut in a few different ways:
- They cause water retention in the small intestine
- They increase gas and bloating
- They cause inflammation in the gut
They can cause that valve between the small and large intestines to stay open because of the bloating that can occur.
And you learned earlier, this can increase SIBO issues…Which can increase leaky gut… which can cause inflammation and immune activation, including Mast Cell Activation.
So how can you know if you have FODMAP Intolerance?
So, for some people it can really help to cut back on FODMAP foods for a while. That way, the mast cells can calm down. And you’re setting your gut up to recover.
I’ve found that when I stopped eating high FODMAP foods, after 3 days my bloating, gas, and gut aches were dramatically better.
And some people have told me they noticed a difference in just 2 days. Whereas others said it took about 5-7 days.
BUT…here’s an important note: you don’t want to avoid FODMAPs forever.
They should be reintroduced gradually at some point. This is because they also help maintain a healthy gut balance.
Now, let’s look closer at where we find FODMAPs in the diet.
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.
And honey is one other animal product that you may need to temporarily avoid, if you have trouble with the FODMAP fructose.
Here are some high FODMAP foods you may still be eating when consuming a low histamine diet.
GRAINS & CARBS
- Almond meal
- Barley including flour
- Bran cereals
- Chestnut flour
- Coconut flour
- Corn (1/2 cob is low, 3/4 a cob is moderate, 1 full cob is high fodmap)
- HI-MAIZE® resistant starch
- Some gluten free breads
- Some gluten free pasta or crackers
- Beets and beetroot
- Broccoli stalks (heads are okay)
- Broccolini heads (stalks are okay)
- Brussels sprouts
- Butternut squash
- Cassava (more than ¼ cup)
- Celery (more than 5cm of stalk)
- Leek (white bulb)
- Lotus root, dried (frozen is okay)
- Savoy cabbage (over ½ cup)
- Scallions/Green onions (white part)
- Split peas
- Snow peas
- Honeydew melon
- All beans
- Lentils (green and red are slightly better)
NUTS & SEEDS
- Brazil Nuts
- Chicory-based sweeteners
- Fructooligosaccharides (FOS)
- High fructose corn syrup
- Sugar alcohols (Including erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol)
- Swerve sweetener
MILK & DAIRY
- Cream cheese
- Evaporated milk
- Goat milk
- Halloumi cheese
- Ice cream
- Plain A2 cow milk
- Ricotta cheese
- Sheep milk
- Sour cream
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! Don’t worry.
There are plenty of great low FODMAP, low histamine options.
Low FODMAP, Low Histamine Foods: What to know when you have Mast Cell Activation Syndrome or Histamine Intolerance
One of the tricks to managing FODMAPs is controlling quantity. But, these are just guidelines.
Serving size listed next to foods is max generally tolerated by people with FODMAP sensitivities. Everyone is different.
If a serving size isn’t listed, people usually tolerate larger amounts of those foods. But again, you have to find out for yourself.
You may find that your gut can handle more or may not be able to handle this much.
Note – this list is primarily about FODMAP foods that are low in histamine. High histamine foods have been omitted. High oxalate and lectin foods are noted below.
For more foods and details, we can 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.
GRAINS & CARB SOURCES
- Blanched almond flour (¼ cup) – VERY high oxalate
- Buckwheat – High oxalate
- Buckwheat flour – High oxalate
- Buckwheat noodles – High oxalate
- Corn – ½ cob – Lectin
- Hazelnut flour (¼ cup) – High oxalate
- Millet – High oxalate
- Oatmeal (½ cup) – High oxalate
- Plantain (1 medium peeled) – High oxalate
- Popcorn – Lectin
- Potatoes (½ medium) – Lectin, Oxalate
- Quinoa – Lectin, High oxalate
- Rice: brown, white, basmati (1 cup cooked) – Lectin
- Rice noodles – Lectin
- Sorghum: black, white, popped (1 cup cooked)
- Sweet potatoes (½ cup) – VERY High oxalate
- Turnips (½ cup)
- Artichokes (½ cup) Med-high oxalate
- Bean sprouts – Med oxalate
- Beets – 2 thin slices – VERY high oxalate
- Bok choy
- Broccoli, whole (¾ cup)
- Broccoli, heads only (¾ cup)
- Broccoli, stalks only (⅓ cup)
- Broccolini, whole (½ cup chopped)
- Broccolini, heads only (½ cup)
- Broccolini, stalks only (1 cup)
- Brussels sprouts – 2 sprouts
- Butternut squash (⅓ cup) – Lectin
- Cabbage: green/white cabbage or red cabbage (¾ cup) and Chinese/Napa cabbage (½ cup)
- Collard greens
- Cucumber – Lectin
- Daikon radish (½ cup)
- Green beans – Lectin – High oxalate
- Herbs: basil, chives, cilantro, mint, Italian parsley
- Kale, Flat-leaf (aka Lacinato or dinosaur kale)
- Kale, Curly – High oxalate
- Leafy greens: arugula (½ cup), bok choy (1 cup), butter lettuce, collards, dandelion greens, endive, iceberg lettuce, mesclun, mizuna, mustard greens, perilla, radicchio lettuce, red & green leaf lettuce, romaine lettuce, watercress)
- Leek: green tops only
- Nopales cactus – High oxalate
- Okra – High oxalate
- Peppers: bell or hot (½ cup) – Lectin
- Potatoes, red or new ½ cup – Lectin (all other high oxalate)
- Rhubarb – VERY High Oxalate
- Rutabaga (1 cup)
- Scallions aka green onions (tops only, no whites)
- Seaweed or nori
- Snow peas (5 pods or less)
- Squash: spaghetti (½ cup) – Lectin
- Squash: summer (⅓ cup) – Lectin
- Squash: winter – Lectin
- Squash: yellow – Lectin
- Swiss chard (VERY high oxalate)
- Sugar snap peas (4 pods or less) – Oxalate
- Sweet potato (½ cup) – VERY high oxalate
- Yam – VERY high oxalate
- Zucchini (⅓ cup) – Lectin
- Cantaloupe (¾ cup) – Lectin
- Cranberries (1 Tbsp)
- Guava – VERY high oxalate
- Honeydew melon – Lectin
- Kiwi (2 small) – High oxalate
- Lemon (½ tsp – not always tolerated in elimination)
- Lime (½ tsp – not always tolerated in elimination)
- Mango (¼ cup)
- Passion fruit (2 fruits)
- Papaya – High oxalate
- Plantain (1 medium peeled) – VERY high oxalate
- Pomegranate (¼ cup) – High oxalate
- Raspberries (¼ cup – not always tolerated in elimination)
- Rhubarb – VERY high oxalate
- Black beans (¼ cup) – High oxalate
- Lentils, especially black lentils (higher in lectin, so use in moderation – soaked overnight and pressure cooked, 1/4 cup)
NUTS & SEEDS
- Almonds (10 nuts) – VERY high oxalate
- Brazil nuts (10 nuts) – High oxalate
- Chestnuts, roasted (10 chestnuts)
- Chia seeds (2 tablespoons) – High oxalate
- Coconut cream (1/4 cup)
- Coconut meat, fresh (⅔ cup)
- Coconut milk (3/4 cup, 100% coconut milk only, without additives)
- Flax seeds (1 tablespoons whole, ½ tablespoon flax meal)
- Hazelnuts (10 nuts) – High oxalate
- Hemp protein powder (2 tablespoons) – High oxalate
- Hemp seeds (2 tablespoons) – High oxalate
- Macadamia nuts (20 nuts) – Medium oxalate at 10 nuts
- Pecans (10 halves) – Medium oxalate at 10 halves
- Pine Nuts (1 tablespoon) – High oxalate
- Poppy seeds (2 tablespoons) – High oxalate
- Pumpkin seeds (2 teaspoons) – Lectin
- Sesame seeds (1 tablespoon) – High oxalate
- Sunflower seeds (2 teaspoons) – Lectin
- Coconut sugar (1 teaspoon)*
- Pure jams, jellies, and marmalades made with allowed ingredients (mango, pomegranate, or raspberry and no sugar)*
- Stevia or monk fruit are the best choices
*I always recommend limiting sweeteners
MILK & DAIRY
- Butter (1 tablespoon)
- Ghee (1 tablespoon)
- Almond milk – (1 cup) VERY high oxalate
- Hemp milk – (1/2 cup) High oxalate
- Macadamia milk – ( 1 cup) check for additives
- Rice milk (3/4 cup) – Lectin
- All unseasoned, low histamine meat, poultry, and fish
HERBS & SPICES
- Basil (1 cup)
- Bay leaves (1 leaf)
- Cilantro (1 cup)
- Coriander ( 1 cup)
- Curry leaves ( 1 cup)
- Fennel seed (1 teaspoon)
- Fenugreek (2 tablespoons)
- Lemongrass (1 x 10 cm stalk)
- Mint (1 bunch)
- Oregano (1 teaspoon)
- Italian leaf parsley ( 1 cup)
- Rosemary (1 cup)
- Sage (1 bunch)
- Tarragon (1 cup)
- Thyme (1 cup)
- Cardamom (1 teaspoon)
OILS & FATS
- Avocado oil (1 tablespoon)
- Coconut oil (1 tablespoon)
- Lard (1 tablespoon)
- Olive oil (1 tablespoon)
- Rice bran oil (1 tablespoon)
- Sesame oil (1 tablespoon)
- Tallow (1 tablespoon)
- Baking powder
Now that 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!
Lowering FODMAPs may help gut issues like bloating, gas, diarrhea, constipation, gut discomfort, leaky gut.
How lowering FODMAPs may help the gut: What to know when you have Mast Cell Activation Syndrome or Histamine Intolerance
If you have Mast Cell Activation Syndrome or Histamine Intolerance and gut issues, this information may be a game changer for you.
Why? Because many gut symptoms have been associated with an intolerance to high FODMAP foods.
Avoiding higher FODMAP foods for a time may allow the gut to recover.
At least to the point that gut symptoms like loose stools, hard stools, gas, bloating, and abdominal discomfort may significantly improve.
Do you have to avoid high FODMAP foods forever? Fortunately, no!
Next, I’ll explain why.
But first, be sure you’re working with your healthcare practitioner. Everyone is different. You need to make sure you are meeting the needs of your body. And ruling out other things that may be affecting you.
Also, it’s important to work on swapping out foods instead of continually reducing foods, under the guidance of your healthcare practitioner.
It’s not good to stay low FODMAP forever.
Reintroducing FODMAPs: What to know when you have Mast Cell Activation Syndrome or Histamine Intolerance
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 extremely important for brain health. They are also anti-inflammatory. 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, this post is for informational and educational purposes. It’s not meant to treat any health condition or to be prescriptive for anyone.
Please be sure to work with your healthcare practitioner.)
This can allow gut irritation to be reduced. And for the gut to start to recover.
This is especially important for Mast Cell Activation Syndrome and Histamine Intolerance because the whole GI tract is lined with mast cells.
If you’re irritating mast cells, look out! You’re going to be producing all kinds of histamine.
But after you’ve given the gut a break and lowered gut irritation, it’s usually time to start reintroducing some of these healthy foods.
Here’s are some Step-By-Step Options for Reintroducing FODMAPS:
Step 1: Try the Low FODMAP Diet for 2-6 weeks (until symptoms improve and your healthcare practitioner recommends reintroduction).
Step 2: Start reintroducing FODMAPs by challenging each FODMAP group separately. The FODMAP groups are fructose, lactose, sorbitol, mannitol, fructans, and GOS.
People with Histamine Intolerance or Mast Cell Activation Syndrome may need to work with a qualified healthcare practitioner to target low histamine options.
Only reintroduce one FODMAP food from the group at a time.
People usually try that food daily for 3 days, starting with a small amount and increasing a little each day. They then see if they can tolerate it.
If it triggers symptoms, though, they leave it out of their diet for now.
If you have a flare of gut symptoms with that food, you would generally then 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:
Step 3: Add back certain high FODMAP foods to create a low histamine diet that is customized to you.
Basically, once you’ve figured out which FODMAPs trigger symptoms and which are safe, you can add back more foods.
As the 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.
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: What to know when you have Mast Cell Activation Syndrome or Histamine Intolerance
While you’re eating low FODMAP, you’re not going to be producing as many of those SCFAs (Short Chain Fatty Acids). Which are extremely important for healing.
That’s where taking a SCFA supplement can help.
There are actually a lot of different SCFAs. They have names like acetate, propionate, and butyrate. The most important and beneficial SCFA by far is butyrate.
Butyrate supports the gut in a number of ways, as it…
- Improves tight junctions to promote healing in leaky gut
- Improves the mucus layers (again, 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 that HI-MAIZE® is high FODMAP.
Now, if you don’t have problems with FODMAPs, HI-MAIZE® is fine. And it’s low in 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 that you might also be interested in.
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 and colonization.
But it took addressing the mold toxins for my gut to improve – it’s a journey and there aren’t usually quick and easy solutions. But, the Tributyrin-X was one of those keys for me that I wanted to share with you.
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 from FODMAPs.
Many people with Mast Cell Activation Syndrome and Histamine Intolerance have tried Tributyrin-X™ with success.
Not only were they able to tolerate Tributyrin-X™… it actually helped them tolerate more foods!
This has been shown in food allergy studies, as well.
It turns out that butyrate has mast cell stabilizing properties
How long until you see results? You will likely notice some positive changes within a few days of starting. Most people notice changes within 3 days!
After 7 days, they report even more improvement.
By 14 days, they are feeling vastly better. 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.
Tributyrin-X™ is a 99.9% pure tributyrin liquid. This means there are no fillers or additives. That’s great news for many with Mast Cell Activation Syndrome or Histamine Intolerance.
You can read about it next here:
The Best POST-biotic Butyrate for Mast Cell and Histamine Supports
Or you can Get Tributyrin-X™ Here
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 this site, addressing gut health is essential when you have Mast Cell Activation Syndrome or Histamine Intolerance!
Curious about other supplements for supporting Mast Cell Activation Syndrome and Histamine Intolerance?
Sign up for my supplements masterclass below:
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References on FODMAPS and Mast Cell Activation Syndrome or Histamine Intolerance
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Cox, S. R., Prince, A. C., Myers, C. E., Irving, P. M., Lindsay, J. O., Lomer, M. C., & Whelan, K. (2017). Fermentable Carbohydrates [FODMAPs] Exacerbate Functional Gastrointestinal Symptoms in Patients With Inflammatory Bowel Disease: A Randomised, Double-blind, Placebo-controlled, Cross-over, Re-challenge Trial. Journal of Crohn’s & colitis, 11(12), 1420–1429. https://doi.org/10.1093/ecco-jcc/jjx073
Edelman, M. J., Bauer, K., Khanwani, S., Tait, N., Trepel, J., Karp, J., Nemieboka, N., Chung, E. J., & Van Echo, D. (2003). Clinical and pharmacologic study of tributyrin: an oral butyrate prodrug. Cancer chemotherapy and pharmacology, 51(5), 439–444. https://doi.org/10.1007/s00280-003-0580-5
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