While I’m recovering from surgery, several other health bloggers are stepping in. Please enjoy this guest post from Claire of Through the Fibro Fog!

If people ask me whether I follow a specific diet for my chronic conditions, the reply to my answer is usually ‘a what diet?’. You see, I follow a low histamine diet, which isn’t very commonly known. You won’t see it in a magazine, or symbols for it on food packaging or a restaurant menu.

But as I have mast cell activation syndrome (MCAS), the low histamine diet is a big part of the measures I utilise to manage my condition and symptoms. So let’s talk about a low histamine diet and what it entails.

What is Mast Cell Activation Syndrome?

Mast cell activation syndrome is a condition where ‘chemicals called mast cell mediators are released too frequently or abundantly and/or in response to triggers that are not typically considered to be harmful, for example; foods or chemicals in the environment’ (Mast Cell Action).

Symptoms of MCAS can vary quite widely in individuals, with some experiencing gut issues, others headaches, flushing, itching, brain fog, nausea and at the more severe end of the spectrum, anaphylaxis.

It can be quite difficult to get a diagnosis of MCAS, at least where I live. It’s not a commonly known condition in society, and often not by doctors either. In the UK there are no NICE guidelines for the condition, meaning that gaining a diagnosis or treatment is very difficult. Sadly, some doctors deny MCAS exists, or say that it is rare and/or over-diagnosed.

How is MCAS diagnosed?

MCAS is typically treated by either an immunologist or allergist, although I have also heard of people being diagnosed by a rheumatologist or dermatologist that have a special interest in the condition.

As there isn’t an ‘agreed upon’ way to diagnose MCAS where I live, it seems to happen in different ways through different doctors. So I’ll speak about my experience, with the doctors that I saw.

The first doctor I saw, referred me for some (very expensive!) private tests that measured my histamine levels as well as other factors. We also measured my allergic response to about 20 common allergens such as dust mites and various foods, tested for dermatographism and did a tryptase test to rule out another condition called mastocytosis.

He also asked me a LOT of questions about my symptoms, when they started, triggers I noticed and so forth. I then took antihistamines for around a month to see my response to them. After the test results showed high histamine levels, the antihistamines had helped a little and with my clinical history, he diagnosed me with MCAS.

My current doctor, knowing that I had already been diagnosed, took a detailed clinical history, looked through my test results and diagnosed me also.

Mast Cell Action has a helpful guide to the typical MCAS diagnostic process that is worth a read.

What are the treatments for MCAS?

Common treatment for MCAS are antihistamines, mast cell stabilisers and, for some, supplements such as vitamin C and quercetin.

Different treatments work for different people, so you will likely need to work with your doctor to find the best treatment options for you. It can take a while to figure this out, often with some trial and error, and changing medications and doses.

What is a Low Histamine Diet?

A low histamine diet aims to reduce the amount of histamine being ingested through food. It’s often suggested for people with mast cell disorders, as well as histamine intolerance and sometimes also for conditions such as eczema, urticaria and migraine.

This diet limits higher histamine foods such as tomatoes, spinach, avocado and others, and focuses on fresh lower histamine foods. Personally, I was advised to use the Swiss Interest Group Histamine Intolerance guide by several doctors and a dietician. It gives the histamine ‘rating’ of dozens of different foods, and so you can see which ones are suitable and those you may wish to avoid. I would suggest asking a doctor or dietician for their suggestion on the histamine list they advise you to follow. I’ve seen some very strange suggestions for low histamine foods on some sites!

Can a low histamine diet help reduce symptoms?

As with many chronic illness conditions, we all respond differently to medications, diets and other lifestyle measures. I know of people who are able to manage their MCAS with diet and supplements alone, while others, including myself, need to take medication alongside the diet.

For me, it’s definitely a big piece of my treatment plan. I’ve come to learn the foods that trigger my mast cells the most (figs and alcohol are a no-go for me!), as well as happily learn that my stomach issues calm considerably when I stick to the diet.

It’s also the case that some people seem able to ‘add in’ medium histamine foods over time, as their MCAS becomes better managed through other treatments.

How do you start a low histamine diet?

It can be tricky to start the diet as it can seem so complicated in the beginning! I know I was quite lost for a while, but it led me to being creative in the kitchen and going on to share low histamine recipes on my website.

I still remember walking out of my doctor’s appointment and wondering what on earth I could eat! But seeing a dietician was really helpful, as well as following some practical tips that I’ve detailed in my ebook How to Get Started on a Low Histamine Diet.

Practical Tips for a Low Histamine Diet

Focus on the foods you can eat. It’s so easy to get caught up on the ‘forbidden’ foods on any diet, but this only leads us to feel negatively about it. Instead, make a list of all the foods you can have and will enjoy making meals with!

Break it down into categories if it is helpful. So the proteins you can have such as meats, low histamine cheeses, then starches such as quinoa, rice and potatoes, then vegetables, fruits, low histamine herbs and spices, low histamine teas and even fun mocktails. You’ll notice the list is quite long!

Figure out some easy meals. When time is tight it’s easy to just grab anything to eat. Instead, come up with some super simple meals that use food you usually have in the fridge or pantry. It will help prevent temptation to opt for a high histamine take-out!

Have snacks to hand. Whether it’s fresh fruit, suitable nuts and seeds or perhaps some energy balls, make sure to have something you can grab if hunger pangs strike!

Take your own food. I know it doesn’t seem much fun, but often taking your own prepared food when visiting friends or having an afternoon out is much easier. It’s sometimes very tricky to find fresh suitable food in cafes and it’s better to have your own than to get hungry!

Summary

Following a low histamine diet is something to ask your doctor or dietician about if you have a mast cell disorder or histamine intolerance. Whether it is alongside medications or perhaps with supplements too, it can be helpful for many with certain chronic illness conditions. It may feel tough to begin with, but you will soon get the hang of it and come to enjoy tasty and fun meals!

My name is Claire and I live in London, UK. I live with a number of chronic illness conditions including mast cell activation syndrome, Ehlers-Danlos Syndrome, Dysautonomia and Fibromyalgia. Part of managing my condition is to follow a low histamine diet and you can find tasty recipes that I share on my website throughthefibrofog.com and on Instagram @lowhistaminekitchen.