A large part of treating mast cell disease, especially if you have significant Gastro-intestinal issues or have reactions after eating, is to follow a low histamine diet. It’s an absolute mine-field. There appears to be very few research papers or clinical trials into the histamine content in food, although I did find a link to the histamine levels in a small sample of foods on the Food Intolerance Network website. Added to that, the diets purported online can’t agree on even the most basic of food groups: some say wheat is fine so long as it’s unbleached flour and yeast free, some say no wheat. Some say bananas are fine, others say no bananas. You get the drift.
The Food Intolerance Network did a study on the reactions of over 800 histamine intolerant patients to various foods, and their results can be found here. As it states quite clearly, each individual will be able to tolerate different foods depending on where they are in the treatment of their histamine intolerance. Non-tolerated, and tolerated foods, will vary enormously from person to person depending on their individual reactions and from food to food, depending on how it’s been picked, stored and transported. It really is a game of trial and error, and there are only a very small list of foods that everyone with histamine issues reacts badly to (red wine, beer, tinned tuna, tomatoes, strawberries, oranges).
Of course, it’s more complicated than just the histamine content of food. There are also foods which are purported to block the DAO enzyme needed to ‘mop up’ histamine (eg. tea), and foods which don’t contain histamine per se but are purported to liberate histamine already in the body (eg. cocoa, nuts and some fruits). I use the word “purported” deliberately, as I’m unclear how these conclusions have been reached.
There is also the fact that you’re cutting out large groups of foods but not replacing them with much of anything. If you’ve had mast cell issues for some years your body is probably going to be in a state of utter disarray. It needs to be slowly built back up, and good nutrition is the key. I personally don’t have the time or energy to become obsessed with my diet, but I do try to buy organically wherever possible and include fresh fruit and vegetable juices. Juicing from scratch is a total faff if I’m honest, is expensive (you need a lot of produce for a small amount of juice), it assumes you already have a good juicer, and many juices are a bit like drinking medicine (!), but it’s a great way to feed your body easy to digest nutrients without having to think about complicated recipes. There are some juicing recipes on my Recipe page, or if you’d like to look into this further I highly recommend The Raw Energy Bible by Leslie Kenton. Not only are the juicing recipes in this book adaptable for a low histamine diet, but so are many of her raw food recipes.
I started off following a quite strict low-histamine diet and found I was both miserable and starving half to death. So I relaxed, and just cut out the worst offenders, however I’m aware this won’t be feasible for some people who will have to stick to a very rigid diet in order to control their symptoms.
Below is the diet I’m (loosely) following (taken from the International Chronic Urticaria Society website): This diet excludes all:
- foods with naturally high levels of histamine
- fermented food
- artificial food colouring, especially tartrazine
- benzoates including food sources of benzoates, benzoic acid and sodium benzoate
- butylated hydroxyanisole (BHA) and butylated hydoxytoluene (BHT)
Items marked with an * are considered controversial and excluded, or included, by other versions of this diet. If you want to see the kinds of foods I eat daily, click here or see my Low Histamine Shopping List page.
The List below is just a guide. No definitive list of low histamine foods exists anywhere in the world – please see my blog post on the Truth About Low Histamine Food Lists for more information on how these lists are made and how accurate they are!
THE LOW HISTAMINE FOOD LIST
Milk & Dairy
- Plain milk
- Ricotta cheese
- Mascarpone cheese
- Quark (similar to cottage cheese though thinner and made without rennet so always vegetarian friendly).
- Cream (I also include Soured Cream, which is excluded by some of the diets).
- Ice cream with allowed ingredients.
- All other cheese, particularly hard mature cheese like mature Cheddar, or aged cheese like Stilton
- *Cottage cheese
- All pre-prepared dairy products made with restricted ingredients.
- All plain, cooked egg.
- Raw egg white (found in some eggnog, hollandaise sauce and milkshakes).
Breads & Cereals
- Any pure, unbleached grain or flour (note: all flour in the UK is unbleached by law).
- Any plain, fresh bread, buns, biscuits, pizza dough with allowed ingredients.
- Home-made or purchased baked cookies, pies etc. made with allowed ingredients.
- Breakfast cereals made with allowed foods including all plain grains, plain oats and oatmeal, plain cream of wheat, puffed rice and wheat.
- Plain crackers with allowed ingredients.
- Plain pasta.
Products made with:
- Artificial colours
- Artificial flavours
- Bleached flour (not available in the UK)
- Restricted fruits
- Some jams (known as jelly in the States)
- Any food made with, or cooked in, oils with hydrolyzed lecithin, BHA or BHT.
- Commercial pie, pastry and fillings.
- Baking mixes
- Dry dessert mixes
- Pre-packaged rice and pasta ready meals.
- All pure, fresh and frozen vegetables except those listed in the restricted group.
- Aubergiene (also known as Eggplant)
- Tomatoes and all tomato products including puree and passata.
- Soy and all soy products, including soya lecithin.
- Cantaloupe melon
- Honeydew melon
- Water melon
- *Papaya (pawpaw)
- Fruit dishes made with allowed ingredients.
- Raisins, currants & sultanas
Meat, Fish & Poultry
- All pure, freshly cooked meat or poultry.
Any freshly caught, gutted, and cooked fish within 30 minutes of being caught (which realistically means no fish, unless you are a fisherman’s wife!)
- All leftover cooked meats.
- All processed meats, eg salami, hot dogs.
- All fish (except those on the allowed list) and seafood.
- All plain legumes, except those on the restricted list.
- *Pure peanut butter.
- Soy beans, including miso and tofu.
- Kidney beans (also known as red beans)
Nuts & Seeds
- All plain nuts and seeds.
- *This diet does not restrict nuts of any kind, but other diets restrict cashew nuts and sunflower seeds, whilst yet other diets restrict nuts of all varieties.
Fats & Oils
- Pure vegetable oil.
- Home-made salad dressings with allowed ingredients.
- Lard & meat drippings.
- Home-made gravies.
- All fats & oils with colour and/or preservatives.
- Hydroloyzed lecithin.
- Pre-prepared salad dressings with restricted ingredients.
- Pre-prepared gravies.
Spices & Herbs
- All fresh, frozen or dried herbs and spices except those on the restricted list.
- Curry powder
- Seasoning packets with restricted ingredients.
- Foods labelled “with spices”.
- Maple syrup
- Corn syrup
- Icing sugar
- Pure jams, marmalades, conserves made with allowed ingredients.
- Plain artificial sweeteners.
- Home-made sweets made with allowed ingredients.
- Flavoured syrups.
- Prepared dessert fillings.
- Prepared icings, frostings.
- Spreads with restricted ingredients.
- Cake decorations.
- Commercial sweets (candies).
- Baking powder.
- Baking soda.
- Cream of tartar.
- Plain gelatin.
- Home-made relishes with allowed ingredients.
- Yeast and all yeast products including marmite, vegemite & bovril.
- All chocolate and cocoa.
- Flavoured gelatin (ie jelly/jello).
- Prepared relishes and olives.
- Vinegar and anything pickled in vinegar.
- Most commercial salad dressings.
- *Quorn is restricted on some lists (I assume because it’s so commercially prepared) but other lists don’t mention it at all. I eat some Quorn (like the mince, as it only has 4 ingredients) but not other Quorn products (like the burgers or sausages) because they contain many artificial ingredients some of which, like yeast, are restricted.
- Plain milk.
- Pure juices of allowed fruits and vegetables.
- Plain and carbonated mineral water.
- Alcohol: plain *vodka, *gin, *white rum.
- Flavoured milks.
- Fruit juices and cocktails made with restricted ingredients.
- All other carbonated drinks.
- All teas.
- All drinks with “flavour” or “spices”.
- All alcohol unless on the allowed list, including beer, cider, wine.
- Non-alcoholic beer and wines.
If you want a stricter low histamine diet, try the Mastocytosis Society of Canada’s list of allowed & restricted foods, although you’ll soon notice that they allow foods my diet does not and visca versa!
My version of the above diet is quite lax at the moment but I seem to be doing relatively well on it. I don’t have the time or energy (due to my M.E.) to make everything from scratch every day. I absolutely have to be able to eat shop-bought produce, though I do choose those with as few ingredients as possible. Click on the Low Histamine Shopping List Menu tab to see the kinds of groceries I buy each week, along with ingredients for pre-prepared items.
Being as though I’m pesco-vegetarian I do worry about my protein intake, so I personally include mild fermented cheeses like Mozzarella and Mild Cheddar. I also occasionally include frozen fish like wild salmon, cod, haddock and pollock (which I figure is frozen very shortly after capture and gutting thereby reducing histamine production, whereas you don’t know how long fresh fish has been sitting around). I will also eat bread containing yeast if I’m out or at someone else’s house, and I do still drink tea – so sue me ;-).
After my Immunology appointment I’ll get some advice on whether I need to be stricter on the list of foods I should avoid.
My list of daily breakfast foods include:
- White toast (I use yeast free bread from the Village Bakery, see Shopping List for details), with butter and blueberry conserve or home-made Rhubarb jam (see Low Histamine Recipes page).
- Allowed breakfast cereal (eg. Weetabix, Cornflakes, Bran Flakes) with organic skimmed milk.
- Fresh fruit: a bowl of chopped cantaloupe melon, mango, bananas.
- Organic Porridge Oats, with skimmed milk.
My list of daily lunch foods include:
- Baked potato, or sweet potato, with ricotta cheese and sweetcorn.
- Scrambled egg on yeast-free toast.
- ‘Tesco’s’ Hummus with plain Italian breadsticks (contain yeast!) or if I have the time and energy chopped raw vegetable sticks, eg. cucumber, carrot. celery and even cauliflower.
- Home-made soup with allowed ingredients. Or ‘New Covent Garden’ Leek & Potato, or Carrot & Coriander, soups. Plus yeast-free bread.
- Soft boiled eggs with yeast-free toast ‘soldiers’ and butter.
- Sliced banana and honey on yeast-free toast.
- Egg mayo-less sandwich on yeast-free bread, plus a packet of plain ‘Kettle’ crisps or plain ‘Hoola Hoops’.
- Home-made roasted vegetables in a flour tortilla (Tesco’s ownbrand are yeast free) spread with ‘Tesco’ organic hummus.
- Organic mild cheddar cheese on toast.
- A fried egg butty (though it’s not quite the same without a good dollop of tomato ketchup!).
- Quorn ‘chicken’ deli fillets and home-made apple sauce sandwich on yeast-free bread, plus packet allowed crisps.
- Stir fried vegetables (eg. beansprouts, spring onions, carrots, courgette, peppers, pak choi) with optional Quorn deli ‘chicken’ fillets, tossed in home-made sweet and sour sauce (see Recipe page) on a yeast-free wrap. Serve hot or cold.
My list of daily dinners include:
- Home-made mushroom risotto (see Recipe page).
- Home-made lentil shepherd’s pie (see Recipe page).
- Home-made roast Quorn dinner (Quorn roast ‘chicken’, home-made Yorkshire pudding, roast potatoes, mashed potatoes, home-made apple sauce and sweet potato/carrot casserole using the juice for gravy – see Recipe page for casserole).
- Home-made roasted vegetable burritos with couscous.
- Home-made lentil macaroni bake (see Recipe page).
- Vegetable omelette plus halved baby potatoes fried in organic olive oil, or salad (no tomatoes or dressing).
- Mixed bean casserole with garlic bread topping.
- Frozen wild Alaskan salmon, with couscous and frozen peas (this is my “I’m shattered” and don’t have the energy to cook meal!).
- Stir fried vegetables and Quorn in a home-made sweet ‘n sour sauce (see Recipe page), on rice or in a tortilla wrap.
- ‘Innocent’ mango & apple juice drink, diluted with carbonated mineral water.
- ‘Pom’ pomegranate juice, diluted with carbonated mineral water.
- ‘Eden’ carrot juice.
- Freshly juiced fruit and veg juices (see Recipe page).
- Organic skimmed (fat free) milk.
- Decaff tea (yes, I know it’s forbidden but life isn’t worth living without my cuppa!!!) or Organic white tea.
- Elderflower cordial made with hot water - makes a nice substitute for tea (most packaged herbal teabags contain fruits not allowed on the low histamine diet, such as strawberries and oranges).
Condiments & Sauces:
- Blue Dragon Sweet Chilli Dipping Sauce: halleleujah this doesn’t contain tomatoes, is free from artifical colours and preservatives, and suitable for both vegetarians & vegans, however it does contain acetic acid.
- Sharwood’s Green Label Mango Chutney, which also contains acetic acid).
- ‘Tesco’s’ Organic Hummus.
Snacks & Desserts:
- Lightly salted ‘Kettle’ chips, ie. crisps.
- ‘Hoola Hoop’ crisps.
- Tesco lightly salted Tortilla Chips.
- ‘Ambrosia’ Rice Pudding dessert pot.
- ‘Tesco’ Malted Milk biscuits.
- ‘Tesco Finest’ all butter traditional Scottish Shortbread biscuits.
- ‘Botham’s of Whitby’ tea biscuits which I get at Booths supermarkets.
- ‘Uncle Joe’s’ mint ball sweets available from Tesco.
- Haagen-Dazs Dairy Vanilla ice cream.
- Carnation ‘Light’ or regular Condensed Milk.
- ‘Pataks’ pappadums.
Acetic Acid: I’m really conflicted about this ingredient. On the one hand it is, I think (!), made from a process of fermentation and is the main component in vinegar. However it is NOT vinegar, which is made by a further fermentation process. Acetic acid is naturally occurring in body fluids and plant extracts and plays a role in body metabolism. Although an E number (E260) it is not artificial and has no known contraindications to human health. It’s present in lots of commercial products, including some bread, as it inhibits mould growth and has antibacterial properties. Unless someone with much more knowledge than me can tell me I shouldn’t be eating it, it’s on my ‘allowed’ list in small quantities.
Tags: low histamine diet, low histamine foods