Tag Archives: low histamine foods

Food Histamine Q&A

Someone obviously very new to the world of histamine in foods asked a question on my blog recently and it took me right back to when I was first really ill and totally confused and bewildered about the whole subject.  I’d barely heard of Histamine Intolerance when I was diagnosed and little of what I read online made sense.  All the low histamine food lists differed from one another and no-one seemed to be able to tell me exactly what to do or what to eat to get myself better.  So I thought I’d do a post of the questions I had 5 years ago in the hopes it helps my readers new to the world of histamine intolerance.  Bear in mind this is just my personal opinion based on my experience and research which I have read – I am not the Oracle of all things histamine and just a (still) bewildered patient alongside the rest of you.

Q. Why are all the lists different?  Why are some more strict than others?
A. All the low histamine food lists online are based mostly on the personal opinion of the Author.  No spice, food preservative, food additive, citrus fruit, chocolate, tea leaf, herb or much of anything else has been tested for its histamine content.  In fact, only a handful of foods (mainly fish, soya, sauerkraut, aubergiene/eggplant, dairy) have been tested for their histamine content, so the lists are mostly pure speculation.  I know that’s not what you want to hear, but it’s true.

Q. Is pak choi/vodka/lentils/bagels/insert-your-food-of-choice-here high in histamine?
A. I have no clue and neither does anyone else.  That’s because it hasn’t been tested for its histamine content.  Even foods thought to be high in histamine, eg. cheddar cheese, will differ depending on how it was produced, stored or transported.  A certain brand of cheddar cheese in Italy may test lower, or higher, than another brand of cheddar cheese in America.

Q. So which low histamine food list should I use?!
A. It’s entirely your personal choice.  None of them are THE definitive food list because that doesn’t exist.  My advice would be to choose a list you think you can stick to, give a go for 4-6 months and see if it helps.

Q. Does the cooking method affect the food’s histamine content?
A. There was a recent study showing that frying and grilling specific types of food increased its histamine content, whereas boiling sometimes decreased it.  However, it depended on the type of food.  Eggs, for example, showed little rise or fall in histamine regardless of how they were cooked but fried vegetables had more histamine than raw vegetables.  As with all things histamine it’s not as simple as fry or don’t fry, boil or don’t boil.  It’s not something I personally worry about.

Q. Why can’t I eat leftovers?
A. It’s the freshness of food which affects its histamine content.  The older the food, the more histamine it has.  So 2 day old leftovers are going to be higher in histamine than fresh food cooked and eaten on the day it’s bought.  At least that’s the theory, but again it’s not that simple.  Who knows whether “fresh” unripe bananas picked in the Caribbean, taken on an open truck in forty degree heat to a warehouse, sorted, repacked onto another truck to go to the docks, travel in an unfridgerated container for a week to reach England, put on another truck to a warehouse, then forwarded to Tescos in Preston, then packed in the boot of your car for an hour as you drive home, then sat in a fruit bowl for three days before you eat them are going to be lower in histamine than chicken soup you made yourself yesterday but have reheated?!

Q. Does refrigeration affect histamine levels?
A. Most of the research on this has been done on fish.  Little is known of the effect refrigeration has on eggs or carrots for example.  However, from the limited research refrigeration slows down histamine formation.  But if the food already contains histamine, eg the banana example above, it won’t reduce it.

Q. Does freezing affect histamine levels?
A. Freezing is the only thing which halts histamine formation.  However, it doesn’t destroy histamine which has already formed.  So if you freeze a week old uncooked chicken breast which already contains high levels of histamine the histamine will still be there.  My advice would be to freeze foods as soon as you buy them or freeze meals as soon as you’ve cooked them, then cook from frozen whenever possible or at least cook or eat as soon as they’ve defrosted.  I never defrost stuff for hours overnight in the fridge, preferring to defrost at room temp for 1-3 hours then cook and eat.

Q. What about histamine levels of canned foods?
A. As far as I’m aware no tinned goods have been tested for their histamine content and in any event it would probably depend on the type of food and how it had been stored and prepared prior to canning.  I guess tinned goods are on the ‘excluded’ lists of low histamine diets because they contain preservatives (which haven’t been tested for histamine either!) and because they’re considered ‘old’ and assumed to be high in histamine, but it is just an assumption.  The truth is no-one knows.  I eat tinned beans and don’t react to them in any way, but that’s just me.

Q. What about dried goods, eg. pasta.
A. Again, they haven’t been tested for their histamine content so no-one knows.

Q. What’s the deal with histamine liberators?
A. Histamine liberators are irrelevant in histamine intolerance as HIT involves DAO and HNMT not mast cell activation per se.  However, I know many people with mast cell disease also follow a low histamine diet, which is why I’ve included this question.  There is no such thing as a histamine liberating food as far as we know.  No research has been conducted that shows any particular food liberates histamine stored in mast cells.  This includes egg whites and stawberries.  Which doesn’t mean to say you don’t have a reaction to a food, but that it’s your immune system which is over-reacting to a harmless substance and nothing intrinsic in the food itself which causes a reaction.  I react badly to apples, for example, because I have a birch pollen allergy and they are related – it doesn’t mean apples are histamine liberators.  I take no notice whatsoever of information online which tells me some food or other is a “histamine liberator” and will continue to do so unless it’s proved otherwise through research.

I’m sure you’re now thinking “well what the hell do I eat and how can I know it’s low in histamine?!”.  The fact is the whole low histamine food area is a very very complex subject with so many variables it makes your head spin.  There is no easy “eat this and don’t eat that” solution, I wish there were.  The histamine content of any particular food depends on so many things including its age and the way it’s been picked, handled, transported, processed and stored.  It will differ from food to food.  A button mushroom in China may differ in its histamine content compared to a button mushroom in Wales.  Strawberries picked out of your garden will differ from strawberries imported from Israel.  And so on ad nauseum.

Nearly every article online about HIT refers to the same single research paper.  However, the paper is fundamentally flawed as explained in my Histamine in foods: the evidence page.  For example, it lists egg whites as a histamine liberator based on a worthless solitary study of animals in 1956 which was never published or replicated let alone tested on human beings.  Yet this has gone viral and now everyone treats it as fact when it is anything but.  The truth is the research evidence on the histamine content of food is poor and much of it is decades old – there were no refridgerated lorries in the 1950s.  In fact there were hardly any fridges in the 1950s.  We have come a long way in the last 70 years in how we pick, transport and store food which is why research needs to be up-to-date.

However, there is hope on the horizon.  A home testing kit is being developed in Germany which will enable us to precisely measure histamine in food.  This is the only way we will know for sure how much histamine is in the actual food we’re eating and it can’t come soon enough.



No time to cook

It’s been some considerable time since I wrote anything diet/food related on my blog, so I thought I should explain why.  When my MCAD finally exploded back in 2012 I was having anaphylaxis every time I ate anything and sometimes after just drinking water.  I have never been so terrified in all my life and honestly thought I would die, especially as the Doctors I saw just looked at me like I was nuts and told me it wasn’t possible.  I was given diagnoses like gastritis and IBS, which I knew were absolute bullshit but I was told “it’s not cancer” and I should be grateful, then just left to get on with it.  Thank God for the internet and eventually receiving my MCAD and HIT diagnoses from Dr Seneviratne.

For the first two years following my diagnoses I was naturally obsessed with food.  I spent months wading my way through the information online on low histamine diets, adapting recipes to be low in histamine, experimenting and finally finding a plan I could stick to and which (on the whole) controls my symptoms.  I am so grateful to no longer pass out after I have a meal I can’t even tell you, though I’m not always symptom free.  That’s because my mast cells react to a whole host of things other than food, so it depends on any one day how full my histamine bucket is as to whether the mere act of digestion (which produces histamine!) sets off a reaction or not regardless of which food I’m eating.  But the symptoms aren’t anywhere near as extreme as they used to be and, although still not pleasant, are liveable with.

After my condition stabilized I really began investigating low histamine foods and made the shocking discovery that hardly any foods have been tested for their histamine content and every diet online is based, for the most part, on guesswork.  It rocked my world really because my life depends on keeping histamine at bay, yet the information on which I was basing my diet couldn’t be trusted.  I could still be eating ‘safe’ foods which are nothing of the sort and may have been cutting out foods, like egg whites, for absolutely no good reason!  What a bloody nightmare.  So I began experimenting again and discovered I don’t react to baker’s yeast, small amounts of lemon juice, vinegar, stone fruits or fresh berries though chocolate is still off the menu *sob*.

By now it’s 2016, I’m in peri-menopause and am having to contend with extra symptoms on top of the dozens I already have.  My Mum has been diagnosed with severe COPD and Emphysemia, is in heart and kidney failure and has become an alcoholic, while my Dad is in the early stages of Dementia.  They both need help with daily living and the job has fallen to me (quite why it hasn’t fallen to my 3 healthy brothers, their wives or adult children, three of whom ironically work for Home Care Agencies, is another story).  It’s hard enough keeping my own life and home going and I’m finding keeping two homes and three lives going tough.  I’m so busy I meet myself coming back, then am so exhausted from all the extra work and my rampant hormones I literally can’t think straight.

These days I no longer have the time or energy to spend hours in my kitchen thinking up and experimenting with new recipes.  In fact, I spend one day a week cooking then shove what I’ve made in the freezer as I don’t have the time or energy to cook myself dinner every day, let alone anything extra.  In any event, I’ve become quite disillusioned with ‘low histamine’ diets because neither I, nor anyone else, have any idea of the histamine content of individual food items and I now use all sorts of ingredients in my dinners which would cause outrage if I were to put them online.  For example, this week I happened to be in Sainsburys and bought 2 jars of pre-made sauces – don’t fall off your chair in shock 😉  One contained concentrated lemons and the other contained additives!  I know for a fact I won’t react to either, yet if I put them on my low histamine shopping list I’d be crucified, because according to the lists online they contain things I shouldn’t be eating.  Only of course no-one knows if I should be eating them or not because they haven’t been tested for histamine – try telling the low histamine zealots that though!  Obviously my ‘low histamine’ diet has helped my symptoms enormously so obviously some foods are higher in histamine than others, but whether I needed to have cut out all the foods I have is anyone’s guess.  My reduction in symptoms might literally be down to cutting out spinach, cheddar cheese and fish and I’ve been unnecessarily cutting out 30 other foods for no good reason.  Or it might be that I absolutely have to cut out 30 foods in order for my diet to be low in histamine.  I have no idea and neither does anyone else.

According to people like the Low Histamine Chef and others I shouldn’t be eating low histamine anyway, but I should be eating anti-inflammatory.  Only there’s about as much robust evidence for anti-inflammatory diets as there is for low histamine diets.  Point me to the research on people, not rats, that measures inflammation after ingesting a particular food and I might change my mind.  Only of course it doesn’t exist.  It’s as impossible to measure inflammation in our bodies after we’ve eaten a specific food as it is to measure histamine in our bodies after we’ve eaten a specific food.  It’s all such bullshit yet is talked about by these self-proclaimed ‘experts’ as fact.  And just because they include research references at the end of their articles doesn’t make it fact either.  Does anyone actually read the research?  Is it a properly conducted, double blind, randomized, controlled trial which has been peer reviewed and published in a nutritional journal?  Because if it’s not it’s not worth the paper it’s written on.  When I was investigating low histamine foods, I discovered that the only reason egg whites were included in low histamine food lists is because of a tiddly trial done on mice in the 1950s, which was never reviewed or published.  The way food was made and stored in the 1950s bears no resemblance to the way food is made and stored in 2017, so quite why this pseudo half-experiment is quoted as fact in the low histamine world astounds me.  All this stuff plays on the absolute desperation of very sick people and it makes me furious.

It extends beyond the world of histamine though.  For years saturated fats were ‘bad’ for us as they raised cholesterol and gave us heart attacks, until it was discovered that actually heart disease is a much more complex issue, trans fats were much more unhealthy than saturated fats and the jury is still out on how big a role saturates play in plaque formation.  Then salt was bad for us, until it was discovered that eating too little might be as bad as eating too much, though again the debate rages on.  Now it’s sugar that’s the demon, until in 30 years time it will be discovered that without sugar our energy levels are half what they used to be or some other such nonsense.  If we’re honest, we know very little about digestion, diet and the impact what we eat has on our health, and I suspect genes and how we as individuals process food will turn out to be the determining factor for health, rather than the foods we eat per se.

I admit I’m no expert on food and the information here on my blog is simply based on my own thoughts and experience.  And my experience is that I am currently managing my symptoms OK with the diet I choose to follow and, due to changing circumstances in my life, I no longer have the time or energy to experiment with new recipes particularly when I’m not even convinced they are low histamine as I have no evidence to back that theory up.  So apologies to anyone reading my blog and hoping for loads of inspiring recipes and foodie facts.  Having said all that, I hope the information and recipes listed in the menus at the top of my site are useful in your own journey through the histamine maize and at least it’s all free and I’m not making money off the back of other people’s suffering.


Before my stay-cations in September and at Christmas I spent a few days making and freezing meals so that I could have a holiday from cooking.  It was so wonderful not to have to spend each morning preparing food that I thought “I should do this all the time!”.  I have no idea why it hasn’t crossed my mind before, numpty that I am.

I’m now spending one full morning a week cooking and freezing and the other 6 days a week resting more.  It’s heavenly.  I admit the morning I make the food is fairly tortuous – standing for any length of time makes me feel particularly shite and my back and hands are screaming for mercy by lunchtime to the point where I can barely unzip my jeans for a pee but it’s worth the pain and exhaustion to have the rest of the week off.

Some meals I can then cook from frozen, while others I defrost at room temperature for a couple of hours, or overnight in the fridge, first.  I avoid this as much as I can, as histamine rises during the de-frosting period, but some meals simply don’t do well cooked straight from the freezer.  As well as food, I’m also making smoothies for the week in individual portions and freezing these, defrosting them each day.  It’s probably better in histamine terms to do that, freezing the fresh fruit as soon as I buy it, than having it sit in the kitchen for days on end before using it.

Main meals which freeze well include:

  • Lentil Dal
  • Nutroast in individual slices
  • Burgers
  • Shepherd’s pie
  • The base of a Cobbler (I then make the dumplings on the day)
  • The base of a Lentil Bake (I then make the topping on the day)
  • Chickpea cakes
  • Meatloaf
  • Lentil loaf
  • Macaroni cheese
  • Bean casseroles

though you do have to make the tomato-free sauce which goes in some of these recipes from fresh on the day- you can’t make it in advance, freeze it, defrost it, put in the meal then refreeze.

Lunch recipes which freeze well include:

  • Mushroom pate
  • Lentil spread
  • Pasties
  • Most soups
  • Leek puffs
  • Baked beans
  • Flans

Other things I freeze are:

  • Pesto
  • Jars of red pepper or tomato-free sauce (full jars, half jars and in tablespoons)
  • Oven chips
  • Chopped veg ready for casseroles etc.
  • Bread
  • Biscuits
  • Fudge
  • Carob chips
  • Flapjack
  • Salsa
  • Stock
  • Chilli dipping sauce

When I have time I’ll add the freezing instructions to each of my recipes.

Speaking of recipes, I made some Ginger Snaps this week that were an absolute doddle and only took 15 minutes from start to finish.  They were so delish the first 2 batches didn’t even last long enough for me to take a photo 😉  They are in no way nutritious but isn’t that the whole point of treats?  Recipe on the Desserts page.

The Truth About Histamine in Foods

As regular readers know, for several weeks (it feels like forever!) I’ve been trying to work out the accuracy of the Low Histamine Food Lists found online.  What I discovered was really shocking.  The fact is, there is virtually no reliable data on which to base any kind of Amine-related food list and it appears that most lists are based on hunches, speculation or research so old the authors are dead.  It may turn out that these hunches are absolutely accurate: nutmeg really is high in histamine and so are pumpkins.  Or it might turn out that we’ve all been avoiding these foods for absolutely no good reason.

The whole subject of histamine is really quite complex.  What started out as a single article turned into an entirely new section of my blog called ‘Low Histamine Food Info’ which contains several new pages – just hover over the tab in the menu and you will see the pages listed.

If you’re feeling lazy and want direct links to the new pages here you go:

Please Read This First!

What is Histamine?

Diet & Histamine Intolerance

Diet & Mast Cell Disease

Histamine & Food: The Evidence

Histamine & Drugs (which is still being written, bear with me I’ll let you know when it’s available)

These pages are then followed by the existing Low Histamine Food List and Low Histamine Shopping List pages which remain largely unchanged.

I stress that the information in this new section isn’t exhaustive – there are a couple of companies which test for amines in food which I don’t have access to (although I question their accuracy) so I’ve only looked at free research which can be found online.  It is also only a personal interpretation of the data and I don’t claim to be any kind of expert at deciphering statistical analysis.  I’m just a sick girl, lying in my bed going round in circles trying to work out what any of this stuff means 😉

So, my friends, knock yourself out and have a read.  I’ll be interested to hear what you think and if you can add anything to the information please do let me know.

I’m still baffled

This week I had yet another delightful comment on my Recipe page basically saying that my site was a joke.  How on earth can I call my recipes low histamine when they contain mushrooms, chillis and lemon juice?! (with an excalamation mark just to shove the point home).  I was not amused, particularly as the writer had obviously not afforded me the courtesy of actually reading my blog.  The Read This First! page in the Low Histamine Food section, and the links contained therein, explain the information my food choices are based on and if you can’t be arsed to read it before mouthing off you’re just being  rude.

I’ve also had a, thankfully much nicer and more polite, comment from SIGHI (the Swiss Interest Group on Histamine Intolerance) informing me that their cookbook has now been translated into English.  I had a look through the excerpt on their website and it’s obviously taken a lot of hard work and is very professional – I’ll add the details to the Links & Resources page when I get the chance.

If you look at the start of the cookbook it lists allowed and excluded foods, some of which differ from those on other low histamine food lists, the list I follow included.  The whole histamine in food thing still baffles me and I know baffles most of you all too.  Here’s the rub: I can find hardly any research on the histamine content of foods, the exception being fish where scombroid poisoning is well documented.

The list I follow was written by Dr Joneja, a world leading researcher on histamine intolerance, so at least has some validity.  The person who told me this week that my site was laughable because I included mushrooms so far hasn’t produced any research to back up their claim that fungi are high in histamine. Barcelona-based nutritionist Adriana Duelo, whose work is regularly submitted to the prestigious Spanish Society of DAO Deficiency  (of which she is also a member) , has tested mushrooms however and found they contain zero to 1.8mg/kg of histamine which is about the same as fruit juice and less than swiss chard or rice.  Having said all that, some people can’t tolerate mushrooms just like I can’t tolerate apples, which are also very low in histamine.

And therein lies another rub: we don’t all have the same immune system malfunctions.  There are people with allergies.  There are people with intolerances, eg to tyramines, salicylates, oxalates, nightshades, gluten, lactose.  There are people with low or inhibited DAO &/or HNMT.  There are people with mast cell disease.  And there are people with immune system problems which don’t fit any of the aforementioned categories.  And although histamine is implicated in all of these illnesses the mechanisms by which it causes symptoms, and the treatment needed, will differ widely.  It is also, in some cases, only a small part of an overall immune system picture.  In MCAD, for example, when mast cells degranulate they produce around 30 mediators – why do we only focus on histamine?  And why do we mainly focus on food, when just about anything can cause mast cell degranulation in MCAD, including the weather, emotions, lack of sleep, hormones, etc. etc.?

To complicate matters further, many people mix low histamine food lists with other issues.  SIGHI exclude wheat on their diet for example, when there is no evidence that wheat is high in histamine.  Wheat may, or may not, be inflammatory and excluded on an anti-inflammatory diet or people may be intolerant to gluten but that still doesn’t make it a histamine rich food.

I’m hoping to have time over the holidays to update my website a bit, including writing a new page tackling these very complex issues.  To be honest though, the more I’ve learned over the last 3 years the more I suspect any low histamine food list.  Who exactly has tested cinnamon, curry powder or nutmeg for its histamine content?  And how on earth is it even possible to test whether a particular food liberates histamine once it’s been ingested?   Are fresh foods always lower in histamine than dried?  Dried oregano, for instance, is miles higher in mast-cell stabilizing luteolin than fresh oregano.  If pumpkin is high in histamine what about related vegetables like squash, or other root vegetables like carrots or turnip?

I can see the logic, if not the research, to back up claims that aged and fermented foods will be high in histamine, eg. aged cheeses, cured meats and dried fruits but where is the science that food colorings are high in histamine (not that I’d ever want to eat artificially coloured food but where is the histamine connection)?

I’m almost certain I inadvertently still eat things which are high in histamine.  I’m also equally as certain that I’m avoiding some gorgeous foods for absolutely no good reason.  And on top of all that I know for sure that histamine in food is only a tiny part of my very complex health issues and I’d love more research on all the other aspects of mast cell mediator release.

I’m just sharing rambling thoughts in this post really and, as I said, will try and put together a more considered and informative page in the near future.



HIT: Info from Dr Joneja

This week I received a lovely comment from Michell at Foodsmatter.com who is going to place a link to my blog on her website.  Having not read the Foods Matter website before I headed on over and found some really useful information on histamine, particularly from Dr Janice Joneja.  Dr Joneja is one of the world’s leading researchers on Histamine Intolerance (HIT) and the diet listed on my blog is based on information from her.  This article on the Foods Matter website is well written and easy to understand and I hope answers some of the questions visitors to my blog have about HIT.

She also does a Q&A list here and I found the section on cheese informative.  Hard cheeses, eg Cheddar, are always excluded from a low histamine diet.  Hard cheese is aged and anything aged is always high in histamine.  However the waters become muddier with young soft cheeses.  Dr Joneja excludes cottage cheese, but allows mascarpone cheese.  Why?  There are two ways to produce soft cheese: curdling without starter cultures (OK) and fermenting with starter cultures (not OK).  Cottage cheese is a fermented milk product made with a starter culture, whereas mascarpone cheese is a curdled milk product made without a starter culture.

Fermented milk products made with starter cultures include:

  • Creme fraiche
  • Cottage Cheese
  • Yoghurt
  • Buttermilk
  • Kefir
  • Feta?
  • Soured cream

Curled milk products made without starter cultures include:

  • Mascarpone cheese
  • Mozarella cheese (however, some mozarellas are made with cultures and should be avoided.  If the ingredients list states “cultured” don’t use).
  • Ricotta cheese
  • Cream cheese – I think!
  • Panir (paneer) – I think!

I’m still confused over some milk products.  Panir (paneer) appears on ‘fermented’ milk lists if you Google it, yet Dr Joneja says it’s a curdled milk product so should be on the ‘allowed’ list. I’ve been using Quark cheese in some of my recipes, but having Googled extensively have found that Quark is usually made with cultures, so it will now be excluded until I can check with the local company I buy from as to how they make theirs – bugger 😦  I do also use a small amount of soured cream in my diet, which I technically shouldn’t and will remove from my ‘allowed’ list, but I don’t think the tiny amount I eat will kill me and I really like it 😉

Curdled cheeses are made with acids, often lemon juice or citric acid.  Obviously lemon and vinegar are excluded from low histamine diets, however, Dr Joneja states “as to vinegar, lemon juice, etc. as a curdling agent: all liquid is removed in the making of the cheese, so any minute residue will not be an issue.”  So that’s good news 🙂

Fish oils are good for heart health and joints but unless the fish is gutted soon after capture fish is not allowed on a low histamine diet.  I was, therefore, interested to read Dr Joneja’s answer to a question on fish oil supplements: “Histamine is poorly soluble in fat, so any histamine that may have been present in the fish from which the oil is derived is unlikely to contain histamine”.  Also good news.

She goes on to clarify other contentious foods.  Nuts are fine – the only exception being pumpkin seeds as pumpkin is a high histamine food.  Legumes (ie peas, beans and lentils) are all allowed as are bananas.  I personally get increased brain fog when I eat bananas, so I avoid them, so it just goes to show how unique and individual each person’s reactions are and why food lists are should only ever be viewed as a guideline and tailored to meet your own needs.

Dr Joneja advocates using anti-histamines for those people in whom restricting diet alone does not significantly control symptoms : “Often, a histamine-restricted diet is not adequate in keeping histamine levels below a person’s limit of tolerance (the level above which symptoms appear) when endogenous histamine (histamine produced within the body) rises significantly. At these times you might try controlling your symptoms of histamine excess with an antihistamine.”  Diet is not the be all and end all and many people also require medication to get their HIT under control.

She also mentions what many of us have already discovered – hormonal changes make our symptoms worse: “hormonal fluctuations contribute quite significantly to histamine sensitivity, as oestrogen and progesterone influence histamine metabolism. Both hormone levels change at ovulation and just prior to the onset of menstruation and many women experience an increase in histamine, and therefore occurrence or worsening of symptoms, at those times.”  Menopause is a prime time for HIT and MCAD to go bonkers and many women have had few or no histamine symptoms until they reach 40+.

Dr Joneja deals with Histamine Intolerance, not Mast Cell Disease which is a totally separate issue – see her explanation on the differences between these two diseases here.  I’m often asked on my blog why diet has not totally eliminated someone’s symptoms and that’s because Mast Cell Disease is much much more than just a histamine problem.  Dr Joneja addresses the question in the following statement:  “a histamine-restricted diet will definitely reduce the amount of histamine in the body by limiting the amount of extrinsic (from outside the body) histamine contributing to the total.  However, because the excess histamine is being released from mast cells within the body (intrinsic histamine), a histamine-restricted diet would be expected to improve a person’s symptoms, but not to eliminate them altogether.  Furthermore, because inflammatory mediators in addition to histamine are released in mast cell degranulation, other symptoms for which histamine is not responsible, will not be affected (by diet).”

The histamine section of the Foods Matter website is well worth a read.