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In short
Triggers in MCAS differ from person to person, so there is no single food list that fits everyone. Mast Cell Action suggests working out your own triggers with your clinician. A simple food and symptom log, steady low effort meals and recipes tagged low histamine make that easier to keep up.
What MCAS is
Mast Cell Action explains that mast cells are found throughout the body and release several different chemicals during a reaction, so symptoms can affect several body systems at once. Their list includes flushing, itching and hives, digestive symptoms, headaches, brain fog, fatigue, palpitations, dizziness, breathing difficulties and allergy type reactions.
They describe symptoms as fluctuating. Some people have periods when symptoms are stable and other times when they are more frequent, severe or affecting different parts of the body, which the charity calls a flare. They also note that symptoms can change over time, for example after an illness, an infection or a medical procedure.
Mast Cell Action says the aim of treatment is to reduce the severity of symptoms, through self management and medical management, and that a medical treatment that works for one person may not work for another. They also say that if you have new, persistent, worsening or unexplained symptoms, you should speak to a healthcare professional rather than assume they are caused by MCAS.
Triggers are personal
The charity lists triggers that can include foods, fragrances, temperature changes, medications, infections, hormones, exercise, and physical or emotional stress. They say that while some people have clear, consistent triggers, others have reactions that seem unpredictable or vary from day to day, and that something tolerated one day may cause symptoms another day.
They describe the combined effect of several small triggers as sometimes being what pushes someone over their threshold, and they say it can take time to work out what affects you. PoTS UK makes a similar point in their advice on diet and fluids, where they write that there is no standard list of high histamine foods and that many things can set off symptoms.
That is why a general list of foods to avoid tends to be unhelpful on its own. The practical version is your own list, written down over time, and a clinician who can help you read it.
Keeping a record that helps
Mast Cell Action suggests keeping a simple record when symptoms affect several parts of the body or change from day to day, noting your main symptoms, when they occur, how long they last, how severe they are, and what seems to make them better or worse. They also suggest that photographs can be useful for visible symptoms that may have gone by the time of an appointment.
The British Dietetic Association make a similar point in their fact sheet on IBS: keep a food and symptom diary while you are making changes, so that you can see what has helped, and make one change at a time so that you can see what has helped. A record is only useful if it can be read, and a record you keep on a bad day has to be quick.
Nomeriu makes that a one tap check-in at the top of Today, headed How are you today, covering water, meals, sleep and how today feels, with morning, midday and evening check-ins and a Same as yesterday button. Cook mode walks through a recipe one step at a time in large text, with a timer where a step needs one, so a note can be made without stopping what you are doing.
Changing food with support
Mast Cell Action says that avoiding triggers is a key part of self management, and that this can include adopting specific diets such as low histamine. They also say that where triggers are complicated, seeking help from a dietitian or nutritionist with knowledge of MCAS can be helpful, and that new triggers may develop over time.
They are clear that it is not always practical to avoid every trigger all of the time, particularly in public. A plan that assumes perfect avoidance is a plan that will be broken, and a plan that is broken is easy to read as personal failure.
Mast Cell Action also warns that anaphylaxis is a serious reaction that needs immediate treatment and emergency medical help, and that signs include difficulty breathing, swelling of the tongue or throat, wheezing, dizziness, collapse or loss of consciousness. Nomeriu is general information and not medical advice, and your GP or clinician is the right person for your own situation and for any reaction you are worried about.
Questions
Should I follow a low histamine diet?
Only with your clinician. Mast Cell Action describes triggers as individual, so any change to what you eat is best planned with a professional who knows your history.
Sources
- Mast Cell Action: Understanding triggers in MCAS What triggers can include, how they differ from person to person and how they change over time.
- Mast Cell Action: Managing MCAS Self management, diets such as low histamine, the value of specialist dietetic input and the note about emergency help.
- Mast Cell Action: What can MCAS symptoms look like? Symptoms across body systems, flares, keeping a record and when to seek medical advice.
- BDA: Irritable bowel syndrome (IBS) and diet Their advice on keeping a food and symptom diary and making one change at a time.
See what Nomeriu plans for this kind of week: low energy.