Low Histamine Diet - Phase 3

Testing Your Limits: After 12-24 months of Phase I and II

This phase is about seeing what your body can handle now that you have gone through some serious healing. Ideally, you will have addressed your underlying Mast Cell Activation Syndrome or Histamine Intolerance Root Causes before this phase. 

DO NOT undertake this phase until your body is in a very good place health-wise. Otherwise, you may backslide.

1. Still only make 1 change every 3-4 days. Keep a Histamine Food Diary. Symptoms can take up to 2-3 days to develop. So don’t introduce anything else new at this time. 
2. Make sure you are still eating plenty of HIGH NUTRIENT Histamine Lowering foods. 
3. Continue to not eat too many high histamine foods on the same day.
4. Continue to avoid junk foods, processed foods, and food with additives like guar gum or carrageenan.
5. Go slowly. If you develop symptoms, note it and let things calm down before you try something else. 
6. Continue to remember that stress, seasonal allergies, mold exposure, and certain medications and supplements can raise histamine levels. You’ll want to control for these things in your testing. So, the day before a stressful event isn’t the best time to introduce a new food.

Here are examples of things you can experiment with in Phase III in moderation and only 1 of these 1x or 2x/week:

• 6-8 ounces Wild Alaskan Salmon, frozen after slaughter (like Vital Choice Fish King Salmon)
• 3-4 ounces freshly caught seafood
• 3-4 ounces chicken, lamb, turkey, or pork at a restaurant
• 3-4 ounces of beef prepared at home
• 2-3 ounces ground meat
• ½ cup high nutrient packaged foods, like Laiki Rice Crackers
• Leftovers refrigerated for 24 hours
• ¼ tsp cinnamon, cloves, or nutmeg
• 1-2 slices pasture-raised bacon
• 2-3 ounces of pasture-raised yogurt (if no casein sensitivity)
• 1-2 ounces raw, fermented sauerkraut
• 2-3 ounces kombucha
• 1 tsp miso
• 1 tsp coconut aminos
• 1 tsp balsamic vinegar
• Small glass of low histamine white wine like Dry Farm Wines

I recommend you not return to these highest histamine foods:

• Fast food
• Packaged foods with additives like MSG, guar gum, or carrageenan
• Flavored alcohols (like coconut rum), packaged mixers (like margarita mix), and significantly aged alcohols (like 10 year aged bourbon)
• Preservatives like sodium benzoate or potassium sorbate
• Peanuts and cashews – very inflammatory

If you find your symptoms are returning at this phase, you’ll need to back up to Phase II. Also, make sure you have completely addressed your underlying Mast Cell Activation Syndrome or Histamine Intolerance Root Causes. 

What if You Don’t See Improvement with the Low Histamine Diet and you have Mast Cell Activation Syndrome or Histamine Intolerance

If you don’t notice a change with reducing Histamine foods, it may be because one or more of these reasons:

1. 1. You may not have given it enough time. You need to be diligent about eliminating low histamine foods for at least 6 months.
   2. You may not be eating low histamine enough. Check and make sure you aren’t sneaking in high histamine foods or eating a lot of processed foods. Think about eating in restaurants too – meat in restaurants is often very high histamine.
   3. You may have other food intolerances or sensitivities that haven’t been addressed yet. These can include oxalates, lectins, and glutamates. These can also include food sensitivities. We’ll talk about this more in the next chapters. 
   4. Eating low histamine may not be enough. You may also have issues with the Histamine Degrading Enzymes. I can help you with this.
   5. You may not notice a major change until you also add in mast cell stabilizing supplements and address the other specific root factors for you. Think of it like this. If you have 12 nails in different parts of your body, you may not notice a big difference if we only take out 1 nail. So, eating low histamine may be helping, but it may not be enough for you to feel significantly better yet.
   6. You may not have Histamine Intolerance. Not everyone with Mast Cell Activation Syndrome has Histamine Intolerance. You may not know until further down the road, though. I encourage you to stay on the Low Histamine Diet until you are symptom free. Then you can experiment with adding in higher histamine foods one at a time to see if your symptoms return. This is the best way to rule out Histamine Intolerance.
   7. Your meat and leftovers may be getting you. Leftovers need to be frozen after cooking. Meat has to be handled in a specific way. Make sure you’ve followed the tips in these posts:

      Are you Raising your Histamine Levels with these Meat Handling Mistakes?

      How to do a Low Histamine Diet for Histamine Intolerance and Mast Cell Activation Syndrome Part 1: Identifying High Histamine Foods

      How to do a Low Histamine Diet for Histamine Intolerance and Mast Cell Activation Syndrome Part 2: What to Eat

Still not sure? Testing for Histamine Intolerance in Mast Cell Activation Syndrome

Histamine Intolerance can be evaluated through a few criteria:

• Ruling out other conditions that could cause continual release of histamine
• Symptoms of Histamine Intolerance without true allergy issues
• Negative skin and blood tests for the allergen antibodies
• Symptom relief with reduction of histamine foods

If the above criteria are true for you, then you can take more steps to narrow down the issues in Histamine Intolerance. Serum Diamine Oxidase testing is available through Dunwoody Labs’ Advanced Intestinal Barrier Assessment. Methylation status related to Histamine Intolerance can be tested in a Doctor’s Data or Genova Blood Methylation Panel. The genes coding for the Histamine Degrading Enzymes can be tested through genetic testing. I use Your Genomic Resource in my practice for genetic testing. This is because it gives the best genetic information for Histamine Intolerance and Mast Cell Activation Syndrome.

Testing isn’t always enough, though. If you have a problem with DAO, you want to look at your gut health. This is because most DAO is made in the brush border cells of the gut. If you have any gut infections, gut inflammation, or are eating inflammatory foods, your DAO product will be affected. 

What about Oxalates and Lectins in Mast Cell Activation Syndrome or Histamine Intolerance? What about other food triggers?

There are other types of foods that people with MCAS or Histamine Intolerance may react to. These include lectins, oxalates, salicylates, glutamates, and FODMAPs. So, try new foods slowly and cautiously until you know how your body will respond. This list is meant to be a starting place for you to make your own personal list. 

If you seem to be reacting to a lot of foods that are low histamine, you may have additional food sensitivities. If this is the case, you can reach out to me for help. I can help you customize your own foods list.

I recommend to my clients they start with the Mast Cell 360 Low Histamine Diet Phase I: Elimination List. Then if there are symptoms left, work with a Mast Cell and Histamine specialist before delving into oxalates or lectins too far. This is because you don’t want to limit foods too much. I’ve seen people get worse and worse when they get down to 20 or less safe foods. This is because they are rapidly losing nutrients needed to stabilize mast cells and build the histamine degrading enzymes.

If you know you have an oxalate issue, PLEASE work with a qualified professional on lowering oxalates slowly. DO NOT go low oxalate cold turkey. People have made themselves extremely sick doing this. 

If you have issues with histamines, oxalates, lectins, salicylates, glutamates, or FODMAPs, I’m here to help. Book a Mast Cell 360 Case Review so we can safely step you through this. I’ll help you build a custom foods list. We’ll also work on your underlying root causes so you can safely add more foods back in as soon as possible.

Do you need help with your Mast Cell Activation Syndrome or Histamine Intolerance?

Mast Cell Activation Syndrome and Histamine Intolerance are both very complex conditions. This is what I’ve spent the past several years studying and dedicating my life to helping others with. It is almost impossible to figure out alone if you don’t have a significant amount of health education and clinical training. I even have a number of high level health care practitioners who consult with me for help with their own Mast Cell Activation Syndrome or Histamine Intolerance. Because it’s that complicated.

If you’d like expert, personalized help you can book a Mast Cell 360 Case Review with me. We’ll explore the root causes underlying your Mast Cell Activation Syndrome or Histamine Intolerance. I’ll help you get the right functional labs needed to figure this out. And I’ll create a comprehensive, individualized action plan to help you through this.