Treatment
Diet
Diet
Diet
Diet
Diet
As if MCAS and Histamine Intolerance weren’t complicated enough, there are dozens of different diets out there.
Some say avoid coffee, some don’t mention it at all. While the most commonly recommended diet is the SIGHI, we’ve developed our own protocol to follow.
Most proposed diets for Histamine Intolerance consist of foods not just low in histamine, but also low in all biogenic amines because they all contribute to histamine toxicity.
The goals of our anti-histamine diet is to reduce the body burden, potentially identify food allergens, and take the pressure off lowered DAO levels.
DAO, the enzyme that breaks down histamine, is found in the so-called skin of the intestines. When a condition like colitis, crohn’s, celiac, or lactose intolerance cause damage to this gut skin, we produce less DAO enzyme.
Many foods and medications also reduce DAO activity.
Food preparation also encourages histamine concentration. The more acidic, hotter temperature and longer exposure to bacteria all raise histamine levels.
Welcome to our very own histamine grocery list and safety guide. Curated by us, for you.
Supplements
Supplements
Supplements can play a valuable role in stabilizing mast cells, reducing histamine load, and supporting immune regulation in individuals with Mast Cell Activation Syndrome (MCAS).
Unlike pharmaceuticals, many of these natural compounds gently modulate inflammation and histamine activity without major side effects. Key options include quercetin and luteolin, two bioflavonoids known for their mast cell-stabilizing and antihistamine properties. Vitamin C also helps degrade histamine and supports immune resilience.
DAO (diamine oxidase) supplements can aid in breaking down dietary histamine, especially in individuals with low enzyme activity. Magnesium and vitamin B6 help regulate histamine metabolism and nervous system reactivity, while omega-3 fatty acids and curcumin support systemic anti-inflammatory pathways. Probiotics, when carefully selected, can help restore gut balance—but must be chosen with caution, as some strains may increase histamine production.
While supplements can be powerful tools, individual tolerance varies. A personalized, step-by-step approach—guided by symptom tracking and clinical insight—is essential to identify what works best for each person living with MCAS.
Drugs
Drugs
Drugs
Drugs
Drugs
Pharmaceutical management of Mast Cell Activation Syndrome (MCAS) focuses on reducing the release and effects of histamine and other mast cell mediators.
First-line treatments often include H1 antihistamines (like cetirizine or loratadine) to block histamine’s action on skin and mucosal tissues, and H2 antihistamines (such as famotidine or ranitidine) to reduce histamine’s effects in the gut and stomach.
Mast cell stabilizers like cromolyn sodium or ketotifen can prevent mast cells from releasing histamine and other pro-inflammatory substances, helping reduce symptoms over time. Leukotriene inhibitors (e.g., montelukast) may be used to manage respiratory or systemic inflammation, while low-dose naltrexone (LDN) has shown promise in modulating immune reactivity and reducing chronic symptoms in some MCAS patients.
In severe or refractory cases, medications like omalizumab (Xolair)—an anti-IgE monoclonal antibody—may be considered, especially if allergic triggers play a role. Benzodiazepines or beta-blockers may help regulate nervous system symptoms like palpitations or anxiety.
Treatment is highly individualized, often involving careful trial-and-error and layering of therapies for best effect. Close monitoring and collaboration with a knowledgeable provider are essential for finding the right combination.
If you need our direct help and live in British Columbia or the Yukon, or just need an educational consultation, book in with us.
