In the presence of typical symptoms and anamnesis which could indicate a mast cell mediator syndrome, the diet described here should in any case be tried out consistently for a limited period of time in order to test whether one responds to it or not.
What is tolerable / incompatible?
All foods with histamine potential should be avoided:
- The most important thing is to avoid histamine liberators (to be more precise: liberators of mast cell mediators).
- Histamine-rich foods can stimulate the mast cells to release even more histamine via the histamine receptors on their surface.
- Other biogenic amines besides histamine can also sometimes cause symptoms by blocking histamine degradation as competing substrates of the DAO. Some biogenic amines also have histamine-like effects.
- Inhibitors of (hist-)amine-degrading enzymes (DAO inhibitors, HNMT inhibitors, MAO inhibitors) can also have unfavourable effects.
Foodstuff compatibility list
The list shows which ingredients may be incompatible with MCAD.
SIGHI food list EN, alphabetical, divided into categories (~ 1 MB).
Other sorting sequences and translations into other languages: see Downloads
The evaluation only applies to the pure staple food WITHOUT any incompatible ingredients or additives. Always pay attention to the list of ingredients, even in basic foods where you would not expect any additives (e.g. thickener in cream)!
This is our recommended procedure to determine your individual tolerance:
- Differential diagnosis by the allergologist: Before starting experimental diets, it should first be clarified whether other allergies, intolerances or other diseases are present. If these remain undetected, this elimination diet alone has little or no success.
- Diagnostic elimination diet: The most reliable way to reach your goal is to start with a minimum number of foods (potato and rice diet) and build up your individual diet step by step. After your symptoms have subsided, add other particularly well-tolerated ingredients, one after the other (according to our food compatibility list, see below). First, follow the elimination diet consistently for about four to six weeks until the symptoms have subsided to a stable low level. It is advisable to keep a food and symptom diary:
- Provocation testing: In order to provoke clear incompatibility reactions to confirm the diagnosis, incompatible staple foods from various food groups (meat preparations, dairy products, vegetables, fruits, additives, etc.) are consumed again until the result is clear enough for the patient. Caution: For anaphylactic patients, omit this step or supervise medically, emergency medications at hand!
- Therapeutic elimination diet:: Reestablishing a varied, balanced diet by reintroducing a new ingredient approximately every two days and ideally consuming it with three successive main meals. If the symptoms increase again, the last ingredients introduced are omitted again. The therapeutic elimination diet determined in this way must be adhered to permanently.
Each meal should contain at least one food from each of the following three categories:
- Proteins: Meat, fish, dairy products, egg yolk, hemp seeds, ...
- Starch: potatoes, cereal products made from spelt, rice, maize, millet, ...
- Vegetables, salad, fruit
- Medical support: Depending on the degree of severity, a combination of several pharmaceuticals is often necessary in addition to the elimination diet in order to achieve complete freedom from symptoms and to further improve the quality of life. The response to the medication also confirms the suspected diagnosis. Since phase 4 (reconstruction of a varied diet) is usually a learning process lasting years, it makes sense to start medication already during the development of a varied diet. The diet should be maintained as the main part of the therapy and not replaced by medication.
The experiment as well as the interpretation of the results is best accompanied by a doctor or a nutritionist. Afterwards, it is essential that a balanced diet plan is drawn up as part of a professional nutrition consultation. The Allergy centre Switzerland maintains a list of qualified nutritionists HF/FH who have completed an advanced training course on the subject of food allergies and intolerances.
"Diet" does not mean a calorie reduction diet for weight loss, but a medical diet in which certain ingredients are restricted or omitted completely for medical reasons (elimination diet, omission diet), with normal portion sizes overall.
Overcoming the displacement phase
Don't disavow the disease any longer, even if you can't imagine to suffer from such a complicated condition. Don't wait any longer. It won't get better on its own. You will save yourself unnecessary time of suffering if you tackle it now despite (or because of) exhaustion and listlessness! As soon as you have started with the change of diet, your strength will return quickly, so that the implementation will be easier for you than you can imagine in your current condition.
In the beginning, everything will seem infinitely complicated and restrictive. With increasing experience and routine this will improve massively. In your search for food, you will even add previously unknown delicacies to your menu. Look forward to these discoveries and to the regained well-being!
Tolerance threshold is individual and fluctuating
The tolerance threshold depends strongly on the individual severity and is influenced by numerous environmental factors such as stress, effort, allergen contact, air pollutants, weather conditions, etc.
Another difficulty is that the histamine content in food is also very variable. The symptoms can occur once in the same dish and not another time.
Compatibility is difficult to judge
It is a very tasking demand to identify some histamine liberators as incompatible because their chronic effect is delayed by several hours. In some cases, it is only after repeated intake of liberators on several consecutive days that the incompatibility becomes apparent. Symptoms gradually begin to appear, which may only slowly subside within days after strict avoidance of all liberators. Depending on individual predisposition, these can be very subtle symptoms, which the brain is unable to associate with food intake due to their nature and their delay. The brain is therefore unable to develop avoidance behaviour in such cases.
Initial decrease in sensitivity
It often happens that with a still irritated intestine certain foods are tolerated moderately at the beginning of the diet, but a few weeks later they are better tolerated. Therefore after some months one can dare to test again the foodstuffs which werde determined as incompatible at the initial phase of the diet.
Additional information can be found on the page Therapie > Verträglichkeit.
The page Therapy > Cooking advice contains advice that can be decisive for the success of the therapy.
The list of intolerable drugs should also be consulted.
Possible reasons for lack of therapeutic success
- Salicylate / benzoate intolerance
- Well adjusted drug support required
- Permanent activation of mast cells, independent from nutrition
- Unrecognized dietary errors
- Diet instructions are insufficient, need to be more restrictive
- Additional intolerances, allergies or other diseases
- Wrong product declaration, quality defects
|SIGHI||The statements on this page reflect the experiences, the point of view and the current knowlege of the SIGHI editorial team.|
|SIGHI.2||Food compatibility list: Our compatibility ratings are based on a combination of different sources, weighted by their plausibility:|