Many have found that just a few simple diet changes can help relieve symptoms caused by post-COVID immune system disruption. This article talks about the low histamine diet and how it is helping people in their recovery.

Updated February 20, 2024

Many have found that just a few simple diet changes can help relieve symptoms caused by post-COVID mast cell activation syndrome (MCAS). MCAS is inappropriate, chronic, multi-system release of mediators that activate the overproduction of histamines, leading to inflammation of nerves and organs. A low-histamine diet is currently the most advised strategy to prevent the symptomatology of histamine intolerance. The vagus nerve is vulnerable to inflammation, which is an issue because it touches every organ of your body. When this MCAS inflames this nerve, one could experience temporary (likely) or permanent dysfunction of organs that it touches. These symptoms include but are not limited to:

Runny nose, congestion, shortness of breath
Nausea, cramping, diarrhea or vomiting
Anxiety, depression, irritability, fatigue, headache
Thyroid issues, adrenal fatigue, liver, kidney, spleen or pancreas dysfunction
Skin rashes, hives, itching, new onset allergies
Diaphragm spasms, chest pains, impaired lung function, low oxygen levels in the body cardiac dysrhythmia
Limb pain, neuralgia, muscle spasm

Some people may also experience issues with certain foods resulting in a runny nose, shortness of breath, or sneezing within a few minutes of eating. Others may notice tinnitus (ringing ears), bloating or diarrhea within 20-60 minutes of eating. It's important to listen to your body. Start a food-symptom-activity journal and look for trends & triggers.

How do I figure out what I can eat?

There are a variety of diets recommended to address Mast Cell Activation Syndrome and Histamine Intolerance, but how do you know which one to follow? The answer is, you don’t. People experience different responses to different foods. Some people can eat wheat, soy, grains, pineapple or avocados… others cannot. Some people can tolerate beer, soda pop, fast food, fried foods… others cannot.

Following all the rules that various people and organizations have created can be defeating and confusing. If you are sick enough to consider dietary changes, don’t stress out over following rules. This is a situation where you need to make your own rules and change them as needed.

When you attempt to modify your diet, it is most important to listen to your body. Food intolerances may show in symptoms like runny nose, sneezing, bloating, diarrhea, constipation, cramping, gut pain, elevated blood pressure, fatigue, joint pain, spinal pain or headache. These are messages from your body that something you ingested (ate) is not agreeing with you.

Remember that histamine levels fluctuate and this is a delicate balance. You might be ok with 1 glass of wine or 1 bite of pineapple, but combining a few high histamine foods/drinks might tip the scale. Your histamine bucket can be more full due to exposure to illness, seasonal allergens, mold, fluctuating hormones, dehydration, stress, etc. In children, growth spurts and social pressures can tip the scales as well. To further confuse things, other types of foods that people with MCAS or Histamine Intolerance may react to include lectins and oxalates.

It’s important to pay close attention to foods, drinks, medications and supplements that cause you discomfort. A good way to start is an elimination diet. To do this, start by eating some simple foods you don’t seem to react to for a few days, and then add one item at a time. An example could be plain chicken sauteed in olive oil with one or two vegetables, salt and pepper. Add new foods slowly until you know how your body will respond. You can start a food-symptom-activity journal to track your successes and identify symptom triggers. If you seem to be reacting to a lot of foods that are low histamine, you may have additional food sensitivities.

Tips to reducing MCAS and histamine reactivity.

COVID-19 Nutrition for Recovery on Facebook — Eating “Clean” - Fresh meats, fruits, vegetables and eggs are typically well tolerated.

Foods like cauliflower, onions, and blueberries have anti-histamine properties. So load up on the anti-histamine foods!
Look for foods with 5 ingredients or less on the package.
Buy meat and fish as close to the packaging date as possible, refridgerate it immediately after buying it, and freeze unused portions within a day of purchase.
Freeze leftovers after cooking – antihistamine levels increase hours after cooking meats.
Emphasize nutrient dense herbs and vegetables that are low histamine.

Common high histamine foods

Histamines build over time. This is the first step in food spoiling. Some canning and pickling methods can stop the food from spoiling, but may still have a high histamine level because the food is not fresh.

Fermented alcoholic beverages, like wine, champagne, beer, whiskey, brandy
Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc.
Soured foods: sour cream, sour milk, buttermilk, soured bread, etc.
Balsamic Vinegar and Vinegar foods: pickles, mayonnaise, olives, ketchup
Cured meats: bacon, salami, pepperoni, luncheon meats and hot dogs
Aged cheese including goat cheese
Smoked fish, fish not gutted within 30 minutes of catch, anchovies, sardines
Ground meat (Increased surface area increases histamines)
Beef (aging process increases histamine)
Smoked or processed meats: salami, bacon, ham, sausage
Dried fruit: apricots, prunes, dates, figs, raisins
Uncooked egg whites (histamine liberator)
Leftovers
Processed carbohydrates and sugars
Avoid caffeine

High Histamine fruits, vegetables and nuts

Some people may tolerate some or all of these foods, and some may have days when they are more sensitive than others. Remember to listen to your body.

Overripe fruits and vegetables
Walnut
Peanut
Spinach
Mushroom
Eggplant
Avocado
Pineapple
Strawberry
Kiwi
Citrus fruits

High histamine additives found in processed and packaged foods

In general, the human body is not designed to ingest non-food items. For example, we know we cannot eat chlorine, lead,or flouride, but in small quantities they don’t seem to do significant damage, in fact, allare found in public drinking water. The same applies to food preservatives. They are typically made from non-food chemicals and can trigger inflammation when your immunity is weakened.

Multiple syllable chemical names that you don’t recognize as a food
Sodium Benzoate
Potassium Sorbate
Monosodium glutamate (MSG)
Citric Acid
Sodium Triphosphate
Potassium Triphosphate
Sodium Nitrite
Maltodextrin
Calcium Chloride
Xanthan Gum
Food colorings
Smoke Flavoring
Yeast Extract

Things you can do to help yourself

Minimizing physical & psychological stressors is essential in recovery from Long COVID.

Nutrition: Try to eat protein and fresh vitamin rich foods daily and avoid chemicals, preservatives, sugars, fast foods, prepared foods and high histamine foods.
Don’t skip meals. Your body needs protein , vitamin C, and vitamin D to heal from any injury or illness. A low histamine or low carbohydrate (sugar) diet is recommended by doctors treating Long COVID (PASC), and many people report a reduction in symptoms within 1-3 days of the diet change, including decreases in sneezing, itching or hives, irritable bowel syndrome, body pain, along with a reduction in swelling and inflammation.
Hydration: A minimum of eight 8 oz glasses of plain water daily is recommended.
Avoid drinks with chemical additives. You can easily make a fresh electrolyte drink yourself by adding a dash of mineral rich Epsom salt and a piece a fruit like a raspberry for flavor instead of spending money on commercial drinks like Gatorade that contain chemicals and sit in plastic bottles for long periods of time. Remember that caffeine and alcohol have dehydrating effects.
Sleep hygiene: Getting 7-9 hours of sleep so your body can repair itself. You need at least 4 hours of uninterrupted sleep to get into the restorative phase of sleep.
Avoid stimulating activities after dinner like thrilling movies or books, arguments, negative news or frustrating stimuli.
If you wake up frequently or with a startle, you may be experiencing drops in your oxygen level, which signal your brain to release adrenaline to force you to take a breath. This could be a temporary inflammation issue or more enduring sleep apnea. Ask your doctor for a sleep study to evaluate your need for a CPAP or BiPAP, a machine that pushes air into your lungs when it senses an apneic episode (periods of not breathing).
Stress management: Stress affects every component of your life.
The only thing you can control about stress is your reaction to it. Try to avoid or minimize your exposure to stressful situations: Turn off the news, make family visits that end unpleasantly short, wait for the morning to have intense discussions, let go of things that annoy you but don’t really matter in the big scheme of things, avoid intense conversations or entertainment in the evening.
Exercise within tolerance: Pace yourself and do not push your body to extremes in any way.
For some this may mean seated breathing exercises, walking to the mailbox. Rest when your body says to slow down. Gradually build on your activity endurance as your body cues you to progress. This can be hard to gauge, because when you feel good you naturally do more, but if you do too much you may experience symptom flare ups 1-3 days later as the post exertion inflammation builds. Some people describe this as post exertional malaise, others experience severe recovery set backs.
Breathwork: You can literally stop the fight or flight reaction by taking slow deep breaths.
Deep slow breathing shuts down the adrenaline flow, slows your heart rate, lowers your blood pressure and decreases stress related histamine release. When you do this, your blood reroutes back to your brain and nervous system to allow you to think clearly. It also allows your body to use its energy and oxygen to heal your inflamed nerves and organs.

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