Low FODMAPs diet may help histamine intolerance and IBS

UPDATE: math is not my strong point so my apologies. I have changed the first graph to reflect verbatim the histamine reduction.

In the last few years research into causes of IBS have explored a link to foods high in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) [1]. And now researchers believe a low FODMAPs diet may work in part because they found “an eightfold reduction of histamine in the low FODMAP group” of a recent IBS study [2].

IBS is a chronic, often disabling condition causing stomach pain and bowel issues. It’s thought that between eight and twenty percent in the US suffer from it, with IBS accounting for nearly half of all gastroenterologist visits [3]. Histamine intolerance and mast cell activation may initially have been misdiagnosed as IBS in the beginning (as mine were).

A number of the studies I read found food elimination diets as an IBS treatment have yielded conflicting results, except in subjects with diarrhea, or the histamine runs as I’ve been known to call it.

Temporary restriction of high FODMAPs foods which cause an increase in fermentable products in the small intestine and colon, resulting in distention and gas however, may provide relief for a subset of IBS patients [4].

A 2016 study in the journal Gut finds that a low FODMAP diet “may significantly improve IBS symptoms”. FODMAPs were shown to affect the histamine levels and microbiotia in some of the study participants. In the low FODMAP group there was an eightfold (800%) reduction of histamine and an increase in good bacteria [5].

While this is certainly interesting news, many of the FODMAPs foods appear on other lists, so it would be best to individually test foods rather than just exclude another entire list. Many of these foods are very healing: anti-cancer etc, and I’m all about eating a balanced diet of healing nutrients. I would also urge you to work with a nutritionist to ensure your diet doesn’t become restricted to the point of malnutrition – something highly probable if you’ve already eliminated high histamine foods and are now on a FODMAPs mission. My approach would rather be to continue as I am, including a smattering of nutrient dense healing foods overall (rather than focusing on histamine, FODMAPs etc).

I’ll be sharing the PDFs I used to help plan my recovery in my upcoming 90 minute online workshop. Because while there’s no point in blindly following lists, we sometimes need a coherent plan to share with nutritionists and doctors who aren’t up to speed with the issues we’re dealing with. You can read more about that here.

In that vein…the Stanford Medical Center points out that issues may arise when FODMAPs are eaten in excess [6]. And that’s my point exactly. When you have an inflamed body, either because your mast cells are generally programmed to be on high alert and constantly releasing inflammation/histamine, or if you have too little of the histamine-degrading DAO enzyme, or your diet is waaaaaaay high in FODMAPs, just dialling things down a little and putting extremist food views aside could be a better way forward. Just the mental anguish of following these incredibly restrictive diets is counter productive in that stress hormones can cause mast cells to dump more inflammation/histamine into the blood stream.

The Stanford Medical Center recommend a trial period of eliminating FODMAPs followed by adding high FODMAP foods back one at a time in small amounts to identify food triggers [7]. Interesting, sounds like my approach exactly: figure out what bothers you rather than eliminating an entire list. Something I’ll help you learn how to do in the online workshop.

Interestingly I’ve long advised those struggling with their health to limit sugar intake, because it can be inflammatory [8]. And so we come to a 2012 study in the journal Gastroenterology and Hepatology seeking to determine why a low FODMAP diet appeared to help IBS patients [9]. They discovered that fructose and fructans in the high FODMAP foods were the most problematic. When starting out on the standard low histamine diet I really read my list as gospel. So when I saw that sugar was fine, I gorged myself on sugary snacks to make up for the misery of the diet. At this point I was unable to tolerate many FODMAPs and salicylate rich foods. Once I eliminated the sugar, wheat (high FODMAPs, very inflammatory) and dairy (mast cell trigger, inflammatory) as well as processed foods (high in fructose and corn syrup which are high FODMAPs), for a good long while, I was able to tolerate previously bothersome foods. Things like garlic and onion which had caused severe flushing, headache and burning in my stomach, broccoli which along with the others induced ear splitting gas eruptions. Mango and other high sugar fruits meanwhile caused brain fog and sleepiness.

Garlic and onion sensitivity is something many of us struggle with at the start. But I’ve seen it time and again, that when the body starts to heal, by using stress relief and meditation techniques to fight stress induced mast cell degranulation and histamine release, while eating a balanced diet rather than a severely restricted one, everything falls into place. There will always be exceptions – but wanting to heal, being open to recovery, dealing with stress, resolving trauma, beginning to train mast cells through exercise (see my interview with mast cell specialist Dr. Castells for more on that), and making a concerted effort to make time to indulge in things that make you truly happy, gives us a fighting chance. Oh, and diet of course. Yes, in that order.

You can check out my 90 minute online workshop here.

You’ll find recipes full of foods with antihistamine and anti-inflammatory properties my books Anti-Recipes and The Anti-Cookbook

CLICK HERE TO CREATE YOUR OWN PERSONALISED HEALING HISTAMINE PLAN.

——————-REFERENCES—————-

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966170/

[2] http://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7B83a788e0-563c-41dc-aab1-cd7313ad8c69%7D/low-fodmap-diet-may-significantly-improve-ibs-symptoms

[3] http://www.ncbi.nlm.nih.gov/pubmed/15862929

[4] http://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7B83a788e0-563c-41dc-aab1-cd7313ad8c69%7D/low-fodmap-diet-may-significantly-improve-ibs-symptoms,

[5] http://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7B83a788e0-563c-41dc-aab1-cd7313ad8c69%7D/low-fodmap-diet-may-significantly-improve-ibs-symptoms

[6+7] https://stanfordhealthcare.org/content/dam/SHC/for-patients-component/programs-services/clinical-nutrition-services/docs/pdf-lowfodmapdiet.pdf

[8] http://www.health.harvard.edu/family_health_guide/what-you-eat-can-fuel-or-cool-inflammation-a-key-driver-of-heart-disease-diabetes-and-other-chronic-conditions

[9] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966170/

13 responses to “Low FODMAPs diet may help histamine intolerance and IBS”

Annette

April 9, 2016

Well done for giving a balanced view of low FODMAPs. Although it’s good to know about FODMAPs and which foods are high in what to help identify and reduce triggeRS, I am very sceptical to the FODMAPs diet exactly because it lists foods high in fructose, fructose, lactose, sorbitals etc all in one list when most people won’t be sensitive to all of these and not all of the time. A low FODMAP diet reduces a person’s population of beneficial gut flora because FODMAPs are prEbiotics. We don’t want too much or too little of these things.Balance is key of course! 🙂 it’s so easy to get excess fructose and fructans from a modern western diet and many people suffer from excesses of these. When there’s too much fructose and it can’t be properly absorbed it carries other beneficial chemicals with it through the digestive tract so they don’t get absorbed either. Some people may only need to reduce fructose and wheat to see a difference. I’m glad you wrote ” it would be best to individually test foods rather than just exclude another entire list”. Very sensible advice, or one could avoid groups of FODMAPs one at a time. and always try to reintroduce the healthy stuff! Could be a person’s only sensitive to onions during stress for example.
Annette

April 9, 2016

Well done for giving a balanced view of low FODMAPs. Although it’s good to know about FODMAPs and which foods are high in what to help identify and reduce triggeRS, I am very sceptical to the FODMAPs diet exactly because it lists foods high in fructose, fructose, lactose, sorbitals etc all in one list when most people won’t be sensitive to all of these and not all of the time. A low FODMAP diet reduces a person’s population of beneficial gut flora because FODMAPs are prEbiotics. We don’t want too much or too little of these things.Balance is key of course! 🙂 it’s so easy to get excess fructose and fructans from a modern western diet and many people suffer from excesses of these. When there’s too much fructose and it can’t be properly absorbed it carries other beneficial chemicals with it through the digestive tract so they don’t get absorbed either. Some people may only need to reduce fructose and wheat to see a difference. I’m glad you wrote ” it would be best to individually test foods rather than just exclude another entire list”. Very sensible advice, or one could avoid groups of FODMAPs one at a time. and always try to reintroduce the healthy stuff! Could be a person’s only sensitive to onions during stress for example.
Kirsty

April 9, 2016

I’m very glad to read this! When I first discovered your work I had acute histamine overload from going hardcore on GAPS/Paleo AIP and could barely think straight (or leave the house, because I needed to be near a bathroom at all times…) I bought your anti-diet cookbook and then started having FODMAPS reactions to all the garlic, apples, broccoli, beetroot, cauliflower etc I was eating to lower histamine. At that point, taking into account the food intolerances I already had, there was pretty much nothing left to eat besides bok choy and turnips, and things got a bit desperate. Over time I figured out how to infuse olive oil with garlic, managed to reintroduce cauliflower, have beetroot in small quantities, but still can’t seem to eat apples or pears without having a bloated stomach for several days. I have a strong intolerance to onions, and many other foods, but my aim is to one day be able to eat all food that is actual food without my body wanting to get in a fight with it!
Kirsty

April 9, 2016

I’m very glad to read this! When I first discovered your work I had acute histamine overload from going hardcore on GAPS/Paleo AIP and could barely think straight (or leave the house, because I needed to be near a bathroom at all times…) I bought your anti-diet cookbook and then started having FODMAPS reactions to all the garlic, apples, broccoli, beetroot, cauliflower etc I was eating to lower histamine. At that point, taking into account the food intolerances I already had, there was pretty much nothing left to eat besides bok choy and turnips, and things got a bit desperate. Over time I figured out how to infuse olive oil with garlic, managed to reintroduce cauliflower, have beetroot in small quantities, but still can’t seem to eat apples or pears without having a bloated stomach for several days. I have a strong intolerance to onions, and many other foods, but my aim is to one day be able to eat all food that is actual food without my body wanting to get in a fight with it!
Linda N

April 10, 2016

Like the other posters I too agree with your sensible approach to FODMAP foods. I have been a nutritionist for a long time, so sugar (in all its forms) has not been in my diet for decades, and neither has processed foods. But I do so hope to regain a tolerance to garlic and onions, some underground veggies, and some fruits at some point as well as being able to eat say some rice or oatmeal. Thankfully I can eat broccoli, cauliflower and most of the other brassicas but my diet is still limited at this point.
Linda N

April 10, 2016

Like the other posters I too agree with your sensible approach to FODMAP foods. I have been a nutritionist for a long time, so sugar (in all its forms) has not been in my diet for decades, and neither has processed foods. But I do so hope to regain a tolerance to garlic and onions, some underground veggies, and some fruits at some point as well as being able to eat say some rice or oatmeal. Thankfully I can eat broccoli, cauliflower and most of the other brassicas but my diet is still limited at this point.
Bill Lagakos

April 19, 2016

taking the fun out of FODMAPs: http://caloriesproper.com/taking-the-fun-out-of-fodmaps/
Bill Lagakos

April 19, 2016

taking the fun out of FODMAPs: http://caloriesproper.com/taking-the-fun-out-of-fodmaps/
Doro Rund

April 20, 2016

I´m also FODMAPs intolerant but I´m doing fine now with vegetables from the onion, brassica and the pumpkin family. What helped me tremendously was taking probiotics for a long time and eating a gut healing diet in general. Fructose and fructans are really the worst for me, also legumes, but I occassionally can tolerate red lentils (soaked for 24 hrs and pressure cooked) now. Interestingly, for me it was often the case that my gut was calm but I had bad skin breakouts and fatigue, or the other way around that I had terrible gas and bloating but my histamine symptoms were silent. So in my case the FODMAPs foods never seemed to increase my histamine load. I´m also not lactose intolerant but sucrose (or too many carbs in general) make me feel tired and give me acne breakouts.
Doro Rund

April 20, 2016

I´m also FODMAPs intolerant but I´m doing fine now with vegetables from the onion, brassica and the pumpkin family. What helped me tremendously was taking probiotics for a long time and eating a gut healing diet in general. Fructose and fructans are really the worst for me, also legumes, but I occassionally can tolerate red lentils (soaked for 24 hrs and pressure cooked) now. Interestingly, for me it was often the case that my gut was calm but I had bad skin breakouts and fatigue, or the other way around that I had terrible gas and bloating but my histamine symptoms were silent. So in my case the FODMAPs foods never seemed to increase my histamine load. I´m also not lactose intolerant but sucrose (or too many carbs in general) make me feel tired and give me acne breakouts.
Forget Food Sensitivities

May 11, 2016

I have been told I have parasites, IBS, Leaky Gut, Gluten Sensitive, Candida everything in between. I have spent hundreds of dollars at a time for different potions from naturopaths which give me some relief at the time but then as soon as I stop them the issues come back. I am eating so much healtier than I EVER have but yet I was still bloated and foggy in the head and just gave up with elimination diets and just ate what I wanted and dealt with the issues. Since reading your article on histamine intolerance I started to look into DAO enzyme supplements to see if with taking them I felt any different then at least I knew that I could begin the low histamine diet. At first I felt a little strange, felt more anxious, a bit uneasy but after a couple of weeks I ate steak and mash at a friends house for dinner and I didn’t feel like I would fall asleep at the drop of a hat immediately afterwards, I actually felt like normal again. So now I am going to begin the low histamine meal plan and see if without the supplements I can stay awake for more then 30 mins after a meal! 🙂 Thank you!!

I have started my own blog with some gluten, sugar and dairy free recipes for others who are still trying to figure out if they have a sensitivity.

Forget Food Sensitivities : https://fitnessieisa.wordpress.com/
Anne

June 7, 2016

Does anyone know about horseradish? Is it high or how histamine, high or low FODMAPS, allowed or not allowed on SIBO diets, etc… I used to love eating it (I’d buy the root and use it in all kinds of dishes), but can’t find any info on it pro or con. It’s very healing/healthy and I’d hate to give it up if it wasn’t necessary.

Going low FODMAP seems to be very important for me. I went on the anti-histamine diet (not radically, but following most things) and it significantly helped my flushing and itching, but my bowel symptoms (and individual episodic rather than chronic reactions) got much worse. It was as if my bowels just decided to stop and wouldn’t move. Not necessarily constipation, just zero movement and lots of pain. My naturopath believes it’s SIBO. Higher FODMAP foods at that point really put things over the edge – and the pain was horrible. (I’m also really impacted by the weather, btw, not sure what that has to do with it.) A few times I ate some higher histamine foods, and that seemed to start things going – perhaps you can go too low histamine?
Hazel

June 11, 2016

I’m about the same but still need to be wary with garlic & too much onions, I find fine chopped boiled best. I am concerned of getting over confident & causing damage to fragile gut collagen again due to having EDS (can’t cure as yet as genetic but also trying Maitake mushroom capsules which is polysaccharides & research suggests may? help the collagen). Could symptoms start silent & not realise damage reoccurring?? until full blown damage again then back at square one. So treading with caution.

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Yasmina was an award-winning broadcast journalist with a decade of experience covering war zones for CNN and the BBC. She devoted her journalism skills to researching and writing about histamine. Click here to learn about her. Each post is carefully and fully referenced with the latest scientific research. Not sure where to start? Here’s a four week meal plan and overall Histamine Reset.