*The image above is an illustration, not a diet recommendation.
Some long haulers discover that they now react to a lot of foods. Those are the patients who tend to see the most benefit from changing their diet. If you’re not sure if you have food intolerances, a trial fast of 16 hours and then another trial fast of 24 hours may help you figure things out. (Extended fasting for more than 2 days is one of the top treatments right now, but it comes with risk. Start with shorter fasts, which will have the added benefit of helping you spot potential food intolerances.) Also try to remember if you stopped eating when you were sick with a cold or stomach bug.
Changing your diet can offer fast, rapid relief of symptoms with very little risk. However, there are caveats:
- Low histamine diets don’t seem to help people recover. It seems to manage symptoms without dealing with the root cause.
- It’s not convenient.
Of the diets out there, the two most proven diets are the gluten-free diet (see this guide) and the low histamine diet. These two diets aren’t necessarily the best diet but they are a solid choice because their popularity means that they have the most data backing them up.
Gluten-free may be easier to get into. See the guide on how to do gluten-free the easy way. If a gluten-free diet doesn’t help you, low histamine may work. It’s worth trying if you know that you have food intolerances.
The food lists online will have some conflicts with other food lists. That’s because:
- There are different ways that histamines form.
- Histamines may not be the problem.
I wouldn’t worry about the science too much. (You can do a deep dive here.) The important thing is that the low histamine diet will work in some people. Who cares if scientists and clinicians are wrong about how it works? What you really want to know is whether or not it works for you.
So here are some food lists:
A low histamine food list can be found here: https://www.histaminintoleranz.ch/downloads/SIGHI-Leaflet_HistamineEliminationDiet.pdf
For those with MCAS, the same group (SIGHI) has compiled a more detailed and complicated food compatibility list: https://www.mastzellaktivierung.info/downloads/foodlist/21_FoodList_EN_alphabetic_withCateg.pdf
I would just start with the easier, less complicated option.
Only a small portion of people report significant improvement from eating low histamine.
Also see the Nov 2022 overview on long haul treatment. Slides are in the video description. See slide 40.
I hope this helps. I never actually tried this diet myself so please feel free to add in your two cents.