Over and above all MCAS treatments is trigger avoidance. You can take all the meds in the world, but if you don’t avoid setting off those pesky mast cells, you’re not going to get anywhere. So where do you start?
Do nothing
Well, that sounds easy, doesn’t it? Ha! 🤪 Remember Grade 9 science, where we learned that when doing experiments you have to control all the variables? This process is a lot like those experiments, more complex of course, but we still have to make sure we are controlling, or at least aware of and considering, the relevant variables.
I’m focusing on food triggers today. Identifying other triggers is usually easier than foods, (although avoidance can be a lot harder!). It’s especially true once you give yourself permission to trust your body. I have had allergists tell me my whole life that you can’t be allergic to perfume. (Seriously, as recently as three years ago an allergist told me that…🙄). I know people who react to almost anything, from vibration to noise to off-gassing chemicals. I know I say it all the time, it bears repeating. Trust your body over any other voice.
Food trigger experiments can be more wholistic and intuitional, or they can be methodical, meticulously documented and cross referenced. Either can work, the key is to make it work for YOU. Trying to control for all factors and testing out foods at once is overwhelming and impractical. So, start with no changes in your basic food ingredients, and pick one or two factors to consider at a time. Pay close attention to the other factors, keeping them as consistent as possible. It may well become obvious that you’re fine with dairy, but not brie, or that canned tomatoes from Europe are fine, but not North American ones. (a story for another day…).
It’s essential to think beyond base ingredients, and to only make one change at a time. Both my daughter and I can eat yogurt the day it is opened and the next day, but not after that. It’s solved by getting individual single serve yogurt (not the best choice environmentally, but it doesn’t make us sick or waste half the yogurt we buy). What else is happening at the time may be far more important than the individual food. I dream of creating an app that could track and analyze that data, but until then, taking one step at a time is the way to go.
Food Factors
There are several factors when trying to figure out what your body can handle and what ticks it off. The biggest factors outside of ingredients for me are:
- Freshness
- This is a vital thing to look at. It’s one of the central tenets of low histamine diets, and for good reason. For example, if we have bread that is over three days old- even if there’s no sign of mold, I can’t eat it. Any moldy or fermented food is much higher risk for the same reason (no Stilton for me…)
- Temperature and completeness of cooking.
- The more well cooked and the higher temperature something is, the better. Anybody who has oral allergy syndrome knows this; cooked apples and carrots are better than raw ones. My daughter can eat potato chips, or powdered mashed potatoes, but not a baked potato.
- Seasonality
- I can eat strawberries two weeks of the year, but strawberry jam all year round. In a lot of instances, raw veggies, fruits and berries are best eaten in season, and otherwise preserved for other times of the year.
- Method of preservation.
- As freshness is key, preservation can make a big difference. I’ve found that canning, freezing and salt curing are safer than things like fermentation: I know several people who were laid flat by kombucha… (how anyone can drink something hat essentially smells like dirty, wet socks that’s have been left for several days, I have no idea… To each their own, i guess.).
- Exposure
- I rarely react to something the first time I eat it. Especially those foods that I am sometimes ok with, sometimes not, if I strictly avoid it for six months, I can usually eat it. At least once. It may not affect my diet a lot, but it helps me navigate social situations such as special events. It also makes it less scary to re-try foods.
- Cross reactivity
- A benign protein that looks very similar to something you are reacting to makes all the difference. A perfect example for me is polyisoprene- my body reacts badly enough to natural latex that it also reacts to synthetic latex (or polyisoprene).
- Overgeneralization (also known as guilt by association).
- I can start reacting to something because I had a bad reaction to something I ate with it. If I react to one thing, everybody else that was there is seen as members of the same gang, including innocent bistanders. I personally find this one extremely annoying. I can have foods that are good to go, and have a reaction to something else that was served with it, and lose the previously safe food as well (although they often subside over time).
- Cumulative reactions.
- There are many foods that I can eat bits of just fine if my body is relatively calm, but if I eat them all together I’m begging for it. If there’s smoke from wildfires, I can’t eat anything without reacting. (A lot of people refer to this as ‘filling up their histamine bucket’; I swear my bucket changes size and there’s a constant drip into it). I finding that even things like eating slowly can make a difference for me, especially if I’m in a bad flare.
So now you can see why, when it comes to food, you simply can’t only look at ingredients. It won’t make sense if you don’t consider the other factors. Is not a simple task to control all of these variables at once, that’s why keeping them as stable as possible before you start changing any foods is so fundamental. It may explain why you can eat bread, but not pasta, or you’re ok with tomatoes some times, but not others. The last thing we want to do is to unnecessarily restrict our lives, whether that be nutritionally, socially, etc.
Learning which of these factors are the most important for me, which ones I really have to look out for has been essential. There are likely more factors that affect some people, if you discover something that affects you, and I haven’t mentioned it, please add it to the comments below. Next in the series will be trigger tests. Stay tuned!