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Understanding the Histamine Bucket and Managing Mast Cell Activation Syndrome (MCAS)

Updated: Jun 14

The Histamine Bucket Concept

The "histamine bucket" is a useful metaphor for understanding how your body manages histamine, a chemical involved in immune responses and allergic reactions. Here's a simplified explanation:

- Histamine Sources: Histamine can come from various sources, including certain foods (like aged cheeses, smoked meats, and fermented products), environmental allergens (like pollen), and internal processes (like stress or infections).

The Bucket Analogy:

Imagine your body as a bucket that fills up with histamine from these various sources. The bucket represents your body's capacity to handle histamine without causing symptoms.

Overflowing Bucket: When the bucket is full, any additional histamine can cause the bucket to overflow. This overflow results in symptoms such as headaches, rashes, itching, digestive issues, and other allergic reactions.

Managing the Bucket:

To prevent the bucket from overflowing, you can:

- Reduce Histamine Intake: Avoid high-histamine foods and drinks.

- Limit Histamine Triggers: Manage exposure to allergens and reduce stress.

- Support Histamine Breakdown: Some people may benefit from supplements or medications that help break down histamine or improve gut health.

Using the Histamine Bucket to Manage MCAS

Mast Cell Activation Syndrome (MCAS) involves the inappropriate activation and release of mediators like histamine from mast cells, leading to various symptoms. Applying the histamine bucket concept can help manage MCAS by controlling the cumulative load of histamine and other mast cell mediators your body is exposed to. Here’s how:

Step-by-Step Guide:

1. Identify and Avoid High-Histamine Foods:

- High-Histamine Foods: Create a list of foods high in histamine, such as aged cheeses, smoked meats, fermented products, alcohol, and certain fruits and vegetables (like tomatoes, spinach, and avocados).

- Elimination Diet:Experiment with an elimination diet to identify personal triggers and then reintroduce foods slowly to see which ones cause symptoms.

2. Manage Environmental Triggers:

- Reduce Allergens: Identify allergens in your environment (e.g., pollen, dust mites, mold) and take steps to reduce exposure.

- Clean Environment: Use air purifiers, regularly clean living spaces, and use hypoallergenic bedding.

3. Minimize Stress:

- Stress Reduction:Practice stress-reduction techniques such as mindfulness, meditation, yoga, or deep-breathing exercises.

- Self-Care: Ensure you have a good support system and take time for self-care.

4. Use Antihistamines and Mast Cell Stabilizers:

- Medical Consultation: Consult with a clinician who understands MCAS about using higher dose antihistamines and mast cell stabilizers to reduce symptoms.

- Medication Management: Follow your doctor's advice on the appropriate type and dosage of medications.

5. Support Gut Health:

- Healthy Diet: Maintain a healthy gut by eating a balanced diet rich in fiber and low in processed foods.

- Probiotics: Consider probiotics and prebiotics to support gut flora, which can influence histamine levels.

6. Monitor Symptoms and Triggers:

- Symptom Diary:Keep a symptom diary to track your reactions to foods, environmental factors, and stress levels.

- Pattern Recognition: Note patterns and avoid identified triggers whenever possible.

Practical Tips:

- Hydration: Drink plenty of water to help flush out histamines from your system.

- Sleep: Ensure adequate and good-quality sleep to help your body recover and manage histamine levels.

- Regular Check-ups: Regularly consult with your healthcare provider to monitor your condition and adjust your management plan as needed.


1. The Low Histamine Kitchen Podcast

  • Host: Michelle Berriedale-Johnson

  • Description: Focuses on histamine intolerance, recipes, and practical advice for managing a low-histamine diet.

  • Listen on Apple Podcasts

2. The Histamine Intolerance Podcast

  • Host: Dr. Janice Joneja

  • Description: Discusses histamine intolerance, symptoms, diagnosis, and management strategies.

  • Listen on Apple Podcasts

3. The Mast Cell Activation Syndrome (MCAS) Podcast

  • Host: Dr. Tania Dempsey

  • Description: Provides insights into MCAS, symptoms, and treatments, featuring interviews with experts in the field.

  • Listen on Spotify


1. The Histamine Intolerance Awareness

  • URL:

  • Description: A comprehensive resource for understanding histamine intolerance, including symptoms, triggers, and dietary advice.

2. The Low Histamine Chef

3. Mastocytosis Society

  • URL:

  • Description: Provides information on mast cell diseases, including MCAS, and supports patients and their families.

4. Histamine Intolerance and Diet

5. Mast Cell Action

  • URL:

  • Description: A charity focused on supporting people with mast cell diseases, providing resources, support, and advocacy.

Scientific papers

  • Histamine and Diet:

  • Maintz, L., & Novak, N. (2007). Histamine and histamine intolerance. The American Journal of Clinical Nutrition, 85(5), 1185-1196. Link

  • Histamine and Environmental Allergens:

  • Jutel, M., Akdis, C. A., & Akdis, M. (2009). Histamine, histamine receptors and their role in immune pathology. Clinical and Experimental Allergy, 39(12), 1786-1800. Link

  • Stress and Histamine Release:

  • Hellstrand, P., Lindmark, M., & Larsson, A. (2000). Stress and its impact on the immune system. Immunology Today, 21(7), 345-348. Link

  • Managing MCAS:

  • Molderings, G. J., Brettner, S., Homann, J., & Afrin, L. B. (2011). Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options. Journal of Hematology & Oncology, 4(1), 1-17. Link

  • Gut Health and Histamine:

  • Sonnenberg, G. F., & Artis, D. (2012). Innate lymphoid cell interactions with microbiota: implications for intestinal health and disease. Immunity, 37(4), 601-610. Link

  • Histamine Intolerance and Symptoms:

  • Schwelberger, H. G. (2010). Histamine intolerance: a metabolic disease? Inflammation Research, 59(2), 219-221. Link

By Dr Purity Carr

GP & Menopause Doctor

Harvey, WA, 6220

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