
Mast cells are immune cells that are located at different sites of the body such as the skin and gastrointestinal (GI) tract. They are known for their role in defending against germs and other pathogens and for triggering allergy-type responses as well as severe allergic reactions.
When mast cells are activated within the body, they release substances such as histamine, enzymes, and chemical messengers. While inflammation and activated mast cells may be part of a beneficial immune response, long-term activation and substance release may contribute to multiple health issues beyond allergies. Since a large population of mast cells are in the GI tract,1 many of these health conditions involve the gut such as irritable bowel syndrome (IBS), functional dyspepsia, inflammatory bowel disease (IBD), and small intestinal bacterial overgrowth (SIBO).2-5
Stabilizing mast cells is the goal for many medications that aim to reduce symptoms of allergic and inflammatory conditions. What foods and nutrients may also help with chronic mast cell activation while also improving gut health?
Histamine & a Low-Histamine Diet
As part of an allergy immune response, activated mast cells release histamine. Diamine oxidase (DAO) is an enzyme in the body that is responsible for breaking down excess histamine. If someone has low levels of DAO, this may cause histamine levels to rise and potentially lead to histamine sensitivity, long-term inflammation, or repeated episodes of allergic symptoms such as:6
- Hives
- Swelling
- Low blood pressure
- Difficulty breathing
- Severe diarrhea
Some patients may be diagnosed as histamine intolerant, based on low DAO levels. Since histamine is also found in foods, eating such foods might cause issues for people with low DAO levels. In recent studies, individuals have reported improved symptoms after clinical interventions that included a prescribed low-histamine diet.7,8 Research also suggests that patients with urticaria, a common skin condition that can be caused by a release of histamine, have also shown improvement on a prescription histamine-free diet.9
Anti-Inflammatory Foods, Nutrients, & Gut-Immune Health
Rather than focusing entirely on removing foods, functional medicine also seeks to enhance gut health and the intake of anti-inflammatory foods to support overall immune health. Long-term inflammation within the body can be harmful and contribute to the development of disease. However, various protective nutrients that can help support immune health and reduce inflammation in the body are found in many minimally processed foods, such as:10-12
- Colorful fruits and vegetables
- Whole grains
- Healthy fats
- Herbs and spices
These are general components of a nutrient-dense diet that provides a range of vitamins, minerals, protective phytonutrients, and other anti-inflammatory and mast cell–stabilizing13 compounds. In addition, plants and plant-based foods are fiber-rich and not only help feed beneficial microbes located in the gut but also have a positive impact on mast cell stabilization.14
The Functional Medicine Approach
Functional medicine practitioners understand that gut and immune health are closely intertwined and that a personalized nutritional intervention is only one tool that may help stabilize mast cells, address chronic inflammation, balance the gut microbiome, and enhance immune and overall health. They provide whole person care and examine lifestyle choices to fully assess the body’s complex processes and suggest ways to decrease chronic disease risk.
Within the functional medicine framework, practitioners collaborate with patients to develop health strategies that are most beneficial for the individual patient and their current conditions and concerns. Click below to find a functional medicine practitioner near you and learn more about lifestyle-based interventions that support your immune system and health.
Related Topics

Chronic Infections: Reducing Inflammation Through Nutrition

What Should You Feed Your Kids?

Skin Health: The Functional Medicine Approach
References
- Albert-Bayo M, Paracuellos I, González-Castro AM, et al. Intestinal mucosal mast cells: key modulators of barrier function and homeostasis. Cells. 2019;8(2):135. doi:10.3390/cells8020135
- Krammer L, Sowa AS, Lorentz A. Mast cells in irritable bowel syndrome: a systematic review. J Gastrointestin Liver Dis. 2019;28(4):463-472. doi:10.15403/jgld-229
- Shah A, Fairlie T, Brown G, et al. Duodenal eosinophils and mast cells in functional dyspepsia: a systematic review and meta-analysis of case-control studies. Clin Gastroenterol Hepatol. 2022;20(10):2229-2242.e29. doi:10.1016/j.cgh.2022.01.014
- Dvornikova KA, Platonova ON, Bystrova EY. Inflammatory bowel disease: crosstalk between histamine, immunity, and disease. Int J Mol Sci. 2023;24(12):9937. doi:10.3390/ijms24129937
- Özdemir Ö, Kasımoğlu G, Bak A, Sütlüoğlu H, Savaşan S. Mast cell activation syndrome: an up-to-date review of literature. World J Clin Pediatr. 2024;13(2):92813. doi:10.5409/wjcp.v13.i2.92813
- Giannetti A, Filice E, Caffarelli C, Ricci G, Pession A. Mast cell activation disorders. Medicina (Kaunas). 2021;57(2):124. doi:10.3390/medicina57020124
- Lackner S, Malcher V, Enko D, Mangge H, Holasek SJ, Schnedl WJ. Histamine-reduced diet and increase of serum diamine oxidase correlating to diet compliance in histamine intolerance. Eur J Clin Nutr. 2019;73(1):102-104. doi:10.1038/s41430-018-0260-5
- Cucca V, Ramirez GA, Pignatti P, et al. Basal serum diamine oxidase levels as a biomarker of histamine intolerance: a retrospective cohort study. Nutrients. 2022;14(7):1513. doi:10.3390/nu14071513
- Son JH, Chung BY, Kim HO, Park CW. A histamine-free diet is helpful for treatment of adult patients with chronic spontaneous urticaria. Ann Dermatol. 2018;30(2):164-172. doi:10.5021/ad.2018.30.2.164
- Ojo O, Ojo OO, Zand N, Wang X. The effect of dietary fibre on gut microbiota, lipid profile, and inflammatory markers in patients with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials. Nutrients. 2021;13(6):1805. doi:10.3390/nu13061805
- Sánchez-Rosales AI, Guadarrama-López AL, Gaona-Valle LS, Martínez-Carrillo BE, Valdés-Ramos R. The effect of dietary patterns on inflammatory biomarkers in adults with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Nutrients. 2022;14(21):4577. doi:10.3390/nu14214577
- Koelman L, Egea Rodrigues C, Aleksandrova K. Effects of dietary patterns on biomarkers of inflammation and immune responses: a systematic review and meta-analysis of randomized controlled trials. Adv Nutr. 2022;13(1):101-115. doi:10.1093/advances/nmab086
- Kaag S, Lorentz A. Effects of dietary components on mast cells: possible use as nutraceuticals for allergies? Cells. 2023;12(22):2602. doi:10.3390/cells12222602
- Folkerts J, Stadhouders R, Redegeld FA, et al. Effect of dietary fiber and metabolites on mast cell activation and mast cell-associated diseases. Front Immunol. 2018;9:1067. doi:10.3389/fimmu.2018.01067