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If you have any concerns regarding consuming items listed in this recipe, it’s best to consult with your healthcare professional or registered dietitian for personalized advice on your specific health condition and dietary needs. We thank you for allowing us to share our own personal food journey and opinions on individualized nutrition and allergies.
This lower histamine ceviche dish is made from an array of nutrient-dense ingredients with substitutions being made to accommodate those with mast cell activation syndrome. If you’ve come to this low histamine ceviche recipe out of pure plant-based curiosity, please excuse the many notes on histamine as it relates to my readers with mast cell issues.
As noted in many of my lower histamine recipes, they are not truly low-histamine as I do not believe this is obtainable as a chef nor is it always nutritionally well balanced. My approach to my own nutrition as a patient with mast cell activation syndrome is to focus on the histamine bucket. In this blog post, we will review what the histamine bucket practice looks like and how it may be beneficial to some individuals’ syndrome and food enjoyment behaviors.
What is Mast Cell Activation Syndrome?
Mast Cell Activation Syndrome (MCAS) is a condition where mast cells in the body are abnormally activated, leading to the release of excessive amounts of chemical mediators such as histamine, causing a range of symptoms. This can result in symptoms such as itching, cardiovascular symptoms, flushing, neurological symptoms, hives, gastro, headache, brain fog, & severe respiratory anaphylaxis. MCAS can be triggered by a range of factors including stress, infections, medications, foods, and environmental factors. With that, we must keep in mind that each person’s mediators may vary which includes a range in histamine reaction along with other mast cell mediators.
While the primary mediator of concern is the vasoactive mediator being histamine (or a mediator that can alter our blood pressure) there are other mediators that play a role in MCAS patient’s anaphylaxis episodes and symptoms. I encourage myself to be graceful with myself when exploring food but also use caution in my consumption of high-histamine foods as a mast cell patient. This means better understanding my main food triggers as well as combining these higher histamine foods with lower histamine foods to help keep my histamine bucket at a reasonable and safe depth.
What is the histamine bucket practice?
The histamine bucket theory or practice is a visual description for patients to understand how their body’s histamine levels, ingestion of histamine, release, breakdown, and intolerance to histamine can result in an “overflow” of the bucket. While this analogy is to help put clinical literature into layman’s terms, it may be difficult for patients to understand and manage. It illustrates that if a patient consumes more mediators than the body can handle, it will result in an “overflow” which is a MCAS reaction or resulting anaphylaxis.
In theory, the best practice for mast cell activation syndrome patients is to keep their histamine intake below their known (individualized) threshold to keep symptoms at bay. As a result, the “bucket” remains empty as the body continues to manage its histamine levels when they remain at a reasonable level.
What causes the histamine bucket to overflow?
There are various reasons some of which can be diet, microbiome health, inflammation, environmental factors, hormones, stress, enzyme levels, genetics, and health predispositions. Personally, I choose to focus on many of the elements that contribute to MCAS flares that do not relate to diet as my diet provides me with the most enjoyment out of all the above-mentioned things as I’ve learned to control my relationship with food as someone living with mast cell issues. While it has taken years to determine my dietary histamine threshold management behaviors and practices, there is a way to enjoy a diet rich in nutrition that also includes high-histamine foods in moderation as a MCAS patient.
Ultimately, histamine intolerance and mast cell activation syndrome management require individualized attention to address the underlying issues & current amplifying issues that contribute to your symptoms.
Is this really a low histamine recipe?
Low histamine recipes are often difficult to create when it comes to fish as there is truly no low histamine fish that exists & here’s why. When discussing fish and histamine intolerance or mast cell activation syndrome it is uncommon to be familiar with the similarities these patients & species of aquatic life share. However, before we get into that it’s important to note that this recipe is not fully low histamine however the overall dish IS lower when compared to traditional ceviche and the risk of significant MCAS flares may be reduced as noted in detail below.
The similarities between MCAS patients & aquatic life have to do with what is called scombroid poisoning which has a similar clinical presentation but with different causes and management.
Why Traditional Ceviche is High In Histamine and May Contain Additional MCAS Triggers:
- Traditional ceviche purchased at many restaurants may contain MSG or what is known as Monosodium Glutamate. Monosodium Glutamate may be a potential trigger for MCAS patients due to its potential ability to release histamine or be a “histamine liberator.” While more research needs to be done on this topic it is a common note that mast cell patients may frequently react to MSG.
- Preservatives & Agriculture Pesticides: When eating at a restaurant it is nearly impossible to confirm where items are sourced and the unidentifiable substances that touch our food before and after harvest. While preservatives and pesticides are common issues for patients without mast cell issues, we risk putting ourselves in jeopardy when we allow sourcing and preparation to be made by someone else.
- Aji Amarillo or Peppers may not be well tolerated by patients as these are high histamine ingredients and a popular Peruvian ceviche is made with yellow Peruvian pepper. While it is delicious, it carries the potential to overflow your histamine bucket when combined with other high-histamine ingredients in the ceviche.
- Marination Time: When an already high-histamine fish is marinated in more high-histamine ingredients the level of histamine increases the longer the fish sits in the citrus. With this recipe, we avoid this time build-up.
- Citrus: Citrus that is used in the marination time is often transferred to the ceviche that is served. While fresh citrus juice may lower the overall histamine, it is uncommon for new juice to be added to the ceviche mixture.
- Additional ingredients: In traditional ceviche, it is not uncommon to see fermented sauces, pickled veggies, sugars, or toppings being used that increase the histamine levels.
What’s In This Lower Histamine Ceviche?
Each individual has unique triggers when it comes to MCAS or histamine intolerance and it’s important to learn how we can manage our unique presentation through diet, lifestyle changes, and exposure. Personally, I have found a happy medium by enjoying what I love, in moderation.
In this recipe, there is a mixture of low-histamine and higher-histamine foods which are in small quantities. I recommend using your best judgment when it comes to consuming this recipe as it relates to your specific nutritional and immunological needs! I also welcome you to make this for a friend that doesn’t factor in histamine load into their food choices! Find out more by checking the notes section of my recipe on specific ingredient details!
Lower Histamine Ceviche (Vegan)
- 1 can organic bamboo shoots (rinsed thoroughly)
- 1/2 cup large toasted coconut flakes (do not use small shreds)
- 1 piece dried kombu
- 1/2 cup sliced easter radishes
- 1-2 tsp minced jalapeno
- juice of 3 limes
- 2/3 cup fresh orange juice
- 1/2 tbsp nori komi furitaki rice seasoning (see above linked product)
- 1 large hass avocado
- 1/2 medium red onion
- 1-2 medium garlic cloves (optional)
- 2 tbsp chopped cilantro
- 1/2 medium sweet potato (optional)
- Start off by thoroughly rinsing your produce and allowing your cilantro to dry thoroughly.
- Next, be sure to thoroughly wash your bamboo shoots a few times to remove it's slightly metallic taste which is due to it's amino acid content. (Building blocks of protein)
- Next, using a mandolin or a sharp chefs knife (linked above) slice the onion into very thin strips. Reserve in a mixing bowl & proceed with the rest of your chopping of ingredients.
- Follow by adding in your lime juice, torn bamboo shoots, and all other ingredients. Mix to combine.
- Once fully combined, serve in a deep ramen bowl & enjoy as is, with plantain chips, or tortilla chips.