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Here's a comprehensive strategy: Step 1: Remove Triggers Start with a low-histamine, low-inflammatory diet: Avoid: Aged cheese, smoked meats, wine, vinegar, fermented foods Leftovers (histamine increases with time) Tomatoes, spinach, avocado, citrus Shellfish Chocolate Alcohol Food dyes, preservatives (especially benzoates) Also Eliminate: Mold exposure (test the home if needed) NSAIDs and other mast cell-activating medications (under supervision) Step 2: Heal the Gut and Support the Microbiome The gut is a major mast cell hub , and healing the gut is essential