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For patients with both MCAS and autoimmunity, flare-ups are often more severe, prolonged, and resistant to standard interventions

Hidden glutamates MSG / monosodium glutamate Hydrolyzed vegetable protein Autolyzed yeast or yeast extract Natural flavors in savory foods Disodium inosinate or guanylate High-glutamate foods Soy sauce, miso, and fermented soy Bone broth and long-simmered stocks Parmesan and aged cheeses Tomato paste and sauces Mushrooms, seaweed, fish sauce, anchovies Common processed triggers Instant noodles and flavor packets Chips, crackers, and savory snacks Bouillon cubes and gravy mixes Frozen meals and boxed dinners Processed meats and meat substitutes Many patients also react more strongly to leftovers, aged foods, stored fish, uncovered cheese, fermented foods, and slow-cooked broths because glutamate and histamine activity can increase as proteins break down

8 , 14835 doi: 10.1038/ncomms14835 (2017)

Borsini A, Alboni S, Horowitz MA, Tojo LM, Cannazza G, Su KP, et al