Dietary Guidelines for Carcinoid and Neuroendocrine Tumors

There are some very basic guidelines for proper eating for those managing symptoms, (eg. specifically diarrhea, gas & bloating and flushing) related to Carcinoid and other Neuroendocrine Tumors. These Guidelines were developed by Miles Hassell MD, Medical Director, Department of Integrative Medicine, Providence Cancer Center along with Monica E Warner, M.S., R.D., C.D.N., Carcinoid Cancer Foundation.

Dietary Guidelines For Carcinoid and other Neuroendocrine Tumors

If no symptoms or other medical problems:

  • Follow whole food Mediterranean diet or American Institute Cancer Research (AICR) guidelines
  • Daily exercise habit
  • Portion and weight control
  • Adequate sleep

If One Or More Symptoms Of Carcinoid Syndrome:

  • Mediterranean or AICR diet, avoiding foods that aggravate symptoms
  • High protein
  • Emphasis ‘good’ fat when making choices, keep fat content moderate or low
  • 5-10 servings of vegetables and fruit daily if tolerated
  • Variety helps, and everyone is an individual
  • Broad variations in amines between batches of a given food

If One Or More Carcinoid Symptoms:

  • Foods most likely to provoke symptoms are large meals, high-amine foods, excessive fat, alcohol, spices
  • Smaller servings or different brands may not cause symptoms
  • Niacin or nicotinamide e.g. 25-50 mg twice daily
  • Maybe a multivitamin
  • Consider fish oil 2 x 1000mg daily with largest meal as source of omega 3 fatty acids
  • Consultation with Registered Dietician

What foods tends to aggravate symptoms?

  • Amines
  • Fatty Foods
  • Vegetables

Particularly high in aged, fermented and spoiled foods, and can vary widely between batches.


  • Aged cheeses (cheddar, Camembert, Stilton)
  • Alcoholic beverages
  • Smoked, salted or pickled fish or meat (herring, salami, sausage, corned beef, bologna, pepperoni)
  • Any spoiled protein foods (chicken liver)
  • Yeast extracts and Brewers yeast, hydrolyzed proteins
  • Broad beans, sauerkraut, shrimp paste, some soybean products, miso soup, soy sauce, tofu


  • Caffeine containing drinks, coffee (in large amounts), soda
  • Chocolate (in large amounts)
  • Some nuts (peanuts, coconuts, brazil nuts)
  • Some pizzas, raspberries, banana, avocado

Food Sources Of Niacin

  • Meat, poultry and fish
  • Whole and enriched grains and cereals
  • Vegetables
  • Legumes, nuts and soy
  • Fruit