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
AMINES
Particularly high in aged, fermented and spoiled foods, and can vary widely between batches.
AMINES IN FOODS (VERY HIGH)
TYRAMINE, DOPAMINE
- 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
AMINES IN FOODS (MODERATELY HIGH)
TYRAMINE, DOPAMINE, XANTHENES, THEOBROMINE
- 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