What Foods Should Be Avoided with Carcinoid Syndrome?

Foods you should avoid when you have carcinoid syndrome include fatty meats; smoked, salted, or pickled fish or meat; aged cheeses; red wine; alcoholic beverages; spoiled protein foods (chicken liver); yeast extracts and Brewer’s yeast; hydrolyzed proteins; broad beans; sauerkraut; shrimp paste; and some soybean products; miso soup; soy sauce; and tofu.

Neuroendocrine tumors are rare and usually slow-growing tumors arising from neuroendocrine cells. Neuroendocrine cells produce hormones that control metabolism, digestion, and other bodily functions.

Neuroendocrine tumors can start growing in the digestive tract, lungs, appendix, thymus, and other organs, and may spread to other parts of the body.

Carcinoid syndrome is a group of symptoms that occur when some neuroendocrine tumors (also called carcinoid tumors) overproduce hormones such as serotonin. 

Dietary modification is one aspect of treatment for carcinoid syndrome. Patients who have carcinoid syndrome should avoid foods and substances that can trigger the release of serotonin and other hormones from carcinoid tumors.

Foods that should be avoided with carcinoid syndrome include: 

• Foods and substances with high levels of amines, nitrogen-containing organic compounds, or adrenaline-like substances
  • Fatty meats
  • Smoked, salted or pickled fish or meat (herring, salami, sausage, corned beef, bologna, pepperoni)
  • Aged cheeses (cheddar, Camembert, Stilton)
  • Red wine
  • Alcoholic beverages
  • Spoiled protein foods (chicken liver)
  • Yeast extracts and Brewer’s yeast, hydrolyzed proteins
  • Broad beans
  • Sauerkraut
  • Shrimp paste
  • Some soybean products, miso soup, soy sauce, tofu
  • Limit: 
    • Chocolate 
    • Caffeine containing drinks, coffee (in large amounts), soda
    • Some nuts (peanuts, coconuts, brazil nuts)
    • Some pizzas
    • Raspberries
    • Banana
    • Avocado
• Foods with high serotonin levels 
  • Eggs
  • Cheese
  • Pineapple
  • Nuts such as walnuts and pecans
  • Bananas and plantains
  • Tomatoes
  • Kiwi fruit
  • Plums
  • Limit: 
    • Avocados (Haas)  
    • Dates                           
    • Grapefruit               
    • Cantaloupe             
    • Honeydew              
    • Olives                         
    • Eggplant                  
    • Certain nuts (Brazil nuts, filberts, almonds, cashews, macadamia nuts)
    • Coconut
• Spicy foods
• Fructose

Smaller, more frequent meals are also easier for patients with carcinoid syndrome to digest. 

Other treatments for carcinoid syndrome depend on the symptoms, where the tumor is located, and how much the cancer has spread.

Treatment aimed at controlling symptoms of carcinoid syndrome includes:

• Anti-diarrheal medications
• Medicines that block neuroendocrine tumors from producing the substances that cause symptoms
• Adjusting prescription medications
  • Some drugs can affect amine or adrenaline levels
  • Never stop taking a prescribed medication without first talking to your doctor
• Palliative therapy (supportive care) to help manage pain, maintain quality of life, and reduce stress that comes with a serious illness
• Treatment for carcinoid heart disease
  • May involve surgery to replace a diseased heart valve with a healthy heart valve

Treatments for neuroendocrine tumors may help relieve symptoms of carcinoid syndrome and include: 

• Surgery to remove all or part of a neuroendocrine tumor
• Embolization  
• Ablation therapy 
• Biologic therapy 
• Chemotherapy 
• Immunotherapy 
• Radiation delivered directly to the tumor
• Somatostatin analogs (SSA) 
• Telotristat ethyl (Xermelo) 
• Targeted therapies