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Patients should be advised to: Consume fresh foods wherever possible and avoid prolonged storage Keep a detailed food and symptom diary to identify personal triggers Manage stress , as psychological stress can influence gut function and histamine release Consult a registered dietitian experienced in food intolerances for a structured approach to elimination and reintroduction (typically 2-4 weeks of restriction followed by systematic challenges) Regarding medications and supplements: Never stop prescribed medications without consulting your healthcare provider If you take oral contraceptives, be aware that Mounjaro may reduce their effectiveness

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Furthermore, we also searched for evidence of grey or unpublished evidence using the Open Grey Repository and Open Thesis Repository databases