What about fat — if red meat is tolerated is it okay to eat?

The only reason for carcinoid patients to eat a low fat diet would be to reduce steatorrhea (fat-containing diarrhea) if they have malabsorption due to short bowel syndrome or as a side effect of Sandostatin.  If fat malabsorption is present or even suggested, then I treat with pancreatic enzymes.  I encourage a high protein diet and that includes lean meat (beef, pork and lamb all have lean parts that would fall into this category).  Tryptophan normally is the only raw material from which protein and niacin are formed and only a little goes to make serotonin, but in an active carcinoid making lots of serotonin, tryptophan is diverted to this use and protein and niacin synthesis suffer.

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