Table 6. Triggers for Excessive Symptoms: The Five “Es”.

Trigger	Response
Exercise	“Overexercise,” which could bring on excessive flushing and other symptoms
Emotion	Avoid situations that evoke strong emotions, particularly anger and stress
Ethanol	Small amounts of alcohol may be OK for some patients; red wine seems to be a particular trigger
Eating	Avoid spicy food and “aged foods” like salami, certain cheeses, cooked tomatoes, and citrus
Epinephrine	Alert emergency personnel in situations such as allergic reaction or a heart problem. Ask dentist for anesthetics without epinephrine.

Note. Information from Northwood NETs (2012).