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Managing Mast Cell Activation Syndrome (MCAS)

 

 

Mast Cell Activation Syndrome

 

  • Common Symptoms[1][2][3][i]
    • Cognitive dysfunction:Brain fog, confusion
    • Neurologic: Headaches, nerve pains, hypersensitive to pain
    • Hyper-reactivity: to everything – foods, meds, supplements, noise, odors
    • Skin:rash, hives, flushing, swelling
    • Abdominal:pain, cramping, bloating, nausea, heartburn, diarrhea, gastritis (H. pylori negative)
    • Respiratory:shortness of breath, cough, runny nose/eyes
    • Fainting or near-fainting
    • Cardiovascular:low/high/fluctuating blood pressure, POTS, Heart palpitations and racing, flushing
    • Psychiatric:Depression, anxiety, panic attacks, bipolar, psychosis

Symptom Assessment – Dr. Afrin’s Questionnaire

Testing

Testing can be challenging due to expense, timing and extreme difficulty of complex sample processing.  Discuss with the doctor.  Histamine, Chromagranin A, tryptase, Prostaglandins.

Treatment requires a multi-pronged approach.

Combo of trigger avoidance, nutrients, herbs, and medications most effective in most cases.

 

Avoid common triggers:

  • Dust, mites, pollens, animals
  • Viruses, bacteria, mold, fungi, yeast
  • Toxins such as heavy metals, glyphosate, BPA, and from infections or vaccines
  • Diet
  • Stress
  • Temperature changes
  • Hormonal imbalances 

Supplements to AVOID in MCAS

  • High dose Niacin – histamine liberator 
 *** This includes NAD for some people ***
  • Ascorbic Acid (Vitamin C) if from fermentation or Aspergillus – high histamine 
and mold trigger
  • Ascorbyl Palmitate (Vitamin C) if from fermentation or Aspergillus– high histamine 
 and mold trigger
  • High dose methyl folate (unless needed for a specific purpose) – increases mast cell activity 

  • Supplements or powders with dried spinach, strawberry, or pineapple– high histamine 

  • Collagen– high histamine 

  • Citrates from fermentation – high histamine 

  • Supplements with citrus oils, clove, cinnamon – histamine liberators 


Supplement/drug fillers to avoid:

  • Titanium Dioxide

  • Potassium Sorbate
  • Sodium Benzoate
  • Guar Gum

  • Xanthan Gum

  • Carrageenan 
  • Citric Acid

  • Sodium Triphosphate

  • Potassium Triphosphate
  • Talc 

Helpful histamine-lowering Nutrients:

  • Quercitin
  • NAC
  • Vitamin C – from a non-corn, non-fermented source
  • Methylation support
  • Diamine Oxidase (DAO) Enzyme – breaks down histamine
  • Alpha lipoic acid
  • Resveratrol
  • Rutin
  • Luteolin
  • Pomegranate
  • Curcumin (turmeric)
  • ECGC (green tea)
  • Pantethine (Vitamin B5)
  • Certain probiotic strains reduce histamine production: Lactobacillus rhamnosus

Pharmaceuticals:

  • Claritin, Zyrtec, Allegra, Benadryl
  • Hydroxyzine – very sedating
  • Montelukast
  • Cromolyn sodium
  • Ketotifen
  • Ranitidine, cimetidine, famotidine
  • Benzodiazepines
  • Corticosteroids
  • Low dose naltrexone
  • Imatinib – immunosuppressant 
  • Peptides – BPC-157, Thymosin-Beta 4, KPV, Cerebrolysin

 

Dietary Avoids – there’s no one-size fits all:

  • Avoid known triggers.  
  • Fermented foods such as sauerkraut, aged cheeses. 
  • Leftovers.  Food bacteria produce histamine that cannot be destroyed once formed.
  • Eat organic, local and fresh
  • Yogurt
  • Fish
  • Cinnamon, Nutmeg, Cloves
  • Chocolate
  • Red wine
  • Beer 
  • Alcoholic beverages in general
  • Kombucha - fermented
  • Dried fruit
  • Avocados
  • Spinach
  • Nightshades (Tomatoes, potatoes, eggplant, peppers)
  • Citrus
  • Bananas
  • Coconut
  • Shellfish
  • Certain nuts – especially cashews, walnuts, peanuts

GI Support

  • Probiotics that rarely cause histamine issues: L. rhamnosus, Bifidobacteria, spore-forming (Bacillus species)
  • Treat imbalances in GI such as SIBO, yeast/fungus, parasites, dysbiosis, 
  • Treat leaky gut: L-glutamine, aloe, quercitin, DGL

1[1] Afrin In: Mast Cells Chapter 6 ISBN: 978-1-62618-166-3 2013

[2]2 Molderings et al. Journal of Hematology & Oncology 2011, 4:10


[3]3 Afrin Brain Behav Immun 2015 Nov50:314-321

 

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