MAST CELL ACTIVATION (and how to manage too much histamine)
THE IMMUNE SENTINELS
Mast cells are like the watchmen of the immune army, scanning the body for known or potential threats.
They concentrate in tissues that contact the outside world, like the respiratory, digestive, and urinary tracts.
These cells have granules containing 200+ active compounds, including amines (like histamine), cytokines, proteases, and anticoagulants.
When a mast cell identifies an infection, allergen, insect sting, or tissue trauma, it dumps these defensive compounds and alerts other immune cells to the site.
These compounds cause membrane "leakiness", leading to the watery eyes, runny nose, flushing, and swelling symptoms that characterize an allergic reaction.
ABNORMAL ACTIVATION
While mast cells play an essential role in the immune response, they can also become overstimulated (known as mast cell activation syndrome or MCAS).
This condition causes systemic inflammation, predominantly impacting the organs and nerves in the gut.
Symptoms of MCAS often overlap with or contribute to other GI issues like acid reflux, nausea, SIBO, IBS, or dysbiosis.
However, it can also be experienced as rashes, migraines, irregular blood pressure, fatigue, joint and muscle pain, brain fog, or other inflammation-related symptoms.
MCAS can be difficult to identify because there is significant symptom overlap with other conditions (and no simple diagnostic test).
Mastocytosis is a related condition, characterized by overproduction of mast cells (versus overreaction).
FACTORS & TRIGGERS
genetics
infection
toxins & chemicals
compounds in meds & supplements
heat
MANAGE HIGH HISTAMINE
ADDRESS THE ROOT CAUSE
unmanaged stress, intestinal dysbiosis, and toxic exposure can drive an abnormal histamine response
TRY A LOW-HISTAMINE DIET
fermented foods, aged cheese, vinegar, alcohol, tomatoes, chocolate, canned meat & fish, and bone broth are high in histamine
SUPPLEMENTAL NUTRIENTS
vitamin C, vitamin D, quercetin, luteolin, DAO, low-histamine probiotic
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References
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Kimata, M., Shichijo, M., Miura, T., Serizawa, I., Inagaki, N., & Nagai, H. (2000). Effects of luteolin, quercetin and baicalein on immunoglobulin E-mediated mediator release from human cultured mast cells. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 30(4), 501–508. https://doi.org/10.1046/j.1365-2222.2000.00768.x
Mast Cell Activation Syndrome: The Functional Medicine Approach. Gregory A. Plotnikoff. (2022) Pathways to Wellbeing - A Functional Medicine Podcast by the Institute of Functional Medicine. Retrieved from: https://www.ifm.org/news-insights/mast-cell-activation-syndrome-the-functional-medicine-approach/
Theoharides, T. C., Cholevas, C., Polyzoidis, K., & Politis, A. (2021). Long-COVID syndrome-associated brain fog and chemofog: Luteolin to the rescue. BioFactors (Oxford, England), 47(2), 232–241. https://doi.org/10.1002/biof.1726
Theoharides, T. C., Tsilioni, I., & Ren, H. (2019). Recent advances in our understanding of mast cell activation - or should it be mast cell mediator disorders?. Expert review of clinical immunology, 15(6), 639–656. https://doi.org/10.1080/1744666X.2019.1596800
Theoharides, T. C., Valent, P., & Akin, C. (2015). Mast Cells, Mastocytosis, and Related Disorders. The New England journal of medicine, 373(2), 163–172. https://doi.org/10.1056/NEJMra1409760
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Weng, Z., Zhang, B., Asadi, S., Sismanopoulos, N., Butcher, A., Fu, X., Katsarou-Katsari, A., Antoniou, C., & Theoharides, T. C. (2012). Quercetin is more effective than cromolyn in blocking human mast cell cytokine release and inhibits contact dermatitis and photosensitivity in humans. PloS one, 7(3), e33805. https://doi.org/10.1371/journal.pone.0033805