MCAS 101

(Mast Cell Activation Syndrome)

In people affected by MCAS, chemicals called mast cell mediators are released too frequently or abundantly, and/or in response to triggers that are not typically considered to be harmful. This can lead to a MCAS which causes a wide range of symptoms that affect many organ systems. Triggers can include foods, chemicals, viruses, wounds, fragrance, exercise, stress and changes in temperature. MCAS symptoms can come and go and may often change over time within the same person. This can make it difficult to identify specific triggers, and the number of triggers and severity of symptoms may continue to increase as the condition progresses.

What is happening with MCAS?

The body detects what IT PERCEIVES AS A DANGEROUS STIMULI (but is benign to people not affected by MCAS) and the body releases chemical mediators to “fight” the “foreign” invader.


Diagnosis

  • Elevated tryptase level during a flare

  • Observation of pathological mast cell under microscope/with pathology: 

    • Ask the pathologist to look at: MCs: CD117, anti tryptase; MC activation markers:CD2, CD25, CD30

  • Symptoms improve with MCAS medications

Symptoms

Chronic runny nose, hives, GI distress, fatigue, headache, itching, anxiety, flushing, swelling of tissues, brain fog, body pain, constipation/diarrhea, irritability, bloating, lightheadedness, hoarse voice, reflux

Treatment suggestions

  • Avoid known triggers!

  • Trial “low histamine” diet (also considered an anti-inflammatory diet), omit if there is a history of disordered eating

  • HI blocker (antihistamines such as Zyrtec, Xyzal, Allegra, Claritin)

  • H2 blocker (famotidine)

  • Mast cell stabilizers (Ketotifen, Cromolyn Sodium/Gastrocrom)

  • Mediator blockers: Antileukotrienes (Singulaire)

  • Mediator blockers: Antiprostaglandins

  • Antibody therapy (Xolair)

  • Vitamins (C, D, magnesium)

Wendy’s beginning 2 week MCAS protocol:

(This is a recommended protocol and should only be done with physician approval as it is a medical treatment plan. Please contact your doctor and review this plan before you begin.)

  1. H1 blocker like Allegra/Zyrtec/Xyzal/Claritin (one AM/one PM)

  2. H2 blocker (20-40 mg famotidine AM and 20-40 mg famotidine PM)

  3. D-Hist (2 capsules, three times a day)

  4. Vitamin C (1000mg daily)

  5. Follow “Low Histamine Diet” as best as you can

Alternative support to quiet underlying mast cell activation/degranulation


If you're specifically looking for natural alternatives to the H2-blocker properties of famotidine (which works by blocking histamine receptors in the stomach to reduce acid production), here are some natural options that may have a similar effect on histamine receptors and stomach acid production:

1. Quercetin

  • How it helps: Quercetin is a flavonoid with anti-inflammatory and antihistamine properties. It helps reduce the release of histamine in the body, which can reduce acid production in the stomach.

  • How to use: You can find quercetin in foods like apples, onions, and citrus fruits or as a supplement.

2. Vitamin C (Ascorbic Acid)

  • How it helps: Vitamin C can help modulate the body's histamine response. Some studies suggest it may have an antihistamine effect, which can help reduce the excessive acid production seen in reflux.

  • How to use: You can consume vitamin C-rich foods (like citrus, bell peppers, or strawberries) or take a vitamin C supplement.

3. L-Theanine

  • How it helps: L-Theanine, an amino acid found in green tea, has been shown to support a balanced stress response, which can impact stomach acid production. It may also help with histamine levels, reducing their impact on stomach acid.

  • How to use: L-Theanine is commonly taken as a supplement, or you can consume green tea.

4. Probiotics (Specific Strains)

  • How it helps: Certain strains of probiotics, like Lactobacillus and Bifidobacterium, may help regulate histamine levels in the gut and improve overall digestive function. Balancing gut flora can help reduce the need for excess stomach acid.

  • How to use: Probiotic supplements or fermented foods like kefir, yogurt, sauerkraut, or kimchi may be helpful.

5. Stinging Nettle (Urtica dioica)

  • How it helps: Nettle has natural antihistamine properties and can help block histamine release, reducing the overall acidity in the stomach.

  • How to use: Stinging nettle can be consumed as tea or taken as a supplement.

6. Fennel Seeds

  • How it helps: Fennel has mild antispasmodic and anti-inflammatory properties that can help reduce stomach acid. While not directly affecting histamine receptors, it soothes digestive issues and promotes healthy acid balance.

  • How to use: Chewing fennel seeds after meals or drinking fennel tea can aid digestion and reduce reflux.

7. Licorice (Deglycyrrhizinated Licorice - DGL)

  • How it helps: DGL may help regulate stomach acid by protecting the stomach lining and reducing irritation. It is also thought to have mild effects on histamine levels.

  • How to use: DGL supplements are available, and they are usually taken before meals.

8. Chamomile

  • How it helps: Chamomile has anti-inflammatory and calming properties, which can help reduce the production of stomach acid by soothing the digestive system.

  • How to use: Chamomile tea is the most common form for digestive health.

9. Turmeric (Curcumin)

  • How it helps: Curcumin, the active compound in turmeric, has strong anti-inflammatory and antioxidant effects. While not a direct histamine blocker, it helps balance digestive processes, potentially reducing the need for high stomach acid.

  • How to use: You can take turmeric supplements or consume it in foods like curries and golden milk.

10. Magnesium

  • How it helps: Magnesium may help regulate stomach acid production by relaxing the muscles around the stomach and esophagus. Magnesium also plays a role in balancing histamine levels in the body.

  • How to use: Magnesium supplements or magnesium-rich foods (like leafy greens, nuts, seeds, and legumes) can be helpful.

Important Notes:

  • Histamine Regulation: The way natural remedies can affect histamine levels varies from person to person. While some herbs, like quercetin, may block histamine receptors, others may act more broadly by soothing the stomach lining and promoting digestion.

  • Effectiveness: While these natural remedies may mimic some of the acid-reducing effects of H2-blockers, they may not have the same potency as famotidine. They are more suitable for milder symptoms or as adjuncts to lifestyle changes.

  • Consultation: If you're dealing with persistent acid reflux or digestive issues, it’s always best to consult with a healthcare provider before substituting or adding supplements to your routine.


    Please note: Wendy4Therapy is not a medical doctor and is not licensed to provide an official medical diagnosis or prescribe medication. Education provided here is for your information only, and it is expected that you visit a medical practitioner who is licensed to provide a diagnosis for further exploration. Wendy4Therapy can take you through the diagnostic criteria but cannot formally diagnose EDS or related conditions. Please do  not reproduce without permission. This is GENERAL and not intended to be customized for individual patients. Please follow consultation and recommendations of your healthcare provider for specific treatment protocols.