Are you wondering if your histamine intolerance or allergic reactions are actually an issue with your mast cells? Or maybe you’ve experienced chronic symptoms that seem like allergies for as long as you can remember?
Histamine is an important but potentially dangerous mast cell mediator and part of the immune system response. Histamine is secreted by mast cells into surrounding connective tissues when there’s an exposure to an allergen. Mast cell histamine works by increasing the permeability of blood vessels and allowing white blood cells and proteins to access affected tissues more easily.
Histamine intolerance is a condition that’s growing in recognition. However, it is mostly considered a part of a much wider problem which is defined as Mast Cell Activation Syndrome (MCAS); a situation in which part of the innate immune system becomes hyperactive and releases multiple inflammatory mediators, of which histamine is one.
Histamine intolerance is considered to be present when there is just too much histamine in your body for it to cope. This is further exacerbated by the fact that histamine is also present in many foods and so a person’s histamine burden may be further amplified by their diet. This histamine isn’t broken down due to a DAO gut enzyme deficiency, or a HNMT deficiency in the liver. A comprehensive guide regarding the low-histamine diet can be found here.
Histamine intolerance is a subset of MCAS
Mast Cell Activation Syndrome is often confused for histamine intolerance. The difference between the two is that when a person has MCAS, their mast cells secrete many mediators, not just histamine. Though, histamine is still a major component of MCAS it’s only a piece of the puzzle.
Histamine intolerance is actually a subset of MCAS. If you’ve discovered you’re histamine intolerant or recently received a diagnosis, you should also be tested for MCAS.
Conditions associated with MCAS
Because MCAS is a multisystem condition with inflammation at it’s core, it’s been associated with a number of other conditions including:
- Chronic inflammatory response syndrome (CIRS)
- Irritable bowel syndrome
- Gut dysbiosis – the gut is rich in mast cells and home to over 70% of the immune system. Parasites, bacteria, fungi, and parasites can all trigger gut mast cells.
- Obesity
- Diabetes
- Asthma and allergies
- Autoimmune diseases (such as lupus, rheumatoid arthritis, and Hashimoto’s)
- Candida overgrowth
- Celiac disease
- Parasite infections
- Skin conditions such as eczema and psoriasis
- Food intolerances and allergies
- Gastroesophageal reflux (GERD)
- Infertility and endometriosis
- Postural orthostatic hypotension (POTS)
If you’ve been diagnosed with one of these associated conditions, it could mean that being diagnosed with MCAS is more likely. Make an appointment with a doctor who specializes in MCAS and begin the diagnostic process. It can be somewhat of a journey, but once you know you have MCAS there’s a lot that can be done to relieve your symptoms and improve your life.
For a comprehensive guide on Mast Cell Activation Syndrome, you can read my in-depth article, Mast Cell Activation Syndrome and Mast Cell Histamine: When Your Immune System Runs Rampant.
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Resources:
https://www.ncbi.nlm.nih.gov/pubmed/25773459
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507480/
https://www.ncbi.nlm.nih.gov/pubmed/15462834
Dr. Bruce Hoffman, MSc, MBChB, FAARM, IFMCP is a Calgary-based Integrative and Functional medicine practitioner. He is the medical director at the Hoffman Centre for Integrative Medicine and The Brain Centre of Alberta specializing in complex medical conditions. He was born in South Africa and obtained his medical degree from the University of Cape Town. He is a certified Functional Medicine Practitioner (IFM), is board certified with a fellowship in anti-aging (hormones) and regenerative medicine (A4M), a certified Shoemaker Mold Treatment Protocol Practitioner (CIRS) and ILADS trained in the treatment of Lyme disease and co-infections. He is the co-author of a recent paper published by Dr. Afrin’s group: Diagnosis of mast cell activation syndrome: a global “consensus-2”. Read more about Dr. Bruce Hoffman.
Other considerations in treating these patients would be to improve their overall digestion, whether that is eliminating food allergens or offering botanical support (e.g. bitters) to stimulate production of digestive enzymes. For both MCAS and histamine intolerant patients limiting higher histamine-containing foods while retraining the system is often warranted. Even alcohol in tinctures can sometimes be a trigger for sensitive MCAS and histamine intolerant individuals, and glycerites, teas, or capsules should be used instead. However, while recommending diet changes, it’s important to foster a positive attitude toward food as many of these patients may become afraid to eat due to hyper-reactivity. Treating dysbiotic flora is also necessary, especially since certain bacteria have been associated with histamine intolerance and even inflammatory states in autoimmune disease
Hi, Dr. Hoffman,
Following leads on handling tinnitus led me to this article. I see possible linkages to other issues, including allergies. Thanks for your information. It’s too bad I can’t find medical assistance where I live, but I can do my own research.
Happy to help Cheryl.