1670 ROUTE 34 N. 3R FLOOR SUITE 3C WALL • NJ 07727
1670 ROUTE 34 N. 3R FLOOR SUITE 3C WALL • NJ 07727

Mast Cell Activation Syndrome

Mast Cells

  • Important mediators of inflammation
  • Play a role in both innate and adaptive immune responses 
  • Mast cells are found in connective tissue throughout the body in almost every organ 
  • When mast cells are activated by immune reactions, they degranulate and release various inflammatory mediators (like histamine) into the extracellular space

Mast Cells Have Many Effects on Immune Response

Mast Cell Activation and CIRS

  • Many people that suffer from chronic inflammatory response syndrome also have excessive mast cell activation 
  • When mast cells are activated and degranulate, they release histamine (as well as several other immune modulating substances)
  • Excess histamine can cause numerous symptoms

Manifestations of High Histamine

Metabolically Directed Approach to Mast Cell Activation

  • Fix what is wrong!
  • Mast Cell Activation is a Symptom of a Hyper-stimulated Immune System
  • Certain Metabolic Imbalances Underlie Mast Cell Activation and Need Addressing
  • Environmental Issues are Frequently Causative

Metabolically Directed Approach to Mast Cell Activation

  • Treat underlying metabolic and hormonal imbalances
  • Identify and reduce stressors (like bio-toxin illness)
  • Diet should be free of excess sugars and toxic oils (canola, soy…)
  • Low histamine diet

Metabolic Imbalances Associated with MCAS

  • Parasympathetic Imbalance
  • Tissue Acidosis (Anaerobic Imbalance)
  • Systemic Alkalosis 
  • Excess Cortotropin Releasing Hormone
  • Lipopolysaccharide (LPS) exposure – from dysbiosis
  • Estrogen Dominance
  • Hypothyroidism

Causes of Mast Cell Activation Syndrome

Estrogen Dominance is a Common Contributor to MCAS

Chronic Stress as a Contributor to MCAS

  • Chronic Stress raises cortisol
  • Elevated cortisol increases anaerobic metabolism
  • Elevated cortisol tends to increase systemic alkalinity
  • Elevated cortisol contributes to reverse T3 syndome and a functional hypothyroidism

Minimize/Avoid High Histamine Foods

  • Pickles, mayonnaise, sauerkraut, vinegar, dried fruits, yeast, food additives, tomatoes, seeds, nuts, chocolate, cocoa, processed meats, canned vegetables, egg whites, spices, beer, wine, champagne, shellfish, tofu cheese, mushrooms, aged cheeses, spinach

Metabolically Directed Treatment for MCAS

  • Fix what is wrong!
  • Improve diet – avoid excess carbohydrates, sugars and PUFAs, High Histamine Foods 
  • Address Environmental/Stealth Organism Issues (CIRS)
  • Address Sex and Adrenal Cortex Imbalances 
  • Address Thryoid Imbalances
  • Address Metabolic Imbalances

Foods with anti-histamine effects

  • Apples – rich in quercitin 
  • Carrots – rich in vitamin A
  • Watercress – inhibits histamine release
  • Broccoli – H2 receptor antagonist
  • Ginger – H2 receptor antagonist 
  • Thyme – anaphylaxis inhibitor
  • Fennel – antioxidant, antihistamine, anti-inflammatory
  • Tumeric – stabilizes mast cells, inhibits histamine release

Potentially Helpful Supplements for MCAS

  • Complex P – to reduce excess parasympathetic activity
  • Proton Plus, Magnesium Chloride – to reduce systemic alkalinity
  • DIM, Calcium-D-Glucurate to reduce excess estrogen activity
  • Immunosynbiotic to repair dysbiosis and decrease lipopolysaccharides
  • Other metabolically directed supplementation as needed

Drugs for MCAS

  • H1 – Histamine receptor antagonists (Diphenhydramine, Hydroxyzine, cetirizine, fexofenadine)
  • H2 – Histamine receptor antagonists (ranitidine, famotidine)
  • Cyproheptadine,is a first-generation antihistamine with additional anticholinergic, antiserotonergic, and local anesthetic properties
  • Mast Cell Stabilizers (NasalCrom, GastroCrom)
  • Leukotriene inhibitors (Singulair, montelukast)
  • Ketotifen is a benzocycloheptathiophene derivative that has powerful antihistamine and mast cell stabilizing effects  cyproheptadine and azatadine
To learn more about Michael Rothman MD contact us today by giving us a call at (732) 268-7663, emailing us at [email protected] or by requesting an appointment online.
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