Histamine and Mast Cell Activation Syndrome (MCAS)

Solving the Puzzle with Dr. Datis Kharrazian

In this episode, Dr. Kharrazian goes over the primary mechanisms of histamine intolerance and mast cell activation syndrome (MCAS). But first, make sure you even have these conditions as these diagnoses are being tossed around a little too casually these days. While the low-histamine diet may reduce symptoms, it does not necessarily address the underlying causes and it deprives you of cultured foods, which support microbiome diversity. Additionally, MCAS is a very serious condition, so make sure your self-diagnosis is valid or you may be addressing the wrong target.

Dr. Kharrazian covers all these topics in a 20-minute talk and then answers questions from viewers. If you suspect you have histamine intolerance or MCAS, this video gives a great foundation from which to move forward.

Synopsis:

Symptoms of histamine intolerance

• Skin urticaria
• Nasal congestion
• Anaphylaxis
• Wheezing
• Chronic gastrointestinal issues
• Chronic migraine issues

Key things to note with histamine reactions

• Determine if you actually have histamine intolerance by taking an antihistamine and looking for relief from symptoms.
• Multiple food sensitivities doesn't necessarily mean you have a mast cell/histamine response.
• Food sensitivities are delayed IgG response or an IgM responses.
• Histamine responses involve immediate IgE responses.
• An allergic reaction IgE reaction to foods and environmental chemicals activate mast cells, which release chemical mediators, including histamine.

Mast cell activation

• Healthy response: Exposure to the antigen triggers mast cells.
• Occasional symptomatic response: Occasional reactions to triggers such as pollen or pet dander.
• Chronic histamine response: Chronic histamine issues with constant symptoms
• Mast Cell Activation Syndrome (MCAS): Massive and chronic mast cell response. The body is producing excess mast cells with exaggerated activity, causing significant and severe symptoms

Things to look at when you have a histamine response

• Genetically low DAO enzyme
• Methylation issues
• Exposure to an allergen that develops IgE reactions, e.g mold, parasitic, Lyme infection
• Underlying triggers
• What is amplifying the immune responses
• Immune tolerance
• Other chronic health issues (leaky gut, leaky lung, low vitamin D, etc.)

Mast Cell Activation Syndrome

Mast cell activation stream is the most aggressive form of histamine reaction, has criteria for diagnosis, and may require pharmacological treatment.

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