Mast cells are like water balloons filled with histamine. When your body reacts to an allergen, it is like sticking a pin in the water balloon, allowing histamine to burst out. Mast Cell Activation Syndrome (MCAS) is a condition in which excessive numbers of mast cells are triggered even in the absence of a specific allergen. The goal is to both reduce the number of mast cells, as well as to mitigate the high histamine levels.
The methylation cycle is also important in processing the histamine that is produced secondary to a lack of THF. FIGLU is an indicator for low THF. When FIGLU is elevated it leads to the formation of histidine, which can convert to histamine. You need methyl groups to process histamine.
Histamine is broken down by the enzymes diamine oxidase (DAO) and histamine N-methyltransferase (HNMT). The HNMT enzyme requires methylation cycle function in order to break down histamine. The DAO enzyme needs copper to function. High levels of copper can be an issue for other neurotransmitters, increasing the breakdown of serotonin and dopamine, as well as negatively impacting attention. So, the goal is to keep copper in a normal range, with zinc levels higher than copper. In this way, there is sufficient copper for DAO function without causing increased serotonin or dopamine breakdown or causing issues with attention.
You may be able to slow down some of the mast cell degranulation and histamine release of an IgE reaction by the use of quercetin. Quercetin is not optimal for those who are COMT + +. While it may be a help for high histamine, as well as for oxidative DNA damage, it is not ideal for those who are COMT ++ because it can inhibit COMT. Cherries are a natural source of quercetin, so while cherries may help with inflammation, gout, and some forms of arthritis, the quercetin levels in cherries may be an issue for those who are COMT ++. Also, Butterbur, which is in Petadolex, blocks the action of histamine.
Finally, more traditional medications may be a help if natural approaches are not enough to address severe MCAS. The antibiotic minocycline has been reported to limit certain inflammatory reactions and can be used for anti-inflammatory purposes rather than for its antibiotic properties. Minocycline has been a help for limiting excessive microglial activation that plays a role in chronic neurological inflammation.
In addition, minocycline has been reported to reduce overall levels of IgE. The action of IgE specific allergens binding to mast cells allows the massive release of histamine in allergic conditions. Limiting IgE levels while identifying and eliminating the allergic triggers may be a help in extreme conditions in which natural approaches have not been sufficient.
The combination of Claritin and Pepcid has been reported to lower the number of mast cells in skin reactions, as well as to decrease histamine levels. While Dr. Amy generally prefers to go the more natural route first, to work on the underlying causes, in extreme conditions of MCAS, the combination of medication with natural supplements may be considered.
Excerpted from Chapter 16 of Feel Good Biochemistry which can be accessed at www.feelgoodbiochem.com
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