Dr. Amy Yasko on Allergic Reactions and Mast Cell Activation Syndrome

Mast cells, basophils, and eosinophils are the cells that generate an allergic reaction. Allergens binding to these cells cause the release of histamine, which causes immediate, and sometimes very intense, hypersensitivity reactions.
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.

Low tetrahydrofolate (THF) levels can cause elevated histidine. Elevations in histidine in turn cause increased levels of histamine. So, high histidine along with high histamine may indicate a need for THF. The FIGLU on a Metabolic Analysis Profile Test (MAP Test) will also climb If there is not sufficient THF. Thus, high FIGLU may be an indirect sign of excess histidine.

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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Nancy Mullan MD
Author, lecturer, clinician,
Dr. Nancy Mullan is best known for her natural treatment of chronic illness, including Autism Spectrum Disorders, Lyme and MTHFR+.
2829 Burbank Blvd., Suite 202, Burbank CA  91505
T: (818) 954-9267 – F: (818) 954-0620

About Nancy Mullan, MD

Some people call Dr. Nancy Mullan the MTHFR genetic medicine expert. Dr. Mullan works with people who are struggling with chronic disease or other significant illness, who are willing to use diet and genetics-based nutritional supplementation, and who want to increase wellbeing and energy, enhance immunity, lift mood, fine-tune genetic function, and get their lives back. Dr. Mullan has studied at a number of exceptional institutions: the University of Pennsylvania, Tufts University School of Medicine, and the University of Chicago Hospitals and Clinics. She excels at integrating the results of biochemical and genetic testing into sustained clinical improvement for you. She has succeeded with patients who confounded the specialists at Massachusetts General Hospital, the Mayo Clinic, the Cleveland Clinic, Stanford, and many well-known integrative medical doctors. When recommending her, her patients say, “This is the woman you need to talk to. She really knows how to handle tough clinical problems.” Dr. Mullan's specialty areas are MTHFR+, methylation genetics, and genetics-based nutritional supplementation. Within this context, she most often works with Chronic Fatigue Syndrome, Lyme Disease, Psychiatric Disorders, Autism Spectrum Disorders, Women’s Health Issues, Thyroid Disorder, Gastrointestinal Disorder, and Heavy Metal Toxicity.
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