Understanding Mast Cell and Histamine Disorders: Caught in the Cycle
Are you caught in a cycle of needing antihistamines to alleviate flaring symptoms? There’s a good chance you’re dealing with mast cell activation syndrome (MCAS) and histamine disorders if you’re like many of our patients dealing with tick-borne illnesses, mold illness, and/or other chronic conditions. But how can you differentiate between histamine intolerance vs. MCAS?
The good news is that you don’t have to relegate yourself to taking antihistamines for the rest of your life. It’s time to find the root cause(s) of why your immune system is reacting so intensely and discover what causes mast cell activation syndrome and histamine disorders. First, let’s go over what histamine and mast cells are.
| Key Takeaways: Mast cell activation syndrome is commonly caused by mold exposure, tick-borne infections, like Bartonella and Babesia, and chronic inflammation. Histamine intolerance involves impaired histamine breakdown, while MCAS involves overactive mast cells releasing inflammatory mediators. Antihistamines may reduce symptoms, but identifying and removing root triggers is essential for long-term improvement. Addressing triggers, lowering inflammation, restoring nutrients, and rebuilding the body are key steps in recovery. |
Histamine Intolerance vs. MCAS vs. Mastocytosis: What’s the Difference?
Because mast cell and histamine symptoms overlap so significantly, it is easy to confuse these conditions. So how can you tell the difference between histamine intolerance vs. MCAS?
While they are related, they are not the same. Histamine intolerance is trouble breaking down histamine, while MCAS describes how overactive mast cells can release histamine and cause wide-ranging symptoms.
Histamine is a chemical made by your immune system and is a type of inflammation. When something is bothering your immune system, such as an allergen or another trigger, histamines try to defend your body and kick the offender out. While histamine is a vital and necessary part of how your body functions, it can easily go into overproduction.
Mast cells are one variety of immune cells that play a part in how your immune system functions. Mast cell activation syndrome (MCAS) occurs when that part of your immune system becomes overactive. After that, histamine is overproduced, causing inflammation and stemming symptoms. Mast cells can be a big source of symptoms. While not every patient with Lyme, co-infections, mold, or chronic health issues deals with mast cell issues, it’s extremely common for it to be an accompanying issue.
Mastocytosis
Mastocytosis involves an abnormal accumulation or overgrowth of mast cells in tissues. This differs from MCAS, where mast cell numbers may be normal, but activity is dysregulated. It is also possible for histamine intolerance and MCAS to overlap.
An Exhaustive List for Exhausting Symptoms
Several well-known books provide useful background on mast cell and histamine-related disorders, including symptom patterns and common presentations:
- Never Bet Against Occam by Lawrence Afrin
- Toxic by Neil Nathan
- Mast Cells United by Amber Walker
There are many reasons why these resources are frequently referenced.
For example, “Never Bet Against Occam” is widely cited for its extensive catalog of possible symptoms associated with mast cell activation disease (MCAD), mast cell activation syndrome (MCAS), and histamine overproduction. The book’s primary strength is symptom documentation, with comparatively limited focus on treatment approaches.
Why symptoms can look so different from person to person
Mast cells release histamine and other chemical mediators involved in immune signaling and inflammation. Because histamine has roles throughout the body, overproduction or dysregulated release can affect multiple systems and create a wide range of symptoms.
Systems commonly impacted include:
- Nervous system: pain, anxiety, insomnia, headaches
- Digestive system: bloating, cramping, constipation, diarrhea
Respiratory system: nasal and sinus symptoms, airway irritation - Skin: flushing, itching, rashes
- Genitourinary system: bladder and urinary symptoms
- Other areas: eyes, ears, hormonal balance
Key point: You use histamine everywhere in and on your body.
Mast cell and histamine disorders can present with broad, overlapping symptoms because histamine and related mediators influence many tissues and organ systems.
The Problem with Band-Aids for Mast Cell and Histamine Disorders
Unfortunately, this book is very lackluster in describing what causes mast cell activation syndrome and histamine disorders. To summarize, in the one chapter where Afrin does talk about solutions, he says we know mast cells can create excess histamine. However, we don’t know why. One cause may be genetics.
There are about 20 different meds that block histamine in some way, shape, or form. Start with the cheapest and safest option. Between now and the next four years, try each option for 2-3 months at a few different dosages to find one that works. That will help you at least 50 percent of the time.
Lastly, he firmly believes there isn’t just one medication that works the best for everyone. You need to figure out which medication and dose work for you. Here at Restorative Health Solutions, we agree with Afrin in this regard!
While there is a method to this approach, it’s still very flawed.
In general, the major medical community gives up much too quickly on finding root causes. They quickly jump to finding prescriptions or OTC drugs to alleviate symptoms, and they blame genetics too much. It’s not evil to address and try to reduce symptoms. But it’s dangerous to abandon potential causes for why the symptoms are occurring.
The standard practices in healing mast cell and histamine issues are missing a big point. In treating MCAS and histamine overproduction, we should ask why the body feels the need to overproduce histamine. It shouldn’t end with just taking an antihistamine for the rest of your life. While it might help, it doesn’t fix the real problem. Consequently, it’s just a band-aid.
Not All Reactions Are Food Sensitivities
It is important not to confuse mast cell or histamine-related symptoms with standard food sensitivities. Food sensitivities typically involve digestive discomfort after specific foods. Histamine intolerance may also involve food reactions, but the underlying issue is impaired histamine breakdown. MCAS, on the other hand, can be triggered by far more than food.
Common MCAS triggers can include:
- Chronic psychological or physical stress
- Temperature shifts of extreme heat and cold
- Environmental exposures, such as mold or toxins
- Acute or chronic infections
- Hormonal changes or fluctuations
If reactions seem unpredictable or extend beyond digestion into neurological, cardiovascular, or systemic symptoms, mast cell activation may be a better explanation.
Uncovering What Causes Mast Cell Activation Syndrome
So what causes mast cell activation syndrome and histamine disorders? In “Toxic,” Neil Nathan does a great job of explaining two of the common causes for why your immune system is triggering these mast cell and histamine disorders. His top two causes are Bartonella and mold. I would add Babesia to that.
Firstly, there’s mold exposure. This usually comes from water-damaged workplaces or homes. One patient even developed issues from regular exposure to a moldy car.
Secondly, there are Bartonella and Babesia, two tick-borne illnesses. They’re similar to Lyme disease, but they are different co-infections that often accompany Lyme-infected ticks.
If you’re struggling with chronic Lyme, most people find they have multiple co-infections as well. Over 90 percent of the time, Lyme patients with persisting symptoms are dealing with co-infections. Any condition a person has for longer than six months is considered chronic.
When patients are suffering from a myriad of symptoms, we know testing is needed to identify the root cause of their inflammation. It’s important not only to test for tick-borne illnesses but to check inflammation markers as well. We need to determine the cause(s). Oftentimes, it’s a combination, but we need to discover the triggers by checking inflammation levels, tick-borne illnesses, mold, and chemicals. When you’re getting this inflammation response, testing can give us some clarity as to what we’re running into.
Some of the inflammation markers we check are histamine, eosinophil cationic protein (ECP), immunoglobulin E (IgE), chromogranin A (CgA), and tryptase levels. If these levels aren’t in a healthy range, inflammation may be driving some of your symptoms.
You’re Not Doomed: DNA and Epigenetics
One of the questions I get asked frequently by patients is whether they’re doomed if genetics play a part in their mast cell and histamine issues.
Only 20 percent of this condition is genetic. The real problems lie in a person’s environment, which constitutes 80 percent of cases. You may have some genetic susceptibility, but by changing your environment so that you aren’t regularly exposed to mold and you’re not battling tick-borne illnesses, you can get over the hump and start feeling better.
Epigenetics describes how your environment alters your genetic expression. Your gut microbiome and diet, sleep quality, mental health, social circles and relationship health, exercise habits, living and working environments, other conditions, and chemical and biotoxin exposures all play a huge role in how your genes are expressed and whether certain gene expressions turn on or off.
We can’t emphasize enough how much of this you have control over. That’s incredibly empowering. You’re not doomed just because you have something that runs in your family.
The Four Phases
To figure out your mast cell and histamine issues, address these four phases.
No. 1: Check for potential triggers. These could be tick-borne illnesses, like Lyme, Bartonella, and Babesia, or mold exposure. I have found this to be the overall best, long-term solution.
No. 2: Utilize histamine-lowering medications or natural supplements such as quercetin, milk thistle, and others to reduce histamine. We want to stress that these are meant to be short-term bridges while you are removing the source of the histamine (such as Babesia or Bartonella).
No. 3: Check on vitamin and mineral levels and other building blocks of the body to make sure it has the raw materials it needs to repair itself from collateral damage.
No. 4: Rebuild and exercise the body. This step comes at the end of this process after the other phases have been addressed.
In order to heal, address these phases. Firefighters want to know what caused the fire so they can prevent the same scenario from happening again in the future. Once you put out the fires, get rid of the fire hazards, rebuild the basic structures of your body with raw materials, and use your body (by exercising at the appropriate time) to help rebuild and strengthen the house.
You have to uncover WHY the immune system is creating extra mast cells and histamine, get rid of the trigger(s), and rebuild the body after you’ve knocked out the trigger and cooled down the inflammation. Don’t stop at putting out frequent fires (symptom flares) with antihistamines forever. The cause(s) must be addressed and the damage repaired.
In our next article, we will address some strategies and recommendations for blocking histamine with medications and supplements, but remember: Merely blocking histamine is a temporary band-aid that’s just meant to give you some help while you’re digging and getting to the root cause.
Get Help for Histamine Intolerance and MCAS
If you want help building a structured plan for overcoming histamine intolerance, MCAS, and other health issues, reach out to our clinic and set up your free consultation with one of our team members. They will go through your history, symptoms, and next steps with you.
To learn more about Lyme disease, co-infections, and other drivers of chronic inflammation and immune responses, check out our Lyme page and blog.
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