Dr. Bray Links

Friday, November 21, 2014

Mast Cell Disorders

Mast cell disorders are on the rise. It is unclear why, but many suspect imbalances in the gut microbiome, a decline in the nutritional quality of our food, and also chronic exposures to toxic/harmful substances. Understanding the interventions for mast cell and histamine problems can be helpful with a wide range of medical problems.

If these symptoms (see graphic below) are present (including the oh-so-common seasonal allergies) and have been challenging to control, consider:
  1. Testing for MTHFR, DAO
  2. Using a low histamine diet
  3. Consider using Ketotifen, Zantac, Zyrtec
  4. Consider using Quercetin, Stinging Nettles, Bromelain, NAC, Vitamin C (D-Hist is one combo product)

"What do chronic illnesses such as Autism, Chronic Fatigue Syndrome (CFS), Fibromyalgia Lupus, Chronic Lyme Disease, Interstitial Cystitis, Multiple Sclerosis, and more have in common? Well, these illnesses may have a lot of things in common, and a lot of overlapping symptoms, but many patients symptoms seem to be compatible with Systemic Mast Cell Activation Disorder (MCAD)."


Dr. T.C. Theoharides, M.D. Ph.D has a wealth of research on the topic:


"The Mastocytosis Center at Brigham and Women’s Hospital (BWH), a first-of-its-kind center, provides expert multidisciplinary evaluation and treatment for patients from across the country. Led by Allergist and Immunologist Cem Akin, MD, PhD, specialists in the Center have developed advanced approaches to diagnosis and treatment of the disease."


"Histamine is found in mast cells. It it released to help fight infection/illness/injury, keep us awake, regulate our hormones, run our digestive system and as a neurotransmitter. Some people have unstable mast cells that release too much of it, or they just have too many mast cells. Some people have allergies which means they also have too much histamine at times. Others have too little of the histamine lowering enzymes diamine oxidase (DAO) or HNMT. An excess of histamine is involved in: allergies, histamine intolerance, mast cell activation, mastocytosis and a number of other medical conditions."


"Dr. Miner has stated that there are 7 deadly sins for mast cell patients to eat: beef, pork, onions, tomatoes, wheat, oranges, and chocolate. These foods are all high in histamine and his research has shown that mast cell patients can clear up a lot of stomach issues by ceasing to eat these foods."


"MTHFR Polymorphism may be a predisposing factor to mast cell disease. 5-MTHF regulates biosynthesis of BH4. The A1298 mutation in the MTHFR enzyme effects the conversion of BH2 to BH4. Less amounts of BH4 inhibits NO formation resulting in increased mast cell degranulation. Inadequate BH4 formation also puts a strain on the conversion of tryptophan to serotonin and tyrosine to dopamine, leading to low levels of the neurotransmitters: dopamine, norepinephrine, serotonin and melatonin.

Low blood serotonin levels help define a sub-group of patients with mastocytosis that are more likely to present with neurological and gastrointestinal complaints. Human mast cells can express and be activated through multiple serotonin receptors, and synthesize and release serotonin. Low blood serotonin levels in such patients may be the result of low BH4 levels due to 5-MTHF deficiency, the result of long-term malabsorption from chronic inflammation of the gastrointestinal tract or both, as is the case with me.

BH4 is a critical factor in cellular activities such as cell proliferation, cell cycle regulation and differentiation. Could BH4 deficiency secondary to MTHFR polymorphism be one of the fundamental mechanisms that underlie mast cell proliferation?"



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