Mast Cell Activation: The Drama Queen of Your Immune System

Your immune system might be a drama queen, and that's not just a metaphor. When mast cells—powerful defenders designed to protect you from threats—become hyperreactive, they create a storm of inflammation affecting everything from your skin to your digestive system to your brain. This phenomenon, known as Mast Cell Activation Syndrome (MCAS), leaves countless patients struggling with mysterious symptoms that conventional medicine often misses or dismisses.

The symphony of symptoms can be bewildering: hives appearing without clear triggers, flushing that comes out of nowhere, debilitating brain fog, crushing fatigue, heart palpitations, and digestive chaos. What makes MCAS particularly challenging is that it rarely has a single cause. Instead, it emerges from a perfect storm of factors—infections like Lyme or long COVID, environmental exposures particularly mold, gut imbalances, genetic variants affecting histamine breakdown, and chronic stress. Each person's MCAS story is unique, requiring a personalized approach to unravel.

Through the lens of functional medicine, I share a comprehensive blueprint for addressing MCAS at its roots. From identifying triggers through advanced testing to stabilizing mast cells with targeted nutrients like quercetin and vitamin C, supporting histamine clearance with DAO enzymes, and optimizing detoxification with glutathione—this multi-layered approach goes far beyond simply suppressing symptoms with antihistamines. I walk through a real patient success story, showing how someone went from daily hives and inability to exercise to returning to CrossFit within six months by addressing multiple underlying factors. For those living with unexplained allergy-like symptoms, this episode offers both validation and a roadmap for recovery.

If you're tired of being told "everything looks normal" while feeling anything but normal, book a functional medicine consultation at harmonyhubhealth.com. Virtual and in-person appointments available in Manchester, Maryland. Let's calm your overactive immune system and help you reclaim your energy and quality of life.

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Episode Transcript

SPEAKER_00 (00:00):
Welcome to Harmony Hub Health, where my mission is
to provide comprehensive,affordable, integrative care
that addresses the root cause ofhealth issues.
At the Hub, the focus is onindividual patient journeys.
I strive to optimize health,vitality, and longevity,
fostering a community where eachperson can thrive in body, mind,
and spirit.

(00:33):
Today I want to talk about mastcell activation and what it
really is.
And it's when your immune systemoverreacts.
I guess we can say your immunesystem is being a little
dramatic.
Mast cells are powerful immunecells that are designed to
protect us from infections andinjury.
But when they release theirchemical messengers too easily

(00:55):
or too often, the result is astorm of inflammation that feels
unpredictable.
It can be frightening and it canbe chronic.
So this is known as mast cellactivation syndrome, also called
MCAS.
So mast cells do releasemediators like histamine,
prostaglandins, leucotrians, andtryptase.

(01:16):
In MCAS, this release happensinappropriately or excessively,
even when there is no realdanger.
Like I said, it's being verydramatic.
Mast cells live in so manytissues.
It lives in your skin, yourlungs, your sinuses, your gut,
your brain, your blood vessels,and symptoms can appear almost

(01:37):
anywhere.
The most popular symptoms ofMCAS are flushing, hive,
swelling, headaches, andmigraines, GI distress like
diarrhea, bloating, pain,palpitations, or when you feel
like your heart's skipping abeat, dizziness or blood
pressure changes, anxiety,insomnia, even brain fog.

(01:59):
So MCAS does not have a singlecause.
It's usually a perfect storm ofstressors that push mast cells
into overdrive.
These causes could be infectionsand chronic illness.
I see it with Lyme, Bartonella,Babesia, EBV, COVID-19, and even

(02:19):
long COVID.
It can be from environmentaltriggers like mold exposure and
mycotoxins, chemicalsensitivity, even fragrances.
It could be caused by gutimbalance if you have a leaky
gut, if you have dysbiosis, ifyou have yeast or candida, or
even SIBO, that small intestinalbacterial overgrowth.

(02:41):
It can also be genetic.
So variants in MTHFR, DAO, HNMT,or COMT can impair histamine
clearance.
Functional genomics testing,like three by four genetics,
does help identify if thesepathways are bottlenecks.
Then we have hormones andstress.

(03:15):
So if your DAO activity is low,whether due to genetics or gut
inflammation or nutrientdeficiencies, histamine
accumulates and contributes toMCAS.
Low DAO equals high histamineload.
So when you have these geneticvariants of the DAO, can also be
MTHFR, the HNMT, or COMT, theyall reduce histamine breakdown

(03:39):
and they impair methylation,which is your second pathway
that clears histamine.
3x4 genetics testing does revealthese polymorphisms and helps
personalize treatment.
So for example, if we'reemphasizing methylation support
with B12 folate riboflavin, orif we need to supplement DAO

(04:01):
with your meals.
This is known as Epigalacatechin galate.
It's the most abundant catechinin green tea.
It has mast cell stabilizingantioxidant and
anti-inflammatory effects.
And in vitro studies show thatEGCG can inhibit mast cell

(04:23):
degranulation.
So that makes it a very usefulnutraceutical for patients with
MCAS who can tolerate green teaextracts.
One of the most overlookedtriggers for MCAS is mold and
mycotoxin exposure.
Mycotoxins act as direct mastcell activators.
So they increase histamine andinflammatory cytokines.

(04:45):
Chronic exposure, even at lowlevels, can worsen MCAS symptoms
and make patients more reactiveto food, supplements, and
medications.
Functional uh medicine testinglike urinary mycotoxin assays or
environmental testing oftenreveals this hidden driver.

(05:06):
Treatment typically involvesmold remediation, binders like
charcoal or bentonite orchlorella, um glutathione, and
mitochondrial support.
What brought this podcast todayis one of my favorite patients,
which we didn't start out asfavorite patients.
So she came to me um withfrequent mystery reactions, I'm

(05:28):
gonna call them.
She complained of hives,swelling after meals, brain fog,
and a crushing fatigue.
And this is someone that wasgoing to CrossFit at one time.
So she did conventional allergytesting, which was all negative,
and she really felt dismissed bythe conventional medical system.
For me, I was a little nervousbecause she was the first

(05:51):
patient, I think, with HarmonyHub Health that I could even
classify as MCAS.
Um, we did some functionalmedicine testing for her and
discovered that she did have lowDAO enzyme activity.
Um, she did have geneticvariants in MTHFR and DAO.
This was all through um the 3x4genetics testing.

(06:15):
And she also had gut dysbiosisand elevated mycotoxin.
So it wasn't just one thing.
Her mast cells weren't behavingum or misbehaving randomly.
They were just very overwhelmed,right?
They were being dramatic.
So I built a layered protocol.
Um, for short-term relief, wedid um quercetin, vitamin C, and

(06:39):
some DAO supplementations withmeals that reduced her histamine
burden.
Um, orthomolecular does have thebest, the highest quality, um I
would say, that have these inthem.
Um and then for long-termhealing, there was mold detox
with binders and a lot ofglutathione, gut repair, and

(07:00):
methylation support.
And then lifestylestabilization.
So we started with a lowhistamine diet.
Um, she started with somenervous system regulation.
She was doing vagus nerveexercises and meditation.
And by the end of her sixthmonth, I know that she was doing
pulsetto also and having greatrelief with that.

(07:21):
So over six months, her dailyhive stopped, her energy
improved, and she could finallytolerate food again.
Some people might say six monthsis a really long time, but I
will tell you, she has feltmiserable for three plus years.
Um, there's no way that any ofthis is a quick fix.
I think month one or month two,I'm sure she's listening, she

(07:42):
was wondering if she wasted hermoney on me.
Um, there's a trust factor.
There is um, you know, belief.
And when you're first meetingsomebody, like I she didn't know
me from anybody else.
She had already been let down bythe conventional medicine
system.
Um, and here I was, someone thatpopped up on Facebook is how she

(08:02):
found me, and had no idea evenif I knew what I was doing.
I was not even sure for thisbecause she was my first MCAS
patient.
But over the six months, thingsjust got so much better.
By the time she got to monththree or four, she was having um
less of those hives.
She was still having some ofthem.
Her body was still being verydramatic.

(08:25):
Um, then we added in the HTMA,we balanced her minerals, then
we checked her gut, um, treatedwhat we found in there, which
what was in there surprised theboth of us.
But by month six, now she isback to CrossFit.
Um, that's a big win for herbecause that's something that
she really loved that she had togive up.

(08:45):
So functional medicine does gobeyond anti-histamines forever,
which is what she was told todo.
And sometimes I do give dehistto some people.
Um, it does help them with theirMCAS, but it doesn't really get
to the root cause.
Like, why are mast cellsoveractive in the first place?

(09:06):
So, my functional medicineapproach, um I'm gonna give you
my blueprint that I follow.
Um, I probably shouldn't becauseit is it's mine.
But I I'm I'm happy to share.
So, functional medicineapproach, my approach to MCAS,
um, is a very strategicstep-by-step process.

(09:29):
Number one is to removetriggers.
This could be going on a lowhistamine diet.
It's gonna mean doing freshcooking.
Um, it could be mold remediationand detoxification.
It really depends what we findyour triggers are.
Um, and sometimes those can bechanging, sometimes you're
chasing yourself.
Um, and then you have to treatgut infections.

(09:51):
Um, I would say um I have neverseen somebody completely resolve
triggers unless they did a deepdive into the gut.
All right.
Number two is stabilized mastcells.
This can be with vitamin C, itcould be with uh luteolin, it
could be with quercetin.
I have a whole arsenal oforthomolecular supplements that

(10:13):
depending on what I feel youneed after consultation, um, we
would try.
Then that EGCG and that greentea extract is something good.
Stinging nettles, I love.
I would say um, I love stingingnettles, um black seed oil.
And then for severe cases, whichI didn't have to go through um

(10:34):
in in her case, um, but cromelinsodium or um catotiphon, um
those are for severe cases, butavailable.
Now, you also want to supporthistamine clearance.
This means DAO enzymesupplements with meals if
needed.
You don't want to just take anysupplement because you heard

(10:54):
someone else did well with it.
You want a really goodconsultation to find out what
exactly you need and look at thetesting.
Okay, you want to test, don'tguess.
Um, then there's methylationsupport.
That would mean the B12, thefolate, the riboflavin,
magnesium, zinc, and thenoptimize your detox pathway.
So you want to make sure thatyou can support the clearance as

(11:17):
well.
Um, and then calming that immunesystem.
This is where the omega-3s comein, bromeline, curcumin.
Again, orthomolecular does havea whole entire arsenal of things
I can choose to help you calmthat immune system, keep it from
being dramatic.
Glutathione is my absolutefavorite.
Um, I love it in so manydifferent forms.

(11:40):
I would say the first form Ilove is, of course, infusions,
IV infusions.
You can get an infusion atHarmony Hub Health.
You can also use it as uminjections.
You can get an injection ofglutathione.
My favorite at home is the umliposomal topical by Aura
Wellness.
Um that's my favorite.

(12:00):
I carry that at Harmony HubHealth.
You can also get it from mywebsite.
Um, then after that, you can goto the liposomal oral, but you
know, just because most peoplealready have bad gut health and
a bad dysbiosis going on, I dotry to limit things going into

(12:20):
the gut like that.
Um, and then knack, knack isvery important as well.
And then adaptogens for stressresilience are always helpful.
I think with this patient, uh,what we had to separate at the
beginning was what exactly is adifference between a flare
versus MCAS?
So she asked me, you know, isthis just a flare or is it mast

(12:42):
cell activation?
And understanding the differenceis very critical.
So a flare would be a temporaryworsening of symptoms.
This can be an autoimmune flare,a Lyme flare, IBD flare,
anything like that.
But MCAS is a syndrome wheremast cells are chronically
unstable and release thesemediators too easily or

(13:04):
inappropriately.
A flare is episodic, it could bedays to weeks and is triggered
by a stressor.
MCAS is an ongoing condition.
It can be recurrent, but thereit's a multi-system symptom.
Um a flare is worsening of anunderlying disease, whereas
MCAS, it is um dysregulated mastcells reacting excessively to

(13:28):
triggers, whether it's food,chemicals, infection, stress, or
temperature.
Symptoms of a flare are verydisease-specific, um, like joint
pain in an immune autoimmuneflare or fatigue in a lime
flare.
MCAS is allergy-like andsystemic.
That's how you get the hives,the flushing, the swelling, the
GI upset, the palpitations, theheadaches, the brain fog.

(13:52):
Um, those are more thansometimes you get with MCAS.
Um, a flare treatment would beto manage that underlying
condition, you know, reduce thestress, calm inflammation.
But treatment for MCAS isstabilizing the mast cells, um,
supporting the DAO, having a lowhistamine diet, and then
detoxing from mold andmycotoxins.

(14:14):
So a flare is the storm itself,while MCAS is the broken weather
system that makes storms morefrequent and severe, if that
makes sense.
So if this is speaking to youand you've been living with
unexplained hives, flushing,food reactions, or fatigue that
no one else can explain, mastcell activation might be part of

(14:37):
your puzzle.
At Harmony Hub Health, I dospecialize in identifying root
causes through advanced testing,whether it's genetics, um, GI
map, oat test, mycotoxintesting.
And I love to createpersonalized treatment roadmaps
that go beyond symptomsuppression.
So if you're ready to calm yourmast cells and reclaim your

(14:58):
energy, book a functionalmedicine consultation with
Harmony Hub Health.
You can find me online atwww.harmonyhubhealth.com.
You can see me virtually.
You can also see me in person inManchester, Maryland at Monarch
Beauty and Spa.
Um, you can send me an email atMichelle, that's M-I-C-H-E-L-E
at harmonyhubhealth.com.

(15:19):
I would love to speak with youand get you on a good path to
health.
This podcast is for educationalpurposes only.
It is not intended to diagnose,treat, cure, or prevent any
disease.
The information providedreflects current functional
medicine understanding of mastcell activation and should not
replace individualized medicaladvice.

(15:40):
Always consult with a qualifiedhealthcare professional before
starting or changing anysupplement, medication, or
treatment plan.