Page 40 - Summer2018

are leading experts in MCAS, and their websites are excellent sources (in “forbidden rice” or black or purple rice),
of information about this complex condition. 2,3,4 However, individuals which has been shown to reduce the release of
seeking to heal with a predominantly food-based approach will need histamine from mast cells. We exercise caution
additional help. with probiotics, which can worsen the symptoms
of histamine overload. We recommend only us-
WHICH ONE? ing the following bacterial strains: L. reuteri, L.
Symptoms of MCAS and the less complex histamine intolerance rhamnosus, L. casei and B. bifidum.
are not always clearly distinguishable. It can be challenging, therefore, Because people often have multiple food
to determine conclusively whether someone is suffering from MCAS or sensitivities due to intestinal permeability, or
histamine intolerance or both. they have other food restrictions (such as low
In our functional nutrition practice, our initial approach focuses on FODMAPs for SIBO), we do not recommend
improving the GI tract and liver function while supporting hormones, implementing a strict low-histamine diet; we
methylation and overall health. In this way, we are able to minimize do not want to be the ones telling people that
histamine intolerance; if someone truly has MCAS, we will see some they can only eat air from now on! However,
improvement but also will be able to recognize that more work needs to we do encourage such people to limit or avoid
be done. We also will have set the stage for that person to do better on the biggest offenders among histamine foods,
the pharmaceutical treatments that are so often necessary with MCAS. which include alcohol, fermented foods, smoked
or cured meats, citrus fruits, shellfish, canned
SYMPTOMS AND TREATMENT fish or meat, fish and seafood in general (except
A first step is to be aware that both MCAS and histamine intoler- salmon, cod and tuna frozen on the boat), vin-
ance can coexist with other conditions, making it very difficult to parse egar, strawberries, nuts, tomatoes and cacao.
out exactly what is going on. Next is the question of how they should be This approach, coupled with addressing the
treated. A major component of the treatment for either condition is to major GI disorders, usually works very well.
reduce the dietary intake of histamine foods as well as histamine “libera- For MCAS, the situation is much more
tors” (see below). We also use the DAO enzyme in a supplement form, complex. Symptoms can include rashes, hives,
5
in conjunction with a formula called NeuroProtek, which contains the itching, flushing, fainting, headache, abdominal
6
bioflavonoids luteolin, quercetin and rutin. We have used both of these pain, nausea, vomiting, gastroesophageal reflux
products with many patients over the past three years, and they have had a disease (GERD), fatigue, chronic pain, trouble
very high success rate in our clinical practice. There is research showing breathing and many more. The conditions as-
that DAO supplementation reduces histamine levels, and quercetin and sociated with MCAS are often complex in their
7
luteolin reduce the release of histamine and tryptase from mast cells. own right. Related conditions may include al-
8
More research is forthcoming in this area, including the results of a just- lergies, autism, autoimmune disorders, cancer,
completed clinical trial. diabetes, Ehler-Danlos syndrome, postural
9
Histamine intolerance symptoms can include rashes, hives, itching, orthostatic tachycardia syndrome (POTS), fibro-
headache, migraine, anxiety, depression, fatigue, insomnia, vertigo and myalgia, Lyme disease, mastocytosis, migraines
GI disorders. When treating histamine intolerance, we always try to and obesity. When one adds MCAS symptoms
address the GI disorders first, while supplementing with DAO and Neu- on top of those conditions, the person may be
roProtek. We also address methylation and, if needed, will supplement extremely ill with twenty to thirty symptoms.
with vitamin C, additional B vitamins, copper, zinc and magnesium. Unlike with histamine intolerance patients,
The dietary recommendations for individuals with histamine intol- it is imperative that MCAS patients implement
erance call for a diet rich in folate, vitamin B , glycine and flavonoids a strict low-histamine diet (provided their diet
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such as quercetin and rutin. We also recommend juicing homemade pea is not already too restricted) and otherwise
sprouts (which are rich in the DAO enzyme) as well as eating rice bran employ the same interventions that we use for

HISTAMINE “LIBERATORS” TO AVOID
• Most citrus fruits • Cocoa and chocolate
• Nuts • Papaya
• Tomatoes • Wheat germ
• Alcohol • Black tea energy drinks
• Green tea, mate tea • Additives (benzoate, sulfites, nitrites, glutamate and food dyes)

38 Wise Traditions SUMMER 2018