Practical MCAS Interventions and Remedies

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Mast Cell Activation Syndrome

Angie writes:

Hello Robb and Nicki -

I have been listening on and off for a couple of years, and I appreciate your perspective and how rational and fair you are in your approach.

Some background, three and a half years ago I got pregnant and early in the pregnancy I identified that I needed to manage my blood sugar with diet, which I successfully was able to do. About a year after having the baby I was diagnosed with methane SIBO, and went through a long treatment, which was successful and improved my gut symptoms drastically. After this, my cholesterol levels and insulin resistance score improved quite a bit. The past year and a half , I have been wearing a continuous glucose monitor, knowing that I am vulnerable to type II diabetes, and in hopes that I will be able to improve my blood sugar and regulate my menstrual cycle. I think it is also be important to mention that I have had poor gut health since I was a child, I suspect I am on the spectrum of PCOS - as I have an irregular cycle which is consistent with those patterns, and I have high cholesterol and have since I was 18 years old, I tend towards inflammation, and I would say I have about 15# to lose. Despite all my efforts by ensuring quality sleep, eating low carb - unprocessed and high quality foods, weight training 3x per week, managing my stress with meditation, and walking 5-7000 steps per day, things are not improving. I have also tried berberine and various other recommended supplements and there is ZERO improvement. My A1C three years ago was 5.3 and most recently it is 5.7.

The week before Christmas I had the flu, 104*F fever for four days, congestion and a cough. A week after having the flu, I noticed that my head, shoulders, chest and other parts of my body seemed to be getting hot and itchy like hives, plus I was having bloating and constipation/diarrhea, and physical anxiety (like tight chest, pulse in the 90s). Plus, my blood sugar was spiking after eating a low carb meals and in other situations that didn't make sense. At a certain point I tried to help myself by taking electrolytes and extra whole food vit C. and things continued to get worse. A couple weeks ago my blood sugar was going up to 125-130 and sitting there all day, even if I walked or exercised, and then it would go down to 90-100 after I went to bed. This has happened a couple other times before, and I could not identify why this was the case. All this time I was eating under 40g or less carbs, around 140g protein, and 100g+ fat. As my symptoms got worse, I was led down the podcast rabbit hole of Mast Cell Activation Syndrome, and histamine intolerance, which I had learned about years ago but didn't necessarily think I fit into this category.

In hindsight, I am realizing that Mast Cell Activation Syndrome and or having high histamine loads in the body, may explain some of the very unexplained and inconsistent patterns I have observed while using the CGM over the past year and a half. Some examples are, blood sugar spikes up to 130 after taking supplements (!), blood sugar spikes up to 160 after eating low carb soup with bone broth and vegetables, spikes after low carb meals that I would include ferments or drinking hot chocolate (made with collagen, coconut milk, salt, cacao and stevia). And maybe, it explains why my blood sugar will go up to 170-200 with any intense exercise, and my inflammation takes days to recover from. And I am wondering now, if it is why I am seeing no improvement with my insulin resistance, even after consistently (not perfectly) doing all the things that are supposed to help with insulin resistance.

Have you explored the relationship between insulin resistance/type II diabetes and Mast Cell Activation Syndrome? As I look back at my health journey this is starting to look very possible to me, but I am not a scientist or medical professional, and know that there is so much I do not understand . And, I am wondering if you have explored this for yourself at all?

But then still my question is! What is to be done? Lymbic system retraining? Somatic experiencing? Making sure the body has balanced and adequate minerals? Low Dose Naltrexone? At this point I have tried many different things, and man, if I knew what to do I would do it.

I am so curious what you guys think, and would be so grateful to hear from you.

Angie

MCAS and histamine after exposure

Jacob writes:

Hi Robb and Nicky,

First thank you very much for the podcast. It's really helpful to hear all the different approaches to the health questions people raise. On last episode you mentioned you might do the next episode on MCAS.

Personally I have post viral POTS and some sort of MCAS after my 2020 COVID infection. LMNT helps me avoid POTS symptoms and if I completely avoid histamine from food I do great, with basically zero issues. I found that I can even take grass fed beef liver pills before I have a meal with histamine and it seems to help me avoid the issues.

I have two questions. First, do you have any experience on how the liver pills help me to not get beat up when I take them prior? It seems to have something with natural DAO but to be honest it's sortof a black box. I have basically no clue how much I'm ingesting from a DAO standpoint. I was taking the Ancestral Health beef liver pills and taking 6 capsules before the meal. That seems to help.

My second question is the more important one. How the heck do I deal with a histamine exposure. If I get got, I have anywhere from 24-48 hours of brain fog, extreme fatigue, malaise, and depressed/depression feelings. If there were something that I could do post exposure to abate this while I recover I would be extremely grateful. I found that if I take antihistamines (my rheumatologist recommended citrizine) that it helps *some* but not really enough.

Thank you!

Jacob

Dry Fasting

Andrea writes:

Hey Robb and Nicki, I was hoping you might talk about dry fasting. I recently listened to a Dark Horse podcast where Brett and Heather talked about their experience dry fasting and have become quite interested in it. Since I greatly value your ability to look at these things reasonably and scientifically, I was hoping you could share your thoughts on the subject.

Thanks

Andrea

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