Histamine Intolerance Muddles the Picture
The connection between histamine and MCAS adds another layer to the confusion. Histamine intolerance, where the body accumulates excess histamine due to enzyme deficiencies, shares many symptoms with MCAS. However, the two conditions require different treatments, and failure to differentiate them may lead to mismanagement (3).
Related: When Everyday Scents Become Overwhelming—Understanding Multiple Chemical Sensitivity
The Link Between MCAS, EDS, and POTS
One of the most intriguing discoveries in functional medicine is the growing connection between MCAS and hypermobility disorders, such as Ehlers-Danlos Syndrome (EDS). Research suggests a higher prevalence of MCAS in patients with joint hypermobility, and many who have EDS endure unexplained symptoms, such as allergic-like reactions or nervous system dysregulation (6).
Similarly, Postural Orthostatic Tachycardia Syndrome (POTS)—characterized by dizziness, fainting, and heart rate irregularities upon standing—is another condition frequently co-existing with MCAS. Up to 30% of POTS patients exhibit mast cell involvement (7).
Here’s why these disorders are interlinked:
1. Collagen Disorders in EDS
EDS is characterized by faulty collagen—a protein found in skin, connective tissue, and blood vessels. Insufficient collagen support might make barriers like intestinal and vascular walls more permeable or “leaky,” increasing the chance of mast cell dysfunction.
2. Autonomic Nervous System Dysfunction in POTS
POTS affects the autonomic nervous system, which regulates involuntary processes like heart rate and digestion. Dysautonomia may trigger mast cell hyperreactivity, causing episodes of inflammation or allergic reactions (5).
3. Immune System Dysregulation Across All Three Conditions
Both MCAS and linked conditions involve hyperactivation of the immune system. This hyperactivity encourages an overload of immune signals, such as histamine, intensifying systemic inflammation and worsening symptoms.
Recognizing these connections is key for refining diagnostic efforts.
The Role of Histamine in MCAS
Histamine plays an integral role in both MCAS and associated conditions. Mast cells release histamine as part of the immune defense mechanism, but when its regulation goes awry, it wreaks havoc on the body.
Histamine triggers in MCAS patients may include:
- High-histamine foods (e.g., aged cheeses, alcohol, or fermented foods)
- Stress or hormonal changes
- Extreme temperatures or environmental chemicals
Patients often adopt low-histamine diets to reduce MCAS symptoms, emphasizing fresh, unprocessed foods while avoiding known triggers like tomatoes, cured meats, or certain spices.
Shop: Digest histamine fast with the patented DAO2 enzyme.
The Histamine-Methylation Connection
Functional medicine has introduced the “histamine bucket” analogy, comparing high histamine levels to an overflowing bucket (8). Genetics play a role—mutations in the DAO enzyme (responsible for breaking down dietary histamine) or methylation-cycle inefficiencies may worsen histamine clearance, amplifying MCAS activity (9).
Individualized histamine regulation strategies can empower patients to regain control.
How Integrative & Functional Medicine is Changing Diagnosis and Care
Unlike conventional medicine, which often treats individual symptoms, functional medicine adopts a root-cause approach. It considers how genetics, lifestyle, and environmental factors interact to affect overall health, making it an ideal lens for understanding MCAS.
Here’s how functional medicine stands out for MCAS patients:
- Personalized Testing: Functional practitioners utilize tailored tests (e.g., urinary histamine metabolites, DAO activity) to pinpoint mast cell involvement.
- Holistic Treatment Plans: Beyond medications like antihistamines, treatment involves low-histamine diets, stress-reduction therapy, gut health repair, and high-quality supplements (e.g., quercetin or vitamin C).
- Focus on Comorbidities: Functional approaches recognize that treating EDS, POTS, or histamine intolerance alongside MCAS improves outcomes.
Read: The Benefits of Quercetin & Other Natural Antihistamines
Steps Toward an Accurate Diagnosis and Better Management
If you suspect MCAS but are struggling with misdiagnoses, here are actionable tips:
Document Symptoms: Keep a journal to note potential triggers, foods, or stress levels linked to flare-ups.
Schedule Integrative Appointments: Seek integrative healthcare professionals with experience in mast cell disorders, such as integrative allergists or functional medicine practitioners.
Request Specialized Testing: Advocate for comprehensive histamine metabolite screenings or DAO testing if relevant.
Functional medicine’s capacity to identify and address root causes makes it a beacon of hope for MCAS sufferers—Contact a provider at CentreSpringMD now!
Crafting a Path Forward
The challenges of living with an underdiagnosed condition like MCAS are immense. Misdiagnoses delay effective treatments and force patients into a cycle of unnecessary medications and frustration. However, emerging research and insights into linked conditions like EDS, POTS, and histamine intolerance are helping more patients find relief.
We encourage you to explore integrative and functional medicine’s potential to clarify your symptoms and improve your quality of life. If your symptoms point toward MCAS, don’t settle for answers that feel incomplete—your health deserves holistic attention.Looking for personalized care? Consider consulting with an integrative practitioner for expert guidance on symptom management and testing. Together, we can reimagine your path toward wellness.
