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Avoid mast cell activating triggers

Chemical triggers

Nutrition

Many foods, food additives and food supplements are mast cell activating. If you find out by self-experi­mentation that you react to them, they should only be consumed rarely, in small amounts or preferably not at all. Now it's your turn to identify your individual triggers and to find out to what extent you can tolerate them. The compati­bility depends on the individual degree of severity, but partially also on the freshness or the manu­facturing process. More detailed information can be found here:

• The page Therapy > Dietary change describes the general procedure to find out which staple foods and additives are tolerated in which quantities (elimi­nation diet). The most important aid for this is probably our detailed foodstuff compatibility list, which can also be down­loaded on that page.
• The above mentioned diet instructions are also available as a book. Many recipes facilitate the imple­mentation of the diet, which at the beginning seems to be somewhat complicated. This mast-cell-friendly and low-histamine cookbook with diet instructions is presented on the page Therapy > Cookingrecipes.
• The above-mentioned foodstuff compatibi­lity list is also available as an app for smartphones, so you can always have it with you and you can search, sort and filter it electronically. See page Therapy > Histamine app.
• The page Therapy > Compatibility provides more detailed explanations on the compatibility of selected foods or food categories.
• Examples of compatible products and sources of supply can be found in the product database on the page Therapie > verträgliche Produkte (currently available only in German and limited to European products).

Hunger due to omitted or delayed meals can also increase the symptoms. However, it is unclear whether a state of hunger activates the mast cells or whether only a temporary undersupply of vitamins, minerals or energy leads to a reduced degradation of the mediators.

Medicinal products (incompatible activeingredients and excipients)

A large number of medicaments can be intolerable, both because of the active ingredients and because of the other excipients / additives. More detailed information can be found here:

• A list of incompatible active substances can be found on the page Therapy > Medicaments.
• Our food compatibility list provides information on the compatibility of the declared excipients.
• You will find detailed descriptions of compatible active ingredients and tips for obtaining information about ingredients and compatible preparations in our SIGHI Medication Guide.

Chemical irritants, multiple chemical sensitivity

Depending on the degree of severity and individual predisposition, an unmanageable number of chemical substances can also have a mast cell-activating effect on many people affected. In most cases, the respon­sible substances have not yet been identified. Since the formulations are regarded as trade secrets and usually contain a large number of substances, it is difficult to find out. From the experience gathered by those affected, we can at least give an overview of which substance groups or product categories are particularly often responsible for intolerance reactions:

• Fragrances, products containing fragrances:
  • Perfumes
  • Cleaning agents, detergents, laundry detergents (and the textiles washed with them)
  • Body care products: soaps, shower products, shampoos, deodorants, skin creams, cosmetics, ointments, hair sprays, ...
  • Air fresheners, interior scenting
• Odours, including the smell of food
• Body care products: Soaps, shower products, shampoos, deodorants, skin creams, cosmetics, ointments, hair sprays, ...
• Irritants: pepper spray, tear gas, itching powder, ...
• Animal poisons: insect venom, insect bites (bee venom, wasp venom, hornet venom, mosquito bites, horsefly bites), snake venom, jellyfish venom, stingray venom, inhaled bed bug droppings [DeVries et al. 2018].
• Plant poisons: nettle poison, hogweed (Heracleum), especially giant hogweed (phototoxic)
• Air pollutants, smog, respirable fine dust
• Environmental contaminants, pesticides?
• Tobacco smoke, cigarette smoke, passive smoking
• Dust: house dust and other dusts
• Amalgam fillings
• Chemicals, e.g. dextran, formaldehyde, ...
• ...

Mental triggers

Nervous excitement, stress

Definition: The term "stress" is colloquially used as a synonym for hecticness, e.g. during high workloads. Here, however, we mean stress in the broadest sense, both psychological/emotional stress and physical stress. Put simply, stress is the body's reaction to all situations or influences that deviate from the "normal state".

The peripheral nervous system is connected to all organs and is in particular inten­sively net­worked with the digestive tract. That's why you "feel butter­flies in your stomach" when you're in love, that's why anger hits your stomach, why worries are causing stomach aches, why you are wetting your pants or shitting yourself when you are scaried, etc. The peripheral nervous system can release histamine during strong excitation. In this way, for example, nervous­ness can lead to diarrhoea. You probably also know the expression "to be allergic to a certain person" because he or she "gets on your nerves". This also illustrates the histamine release controlled by the brain.

• Psychological/emotional stress
• Emotions: Fear, anger, annoyance, nervousness, tension, but also joy, excitement, and a bad conscience
• hecticness, time pressure, pressure to perform, expectations, fear of failure, feelings of inferiority, existential fear
• Mental exertion, highly concen­trated mental work
• Sexual arousal
• Stimulants (e.g. caffeine)

Psychological characteristics and diseases, psychoses

• Anxiety, anxiety disorders, hypochondria
• Psychosomatic disorders (It should be noted here that many MCAD patients are mistakenly diagnosed as "psychosomatics" on the assumption that an overexcited psyche triggers symptoms that cannot be explained otherwise. There are certainly true psychosomatics as well, but in most cases a mast cell activation disease is probably the reason for the excessive release of mediators, not the psyche! With MCAD, even normal, everyday nervous arousal of a mentally healthy person can lead to excessive mediator release.)

Physical triggers

Physical stress, mechanical effects

Mast cells can also be activated by mechani­cal stimuli:

• Physical exertion (work, sport, sexual activity)
• Pressure, tension, shocks, blows, friction, vibrations, shocks, scratches, injuries. Mechani­cal stimuli can lead to physical urticaria (e.g. Darier's signs in skin masto­cytosis after scratching or touching, wool intolerance when wearing woollen textiles directly on the skin).
• Declining or constantly fluctu­ating air pressure (sensitivity to certain weather conditions, in particular cold fronts, certain local wind systems caused by topography (like "Bise" or "Foehn" in Switzer­land), storm, windy weather), possibly air travel, travel to a region with higher altitude, possibly also the decom­pres­sion phase for divers?)

Temperature, radiation, energy

Energetic influences can also be mast cell activating:

• Cold, heat and temperature fluctuations can release mast cell mediators or even cause mast cells to suddenly degranulate. Example: draught, jump into cold water, a cold shower, hot summer days, sauna. Some react more to cold, others more to heat.
• Sunlight: Too much sun leads to "sun allergy", but treating the skin with light can in some cases also have a healing effect on skin masto­cytosis. The UV radiation in sunlight is also neces­sary for the formation of vitamin D3, which has a mast cell stabi­lizing effect. Therefore it is recom­mended to stay outdoors frequently, but without exceeding the individual tolerance threshold. Shade or semi-shade should be preferred.
• Electrosmog? Many sufferers describe themselves as electro­sensitive and attribute their electro­sensi­tivity to their MCAD or histamine intolerance.
• Sensitivity to earth rays, water veins, force points, lattice structures and other phenomena of radiesthesia???

Physiological triggers

Allergies

Allergens are very strong mast cell activators for allergy sufferers. The avoidance of allergens is therefore very important. Unfortunately, there are also allergens that can hardly be avoided (e.g. pollen, house dust mite droppings, fungal spores).

Even without allergen contact, allergy sufferers or atopic patients may be more susceptible to histamine release from mast cells than other people.

Allergy sufferers should also inform themselves about cross reactivity. For example, pollen allergy sufferers sometimes, but not always, react to certain foods with protein sequences similar to those of pollen. So similar that by mistake the antibody directed against pollen also happens to fit there.

Allergies mediated by IgE antibodies are particu­larly strong mast cell activators. Mast cells also have IgG receptors. Depending on the receptor, contact with IgG antibodies can be mast cell stabilizing or mast cell activating [Molderings 2010].

Autoimmune diseases

[This section is still in progress.]

Hormones, hormonal cyclesn

Mast cells possess estrogen receptors, the stimulation of which leads to increased mediator secretion, and pro­geste­rone receptors, the stimulation of which inhibits mediator release. The decisive factor is not the absolute amount of a hormone, but the ratio of the different hormonal counter­parts. If the hormone balance shifts too much towards estrogen (female), the symptoms worsen. If pro­geste­rone (male) dominates, the mast cells are more stable, which improves well-being.

• Female monthly cycle ("period", menstruation)
• Hormonal contraceptives (antibaby pill, birth control pill)
• Hormone therapies with female hormones (estrogens, estradiol)
• Hormone-active environmental pollutants, endocrine disruptors
• Hormone-active foods, phytoestrogens, e.g. hops, beer, soy products

Adrenal insufficiency

In cases of adrenal insufficiency, the body's own production of cortisone in the adrenal cortex may be too low. If this natural attenu­ation of mediator effects is elimi­nated, multiple allergies and pseudo­allergies may flare up.

Circadian rhythms (day-night rhythm)

• The body's own production of cortisone in the adrenal cortex is subject to a day-night rhythm. Therefore, the symptoms are not the same at every time of day. This is not only true for MCAD, but also for allergy sufferers, asthmatics, etc.
• Disruption of the circadian rhythm due to lack of sleep, sleep deprivation, irregular sleeping times, jet lag

Mediator breakdown disorders

Histamine degradation disorders (insuffi­cient breakdown capacity of histamine-degrading enzymes, e.g. DAO deficiency) can cause a tempo­rarily or perma­nently increased histamine level. The higher histamine level leads to a stronger stimu­lation of histamine receptors on the surface of mast cells. This way, histamine breakdown disorders have a mast cell activating effect. Such enzyme deficiencies can be acquired (intestinal infections, intake of DAO inhibitors) or more rarely they can also be genetically caused (DAO defect, HNMT defect).

Further information:

www.histaminintoleranz.ch/de/histaminose.html

Pathogens

Anything that stimulates the immune system can also activate the mast cells. This includes various infectious diseases.

• Viral infections (common cold, flu, ...)
• Bacterial infections or simply fragments of bacterial components. Recognition is carried out via the Toll-like receptors TLR1-9 on the surface of the mast cells.
• Parasites (worms etc.) are able to activate the mast cells and the baso­philic granulo­cytes.
• Bed Bug faeces contains a lot of histamine. The house dust, which is inhaled in rooms infested with bedbugs (apartment, hotel room etc.), can cause complaints because of its histamine content. This is possible even long time after the infestation was eliminated. [DeVries et al. 2018]
• Caution: Food supplements to "strengthen" the immune system (e.g. echinacea extract) and hypo­sensiti­zation therapy for allergy sufferers ("desensiti­zation") also worsen mast cell diseases! MCAD patients often mistakenly have the feeling that they have a "weak immune system". In reality it is not weak, but on the contrary over-stimulated by overactive mast cells. As a result, it no longer functions properly (high susceptibility to infections). Many then fatally resort to immune-strength­ening agents, which make the condition even worse. On the contrary, one would rather have to suppress the immune system (immuno­suppres­sants), e.g. with corticosteroids (which can also have side effects).
• Autohaemotherapy [Molderings et al. 2014]
• ATI cereals (modern wheat and other cereal species bred for a high content of amylase trypsin inhibitors)

Infections are not neces­sarily mast cell activating in all affected persons. The opposite may also be true. We know several affected persons who reported a clear impro­vement of the mast cell mediator symptoms from the time of infection with a virus until the infection subsides. (The impro­vement of symptoms already starts during the incu­bation period, before the patient is able to feel the outbreak of the infection.) This is reliably repro­ducible in these persons with any viral infection (common colds, flu-like infections, flu). The reason is still unclear.

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References and bibliography

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