Posts Tagged ‘low blood pressure’

Mast Cell Activation Syndrome!

Friday, June 15th, 2018

 

Does histamine control your life?   Are you even aware that it might?  You might have MCAS!!

Much of this information comes from Dr Tania Dempsey and Dr Jill Carnahan in the States….  but it is a Syndrome worth thinking about if you’re simply not getting on top of your pain, allergies, nervous system stresses etc….  Many doctors in Australia are totally unaware of this condition.

What is Mast Cell Activation Syndrome?

Mast cells, a type of blood cell, play an important role in the body’s immune system. They reside in all body tissues and form part of the body’s initial defence system. Mast cells react to foreign bodies and injury by releasing a variety of potent chemical mediators, such as histamine, when activated. In a healthy person these chemicals will act beneficially to protect and heal the body, but in a person with MCAS these same chemicals are inappropriately triggered and released and have a negative effect on the body. Amongst the triggers are a variety of different foods, exercise, chemicals, fragrances and stress. Many sufferers struggle to identify their triggers and continue to discover new triggers for many years after diagnosis.

MCAS forms part of a spectrum of mast cell disorders involving proliferation and/or excessive sensitivity of mast cells, it has been identified since 2007. It features inappropriate mast cell activation with little or no increase in the number of mast cells, unlike in Mastocytosis*.  MCAS causes a wide range of unpleasant, sometimes debilitating, symptoms in any of the different systems of the body, frequently affecting several systems at the same time. The onset of MCAS is often sudden, affecting both children and adults, sometimes in family groups, mimicking many other conditions and presenting a wide-range of different symptoms that can be baffling for both the patient and their physician. Often there are no obvious clinical signs since MCAS confounds the anatomy-based structure underpinning the traditional diagnostic approach. Very often Mast Cell Activation Syndrome is hiding in plain sight.

Mastocystosis:  very rare and NOT what we’re talking about here…

Mastocytosis involves inappropriate mast cell activation AS WELL AS an increased number of mast cells. It is a rare but relatively well known mast cell disorder and is currently easier to diagnose than MCAS.

Mast Cell Activation Syndrome (MCAS): When Histamine Goes Haywire…

Mast cells are present in most tissues throughout the human body, especially connective tissue, skin, intestinal lining cardiovascular system, nervous system, and reproductive organs. They are part of the allergic response designed to protect us from threat and injury.  When the body is exposed to a perceived threat, the mast cells secrete chemical mediators, such as histamine, interleukins, prostaglandins, cytokines, chemokine and various other chemicals stored in the cytoplasm of the cell.  These chemical messengers produce both local and systemic effects, such as increased permeability of blood vessels (inflammation and swelling), contraction of smooth muscle (stomach cramps and heart palpitations), and increase mucous production (congestion, sneezing, etc).   Historically, we thought of mast cells only in relation to an allergic or anaphylactic response.  We now know they play a profound role in immune activation, development of autoimmunity and many other disorders, such as POTS (postural orthostatic tachycardia syndrome).  Sadly we are seeing a large increase in patients presenting with mast cell disorders and MCAS.  I believe it is in part do to the onslaught of more pervasive environmental toxins, moulds and chemicals.

Withouts mast cells, we would not be able to heal from a wound.  They protect us from injury and help the body to heal.  Unfortunately, overactive mast cells can cause a variety of serious symptoms.

Symptoms of overactive mast cells may include:

  • skin rashes/hives
  • swelling/oedema
  • flushing
  • asthma
  • itching
  • abdominal pain
  • nausea/vomiting
  • diarrhoea
  • wheezing
  • shortness of breath
  • heart palpitations
  • anxiety, difficulty concentrating
  • headaches
  • brain fog
  • low blood pressure
  • fatigue

Mast cell activation syndrome (MCAS) is a condition symptoms involving the skin, gastrointestinal, cardiovascular, respiratory, and neurologic systems. It can be classified into primary (clonal proliferation or mastocytosis), secondary (due to a specific stimulus), and idiopathic (no identifiable cause). Proposed criteria for the diagnosis of MCAS included episodic symptoms consistent with mast cell mediator release affecting two or more organ systems with hives, swelling, flushing, nausea, vomiting, diarrhea, abdominal pain, low blood pressure, fainting, heart palpitations, wheezing, red eyes, itching, and/or nasal congestion.  For a diagram of all of the varied symptoms histamine can cause, click here.

Triggers may be medications, foods, supplements, hormones, opioids, stressors (physical or emotional), cold temperature, heat, pressure, noxious odors, chemicals, insect bites, trauma or environmental toxins.

We commonly see mast cell activation syndromes associated with CIRS (chronic inflammatory response syndrome) in response to biotoxins, such as mould, inflammagens, and lyme-related toxins.

Low MSH and Mast Cell Disorders?

As mentioned above, we frequently see histamine intolerance and MCAS in patients with mold-related CIRS (chronic inflammatory response syndrome).  It is interesting to note that a common finding in CIRS is low MSH.  According to this study in the Journal of Investigative Dermatology, alpha-MSH plays an immunomodulatory role during inflammatory and allergic reactions of the skin.  In addition, there is evidence that MSH induces mast-cell apoptosis(cell death).

Definition of Mast Cell Activation Syndrome (MCAS)

  1. Typical clinical symptoms as listed above
  2. Increase in serum tryptase level or an increase in other mast cell derived mediators, such as histamine or prostaglandins (PGD2), or their urinary metabolites,
  3. Response of symptoms to treatment
Mast Cell Activation Syndrome (MCAS)

Mast cells can be activated by both direct and indirect mechanisms as a result of exposure of the host to pathogens.

Diseases Associated with Mast Cell Activation Syndrome (MCAS)

  • Allergies and Asthma
  • Autism
  • Autoimmune diseases (Hashimoto’s thyroiditis,  systemic lupus, multiple sclerosis, bullous pemphigoid, rheumatoid arthritis and others.Eczema
  • Celiac Disease
  • Chronic Fatigue Syndrome
  • CIRS (chronic inflammatory response syndrome)
  • Eosinophilic Esophagitis
  • Fibromyalgia
  • Food Allergy and Intolerances
  • Gastroesophageal reflux (GERD)
  • Infertility (mast cells in endometrium may contribute to endometriosis)
  • Interstitial Cystitis
  • Irritable Bowel Syndrome (IBS)
  • Migraine Headaches
  • Mood disorders – anxiety, depression, and insomnia
  • Multiple Chemical Sensitivities
  • POTS (postural orthostatic tachycardia syndrome)
Mast cells are known to be the primary responders in allergic reactions, orchestrating strong responses to minute amounts of allergens. Several recent observations indicate that they may also have a key role in coordinating the early phases of autoimmune diseases, particularly those involving auto-antibodies.

Mast cells are known to be the primary responders in allergic reactions, orchestrating strong responses to minute amounts of allergens. Several recent observations indicate that they may also have a key role in coordinating the early phases of autoimmune diseases, particularly those involving auto-antibodies.

Lab Tests for Mast Cell Activation Syndrome (MCAS) – many of these are as yet unavailable in Australia …  Possibly histamine is as yet the only available, but chat to Georgia about what our Naturopathic Labs can offer….

  • Lab tests specific to mast cell activation for suspected MCAS may include:
    • Serum tryptase (most famous mast cell mediator)
    • Serum chromogranin A
    • Plasma histamine
    • Plasma PGD2 (chilled)
    • Plasma heparin (chilled)
    • Urine for PGD2 (chilled)
    • PGF2a
    • N-methylhistamine
  • Tryptase is the most famous mast cell mediator. Serum tryptase value is usually normal in MCAS patients, but sometimes it is elevated.  Tryptase values that show an increase of 20% + 2 ng/ml above the baseline level are considered diagnostic for MCAS.
  • Chromogranin A is a heat-stable mast cell mediator.  High levels can suggest MCAS, but other sources must first be ruled out, such as heart failure, renal insufficiency, neuroendocrine tumors and proton pump inhibitor (PPI) use.
  • Heparin is a very sensitive and specific marker of mast cell activation.  However, due to its quick metabolism in the body, it is very difficult to measure reliably.
  • N-methylhistamine is usually measured in a 24 hour urine test to account for the variability in release over the course of the day.
  • Prostaglandin D2 is produced by several other cell types, but mast cell release is responsible for the dominant amount found in the body.  PGD2 is less stable than histamine and metabolized completely in 30 minutes.
  • Other less specific mast cell mediators that are sometimes abnormal in MCAS patients include Factor VIII, plasma free norepinephrine, tumor necrosis factor alpha, and interleukin-6.

Treatments to reduce MCAS symptoms and lower histamine

  • H1 Blockers
    1. hydroxyzine, doxepine, diphenhydramine, cetirizine, loratadine, fexofenadine
  • H2 Blockers
    1. Famotidine (Pepcid, Pepcid AC)
    2. Cimetidine (Tagamet, Tagamet HB)
    3. Ranitidine (Zantac)
  • Leukotriene inhibitors
    1. Montelukast (Singulair)
    2. Zafirlukast (Accolate)
  • Mast cell stabilizers –
    1. Cromolyn
    2. Ketotifen
    3. Hyroxyurea
  • Tyrosine kinase inhibitors – imatinib
  • Natural anti-histamines and mast-cell stabilizers
    • Ascorbic Acid
    • Quercetin
    • Vitamin B6 (pyridoxal-5-phosphate)
    • Omega-3 fatty acids (fish oil, krill oil)
    • Alpha Lipoic Acid
    • N-acetylcysteine (NAC)
    • Methylation donors (SAMe, B12, methyl-folate, riboflavin)
  • Certain probiotics decrease histamine production
    • Lactobacillus rhamnosus and bifidobacter species 
  • DAO Enzymes with meals – UmbrelluxDAO
  • Decrease consumption of high histamine foods (more on histamine-restricted diet)
    • Avoid alcoholic beverages
    • Avoid raw and cured sausage products such as salami.
    • Avoid processed or smoked fish products. Use freshly caught seafood instead.
    • Avoid pickles
    • Avoid citrus fruits.
    • Avoid chocolate
    • Avoid nuts
    • Avoid products made with yeast and yeast extracts
    • Avoid soy sauce and fermented soy products
    • Avoid black tea and instant coffee
    • Avoid aged cheese
    • Avoid spinach in large quantities
    • Avoid tomatoes, ketchup and tomato sauces
    • Avoid artificial food colorings & preservatives
    • Avoid certain spices: cinnamon, chili powder, cloves, anise, nutmeg, curry powder, cayenne pepper

References

  1. Mast Cell Activation Syndrome, A Review
  2. Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options
  3. Presentation, Diagnosis and Management of Mast Cell Activation Syndrome by Dr. Afrin
  4. Histamine and Gut Immune Mucosal Regulation
  5. Dr. Theoharides presents “Mast Cell Disorders”
  6. Diagram of Histamine Symptoms
  7. Mast Cell Aware
  8. A Tale of Two Syndromes
  9. Mold Histamine Connection

Adrenal Fatigue, Adrenal Exhaustion, Chronic Fatigue Syndrome… we’ve been treating for over a dozen years or more!!!

Wednesday, September 7th, 2011

Tired all the time.  Exhaustion by getting home from work – playing havoc with libido, happiness and life in general??

Your adrenal glands are each no bigger than a walnut and weigh less than a grape, yet are responsible for one of the most important functions in your body: managing stress.

“The adrenals are known as ‘the glands of stress,’” writes James Wilson in his book Adrenal Fatigue: The 21st Century Stress Syndrome. “It is their job to enable your body to deal with stress from every possible source, ranging from injury and disease to work and relationship problems. Your resiliency, energy, endurance and your very life all depend on their proper functioning.”[1]

When your adrenal glands are fatigued, a condition known as adrenal fatigue or adrenal exhaustion, your entire body feels it and suffers from extreme exhaustion as well.

It’s estimated that up to 80 percent of adults experience adrenal fatigue during their lifetimes, yet it remains one of the most under-diagnosed illnesses in Australia and the United States.[2]

The Optimal Function of Your Adrenal Glands

Your body has two adrenal glands, located just above each of your kidneys. As part of your endocrine system, your adrenal glands secrete more than 50 hormones, many of which are essential for life and include:

  • Glucocorticoids. These hormones, which include cortisol, help your body convert food into energy, normalize blood sugar, respond to stress and maintain your immune system’s inflammatory response.
  • Mineralocorticoids. These hormones, which include aldosterone, help keep your blood pressure and blood volume normal by maintaining a proper balance of sodium, potassium and water in your body.[3]
  • Adrenaline. This hormone increases your heart rate and controls blood flow to your muscles and brain, along with helping with the conversion of glycogen to glucose in your liver.

Together, these hormones and others produced by your adrenal glands control such body functions as:[4]

  • Maintaining metabolic processes, such as managing blood sugar levels and regulating inflammation
  • Regulating your body’s balance of salt and water
  • Controlling your “fight or flight” response to stress
  • Maintaining pregnancy
  • Initiating and controlling sexual maturation during childhood and puberty
  • Producing sex steroids such as estrogen and testosterone

Ironically, although your adrenal glands are there, in large part, to help you cope with stress, too much of it is actually what causes their function to break down.

In other words, one of your adrenal glands most important tasks is to get your body ready for the “fight or flight” stress response, which means increasing adrenaline and other hormones.

As part of this response, your heart rate and blood pressure increase, your digestion slows, and your body becomes ready to face a potential threat or challenge.

While this response is necessary and good when it’s needed, many of us are constantly faced with stressors (work, environmental toxins, not enough sleep, worry, relationship problems and more) and therefore are in this “fight or flight” mode for far too long — much longer than was ever intended from a biological standpoint.

The result is that your adrenal glands, faced with excessive stress and burden, become overworked and fatigued. Some common factors that put excess stress on your adrenals are:[5]

  • Anger, fear, anxiety, guilt, depression and other negative emotions
  • Overwork, including physical or mental strain
  • Excessive exercise
  • Sleep deprivation
  • Light-cycle disruption (such as working the night shift or often going to sleep late)
  • Surgery, trauma or injury
  • Chronic inflammation, infection, illness or pain
  • Temperature extremes
  • Toxic exposure
  • Nutritional deficiencies and/or severe allergies

Signs and Symptoms of Adrenal Fatigue

When your adrenal glands become depleted, it leads to a decrease in certain hormone levels, particularly cortisol. The deficiencies in certain adrenal hormones will vary with each case, ranging from mild to severe.

In its most extreme form, this is referred to as Addison’s disease, a condition that causes muscle weakness, weight loss, low blood pressure and low blood sugar, and can be life threatening.

Fortunately, only about four persons per 100,000 develop Addison’s disease, which is due to autoimmune disease in most cases but can also develop after very severe stress.[6]

At the other end of the spectrum, as well as in between, lies adrenal fatigue (also known as hypoadrenia). Though the symptoms are less severe than in Addison’s disease, symptoms of adrenal fatigue can be debilitating. As Wilson writes:

“Non-Addison’s hypoadrenia (adrenal fatigue) is not usually severe enough to be featured on TV or to be considered a medical emergency. In fact, modern medicine does not even recognize it as a distinct syndrome. Nevertheless, it can wreak havoc with your life.

In the more serious cases of adrenal fatigue, the activity of the adrenal glands is so diminished that the person may have difficulty getting out of bed for more than a few hours per day. With each increment of reduction in adrenal function, every organ and system in your body is more profoundly affected.”[7]

Classic signs and symptoms of adrenal fatigue include:

  • Fatigue and weakness, especially in the morning and afternoon
  • A suppressed immune system
  • Increased allergies
  • Muscle and bone loss and muscular weakness
  • Depression
  • Cravings for foods high in salt, sugar or fat
  • Hormonal imbalance
  • Skin problems
  • Autoimmune disorders
  • Increased PMS or menopausal symptoms
  • Low sex drive
  • Lightheadedness when getting up from sitting or lying down
  • Decreased ability to handle stress
  • Trouble waking up in the morning, despite a full night’s sleep
  • Poor memory

Additionally, people with adrenal fatigue often get a burst of energy around 6 p.m., followed by sleepiness at 9 p.m. or 10 p.m., which is often resisted. A “second wind” at 11 p.m. is then common, which often may keep you from falling asleep until 1 a.m.[8]

Further, those with adrenal fatigue often also have abnormal blood sugar levels and mental disturbances, such as increased fears and anxiety, and rely on coffee, soda and other forms of caffeine to keep them going.

As the names implies, the most common symptom of adrenal fatigue is unrelenting fatigue, a feeling of being run down or not able to keep up with your daily demands. And because fatigue is such a common symptom, the syndrome is very often missed or misdiagnosed by physicians.

The Common Medical Test for Adrenal Function Cannot Diagnose Adrenal Fatigue

Adding to the problem of misdiagnosis is the fact that doctors typically use an ACTH (adrenocorticotropic hormone) test to check for problems with your adrenal glands. However, the test only recognizes extreme underproduction or overproduction of hormone levels, as shown by the top and bottom 2 percent of a bell curve.

Symptoms of adrenal malfunction, meanwhile, occur after 15 percent of the mean on both sides of the curve. So your adrenal glands could be functioning 20 percent below the mean, and your body experiencing symptoms of adrenal fatigue, and the standard test won’t recognize it.[9]

The test that will recognize adrenal fatigue, in all of its stages, is a salivary cortisol test. This is an inexpensive test you can purchase online and do at home, as no prescription is needed. However, if you suspect you have adrenal fatigue a knowledgeable natural health care provider can help you with diagnosis and treatment.

Natural, and Simple, Steps to Recover From Adrenal Fatigue

It takes time to burnout your adrenal glands, and as you might suspect it also takes some time to recover. You can expect:

  • Six to nine months of recovery time for minor adrenal fatigue
  • 12 to 18 months for moderate adrenal fatigue
  • Up to 24 months for severe adrenal fatigue[10]

The good news is that natural treatments are very effective for this syndrome, and with time, patience, and the tips that follow it is possible to recover.

  • Probably the single most important area is to have powerful tools and strategies to address the current and past emotional traumas in your life. Prayer, meditation and meridian tapping techniques can be very helpful here. See us at New Leaf Natural Therapies for Kinesiology sessions to help resolve the stressors that have created these health issues and use kinesiology, energy clearing techniques to heal the body long-term.
  • Listen to your body and rest when you feel tired (this includes during the day by taking short naps or just laying down)
  • Sleep in (until 9 a.m. if you feel like it)
  • Exercise regularly using a comprehensive program of strength, aerobic, core, and interval training
  • Eat a healthy nutrient-dense diet like the one described in my nutrition plan, according to your Nutritional Type:  Talk to us at New Leaf for the right food choices for you.
  • Avoid stimulants like coffee and soda, as these can further exhaust your adrenal glands

Further, to maintain proper adrenal function it is imperative to control your blood sugar levels. If you are eating the right foods for your Nutritional Type, your blood sugar levels should balance out, and the following guidelines will also help:

  • Eat a small meal or snack every three to four hours
  • Eat within the first hour upon awakening
  • Eat a small snack near bedtime
  • Eat before becoming hungry. If hungry, you have already allowed yourself to run out of fuel (low blood sugar), which places additional stress on your adrenal glands

You may also want to see a physician well versed in bioidentical hormone replacement, and get tested to see if you could benefit from the use of DHEA. DHEA is a natural steroid and precursor hormone produced by the adrenals, and levels are often very low in people with adrenal fatigue. Keep in mind, of course, that DHEA is not a quick cure, and should not be used as a sole treatment.  We have supplements that help to increase DHEA rather than the hormone if you prefer.

Treating adrenal fatigue requires a whole-body approach, one that addresses the excess stress and unhealthy lifestyle habits that wore out your adrenals in the first place.

Interestingly the very first step in normalizing sex hormones, either male or female, is to first address the adrenal hormone system. For example if you were to only measure female hormones and then replace them with bioidentical hormone therapy, you will virtually be guaranteed to fail because the weakened adrenals will never allow the hormones to equilibrate properly.

Because your adrenal health is so important to your overall health and well-being, I highly recommend you work with a knowledgeable natural health care practitioner to find out if you have adrenal fatigue and then remedy it.

The tips above are an excellent starting point, however, and can be used by nearly everyone to help give your adrenal glands a healthy boost.


[1] Wilson, James. “Adrenal Fatigue: The 21st Century Stress Syndrome.” Smart Publications, p. 3, 2002.

[2] Wilson, James. “Adrenal Fatigue: The 21st Century Stress Syndrome.” Smart Publications, p. 6, 2002.

[3] MayoClinic.com Addison’s Disease http://www.mayoclinic.com/health/addisons-disease/DS00361/DSECTION=causes (Accessed June 11, 2009)

[4] National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, “Adrenal Gland Disorders” http://www.nichd.nih.gov/health/topics/Adrenal_Gland_Disorders.cfm (Accessed June 11, 2009)

[5] Understanding Adrenal Function August 27, 2000, Mercola.com http://articles.mercola.com/sites/articles/archive/2000/08/27/adrenals.aspx (Accessed June 11, 2009)

[6] Wilson, James. “Adrenal Fatigue: The 21st Century Stress Syndrome.” Smart Publications, p. 7, 2002.

[7] Wilson, James. “Adrenal Fatigue: The 21st Century Stress Syndrome.” Smart Publications, p. 7, 2002.

[8] Veracity, Dani. “Recovering From Adrenal Fatigue: How Your Body Can Overcome Chronic Stress and Feel Energized Again.” Natural News, April 6, 2006 http://www.naturalnews.com/019339.html (Accessed June 11, 2009)

[9] Veracity, Dani. “Recovering From Adrenal Fatigue: How Your Body Can Overcome Chronic Stress and Feel Energized Again.” Natural News, April 6, 2006 http://www.naturalnews.com/019339.html (Accessed June 11, 2009)

[10] Veracity, Dani. “Recovering From Adrenal Fatigue: How Your Body Can Overcome Chronic Stress and Feel Energized Again.” Natural News, April 6, 2006 http://www.naturalnews.com/019339.html (Accessed June 11, 2009)

Madonna Guy ND
New Leaf Natural Therapies
3348 6098 / 0417 643 849