by Ilene Ruhoy, M.D., Ph.D.  Integrative Neurologist

Ilene Ruhoy M.D., Ph.D. is a board-certified neurologist practicing integrative pediatric and adult neurology in Seattle. She is the owner and founder of the Center for Healing Neurology and is on the faculty of Seattle Children’s Hospital. Her holistic approach includes full neurological care with the addition of acupuncture, neurofeedback, and herbal and nutritional guidance.

Tired? Brain fog? Rashes? GI issues? It could all be due to your mast cell.

Mast cells are cells of the innate immune system that are strategically located in our bodies to protect us from the outside environment. Found primarily in mucosa, they are ubiquitous in the human body, waiting to fight off exposure from organisms, toxins, and toxicants. These mucous membranes are in our gastrointestinal tracts, in our respiratory tracts, and our genitourinary tracts. 

Mast cells are also present in large concentrations within our lymph and blood vessels walls, our skin layers, and our connective tissue. They live in our joints, around our heart, in our brain, and around our glands. They are even in hair follicles. Typically associated with allergies, mast cells can actually cause a myriad of symptoms throughout the body.

Mast cells, explained.

Mast cells serve to protect the central nervous system. They live on the inside of the blood-brain barrier and interact with the cells of the barrier, namely, the astrocytes, microglia, and blood vessels. This is one of the critical ways the immune system interacts with the central nervous system. And this interaction can lead to vascular inflammation and neuroinflammation. 

When mast cells suspect danger, they degranulate, which means they release stored chemicals, as part of the cell danger response. These chemicals include, already formed and ready to be released, transmitters such as histamine, tryptase, serotonin, and dopamine. But they also contain enzymes that can disrupt cellular membranes, blood clotting, and cellular signaling. Furthermore, upon activation, they begin to produce a multitude of inflammatory mediators such as interleukins, cytokines, chemokines, mitokines, and factors that play a role in many of the body's physiological pathways. They may even be tumorigenic, or tumor-forming. 

What is mast cell instability?

When the mast cells are overactivated, and relentlessly triggered, their own release and initiation of inflammatory cascades perpetuate their degranulation. This can lead to a mast cell activation disorder(MCAD). MCAD can cause cognitive symptoms and fatigue and has been implicated as a contributor to many neurodegenerative diseasessuch as multiple sclerosis, traumatic brain injury (TBI), stroke, and Alzheimer's disease. But because the mast cells reside in almost every organ system of the body, mast cell instability is a state of chronic activation that can cause problems with your gut, skin, lungs, and joints, even before it becomes a full-blown mast cell disorder.

What causes mast cell instability?

We face a world in which we are exposed to an overwhelming number of assaults from our environment. Whether it's the air we breathe, the water we drink, the food we eat, the chemicals we use to clean our homes, or the stressors we experience, the innate immune system is meant to be our first defense. 

But when an important soldier of the innate immune system, mast cells, is unstable, it goes rogue and releases its contents to a detrimental extent. It is then we may experience lack of mental clarity, intense fatigue, skin inflammation in the form of rashes and hives or various "bumps," gut dysfunction that often disrupts motility causing stagnation and an altered microbiome (with further perpetuates the problem), joint and muscle pain, and more. Many of those with chronic mast cell dysfunction develop autonomic nervous system dysfunction. Mast cell activation is noted to be associated with other disorders such as postural orthostatic tachycardia syndrome (POTS) and hypermobility.

10 ways to treat mast cell instability naturally.

Because mast cells contain large amounts of histamine, many will get some relief from antihistamines, but antihistamines have a range of side effects; however, as you now know, mast cells release a whole lot more that can mess with your system. In terms of medications, mast cell stabilizers are often prescribed and are usually more effective for symptom control as they minimize the release of all of the mast cell contents.

Here are nonpharmacologic measures we can take to combat mast cell activation: 

  1. Quercetin is a flavonoid that inhibits and counteracts histamine. Quercetin is found in apples, red grapes, berries, citrus fruits, onions, and broccoli.
  2. Palmitoylethanolamide (PEA) is an endocannabinoid-like compound that impedes mast cell degranulation. PEA is found in dark chocolate. 
  3. Luteolin is a flavonoid that further reduces mast cell degranulation and is thought to work synergistically with PEA. The combination is often used for neuroprotection. Luteolin is found in peppers, apples, celery, thyme, and chamomile tea.
  4. Coleus forskohlii is a botanical plant used historically for its natural antihistamine properties. 
  5. Diamine oxidase is an important enzyme the digests histamine. It can be found in supplement form.
  6. Consume a low-histamine and anti-inflammatory diet to not stoke the flame any further. Anti-inflammatory foods are of plant-based sources in their natural state. The more we process food, the greater our risk of inducing a cell danger response from mast cells and other cells of the innate immune system. Compounds contained in food in their natural state trigger appropriate gene expression for defense and longevity.
  7. Further combat inflammation with daily movement, daily sweat, exposure to nature, stress management, and human connection.
  8. Use green personal care and cleaning products to reduce exposure to chemicals.
  9. Choose organic when possible, to avoid exposure to pesticides and herbicides.
  10. If you are suffering from the effects of chronic mast cell activation, please see a physician well versed in mast cell activation for further guidance because there is help.

It is important to understand that mast cells are part of the innate immune system, our first defense. It is meant to protect our whole body—each and every cell contained within it—even when it is a local assault. The entire system will come to its defense. When the first defense fails, it recruits the second defense, the acquired immune system. When this system is "over-recruited," there is a risk of autoimmunity

We are learning more and more about the incredible design of our bodies, and we must learn to protect it and not betray our naturally built-in defense systems. Our bodies don't want to be sick, but sometimes we give it no other choice.

NATURAL BIOLOGY SUGGESTIONS:   Most everything you will ever need in a supplement can be found in EVEREST Earth & Sea Formula or 7 BASICS - and we have had multiple reports of customers who have overcome mast cell instability using these products, correcting their diets (usually cutting out gluten & dairy), buying organic when it makes sense,  and using toxin free chemicals in their homes.