Allergies? Could this little known syndrome be the problem?

An allergy is when our body’s immune system reacts to normally harmless substances that it sees as harmful. The allergy-causing substances are called allergens. 

Many substances can cause an allergic reaction, including: pollen, mould, animal hair, dust and dust mites, latex, medicines, insects, foods, trans fatty acids, intestinal microbiota, pre/probiotics, fibre intake, breast milk, environmental factors, farming practices, toxic load, pollution, food processing, and infections.

How big is the Allergy problem?

Allergy UK’s statistics show: 44% of adults in the UK suffer from at least one allergy, and the number is always increasing. Around 10 million allergy sufferers in the UK have more than one allergy – which equates to about 50% of all British allergy sufferers.

Common allergens include:
  • tree and grass pollen (hay fever)
  • house dust mites.
  • foods, such as peanuts, milk and eggs (food allergy)
  • animal fur, particularly from pets like cats and dogs.
  • insect stings, such as bee and wasp stings.
  • certain medicines
  • certain chemicals
Mast Cell Activation Syndrome – could this be causing your allergies?

What is Mast Cell Activation Syndrome?

Mast cell activation syndrome (MCAS) causes a person to have repeated severe allergy symptoms affecting several body systems. In MCAS, mast cells mistakenly release too many chemical agents, resulting in symptoms in the skin, gastrointestinal tract, heart, respiratory, and neurologic systems.

Mast cells are present throughout most of our bodies and secrete different chemicals during allergic reactions. Symptoms include episodes of abdominal pain, cramping, diarrhoea, flushing, itching, wheezing, coughing, light-headedness, rapid pulse and low blood pressure. Symptoms can start at any age, but usually begin in adulthood. The cause of MCAS is unknown. Diagnosis is based on the symptoms, clinical exam, and specific laboratory testing. Other conditions may need to be excluded before MCAS can be diagnosed.

What causes MCAS?

Researchers aren’t sure what causes some people to experience MCAS. Some studies suggest there may be a genetic component to MCAS, but more research is needed to fully understand what puts a person at greater risk of developing the condition.

Researchers have identified three variants of MCAS. They include:

  • Primary MCAS: Primary MCAS occurs when a certain mutation, known as the KIT D816V mutation, is found and the mast cells display CD25, often with a confirmed case of mastocytosis. Mastocytosis occurs when the body produces too many mast cells.
  • Secondary MCAS: Secondary MCAS occurs as an indirect result of another immunologic condition, IgE-mediated allergen (food or environmental allergy), or hypersensitivity to another trigger.
  • Idiopathic MCAS: Idiopathic means that the cause of MCAS can’t be determined. Unlike primary MCAS, it’s not the result of a cloned cell. And unlike secondary MCAS, a doctor or healthcare professional can’t determine an underlying trigger for the MCAS.

If you have secondary MCAS, you may find that exposure to certain things can trigger your symptoms. If you have primary or idiopathic MCAS, symptoms will occur without exposure to any particular trigger.
Some possible triggers include:

  • Food with Histamines
  • Infections
  • Toxicity
  • Nutritional deficiencies
  • Low oxygen
  • Hormone imbalance
  • Stress and early trauma
  • Fragrances
  • Exercise
  • Medications

What are the symptoms?

The release of too many mast cell mediators can impact almost every part of your body. The primary affected areas typically include your skin, nervous system, heart, and gastrointestinal tract. The number of mediators released can cause symptoms that range from mild to life threatening.

Symptoms may include:

  • skin: itching, flushing, hives, sweating, swelling, rash
  • eyes: irritation, itching, watering
  • nose: itching, running
  • mouth and throat: itching, swelling in your tongue or lips, swelling in your throat
  • lungs: trouble breathing, wheezing
  • heart and blood vessels: low blood pressure, rapid heart rate
  • stomach and intestines: cramping, nausea, diarrhea, abdominal pain
  • nervous system: headache, confusion, fatigue

What can be done about it?

Treatments can include:

  • H1 or H2 antihistamines. These block the effects of histamine, which is one of the primary mediators that mast cells release. Histamine type 1 receptor blockers include cetirizine and loratadine and can help with symptoms, such as itching and stomach pain. Histamine type 2 receptor blockers include ranitidine and famotidine, which can treat abdomen pain and nausea.
  • Aspirin. This may decrease flushing.
  • Mast cell stabilizers. Quercetin may help prevent the release of mediators from mast cells.
  • Antileukotrienes. Antileukotrine medications, such as zafirlukast and montelukast, block the effects of leukotrienes, another common type of mediator, to treat wheezing and stomach cramps.
  • Corticosteroids. These should only be used as a last resort for treatment of edema, wheezing, or hives.