Hi Friend,
When you have Mast Cell Activation Syndrome (MCAS) or chronic histamine intolerance, most standard advice stops at: "Take a cetirizine and avoid strawberries."
But if you are dealing with multisystemic inflammation—brain fog, joint pain, fatigue, and gut issues—a simple allergy pill often isn’t enough. You aren't just dealing with the sniffles; you are dealing with an immune system that is stuck in the "On" position.
Here is a look inside our toolkit at the Mend Clinic for calming the MCAS storm, ranging from foundational support to cutting-edge therapies.
Level 1: The Blockers (H1 & H2 Protocol)
Think of histamine like water flooding a bathroom. Antihistamines don't stop the water, but they do "plug the drain" so the room doesn't flood quite as fast.
H1 Blockers (The "Daytime" Guard): Medications like Zyrtec (Cetirizine) or Allegra (Fexofenadine). These target skin and brain receptors to help with itching and hives.
H2 Blockers (The "Gut" Guard): Medications like Pepcid (Famotidine). Since the gut is lined with mast cells, this is crucial for reducing nausea, acid reflux, and abdominal pain.
Level 2: The Stabilisers (Rx & Natural)
If antihistamines clean up the mess, Mast Cell Stabilisers stop the mess from happening. These agents reinforce the walls of the mast cell so they don't "degranulate" (explode) and release chemicals in the first place.
We use a mix of prescription and natural options depending on the patient:
Oral Cromolyn Sodium: Often called "liquid gold" for the gut. It coats the digestive tract to prevent reactions to food.
Ketotifen: A unique medication that acts as both a powerful antihistamine and a mast cell stabilizer.
Natural Support (Quercetin & Luteolin): These are powerful bioflavonoids derived from plants. Research shows they can be just as effective as some pharmaceuticals at inhibiting mast cell release, making them a great starting point for sensitive patients.
Level 3: The Regulator (Low Dose Naltrexone - LDN)
If stabilisers are the shield, LDN is the peacekeeper.
Naltrexone was originally designed to block opioid receptors at high doses. But at very low doses (0.5mg to 4.5mg), it acts as an immune modulator.
Why it works for MCAS & hEDS:
LDN temporarily blocks your endorphin receptors while you sleep. Your body responds by producing more natural endorphins (the body's natural painkiller). These endorphins regulate the immune system and calm down overactive mast cells. It is one of our favorite tools for chronic pain and fatigue.
I have seen some really good results with LDN, you can book here for your consult
Level 4: The New Frontier (Microdosing GLP-1s)
You have likely heard of GLP-1 agonists (like Semaglutide) for weight loss. But new research suggests these peptides are powerful neuro-anti-inflammatories.
For our chronic illness patients, we often use a "Microdosing" approach—using a tiny fraction of the standard dose.
The MCAS Connection:
Blood Sugar Stability: Insulin spikes are a massive trigger for histamine dumping. GLP-1s flatten these spikes.
Brain Inflammation: GLP-1 receptors are found in the brain. Activating them can reduce neuroinflammation (brain fog) without the intense side effects of high-dose weight loss protocols.
Finding Your Protocol
There is no "one size fits all" for MCAS.
Some patients thrive on Quercetin and H1 blockers; others need the heavy lifting of Cromolyn, LDN, or the metabolic support of GLP-1s to finally feel like themselves again.
If you are stuck in a cycle of reactions and fatigue, it might be time to upgrade your toolkit.
The clinic is once again full, we have opened some extra slots in Feb and March to help with chronic illnesses and MCAS, HERE
Stay Well
[Disclaimer: This email is for educational purposes only. LDN, Cromolyn, and GLP-1s are prescription treatments that require medical consultation. Do not start or stop medications or supplements without consulting your provider.]
