Hi Friend
If you are living with endometriosis, you know the drill: the debilitating cramps, the fatigue, and the chronic pain are part of the "package." But what about the other symptoms that don’t seem to fit the textbook definition?
Do you experience random flushing, sudden anxiety, headaches, or that infamous "endo belly" where you look six months pregnant after eating a seemingly harmless meal?
For years, patients have been told these are just "part of having endo" or, worse, "all in your head." But emerging research suggests a fascinating biological culprit connecting these dots: Mast Cells.
In today’s newsletter, we are diving deep into the link between Endometriosis and Mast Cell Activation Syndrome (MCAS)—and why understanding this connection might be the missing piece in your management plan.
🔬 The Science: A Vicious Cycle
To understand the link, we have to look at mast cells. These are immune cells responsible for allergic reactions. When triggered, they release a cocktail of chemicals, including histamine, to help your body fight off "invaders."
In a healthy body, this is a good thing. In someone with MCAS, these cells are hypersensitive—they overreact to triggers like stress, food, or temperature changes, flooding the body with inflammation.
Here is the connection to Endometriosis:
Research shows that endometriotic lesions are packed with mast cells. Even more critical is the role of estrogen.
Estrogen triggers mast cells to release histamine.
Histamine stimulates the ovaries to produce more estrogen.
The result? A self-feeding loop of inflammation, pain, and hormonal dominance.
This explains why your allergy-like symptoms (hives, congestion, bloating) often flare up right before your period, when your hormones are shifting.
🚩 Signs of the Endo-MCAS Overlap
You might have both conditions if your endometriosis is accompanied by:
"Endo Belly" that feels more like an allergic reaction than just bloating.
Food sensitivities that seem to change randomly.
Dermatographia (skin that turns red or welts easily when scratched).
Heat intolerance or flushing after a hot shower or exercise.
Bladder pain (Interstitial Cystitis is often a "sister" condition to both).
💡 3 Ways to Break the Cycle
If this resonates with you, you don't have to suffer in silence. Calming down your mast cells can often reduce endometriosis pain. Here are three places to start:
1. Consider a Low-Histamine Diet Trial
Many "healthy" foods are high in histamine, including spinach, avocado, fermented foods (like sauerkraut), and aged cheeses. Try reducing these for 2–4 weeks to see if your pelvic pain or bloating decreases.
2. Natural Mast Cell Stabilizers
Before jumping to medication, nature offers powerful stabilizers. Quercetin (found in apples and onions) and Luteolin are flavonoids that help prevent mast cells from "exploding" and releasing histamine.
(Note: Always consult your doctor before starting new supplements, especially if you are on blood thinners.)
3. Review Your Medication with a Specialist
Some patients find relief using H1 blockers (like Zyrtec/Claritin) and H2 blockers (like Pepcid) in combination. If you suspect MCAS, bring this up with your excision specialist or an immunologist.
🌿 The Takeaway
You are not imagining your symptoms. The body is an interconnected web, and for many endo warriors, the immune system is just as involved as the reproductive system.
Acknowledging the role of mast cells opens up a new toolbox for pain relief that goes beyond hormonal birth control and surgery.
Here’s to connecting the dots and finding relief.
Regards
Dr Ahmed
