Harmony Hub Health
Functional Medicine, Hormone Health and Weight Loss with Michele Postol, CRNP
Harmony Hub Health
Mast Cell Activation: The Drama Queen of Your Immune System
Your immune system might be a drama queen, and that's not just a metaphor. When mast cells—powerful defenders designed to protect you from threats—become hyperreactive, they create a storm of inflammation affecting everything from your skin to your digestive system to your brain. This phenomenon, known as Mast Cell Activation Syndrome (MCAS), leaves countless patients struggling with mysterious symptoms that conventional medicine often misses or dismisses.
The symphony of symptoms can be bewildering: hives appearing without clear triggers, flushing that comes out of nowhere, debilitating brain fog, crushing fatigue, heart palpitations, and digestive chaos. What makes MCAS particularly challenging is that it rarely has a single cause. Instead, it emerges from a perfect storm of factors—infections like Lyme or long COVID, environmental exposures particularly mold, gut imbalances, genetic variants affecting histamine breakdown, and chronic stress. Each person's MCAS story is unique, requiring a personalized approach to unravel.
Through the lens of functional medicine, I share a comprehensive blueprint for addressing MCAS at its roots. From identifying triggers through advanced testing to stabilizing mast cells with targeted nutrients like quercetin and vitamin C, supporting histamine clearance with DAO enzymes, and optimizing detoxification with glutathione—this multi-layered approach goes far beyond simply suppressing symptoms with antihistamines. I walk through a real patient success story, showing how someone went from daily hives and inability to exercise to returning to CrossFit within six months by addressing multiple underlying factors. For those living with unexplained allergy-like symptoms, this episode offers both validation and a roadmap for recovery.
If you're tired of being told "everything looks normal" while feeling anything but normal, book a functional medicine consultation at harmonyhubhealth.com. Virtual and in-person appointments available in Manchester, Maryland. Let's calm your overactive immune system and help you reclaim your energy and quality of life.
Welcome to Harmony Hub Health, where my mission is to provide comprehensive, affordable, integrative care that addresses the root cause of health issues. At the Hub, the focus is on individual patient journeys. I strive to optimize health, vitality, and longevity, fostering a community where each person can thrive in body, mind, and spirit. Today I want to talk about mast cell activation and what it really is. And it's when your immune system overreacts. I guess we can say your immune system is being a little dramatic. Mast cells are powerful immune cells that are designed to protect us from infections and injury. But when they release their chemical messengers too easily or too often, the result is a storm of inflammation that feels unpredictable. It can be frightening and it can be chronic. So this is known as mast cell activation syndrome, also called MCAS. So mast cells do release mediators like histamine, prostaglandins, leucotrians, and tryptase. In MCAS, this release happens inappropriately or excessively, even when there is no real danger. Like I said, it's being very dramatic. Mast cells live in so many tissues. It lives in your skin, your lungs, your sinuses, your gut, your brain, your blood vessels, and symptoms can appear almost anywhere. The most popular symptoms of MCAS are flushing, hive, swelling, headaches, and migraines, GI distress like diarrhea, bloating, pain, palpitations, or when you feel like your heart's skipping a beat, dizziness or blood pressure changes, anxiety, insomnia, even brain fog. So MCAS does not have a single cause. It's usually a perfect storm of stressors that push mast cells into overdrive. These causes could be infections and chronic illness. I see it with Lyme, Bartonella, Babesia, EBV, COVID-19, and even long COVID. It can be from environmental triggers like mold exposure and mycotoxins, chemical sensitivity, even fragrances. It could be caused by gut imbalance if you have a leaky gut, if you have dysbiosis, if you have yeast or candida, or even SIBO, that small intestinal bacterial overgrowth. It can also be genetic. So variants in MTHFR, DAO, HNMT, or COMT can impair histamine clearance. Functional genomics testing, like three by four genetics, does help identify if these pathways are bottlenecks. Then we have hormones and stress. So if your DAO activity is low, whether due to genetics or gut inflammation or nutrient deficiencies, histamine accumulates and contributes to MCAS. Low DAO equals high histamine load. So when you have these genetic variants of the DAO, can also be MTHFR, the HNMT, or COMT, they all reduce histamine breakdown and they impair methylation, which is your second pathway that clears histamine. 3x4 genetics testing does reveal these polymorphisms and helps personalize treatment. So for example, if we're emphasizing methylation support with B12 folate riboflavin, or if we need to supplement DAO with your meals. This is known as Epigala catechin galate. It's the most abundant catechin in green tea. It has mast cell stabilizing antioxidant and anti-inflammatory effects. And in vitro studies show that EGCG can inhibit mast cell degranulation. So that makes it a very useful nutraceutical for patients with MCAS who can tolerate green tea extracts. One of the most overlooked triggers for MCAS is mold and mycotoxin exposure. Mycotoxins act as direct mast cell activators. So they increase histamine and inflammatory cytokines. Chronic exposure, even at low levels, can worsen MCAS symptoms and make patients more reactive to food, supplements, and medications. Functional uh medicine testing like urinary mycotoxin assays or environmental testing often reveals this hidden driver. Treatment typically involves mold remediation, binders like charcoal or bentonite or chlorella, um glutathione, and mitochondrial support. What brought this podcast today is one of my favorite patients, which we didn't start out as favorite patients. So she came to me um with frequent mystery reactions, I'm gonna call them. She complained of hives, swelling after meals, brain fog, and a crushing fatigue. And this is someone that was going to CrossFit at one time. So she did conventional allergy testing, which was all negative, and she really felt dismissed by the conventional medical system. For me, I was a little nervous because she was the first patient, I think, with Harmony Hub Health that I could even classify as MCAS. Um, we did some functional medicine testing for her and discovered that she did have low DAO enzyme activity. Um, she did have genetic variants in MTHFR and DAO. This was all through um the 3x4 genetics testing. And she also had gut dysbiosis and elevated mycotoxin. So it wasn't just one thing. Her mast cells weren't behaving um or misbehaving randomly. They were just very overwhelmed, right? They were being dramatic. So I built a layered protocol. Um, for short-term relief, we did um quercetin, vitamin C, and some DAO supplementations with meals that reduced her histamine burden. Um, orthomolecular does have the best, the highest quality, um I would say, that have these in them. Um and then for long-term healing, there was mold detox with binders and a lot of glutathione, gut repair, and methylation support. And then lifestyle stabilization. So we started with a low histamine diet. Um, she started with some nervous system regulation. She was doing vagus nerve exercises and meditation. And by the end of her sixth month, I know that she was doing pulsetto also and having great relief with that. So over six months, her daily hive stopped, her energy improved, and she could finally tolerate food again. Some people might say six months is a really long time, but I will tell you, she has felt miserable for three plus years. Um, there's no way that any of this is a quick fix. I think month one or month two, I'm sure she's listening, she was wondering if she wasted her money on me. Um, there's a trust factor. There is um, you know, belief. And when you're first meeting somebody, like I she didn't know me from anybody else. She had already been let down by the conventional medicine system. Um, and here I was, someone that popped up on Facebook is how she found me, and had no idea even if I knew what I was doing. I was not even sure for this because she was my first MCAS patient. But over the six months, things just got so much better. By the time she got to month three or four, she was having um less of those hives. She was still having some of them. Her body was still being very dramatic. Um, then we added in the HTMA, we balanced her minerals, then we checked her gut, um, treated what we found in there, which what was in there surprised the both of us. But by month six, now she is back to CrossFit. Um, that's a big win for her because that's something that she really loved that she had to give up. So functional medicine does go beyond anti-histamines forever, which is what she was told to do. And sometimes I do give dehist to some people. Um, it does help them with their MCAS, but it doesn't really get to the root cause. Like, why are mast cells overactive in the first place? So, my functional medicine approach, um I'm gonna give you my blueprint that I follow. Um, I probably shouldn't because it is it's mine. But I I'm I'm happy to share. So, functional medicine approach, my approach to MCAS, um, is a very strategic step-by-step process. Number one is to remove triggers. This could be going on a low histamine diet. It's gonna mean doing fresh cooking. Um, it could be mold remediation and detoxification. It really depends what we find your triggers are. Um, and sometimes those can be changing, sometimes you're chasing yourself. Um, and then you have to treat gut infections. Um, I would say um I have never seen somebody completely resolve triggers unless they did a deep dive into the gut. All right. Number two is stabilized mast cells. This can be with vitamin C, it could be with uh luteolin, it could be with quercetin. I have a whole arsenal of orthomolecular supplements that depending on what I feel you need after consultation, um, we would try. Then that EGCG and that green tea extract is something good. Stinging nettles, I love. I would say um, I love stinging nettles, um black seed oil. And then for severe cases, which I didn't have to go through um in in her case, um, but cromelin sodium or um catotiphon, um those are for severe cases, but available. Now, you also want to support histamine clearance. This means DAO enzyme supplements with meals if needed. You don't want to just take any supplement because you heard someone else did well with it. You want a really good consultation to find out what exactly you need and look at the testing. Okay, you want to test, don't guess. Um, then there's methylation support. That would mean the B12, the folate, the riboflavin, magnesium, zinc, and then optimize your detox pathway. So you want to make sure that you can support the clearance as well. Um, and then calming that immune system. This is where the omega-3s come in, bromeline, curcumin. Again, orthomolecular does have a whole entire arsenal of things I can choose to help you calm that immune system, keep it from being dramatic. Glutathione is my absolute favorite. Um, I love it in so many different forms. I would say the first form I love is, of course, infusions, IV infusions. You can get an infusion at Harmony Hub Health. You can also use it as um injections. You can get an injection of glutathione. My favorite at home is the um liposomal topical by Aura Wellness. Um that's my favorite. I carry that at Harmony Hub Health. You can also get it from my website. Um, then after that, you can go to the liposomal oral, but you know, just because most people already have bad gut health and a bad dysbiosis going on, I do try to limit things going into the gut like that. Um, and then knack, knack is very important as well. And then adaptogens for stress resilience are always helpful. I think with this patient, uh, what we had to separate at the beginning was what exactly is a difference between a flare versus MCAS? So she asked me, you know, is this just a flare or is it mast cell activation? And understanding the difference is very critical. So a flare would be a temporary worsening of symptoms. This can be an autoimmune flare, a Lyme flare, IBD flare, anything like that. But MCAS is a syndrome where mast cells are chronically unstable and release these mediators too easily or inappropriately. A flare is episodic, it could be days to weeks and is triggered by a stressor. MCAS is an ongoing condition. It can be recurrent, but there it's a multi-system symptom. Um a flare is worsening of an underlying disease, whereas MCAS, it is um dysregulated mast cells reacting excessively to triggers, whether it's food, chemicals, infection, stress, or temperature. Symptoms of a flare are very disease-specific, um, like joint pain in an immune autoimmune flare or fatigue in a lime flare. MCAS is allergy-like and systemic. That's how you get the hives, the flushing, the swelling, the GI upset, the palpitations, the headaches, the brain fog. Um, those are more than sometimes you get with MCAS. Um, a flare treatment would be to manage that underlying condition, you know, reduce the stress, calm inflammation. But treatment for MCAS is stabilizing the mast cells, um, supporting the DAO, having a low histamine diet, and then detoxing from mold and mycotoxins. So a flare is the storm itself, while MCAS is the broken weather system that makes storms more frequent and severe, if that makes sense. So if this is speaking to you and you've been living with unexplained hives, flushing, food reactions, or fatigue that no one else can explain, mast cell activation might be part of your puzzle. At Harmony Hub Health, I do specialize in identifying root causes through advanced testing, whether it's genetics, um, GI map, oat test, mycotoxin testing. And I love to create personalized treatment roadmaps that go beyond symptom suppression. So if you're ready to calm your mast cells and reclaim your energy, book a functional medicine consultation with Harmony Hub Health. You can find me online at www.harmonyhubhealth.com. You can see me virtually. You can also see me in person in Manchester, Maryland at Monarch Beauty and Spa. Um, you can send me an email at Michelle, that's M-I-C-H-E-L-E at harmonyhubhealth.com. I would love to speak with you and get you on a good path to health. This podcast is for educational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease. The information provided reflects current functional medicine understanding of mast cell activation and should not replace individualized medical advice. Always consult with a qualified healthcare professional before starting or changing any supplement, medication, or treatment plan.