Allergies, Autoimmune, Histamine Intolerance, MCAD/MCAS, Mastocytosis, IgE... What is going on?

In our groups we welcome anyone who needs or wants to avoid corn. That's our primary goal. Avoiding corn. 

And as most of you know, that's easier said than done. 

Within our groups, you'll find people avoiding corn for many different medical reasons and sometimes people get confused on cart vs horse or unicorn or zebra. 

So we're going to try to write up something simplistic to help clarify the different conditions and diagnosis as best we can. Even medicine sometimes changes their minds on how things work so this is confusing for many. 

Let's start with the basics of how the immune system works with allergies and autoimmunity.

The body produces IgE in response to what it considers the enemy. These are specifically programmed to detect the presence of that enemy. They attach themselves to mast cells. When the enemy is present, the mast cell degranulates giving off multiple substances to help the body fight the enemy. 

Some of the items released from Mast Cell Degranulation are:
Histamine
Tryptase
Heparin
Prostaglandins

Leukotrienes

Kinins

Serotonin 

Serine proteases

How much of which and how many and whatnot.. that is very individual and can differ based on the "enemy" detected.

So with the same "enemy" -  Person A might just have bunch of histamine, some tryptase maybe.. Person B might have a little histamine, a bunch of heparin, tons of leukotrienes. 

 Meanwhile with different "enemies", Person A might have a ton of histamine with one, and almost no histamine with another. 

Our bodies even with similar diagnosis will always present differently because of the many many ways our systems work differently. 

And some of the ways our bodies work different are based on set DNA, and sometimes based on epigenetic changes in our bodies. Just to add more to the pile of confusion.

MCAD/MCAS & Mastocytosis:

Unlike allergies, Mast Cell Activation Disorders (MCAD) are immune adjacent and do not require immunoglobulins (IgE, IgG, IgA, etc) for mast cell degranulation. 

In the image above, you notice that IgE attaches to the mast cell and then the mast cell degranulates when in contact with the enemy.  

In MCAD, this step is skipped. The mast cell is highly volitile all on it's own and degranulates for various reasons and with various enemies. 

In the process of diagnosing MCAD, many diseases and conditions must be ruled out first, and one of those is allergies. IgE tests are done to make sure the reactions the person is experiencing is not a normal immune response. 

Now it is possible to have MCAD and allergies, but MCAD is only indicated IF the reactions cannot be explained by IgE involvement (or any other disease).

Histamine Intolerance:

Intolerance is bandied about a lot in our groups and covers pretty much anything that isn't proven as an IgE allergy.  

However, true histamine intolerance is more akin to lactose intolerance than anything else. 

In lactose intolerance, the body doesn't make the right enzymes to break down lactose so the body cannot digest it. And so it wreaks havoc. 

Same goes for true histamine intolerance. 

The body has two main enzymes for breaking down and removing histamines from the body.

Histamines are a normal body process. They're naturally created during eating and help with digestion among other uses.

The problem comes in when the body can't remove them fast enough. In reactions, this is because the flood of created histamine (released histamines from mast cells) is way more than the body can remove. 

But for people with histamine intolerance, this can happen for a multitude of reasons because their bodies either don't produce enough enzymes to break down histamine or they produce faulty enzymes. So even small amounts of histamine cause histamine buildup and they see a histamine reaction. 

People with IgE or MCAD can also have histamine intolerance to complicate matters as the combination only makes it all worse.  

But having Histamine Intolerance does not mean you will have allergies nor does it indicate that you have a mast cell issue.

Type 2 Diabetes - an immune connected disorder?

Personally, I've known that type 2 diabetes was super complicated for many years.

 Type 2 .. while it's suspected that the pancreas doesn't produce insulin or that there's a problem with the organ, research has shown that this isn't the case for everyone and more and more research is starting to find that Type 2 Diabetes is a "symptom" of a larger issue or a secondary issue to something else.

 There's been research connecting it to immune disorders.. which is why I'm posting about it here.

For instance: Diabetes.Co.UK:

"The immune system also plays a part in type 2 diabetes Researchers have linked insulin resistance to high levels of cytokines, which are released in response to inflammation in the body. The immune’s system’s response to inflammation leads to fat cells being unable to respond well to insulin and sees the fat cells releasing fatty acids into the blood, leading to higher than normal levels of cholesterol."

Not to get too technical, but Cytokines are released by various cells including T Cells and Mast Cells (here and here). Mast Cells are triggered to release or degranulate by the immune system (as well as other cells).. this happens when diseases are detected or when exposed to an allergen. For those with any MCAD disease (Mastocytosis or MCAD or Hereditary Alpha Tryptasemia), insulin resistance is going to be hard to avoid.

And this study also linking Type2 to the immune system:

"Our findings provide evidence that an immunometabolic crosstalk between islet-derived IL-33, ILC2s, and myeloid cells fosters insulin secretion."

So if you already have an immune related disease, your chances of developing Type 2 aren't insignificant and you may not be able to entirely avoid it without taking some medical, medicine, or other action.

But you can help yourself a little by investigating just how your body deals with sugars/carbs.

Not too long ago, there was a research study that showed that 1 sugar + 1 sugar did not always equal 2, and it differed from person to person.

Here's the CBS article on it: CBS News: "Huge" differences even though people ate the same foods
Here's one by Science Daily: Science Daily: Blood sugar levels in response to foods are highly individual

One of the reasons it's taken so long for a cure for Type 2 Diabetes, is that it's not a one size fits all disease. What works for one person doesn't always work for the next. (You know, just like there's not a perfect diet that works for everyone.)

If you've been warned that you're heading to Type 2 Diabetes and you have food allergies or autoimmune issues, you're going to want to listen and start NOW with figuring out what works for you and what doesn't.

- Please note.. this is not intended as a replacement for medical advice, but simply as a data gathering method to help inform YOU and YOUR DOCTOR of what is actually going on in your body in relation to sugar consumption, absorption, and processing. -

Many many years ago, I wrote an article here about the best food diary (food journaling) for figuring out your allergens/intolerances. This is still a good method for Type 2 as well.

I explain more in that article about the ins and outs of what to do daily and charting it, but just to explain here as well.

For blood sugar testing, you will want to record the following items.

Your Fasting Blood Sugar (every morning before you eat or drink. Test your BS.)
Your Blood Sugar after every meal (Test 2 hours after every meal.)
Your Weight (same time every day, preferably after waking before eating or drinking)
Water Consumption (this is optional, but if you're not getting enough water it can affect your blood sugar levels and readings)

- If you're wanting to be super anal about this, you can also test your blood sugar before going to sleep as well as if you wake up in the middle of the night with insomnia. Over-testing for BS isn't really a thing so you can test as much as you want, just note that your fingers will get very sore so you'll want to spread the testing around to different fingers or even parts of the body as your meter allows. (To clarify, you can over-test and cause damage if you're using the same spot on your body too much. This can cause nerve damage over extended time. So switch it up.)

Reading the testing.

Normal Blood Sugar Ranges for those without Diabetes

• Fasting Blood Sugars: 72-99mg/dL
• Before & After Eating: 80-130 mg/dL
• High Blood Sugar: 140 mg/dL or greater

Diabetic Blood Sugar Ranges:

• Fasting Blood Sugar: 80 -130 mg/dL
• After Eating: less than 180 mg/dL (about 1-2 hours after)
• High Blood Sugar: greater than 180 mg/dL

See also: American Diabetes Association

If you are not diabetic yet, you should be using the "normal" of blood sugar scale:

If you're not seeing any jumps in your blood sugar no matter what you eat, and your fasting blood sugar is constantly in the normal zone, and your A1C is in the safe zone. Congratulations! You can stop testing and go on with your merry little life. Keep with your current diet, just be mindful about keeping hydrated and exercise.

If you're not seeing any jumps in your blood sugar no matter what you eat, and your fasting blood sugar is constantly in the normal zone, but your A1C is still high (over 6). Then you're missing a piece of the puzzle somewhere. You may want to try testing at 1 hour after eating as well as at 2 hours or possibly before eating AND after eating. There may be issues with gastroparesis or something else causing delays in your sugar processing outside of meal times (aka testing at 2 hours isn't catching it), or you're having sugar dumps (this happens with fight/flight triggers and allergic reactions).. Basically something is going on and you'll want to discuss this with your doctor.

If you're not seeing any jumps in your blood sugar no matter what you eat, BUT your fasting blood sugar is occasionally high.. Congratulations! You're on your way to figuring things out. Note which days your fasting is high, and try to replicate it by eating similarly again, including eating at the same times of day. If you cannot replicate it, and it continues to be randomly occuring.. there may be something else going on. Start writing down symptoms. Did you wake up that night with insomina? Did you drink less water? Did you go some place different?  If you really cannot replicate it (and I don't mean the exact BS number, I mean replicate it being high or low.. aka control it) then you're stuck. Do your best to eat a balanced diet and get some exercise. You can always return to this type of testing/food journaling if things get worse.

If you're seeing some blood sugar jumps with some meals and not others, or every meal, you're going to want to look at your diet.

If jumps are happening every meal, are you eating the same foods every meal? Milk? Wheat? Eggs? Corn? Soy? Are you eating too much or too little protein? Too much carbs or not enough? You're going to want to vary things up to see if removing or adding things makes any difference. Eat simple foods with simple ingredients so you can help narrow this down a bit.

If jumps are happening some meals but not others, you're on your way to getting answers. Make note of the meals that caused the jump. Start removing and adding foods based on that data. Can you replicate the jump? Does it happen every time with the same food? Or only when two foods are eaten together?  (Personally, my biggest jump was pizza. I could eat the cheese fine. The sauce fine. The crust fine. But if I ate them together in the same meal.. Blood sugar jump.)

With this whole process, you're looking to keep your blood sugars steady or even keel. Jumps often come with lows, and if you're not cognizant of this.. you can easily find yourself on a blood sugar rollercoaster as you crave foods during your lows that often can cause spikes.. followed again by lows.. followed by spikes.. and so on. This is not awesome for your body.

Foods that help stabilize blood sugars are fats and proteins.

If you're eating a low fat diet, you should stop. Most low fat diets have more sugar or the carbs in the diet are often just carb with very little to keep blood sugars steady. Moderation is key as well as making sure you're eating good fats. So eat some avocado, not french fries.

There is also several studies out now that eating too low-carb can also be dangerous.

When eating carbs, try to make sure those carbs aren't just easy digestible empty calorie carbs. You're going to want to make sure you're getting adequate dietary fiber (roughage), fats, and proteins with every snack/meal. You don't need to give up items like ice cream or cookies (or at least not yet), but you should go for the full-fat whole milk or heavy cream ice cream.  The fats can help curb sugar jumps/lows, but whole milk/cream ice creams also tend to be less sugar per ounce and the fats in it will make you feel more full quicker so you'll eat less. Cookies made with protein in them or whole grains will also help lessen the sugar spike and keep you going longer.

It's also best to make sure if you're eating something high carb, that it's with a meal and that you're eating protein often with each meal.

Results with diet changes will vary greatly from one person to the next. Diabetes is not a one-size-fits-all kind of thing. Which is why I suggest doing the testing and food journaling to help you figure out what works best for you.

Anyway, I hope this helps. Consult your doctor if you have any questions.

******

As a side note, MUCH of the literature around Type2 Diabetes blames fat for the issue. IMO this is cart/horse. Leading research today is more about inflammation and the immune system, but prejudices abound around fat so it'll be awhile before medicine catches up (if it ever does).

While excess fat can complicate Type2, and heavy excess of fat isn't great for anyone, I believe fat is the symptom of the cascade from the actual problem.

I believe that the immune related issue causing the inflammation, causing the insulin issues.. that that core issue causes a cascade of problems resulting in weight gain BEFORE the inflammation issue or insulin issues are bad enough to be clinically detected.

Should you attempt to lose weight healthily? Should you exercise? Yes. Please do.

But if you're beating yourself up for not being the size/weight you think you should be.. Please don't. The added stress is not helping any of this, and may actually be worsening your inflammation.

Focus on eating right, exercising right, and being healthy. If your immune system is buggered, you may never get the weight off.. but you can make yourself the healthiest and fittest and happiest you can be.

Defining Your Sensitivity category for our groups. Corn-Lite VS Corn-Free

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In our groups, we are only concerned about your sensitivity when evaluating product safety. If you have no idea what that means, please check out this post here: Grading the severity of your allergy: Sensitivity vs Reaction Level

Why don't we rank Reactivity? Because in the grand scheme of things, it's not that important to your fellow group members. We're all a little selfish and concerned about what matters most to us. Don't worry, you're a little selfish and concerned about the same things.

We all simply want to know how much corn is in a product and if that much corn is enough to cause a reaction for us.

This is where sensitivity comes in.

If Abe states that he reacted to ACME's almond butter, you will want to know a few things about Abe, especially if you like almond butter but also if you happen to be enjoying some ACME almond butter.

You'll want to know:

A.    Just how much corn exposure does it take for Abe to have a reaction.

B.    Is Abe sure it was the almond butter?

C.   (unless you're a sociopath) You might also want to know if Abe is ok.

So, Abe says he's fine but he's certain it was the almond butter.

Now you need to know how sensitive to corn Abe is and how sensitive in comparison you are, so you'll know if you should risk having that almond butter sandwich or not.

Thus, our ranking scale which is based on American/Canadian diets and environments. Food regulations in countries overseas as well as Mexico (even Canada in some cases) are vastly different even on goods imported (imported goods to the US have to abide by at least some of the US standards and thus are often different than the same named products in the originating country) making sensitivity comparisons with people in other countries outside the US is often widely different. 

Our ranking scale is not fool-proof and no one is 100% in any category. Pick the one that best represents your allowable corn avoidance. And by allowable, I mean the amount of corn removal you absolutely have to be at to stay healthy and alive. If you feel you're in-between two categories, when suggesting or recommending something, use the more corny category in your recommendation disclaimer (you don't want to endanger someone else) and when asking people to recommend things use the next category up (for safer recommendations to you).

Corn-Lite: 

We wrote a very long article on what is Corn-lite, you can read it here:  Defining Corn-Lite, and Corn-Free, and all that wordy jazz.

"Corn-lite would be avoiding the major corn ingredients like corn syrup, corn starch, corn meal, etc.. and trying to avoid as much citric acid and ascorbic acid as possible.  Basically, eating lots of fresh veggies, meats, and home baked goods."

Corn-lite not only removes obviously “corn” named ingredients but also anything labeled where the source has not been confirmed to be something else: starch, modified starch, glucose syrup, fructose syrup, baking powder, grits, maize, zea mays, zein, iodized salt, dextrose, fructose, glucose.

This does not include just foods, but all products.

For the most part, a corn-lite lifestyle is full of reading labels and buying specific brands of foods. Focusing most meals on fresh produce and simple ingredients to cook at home.

Restaurants: If they are very careful, they can occasionally eat out.

****If you can safely eat any of the items listed for removal for "Corn-Lite", please do not recommend products in the group. Your sensitivity category would be "Corny" and while you may benefit from asking questions and other's recommendations, your sensitivity is not high enough for you to make safe recommendations within the group.*****

Corn-Moderate:

The term corn-moderate may be used by anyone who needs to remove more corn than corn-lite, whom also meets the following requirements:

A person's sensitivity category may be deemed corn-moderate if they have to avoid ALL corn derivatives and cannot source many of their groceries through a grocery store.

Produce: They may be able to tolerate a couple items but most produce must be found through alternative sources.

Meats: Most plain unseasoned meats at the grocery store are unsafe for them and will cause a reaction. (If you're still able to eat seasoned meats, hotdogs, lunchmeats, you are still corn-lite.) They may be able to do one meat source found at a grocery store, likely a particular product from a particular store. Most moderates special order at least some meat (possibly even all) from trusted farmers that have been vetted for safety.

Water: They cannot tolerate tap water. Water must be filtered.

Ingredient labels of the products they do buy list no more than 5 ingredients, and they make almost all their snacks/foods from scratch at home.

This doesn't include just foods, but all products.

Restaurants are nightmares.

*** If you are new to our groups, you should stick to the disclaimer of corn-lite on all your recommendations until you've had a chance to read all the literature and get a good feel for the group. Probably 6 months.***

Corn-Extreme:

I just decided to make this one up for our very few members which would qualify for this. Since the term "corn-free" is banned from us in our groups, our members the most extreme about corn removal may use this term. And by "extreme" I mean, they do this because they have to in order to stay alive and well. Corn-Extreme is as close to corn-free as is humanly possible. Not comfortably possible. Not semi-socially awkwardly possible. Not "in modern times" possible. But in all things.. ALL THINGS.. as corn-free as it is possible BECAUSE it's medically necessary.

If you use this term and you are NOT one of the very few members who qualify for this title, you will be - no questions asked - booted from the groups. If this title sounds like it might be you, but you can think of someone more extremely limited than you are, you probably are still moderate.

*If you feel this label is right for you, do not use it unless: 1. You've been a member of the group for more than one year. 2. You've joined Level 2 and you've been cleared with the Admin for use of this label.*

Our corn-extreme members barely remember what grocery stores are, and definitely don't buy anything more than an item or two.. and likely only for family members. 

Our corn-extreme members inhabit the spirit of living like it's 1899 in all its wondrous glory. They make the ingredients their ingredients are made of, always, including almost all of their spices.

They also research everything that goes into their mouths down to the very last detail.  They have talked to the customer service, owner, foreman, and line personnel. They talk to the guy that supplies the products to the guy they're buying the end product from. They trust nothing and no one. 

They buy meats from special deals with farmers and processors, eliminating corn-fed animals, carcass washes, processing aids, packaging issues, and often with the farmer or processor agreeing to do something different than they normally do. They buy only no-spray produce from trusted farmers, if they can't grow it themselves. They send Holiday gifts to their farmers and know them like family.

Almost nothing they buy has an ingredient label, and they're looking into buying farmland and already raise chickens. They also know or are learning how to "dress" an animal, and it has nothing to do with lace. 

Their kitchen is outfitted with awesome tools like meat grinders, slicers, grain mills, dehydrators, a wide variety of knives (all sharp). 

Their water is extremely filtered, and they probably have their own distiller. They likely only have one water source that is tolerated. 

There is a legitimate fear of starvation should any one of their suppliers change a product they use or go out of business.

They actually have a hazmat suit for staying safe outdoors. 

They're pretty sure they remember what restaurants are, but it's been so long it seems like another lifetime ago. 

*****Please, understand there is no social hierarchy or shame with any category of corn sensitivity. It is most honorable and safe for others for you to accurately state your sensitivity, and with accuracy comes respect and trust of your fellow members.****** 

Lets Get Complicated!

You thought we were done.. we're not. We know you still have questions, and we'll try to answer them.

While most of the categories above were described as foods, there's more to the story. 

There are three main areas of sensitivity:

A.    Ingestion (eating, swallowing)

B.    Airborne (breathing, inhaling)

C.   Skin Contact (direct contact with skin, touching)

It is completely possible to have one category of avoidance for one of the above areas, but another category for the other areas. Or to have a different categories of avoidance for all three areas.

Bodies are weird!

This means that while you may eat "Corn-Lite", when looking for lotion recommendations you may more accurately need to use the label of "Corn-Moderate" if you're more contact sensitive than the corn-lite category would fit.  Or if you're not contact sensitive at all, but you have to wear a mask often due to corny scents or ethanol fumes or whatever.. you may want to use "corn-moderate" when asking for air freshener ideas. 

Please use the best fitting label depending on the topic and product being discussed. If you can't decide between two categories, use the lower or more corny category.

*****Please, understand there is no social hierarchy or shame with any category of corn sensitivity. It is most honorable and safe for others for you to accurately state your sensitivity, and with accuracy comes respect and trust of your fellow members.****** 

Related definitions:

Corn light

Corn-Medium: A person who utilizes metaphysical methods to devine whether or not something has corn in it. This would make for an awesome Halloween costume.

Corn light

Corn-light: a particular type of bulb that looks like corn on the cob, may also be used for a corn shaped lamp.