Monday, August 22, 2022

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:
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.

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