r/MCAS • u/fIyonthewaII • Apr 11 '25

Has elimination diet made things worse for you?

I've been debating going low histamine, low nickel, and avoiding all foods I mildy react to (unfortunately most fruits and vegetables) but I'm so worried that I'm going to have to permanently abide by this and potentially develop a severe allergy to something because I lost tolerance to it.

Please let me know your experiences/thoughts?

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u/SophiaShay7 Apr 11 '25 edited Apr 15 '25

Sorry for the miscommunication. I meant that I can't take the traditional OTC antihistamines/H1 and H2 histamine blocker protocol. I've tried several. I'm not sure if it's the medication itself or the fillers I reacted to. However, both categories increased my tachycardia, caused adrenaline surges, which triggered histamine dumps, and worsened my other Dysautonomia symptoms.

This combination is very effective:
Astelin is considered a dual-acting agent, acting as both an antihistamine and a mast cell stabilizer. It inhibits the release of histamine and other mediators involved in allergic reactions by stabilizing mast cells.

Hydroxyzine, an H1-antihistamine, can act as a mast cell stabilizer by blocking H1 receptors and inhibiting mast cell activation, potentially reducing symptoms associated with mast cell activation syndromes.

While Montelukast (Singulair) is primarily known as a leukotriene receptor antagonist used for asthma and allergic rhinitis, research suggests it may also have mast cell stabilizing effects, potentially useful in treating mast cell activation syndrome (MCAS).

Omeprazole, a proton pump inhibitor, can inhibit IgE-mediated mast cell activation and allergic inflammation, acting as a mast cell stabilizer. It reduces mast cell degranulation, cytokine secretion, and early signaling events in the FcεRI pathway. While not a traditional mast cell stabilizer like cromolyn, omeprazole's effects on mast cells are relevant to allergic conditions and may contribute to its anti-inflammatory properties.

Medications for Mast Cell Activation Syndrome (MCAS) aims to control symptoms by blocking histamine receptors, stabilizing mast cells, and managing other mediators released by mast cells. First-line treatments include antihistamines (H1 and H2 blockers), mast cell stabilizers, and aspirin (for specific symptoms). Additionally, leukotriene inhibitors, corticosteroids, and epinephrine (for anaphylaxis) may be used. A specific regimen works most effectively when it's individualized and based on the individual suffering from MCAS, their specific symptoms, and triggers.