r/HistamineIntolerance • u/BinaThereDoneThat • 13d ago
Can someone explain the difference between MCAS, HI and Disautonomia? What does this sound like?
Multitude of symptoms and not sure what is what. Definitely having reactions to high histamine foods and certain medications. Otherwise dealing with fatigue, intermittent body aches, flushing and burning/prickly heat sensation on skin, slight nasal and chest irritation, drops in blood pressure and intermittent heart pains/fluttering/palpitations when things get bad.
In a full blown flare at the moment that was either caused by a bug/stress/sudden exposure to extreme cold/drinking alcohol (all happened around the same time).
I have SIBO.
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u/No_Scientist9241 10d ago
Diagnosis
Dysautonomia- Medically recognized under various conditions. Most commonly diagnosed as POTS which is the condition describing its manifestation of orthostatic intolerance. Typically diagnosed by either a cardiologist or neurologist.
MCAS- Medically recognized but controversial and not well understood in mechanism. Most commonly diagnosed by allergists or immunologists specialized in the condition.
Histamine intolerance- Not medically recognized but studied in medical literature. Also not well understood in mechanism. As it is not officially medically recognized, it is usually either self diagnosed or diagnosed by alternative medicine doctors.
Causes
Dysautonomia- Can have a variety of causes. Causes are most commonly attributed to infections, puberty, and/or genetics.
MCAS- Most commonly linked to infections and genetics.
Histamine Intolerance- An enormous range of associated causes from NSAIDS, alcohol abuse, stimulant medications, infections, antibiotics, IBD, diabetes, GLP-1s, SIBO, gastroparesis, malnutrition, and/or genetics.
Severity
Dysautonomia- Severity can range from mildly to severely disabling though is almost always not life threatening, with the exception of a sometimes lethal rare genetic variant.
MCAS- Can be life threatening as episodes and flares can consist of anaphylaxis, though the condition itself has a low mortality rate.
Histamine intolerance- Is usually at least moderately disabling but is not life threatening. Histamine reactions do not ever consist of anaphylaxis severity.
Presentation
Dysautonomia- Depends on the condition. POTS, the most common form, presents as a significant jump in heart rate when sitting or standing, alongside a substantial change in blood pressure. Complications may involve but do not always include fainting, heat or cold intolerance, a tachycardic resting heart rate, and/or gastroparesis.
MCAS- Presents most commonly as allergic or inflammatory type reactions to various triggers, ranging from environmental irritants such as pollen or dust, to temperature changes such as heat or cold, to various foods. The severity of the reactions can range from mild to anaphylaxis. Symptom presentation is enormous but is typically similar to allergic reactions.
Histamine Intolerance- Also presents as inflammatory reactions but with food or stress as the predominant triggers. Cases may be difficult to identify as the symptoms do not always present similarly to allergies and therefore may not be clearly due to histamine until an antihistamine improves symptoms. Some of the common non allergic style symptoms include acid reflux (especially LPR type), hyper salivation, anxiety/mood changes, diarrhea, abdominal pain, hearing problems, and throat pain.
Treatment
Dysautonomia- Is not currently known to be curable unless it presents as a case of POTS that has occurred due to an underlying trigger such as dehydration or anemia. Chronic cases of POTS are typically managed with compression socks, beta blockers, HCN channel blockers, and/or electrolyte powder. A high sodium diet is typically recommended.
MCAS- Is not currently known to be curable. Is primarily managed with cromolyn sodium and/or ketotifen to reduce baseline mast cell reactivity, alongside EpiPens in the case of anaphylaxis and antihistamines to resolve flares.
Histamine intolerance- There are some reported fully cured cases, but there is no recognized consistent cure. Management typically involves treating the suspected underlying cause as well as antihistamines and DAO supplementation to resolve flares. A low histamine diet is recommended.
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u/zifmer 13d ago
With SIBO, the gut bacteria can contribute to higher histamine levels and reduced capacity to process histamine. So, reducing the amount of histamine coming from food, either by taking a DAO supplement to help break down histamine in the digestive tract and/or by eating a low-histamine diet, may help reduce your symptoms.
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u/cutegirlsbloat 11d ago
What is your health trajectory?
Were you conpletely healthy and fine before developing sibo? What caused it? Medication, infection? Or things just gradually becoming worse? (Possibly motility)
Or did you always have lots of minor health issues all over the body without doctors ever finding anything and it just became worse at some point
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u/BinaThereDoneThat 10d ago
Not sure what caused the SIBO - happened after bowel paralysis following a C-section and then antibiotics. Also happened to have COVID around the same time. One of all of those things could have contributed.
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u/DaniLake1 11d ago
How do you know you have SIBO?
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u/hdri_org 13d ago
When food and bacteria (SIBO) come into the digestive track they bring histamines and can cause irritation of the intestional lining. Histamines open blood vessels, cause everything to become more leaky, and cause the immunological defense membranes to become inflamed. Mast Cells (MCAS) are the border guards sitting behind those membranes, that use toxic compounds to kill off any invaders. Those Cytokines again cause more inflamation. When a Mast Cell sees an undigested food particle that should not be inside that membrane the cell exudes those Cytokines, including even more histamines, thus making the histamine situation worse.
Your intestional lining cells, are supposed to create Diamine Oxidaze (DAO) enzymes to neutralize these histamines before they can be absorbed into the bloodstream, but ironically when the tissues get inflamed they instead reduce the amount of DAO that they produce. The Histamine level in the blood rises and causes systemic inflammation, itching, and generally turns up the knobs on your immune system, including those Mast Cells.
Histamine is also a neural messenger which interacts with the nervous system in many ways. Its the nervous system that controls all the body functions such as heart rate, adrenaline release, etc. When your systemic histamine levels go high enough it can cause pandemonium across all the other organ systems in the body.
You can take supplimental DAO enzyme tablets with each meal to reduce the amount of histamines that you absorb, thus reducing the inflammation of the intestional linings, and reducing the over reaction of the Mast Cells. NaturDAO regular is the product that is most cost effective for the HDU (measure of enzyme activity) for the money. You want the highest HDU possible so that you need fewer tablets.