Dr. Paul Andersen explains how to treat mast cell activation syndrome and mastocytosis through three strategies: stabilizing mast cell degranulation, blocking histamine receptors, and clearing mediators faster. He warns against long-term high-dose steroids, which suppress immunity, and stresses treating underlying triggers like infections and stress.
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A lot of times you might be given two types of histamine blockers, an H1 and an H2 blocker and a steroid and then some other drugs just to get the genie back in the bottle and calm everything down. Now, that's great for an emergency purpose, but as you know or probably heard, if you have to be on high doses of steroids for a long time, that eventually not only takes away your mast cell response, but it can take away your immune response. Good day. Welcome to Medicine Health with Dr. Paul Andersen. I'm Dr. Paul. Thanks for joining us. We're doing a series on mast cell problems, or I call it mast cells behaving badly. And that includes the spectrum of mast cell activation syndrome, which has a lot of components and a lot of bad health effects. And then disease called mastocytosis, which is also a spectrum for from non cancerous to cancerous mast cell activation problems as well. And in this section, I wanted to talk about drug treatments in the world of mast cell activation. And it's much more than histamine overload, but histamine overload is a portion of the problem. So although there are many, many resources, one of them that I have here, just because it has some real unique research on it, is it's titled synthetic mast cel stabilizer. So want to just start out with the three parts of mast cell activation that we have to look at, taming, if you will. There's the release, which is literally mast cell activation, where the granules shoot these chemicals out of which histamine and other inflammatory things are in there. Then there is the binding at receptor sites, and that could be histamine receptors, other receptors. It could be almost any cell in your body, including in your brain, as we've talked about. And then there is the metabolism of the chemicals involved. This particular little chart here, with a lot of research summaries on it, looking at synthetic mast cell stabilizers is for the first part, which is to calm the mast cell down so it doesn't release all of these chemicals, such as histamine, et cetera, in an abnormal kind of way. And so if we can stabilize the mast cell, we lower the amount of degranulation, the amount of mast cell release of chemicals that we don't need. So again, much like a typical allergic response, mast cell activation is a misguided response by the body. It's doing the right thing at the wrong time or too much. One of the things on this particular sheet, this just comes from a particular pharmacology review. There There are whole books written about this now, etc. You can look online. Dr. Theoridis has a lot of online Mast Cell information. Dr. Lawrence Afrin, Afrin, who is an oncologist, who obviously was sent people because it looked like they had maybe cancerous mastocytosis or something else to diagnose. And he, he started to notice, well, there's non mastocytosis mast cell problems and now it's mast cell activation syndrome. But in this one, as far as stabilizing the mast cells, you have all these different things that are here. They work on different parts of the mast cell's biology, which would either speed up or slow down it, releasing all this chemistry that we don't want in our body. And we blame histamine because one of the major things released, but there's many other chemicals too, and that what they're supposed to do is cause an inflammatory response to get immune cells into an area if we're having an infection. But in allergy and in mast cell release syndrome, etc. We're having those responses when there's no infection to treat. So it's an inappropriate problem. So in the drug section of the world, what we have different types of compounds and then they target different subpopulations of mast cells. So as I said, I think in the introductory section about what is a mast cell, what's it doing? Many, many moons ago, when we were looking with light microscopes and we didn't, you know, have as much tech to do, you know, a lot of cell biology, we just started to stain everything in all the cells in the body. And we noticed some cells had granules in them because they stained like little dots inside the cell and other cells didn't have granules. And we saw when we started to challenge those cells with granules that they would release chemicals. And then we, you know, things got better in chemistry and we could tell what was being released. And then we saw, oh gee, you know, a lot of these things are releasing inflammatory compounds. It must be part of the immune response. So now we also know there's mast cells as a family, but there are many different types of mast cells underneath, which makes it a little bit more complex. So for example, you have targets in some of the drugs that will target a large group like basophils. And so a basophil, it ends in fill. It's stain loving it means there's granules in it. Then you have other compounds here that target, you know, the RBL class and the HUMC class and lung Mast cells specifically of different types and RPMCs and all sorts of other stuff. Now, these are a growing area of investigation in pharmacology as far as mast cell stabilization. So you might think, well, why don't we just put everybody in the mast cell spectrum, you know, on a bunch of these drugs and, you know, just keep the mast cells chilled out. Well, that's one good way to think of it and do it. But the problem is, a lot like with other targeted therapies, the mast cells and their subfamilies are not just there to create this one reaction. We probably use them for other things in our immune system. So sometimes if we suppress certain parts of our immune system too much, we wind up with immune dysregulation or even immune suppression, which can leave us open to more infections and other. So the drug therapy has to be monitored and modulated so it's not overbearing. A good example of this is if you're having acute mast cell response, you're trying to get under control a lot of times, and I mean a real bad one, a lot of times you might be given two types of histamine blockers, an H1 and an H2 blocker and a steroid and then some other drugs just to get the genie back in the bottle and calm everything down. Now, that's great for an emergency purpose, but as you know or probably heard, if you have to be on high doses of steroids for a long time, that eventually not only takes away your mast cell response, but it can take away your immune response. You can, you can get more opportunistic infections, get sick more frequently, all kinds of things that you don't really want. And that's usually, you know, of course, higher dose steroids, but that's what's required for the emergency situations. So just like it's always best if we can avoid long term chronic steroid use, certainly at high doses, we also don't want to do too much mast cell blockade because it's going to block these categories of cells that are also involved in an immune response. So there's a very delicate balancer. Now, we have a few minutes left here. And what I want to really get back to is, and we're going to do a whole section on more natural therapies for mast cell problems. But if you're looking at drug treatment, drug treatment options, remember, there's sort of these three categories that can be targeted. One is the mast cell stabilizer. So it literally goes to the mast cells and says, no, don't Be releasing all this inflammatory chemistry. We don't need you right now. Then there is the targets. So the receptor sites on the cells that would then create a problem. So let's say the horse is out of the barn and the mast cells have released all their stuff. Let's go target the other end of the problem where those chemicals are going to bind. So that would be things such as antihistamines and other things of that nature. But then there's also the metabolism to remove these chemicals from our body. And we'll talk about that a little more in the natural treatment section. But you need to be targeting all of these together. Now, here's the other thing that becomes a big problem. Obviously, if you're on the pathology end of the spectrum where you have mastocytosis and your mast cells, you know, are behaving badly for either genetic or cancer or other reasons, you got, you know, bigger problems, need, you know, the management is a lot more tricky. If you're on the more common and very disruptive to life end of the spectrum mast cell activation syndrome, your signs and symptoms can be all over the map. It can be your whole body or it can be just joints. It can be pain, it can be neuropsychiatric problems, it can be sleep issues, it can be respiratory problems, it can be all of the above. So here's the other side of it pushes on this system to make the mast cells more likely to degranulate when they're not supposed to, to behave badly. Well, what pushes on the systems? Other competing factors such as infections, toxicity, stressors on the body. So you start out with a little mast cell activation, then you put these things together, you got other problems and those need to be targeted medically in one way or another. So the drug targeting, very complex, has to work on all three parts of the problem and you also have to think about all the other stuff. But in the next section, we talk about natural treatments that work in this area. Get a little more deeply into how we might address and assess those things, please, like Share, Subscribe, Hit the notifications. Thanks for listening. Dr. Aow.com's got all the links to everything, but we're off for this one. I'll see you on the next one.
