In this educational video Dr. Paul Anderson outlines a comprehensive, three‑part approach to managing mast cell disorders such as mast cell activation syndrome and mastocytosis. He first presents the core model: (1) mast cell stabilization, (2) receptor modulation (e.g., antihistamines), and (3) histamine/metabolite metabolism. He then emphasizes that underlying systemic stressors—chronic infections, environmental toxins (mycotoxins, metals), and hormonal imbalances (cortisol, sex hormones)—must be addressed because they sensitize mast cells. The bulk of the talk focuses on natural and quasi‑natural agents that act on each pillar. He reviews plant‑derived flavonoids (cromolyn, luteolin, EGCG, quercetin, apigenin, silymarin), coumarins, phenols (curcumin, resveratrol, honokiol, mangosteen), terpenes/ sesquiterpene lactones, and the amino acid theanine as mast cell stabilizers. He then details the three biochemical routes for histamine clearance—N‑acetyltransferase (supported by vitamin B5), diamine oxidase (supported by vitamin C, magnesium, B6), and the histamine N‑methyltransferase → MAO → aldehyde reduction cascade (requiring methylfolate/B12, vitamin C, magnesium, B6, thiamine). He warns that incomplete metabolism can produce “evil histamine” and toxic aldehydes. Finally, he ties together the need to combine stabilizers, receptor blockers, metabolic support, and removal of systemic triggers for optimal control of mast cell‑related symptoms.
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Good day. Welcome to Medicine Health, Dr. Paul Anderson. I'm Dr. Paul. Thanks for listening. Today we're doing a whole series on mast cell problems, mast cell activation syndrome, mastocytosis, this whole spectrum of problems with mast cells. And you can go back and listen to the other ones if you want the basics of what is a mast cell, etc. But the bottom line problem is it's a group of cells in our body that are supposed to be used for immune reactions. that get misguided, just like with a traditional allergic response, but only more complex. And so they release their chemicals and give us all these symptoms that we don't need. There's no purpose for their chemical release. There is a purpose. They're just not following it. So the last section I wanted to do today on mast cell problems involves, uh, the integration of natural or quasi-natural treatments and mast cell modulation. So if we go back to our original model that we have the mast cells, and if we stabilize them, then they don't release as many chemicals. That's one target. Then we have the receptor areas, and if we can block them or calm them down— a classic example is a histamine-blocking drug for the histamine receptors, blocks them off. There's other drugs that block other parts of the system. Then that'll slow down the problem too, but the, the receptor blockers don't do anything about the mast cells too much. And then there's the metabolism of these chemicals like histamine, etc., to get them out of there. So first thing is it's important to think of all parts of the problem. The second thing is it's good to try and treat all parts of the problem. But the third thing is with mast cell activation syndrome or even mastocytosis, we have an underlying milieu in the body which can make the mast cells more reactive. That has nothing usually to do with an allergic trigger or anything. And so those are other pro-inflammatory things in the body. So when we're treating somebody with mast cell activation syndrome or mastocytosis or anything in that world, we think about the big 3. So mast cell stabilization, receptor modification, and then metabolism. But then we also have to think about who's poking the bear here and making the mast cells overreact. Well, the big things that poke the bear are other chronic inflammatory things. So that could be an acute infection. Usually it's chronic infections that we carry around with us that get active and deactivated and active, but also toxicity. So mold mycotoxins are a huge reason for immune deregulation triggering mast cell problems, etc. Chemical toxins, metal toxins. Those sorts of things that we encounter every day in our life. The bigger our toxic burden, usually the more reactive our mast cells can become. Now, other things that will get into the act and be a problem can be hormonal dysregulation or deregulation. And so that could include something like inappropriate amounts of our own natural cortisol that we release in our body every day. If we don't have cortisol in our body, we will die literally. So it's a big deal, but it. it's got to be regulated. Cortisol is released generally more in the morning, less at night, and we can have states where we have chronically low cortisol. Now, truly low cortisol is a disease called Addison's disease, and if you have that, it's even a bigger problem that has to be treated with cortisol replacement, etc. But a lot of people just have borderline cortisol release problems, so they don't have enough deficit to cause Addison's, they don't have enough excess to cause Cushing's disease, but they just have sort of not enough or maybe a little too much. Either not enough or a little too much will create an imbalance in the way that the mast cells perceive the inflammatory situation in the body, and they'll be more likely to go out. So, certain hormones do that. Also, the balance in our reproductive hormones can make this worse. For example, We need testosterone, progesterone, and estrogen regardless of what, you know, what gender we are. We just have them in different amounts. But the balance between those is very, very important to the body. So if you get your estrogen, you got a good robust amount, but you have kind of low progesterone, that can trigger certain inflammatory responses, especially in the mast cell world. The testosterone, men or women, is too low, that can be very triggering to mast cell problems, et cetera. So toxicity, chronic infections, hormonal problems, all of these things can get into the act of making it worse. So we're thinking about treatments. We need to treat kind of everybody. Now, when I talked about drugs, I talked sort of symbolically about them because so many of the drugs are research drugs and they just have acronyms. But one drug that actually comes from a natural part of the world, uh, is that's used in this syndrome is cromolyn sodium, and that can be used as an oral agent, you can inhale it in the nose, you can inhale it as an inhaler in the lungs, uh, it, it can be used in many, many ways, eye drops, and they're mast cell stabilizers. Cromolyn comes from a flower that has a particular flavonoid, so the first, if you look at drug categories, the first group are flavonoid drugs. Well, cromolyn would be one that's commonly seen. You get over-the-counter now for nasal use, like, you know, NasalCrom. You can have it prescribed for other purposes. But are there other flavonoids that have been researched with mast cells? Well, one is luteolin, and that slows down a number of the triggering molecules. You can have the constituent of green tea, EGCG. You've heard of that. That's another flavonoid that's used that way. Silymarin, or milk thistle, actually has some mast cell control. Quercetin— you've probably heard of quercetin as a, you know, people use it for allergies and other stuff. That's because it does many things, but it's a mast cell stabilizer. Um, apigenin, and a number of other things that, that you may or may not have heard of. Now, what are flavonoids? They're usually from, uh, the part of the plant that is either the colorful part, or, or if it's a fruiting plant, it's the rind part. And they are antioxidants, and stabilizers to keep the fruit from going bad on the tree, et cetera. And same with flowers, a little different biology with flowers. So that's why these largely come from fruit rind extracts and certain flower extracts and stuff like that. If you look at silymarin from milk thistle, then that's coming from the flowering end of the business. So we use those a whole lot. Then there is a group of things called coumarins. And coumarins are not Coumadin, that's a drug. Coumarins are part of the plant kingdom. Cinnamon has coumarins in it, ellagic acid. There's a whole bunch of other ones that we use there. Then, excuse me, there are the phenol family. And that would be things like, we talk a lot about curcumin. So curcumin's in the phenol family— resveratrol, uh, honokiol. We, we actually use that in cancer for particular things. Mangosteen, you know, a bunch of stuff you've probably heard of like that. Then there are the terpenes or the terpenoids, um, and, uh, there are a number of sesquiterpene lactones which are also mast cell stabilizing. And then there's even an amino acid that helps stabilize mast cells. You've probably heard of Theanine, T-H-E-A-N-I-N-E. We use theanine a lot to help calm down neurological activity. It slows down some of your more excitatory chemistry in the brain and stuff like that. Well, theanine is also very useful to calm down the mast cells. And so when we're thinking about these things, where are these things working? Well, these are working on part one of the problem, which is the mast cell itself, to try and stabilize it. So whether you take the flavonoid or these other things as a drug, you know, like Chromalin, which is just a flavonoid that's been, you know, synthesized over into a real pure form, or you take it as a supplement, as say a bioflavonoid or a coumarin, a terpene, or one of these other things, they're all trying to help you calm down the mast cell response. But what if you're taking them and it's like, well, I'm not getting very far with this. You gotta remember that you've got the other parts of the problem. You've got binding at the cells, which is a little harder to attack in regard to natural products. We think of like antihistamines and stuff binding at the cells. But a big thing that helps with the cell binding is enough antioxidants. So that helps with the, you know, calm down the mast cells, also helps calm down the binding activity and release at the target cells. But then the big one is that gets left out because there's not a lot of drug treatments here, are like just with histamine, we have 3 different chemical pathways to get rid of histamine. So for example, there is a simple one which many people forget about because we're— us biochemistry teachers don't always make you memorize this one, but it's very useful chemically, medically, and that is N-acetyltransferase. NAT is supported by pantothenic acid, vitamin B5, and Old old treatments for mast cell problems included a lot of B5, and we didn't really understand all of it. Well, it's supporting N-acetyltransferase. So that's one way out. Another way out, which is popular because there are supplements that support it for the gut, but it's systemic as well, is diamine oxidase. Now, we used to call this histaminase, but we recategorize it because more accurately called diamine oxidase. And so DAO support. Now you can support DAO with DAO itself. Also DAO. requires a lot of vitamin C and magnesium and vitamin B6, so that can be helpful there. But then there's this big pathway that usually us teachers make you memorize, which is the histamine N-methyltransferase pathway. And that's where you take histamine and then you methylate it, like with methylfolate or methyl B12, and becomes methylhistamine. But then there's these other steps down below it. So methylhistamine has to undergo conversion through monoamine oxidase, so that's the cousin of diamine oxidase, so MAO, and then it has to be broken down further in an aldehyde step to get rid of the histamine aldehyde that is formed. Problem with the histamine methyltransferase is it's the bulk of your histamine removal and it's the most complicated, so for example, if you just methylate all your histamine and it can't get out through MAO, you're going to have worse problems because methylhistamine binds worse than regular histamine, I call it evil histamine. You get through MAO, you still have histamine aldehyde residues, and aldehyde residues will make you feel very toxic. They can give you headaches, they can make you deranged, you know, in your mind, they can do all sorts of stuff and make you have pain all over. So getting all the way through, so you have to methylate first, then you have monoamine oxidase, which is again vitamin C, magnesium, B6, and then the histamine reduction is largely B1, vitamin B1 or thiamine and a bunch of other things. So when we're thinking of natural treatments, if you're not getting as far as you want with mast cell stabilizers like flavonoids and stuff, think about the histamine metabolism. You got those 3 ways out. And then think about all the other things that can trigger histamine response and mast cell response, such as chronic toxicity, chronic infections, acute infections, hormone balance, etc. But I'm out of time. Dr. Paul Anderson, please check us out on dranow.com. 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