Have Sensitivities to Everything? Could Be Mast Cell Activation (PEA Can Help)

So many of us seem to be hypersensitive to almost everything. Much of this comes from inappropriate activation of "mast cells," which are allergy cells that play a role in your body's immune system. When mass cells are overactive, your body unnecessarily experiences allergy symptoms. The cells also release a chemical called "histamine" into the hypothalamus, which can be a major trigger for fatigue, insomnia, physical discomfort, and brain fog. So, addressing overactive mast cells is important for avoiding the occurrence of hypersensitivities.

In our last newsletter I discussed the exciting research showing that a new, highly absorbable form of a natural cell produced in our bodies called PEA can dramatically help settle down overactive mast cells, microglial cells, and the entire hypersensitivity process.

But for those with more problematic sensitivities, addressing it from several directions synergistically with PEA may be the best approach. The good news? Most of what you can do is low cost and easily accessible without a prescription. Meaning you don’t need to convince your doctor :-)

Although mast cell activation is a key player in sensitivities, there are other causes as well. Feel free to email me at FatigueDoc@gmail.com for a free copy of the chapter from my book From Fatigued to Fantastic called "Sensitive to Everything?" Reading it will give you a better understanding of food allergies, mold toxins, and limbic system retraining.

Let's discuss how you can address and resolve mast cell activation and hypersensitivities.

Mast Cell Activation

[By Jacob Teitelbaum, M.D., reprinted from his books From Fatigued to Fantastic (Penguin June 15, 2021) and You Can Heal from Long COVID (June 2024)]

Mast cells are our body's first responders when contacting things in the outside world. If they meet something in the environment that concerns them, they can pour out over two hundred chemicals. The most prominent of these is histamine. This is one reason why antihistamines are a mainstay of treating allergies.

Just like our immune system in fibromyalgia can be on overdrive in general, in some people this is also occurring for their mast cells. These guardians then have an itchy trigger finger, seemingly reacting to things at random.

"Random" is the key word here, and this helps distinguish mast cell activation from regular allergies and sensitivities. One day you may have no reaction to something, but you react excessively to the same trigger on other days. So, no problem eating an ear of corn one day. But the next day, you have may have the sudden onset of flushing, nausea, diarrhea, sweating, or palpitations.

Interestingly, most of the brain’s histamine is located in the hypothalamus. Also, mast cells are also found in the pituitary and other glands. Because of this Dr. Theoharis Theoharides, one of the main researchers on mast cell activation, theorizes that this may be a major trigger for many people with CFS/FMS. The mast cells may then be a major trigger for microglial cells pouring out inflammatory factors (central sensitization) even in response to minimal stress.

Testing

Testing is usually not helpful for this condition. As about half of fibro folks with sensitivities have mast cell activation syndrome, and treatment is simple. So it's better to simply try these and see if they help.

Treatment

I usually begin in the following order:

1. Quercetin

This bioflavonoid is a cousin to vitamin C. It helps stabilize the mast cells, kind of like calming down and soothing a crying baby. I start with 500 milligrams once a day. If your main sensitivities are to foods, take it about thirty minutes before major meals so it can be in place when you eat. This simple supplement can often be very helpful, is low cost, and can be found in any health-food store. After a few days, you can increase to 500 milligrams (or even 1,000 milligrams) two to four times daily.

2. PEA (palmitoylethanolamide)

This directly settles down both mast cells and microglial activation. It takes about two to three months to start working. But it can help relieve the entire pain, fatigue, and sensitivity process. Using the proper brand is critical because of absorption problems. I recommend the new "PEA Healthy Inflammation Response with Serratiopeptidase," which contains Gammasorb as well. Take two capsules each night.

3. Montelukast (Singulair, by prescription)

Take 10 milligrams at bedtime. This prescription asthma medication is only thirty cents a day using the GoodRx phone app, and most physicians will be comfortable letting you try it.

4. Loratadine (Claritin)

Take 10 milligrams in the morning. If this over-the-counter medication makes you drowsy, you can use it at bedtime or try 10 milligrams of cetirizine (Zyrtec). Doses over 20 milligrams or more are likely to be sedating. If you have any other side effects to these medications, it is likely caused by the binders or fillers rather than the medication itself. In that case, try a different brand or have it made by a compounding pharmacy without the fillers. If this medication helps, consider 12.5 to 50 milligrams of diphenhydramine (Benadryl) at bedtime.

5. Acid-blocking medications

Some people will get additional benefits by adding 150 milligrams of ranitidine (Zantac) twice a day, 20 milligrams of famotidine (Pepcid) twice a day, or even 150 to 300 milligrams of cimetidine (Tagamet) twice a day. These acid-blocking medications are actually also antihistamines. Do not use the other acid-blocking medications (called PPIs). They will not help here and are quite toxic long term.

Cimetidine, famotidine, and ranitidine have the additional benefit of modifying immune function quite dramatically in ways that can be beneficial, especially against Epstein-Barr virus. In fact, I have seen cimetidine knock out acute cases of Epstein-Barr (mono) in less than twenty-four hours. This tip was taught to me by Dr. Jay Goldstein.
The downside is that they turn off stomach acid production as well, and your body needs stomach acid to digest your food. The cimetidine can be the best choice of these three for long-term use in this regard, but see which one works best for you.

These medications may work within days, but Dr. Neil Nathan finds that it may take up to two months to see the full effect.

6. DAO (Umbrellux)

This supplement taken fifteen to thirty minutes before eating can be helpful, but it costs about a dollar per capsule. DAO contains the enzyme diamine oxidase, which helps break down histamine. Starting with one capsule taken thirty minutes before a meal, the dosage can be increased to two to three capsules before each meal.

7. Cromolyn (gastrocrom, by prescription) ampoules

Taking one ampoule (100 mg/5 mL) before each meal can be quite effective for histamine reactions from food, but this is often not insurance covered. With the GoodRx app, they are about a $1.60 per ampoule.

8. Low-histamine diet

In persistent severe cases, consider a low-histamine diet. Information can be found online, but this is quite a nuisance and I rarely use it.