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Symptoms

Summary:

Mast cell diseases cannot be identified from a uniform clinical picture. Each case presents itself differently. The symptom constellation is as changeable as a chameleon.

The symptoms often resemble an allergy, food poisoning, a cold or other infectious disease. They occur in particular in connection with food intake, but can also persist chronically or occur in episodes without the affected person recogni­sing any connection with the diet. An enormously wide range of pre­domi­nantly unspecific symptoms is possible. The symptoms that occur vary from person to person. The following typical cardinal symptoms may occur:

• Acute or chronic irritation, inflammation, pain, swelling
• Disorders of the nervous system: sleep disorders, fatigue, nervous­ness, exhaustion syndrome, concen­tration disorders, memory disorders, suscepti­bility to stress, depressive moods
• Indigestion: diarrhea or consti­pation, abdominal pain, flatulence, heartburn, bad-smelling intesti­nal winds, irritable bowel syndrome
• Chronic inflammatory diseases
• Itching, skin rash, skin redness, flushing (flush on face)
• Hot flushes, sweating, disturbed tempe­rature sensation [Carlin et al. 2015]
• Tachycardia, cardiac arrhythmia, palpi­tations, drop in blood pressure
• Headaches, migraines, dizziness
• Nausea, vomiting
• Dysmenorrhea, menstrual cramps, painful periods
• Edema (swelling, fluid accumu­lation, e.g. swollen eyelids)
  

General information

There is no uniform clinical picture!

Mast cell activation diseases (MCAD) cannot be identified from a uniform clinical picture. Each case presents itself differently. The symptom constellation is at least as changeable as a chameleon.

To find out whether one has a certain disease or not, everybod tends to compare his own symptoms with those of other affected persons or with those described in literature. This seems obvious, but unfortu­nately does not work with mast cell activation diseases. Every case is different:

• Everyone has their own symptoms. The symptoms mentioned here may or may not be present, and the list does not claim to be complete. Many symptoms occur only tempo­rarily and not neces­sarily simultaneously. Thus the affected person often does not suspect that his/her various complaints have something to do with each other.
• The severity is very different. Everything is possible, from those who are easily affected, who only have a little diarrhoea, headaches or itching from time to time, to those who are severely affected by almost all the symptoms described here and are permanently unable to work, or who are even dependent on stationary care in a clinic. Fortuna­tely, the vast majority are only slightly affected.
• The symptoms are also non-specific, i.e. there are many other diseases which can also cause such symptoms.

In short: The symptoms alone do not indicate whether it is an MCAD or not.

Very broad variety of symptoms possible

More than 200 different mediators (messengers) can be released from activated mast cells, which can influence countless processes in the body. Histamine alone - probably the most important symptom trigger - fulfils numerous functions in our body. If histamine is released excessively (histaminosis), these processes are incorrectly regulated. Depending on the part of the body into which pathologically altered mast cells have migrated, different tissues, organs or organ systems can be affected. The type and strength of the triggering stimulus also determines which symptoms occur. Therefore, a particularly wide range of symptoms is possible, but not every affected person shows the same symptoms, and a single affected person does not always have the same symptoms. Some symptoms are chronic or very common, others may be sporadic.

In some patients, acute symptoms dominate, which occur shortly after the confrontation with a trigger and quickly decrease again. In others, the course is rather chronic, so that a single trigger contributes only imperceptibly to the permanent symptom level and is therefore difficult to recognise as such. Of course there are not only these two extremes, but one can also lie somewhere in between or react to a trigger with acute symptoms as well as with other chronic symptoms. In addition, the nature of the symptoms also depends on the characteristics of the trigger in question.

The figure below illustrates the different course of symptoms over time using a highly simplified model calculation. The calculation example shows how the intensity of the symptoms increases when an incompatible meal is taken daily at 6 am, 12 am and 6 pm.

In the acute course of the disease, the amount of histamine rises sharply, but then quickly decreases again. In a chronic course, the amount of histamine after a single meal does not increase much compared to a healthy person. However, it only decreases very slowly. At the next meal, the new histamine dose is added to the remaining amount of histamine and thus increases from day to day until after several days an equilibrium concen­tration is reached where the increase and decrease are the same.

The concentration levels of released mast cell mediators (e.g. histamine) only reach their maximum a long time after the trigger concentration has already started to sink again. Reason: Even after the trigger has reached its maximum concen­tration and decreases again, it continues to release mediators. The mediator level therefore continues to rise as long as the release rate exceeds the elimination rate (hypothetical model calculation).

Triggers are difficult to identify

If the affected person succeeds at all in identifying some of the many triggers, then these are the most likely:

Foodstuffs: red wine, sparkling wine, champagne (“alcohol allergy”), well-ripened cheese, fish (especially tuna) and seafood, meat (sausages, dried meat), tomato, pizza (“pizza allergy”), nuts, sauerkraut, convenience food, additives (“additive intolerance”).

Active drug ingredients: acetyl­salicylic acid (aspirin), X-ray contrast agents, painkillers, anaesthetics, (“drug allergy”).

Various degrees of severity

The severity of MCAD can be very different. Slightly affected persons or healthy persons may only notice symptoms in extreme situations, for example after eating sumptuous meals in combination with alcohol or medication. In very severe cases, the untreated metabolic disorder can lead to daily or even permanent inability to work, usually due to exhaustion. As long as they do not yet know and treat the disease, many sufferers are constantly a little ailing and severely restricted in their quality of life. They suffer from some kind of discomfort every now and then or permanently. Most of them are not really ill (in the sense of unable to work), but can lead a reasonably normal life.

Unspecific symptoms

Important: The symptoms listed here are mostly non-specific symptoms. This means that many other conditions may cause the same symptom(s) as well. It should therefore always be clarified whether other diseases are also possible (differential diagnosis). It is not possible to diagnose histaminosis on the basis of symptoms. However, if a patient suffers again and again from some of the listed symptoms without a clear cause or trigger being identifiable, a histaminosis (especially a mast cell activation disease) should be considered. See also our note on health topics.

Typical symptoms of mast cell activation

In scientific publications, the following symptoms are mentioned as the most important, which most reliably indicate mast cell activation:

However, in reports on their experiences, those affected also mention countless other symptoms, the cause of which they see in their mast cell disease. In the following, we list symptoms which, according to reports from affected persons, either decrease significantly or disappear completely under the therapy described on this website (mast cell-specific medication and/or elimination diet). Listing without claim to complete­ness. The symptoms listed here are optional i.e they may or may not occur:

Digestive tract, gastrointestinal system

The most common type of histaminosis is acute or chronic gastro­intestinal discomfort. These complaints are often referred to as non-specific, as the often very extensive diagnostics do not show any patholo­gical findings and many possible causes are possible. One speaks of an irritable stomach or irritable bowel. A direct connec­tion between food intake and symptoms is often difficult to detect. This is due to the fact that the food components are only slowly absorbed into the body during the intestinal passage of several hours and that there is a delay before complaints occur. However, foods heavily contami­nated or spoiled with histamine can also lead to abdominal cramps and acute diarrhoea within about 15-30 minutes.

• Digestive complaints, flatulence, stomach ache, stomach sting, stomach and intestinal cramps
• Frequent or chronic diarrhoea, morning diarrhoea, histamine increases the motility of the intestinal movements, whereby the food pulp passes through the intestine faster than normal and can only be digested incompletely due to the shortened residence time.
• More rarely also constipation or alter­nating diarrhoea and constipation
• Heartburn, stomach acid upsetting (gastro­eso­phage­al reflux)
• Inflammatory gastrointestinal diseases, irritable bowel syndrome (IBS)
• Nausea, vomiting
• Seasickness, motion sickness, travel sickness
• Chinese restaurant syndrome (contro­versial)
• Symptoms similar to gastro­intesti­nal influenza (gastro­enteri­tis)

Cardiovascular system

• Drop in blood pressure, low blood pressure (hypotension, hypotonia)
• Irregular heartbeat (cardiac arrhythmia, “heart stumbling”)
• Palpitations (increase of the heart's power by releasing adrenaline)
• Rapid heartbeat, increase in heart rate (tachy­cardia), up to panic attacks

Skin, mucous membranes, respiratory tract

• “persistent cold”, swelling of the nasal mucous membrane, runny nose (rhinitis, rhinorrhoea), especially when taking meals, maybe even independent of the type and histamine content of the meal, possibly intensi­fied by cold weather / smoke / smog / odors
• When blowing the nose, there may also be some blood (increased permeability of blood vessels).
• Severe sweating, night sweats (nocturnal sweating), sweaty feet (perspiring feet) / sweaty hands, hot flash (hot flushes)
• Flushing of the face after meals, feeling of heat, facial skin feels slightly inflamed
• Facial skin impurities, acne, pimples, blackheads, sebum overproduction, oily skin
• Rashes, skin redness, eczema, hives (urticaria)
• Itching (e.g. itchy scalp, itchy vaccination scars)
• Physical stimuli such as scratches, blows or heat cause reddening / skin rash and itching.
• Follicular keratosis, chicken skin, keratosis pilaris: Upper arms, sometimes also thighs, face etc. are covered with small red spots / pimples, occasionally keratinised or purulent (keratinisation disorders). Possible connection with pollen allergies? (picture on wikipedia.org)
• Burning and/or painful inflammation on the hands / bubbles / nodules / calluses (picture)
• “Sun allergy”: sensitivity to sunlight. The skin quickly turns red in the sun, but on the following day the “sunburn” is gone again.
• Dry lips
• Aphthae: Micro injuries of the oral mucosa become small yellow-white “holes” or “wounds” that hurt like hell and do not heal for days or months. In addition to the mucous membrane of the mouth, individual papillae on the tongue can also hurt like an aphtum.
• Chronic cough, permanent tickly throat, dry irritable cough, bronchitis, irritated bronchi
• Frequent clearing one's throat or coughing slightly, especially in stressful situations
• Sputum, phlegm: coughed-up material from the lower airways, hoarse voice, especially after sumptuous meals (similar to cystic fibrosis)
• Edema, oedema (= swelling due to fluid accumulation in the interstitial tissue), e.g. swollen eyelids, swollen legs

Nervous System

Histamine is a neurotransmitter and is also involved in the regulation of the sleep-wake cycle [Kim et al. 2015]. If the body is flooded with histamine and other mast cell mediators, this can also lead to a variety of neurological symptoms [Afrin et al. 2015, Pöhlau et al. 2015].

• Headache, migraine, feeling of pressure in the head, dizziness
• Fatigue, tiredness, listlessness, lack of energy, exhaustion
• Insomnia, sleeplessness, sleeping disorders, only superficial dozing without deep sleep, dreamlessness
• Concentration disorders, impairment of mental performance, slowness
• Forgetfulness, limited recall of memories
• Sensitivity to noise, search for calm and uneventful­ness, suscepti­bility to sensory overload
• Susceptibility to stress, reduced resilience, burnout feeling (feeling of mental/nervous exhaustion or overwork), reduced labour productivity under pressure to perform
• Always coughing slightly, especially in stressful situations
• Nervousness (even without external cause), rest­less­ness, tingling, feeling like a caffeine overdose or neurotoxin poisoning, hyped-up, over-excited
• Anxiety, panic attacks
• Muscle cramps, muscle twitches, tremors, cramped jaw muscles, teeth grinding, sanded teeth
• Symptoms like mild intoxication with a neurotoxin
• Melancholy, sadness, tearfulness, depres­sive moods, depressions (often for no apparent reason)
• Suicidal thoughts
• Temporary loss or impairment of the sense of smell
• Central and/or peripheral psychiatric and neurological disorders, e.g. personality changes [Afrin et al. 2015, Pöhlau et al. 2015]

Hormonal system

• Menstrual cramps: Dysmenorrhea (= pain in periods, menstrual pain), cycle disorders
• Endometriosis
• Developmental disorders, failure to thrive

Susceptibility to inflammation, immune system

• Increased susceptibility to infections, frequently ill
• Increased susceptibility to inflammation, inflam­mable parts / areas
• Sore throat
• Hoarseness
• Flu-like symptoms without clear outbreak of disease, persistent feeling of illness, pain in limbs
• Sinusitis: inflammation of the maxillary sinus, inflam­mation of other sinuses such as the sphenoid sinus or the ethmoidal sinus
• Lymph nodes permanently swollen or painful
• Tonsillitis, growth of the pharyngeal tonsils (pharyngeal tonsil hyperplasia), possibly surgical removal of the tonsils. (The tonsils serve the immune defence. Their absence after the operation can increase the increased suscepti­bility to infection.)
• Feeling of a lump in the throat
• Connective tissue inflammation: tissue sites under the skin with inflammation pain or pressure sensitivity
• chronic (non-bacterial) inflammation of the brain (chronic encephalitis), feeling of heat and pressure inside the head
• Inflammation of the bladder (non-bacterial cystitis): painful and burning urinary bladder, urge to urinate, frequent passing of water (similar to bacterial cystitis)
• burning eyes, inflammation of the conjunctiva, reddened, scratchy eyes, watery eyes
• Yellow-white material accumulates in the inner corners of the eyes.
• Hazy vision, veil vision, blurred vision
• Joint pain
• Bone pain, sore bones, boneache (ostealgia)
• Inflammatory rheumatic diseases, articular rheumatism (e.g. finger joint rheumatism)
• Soft-tissue rheumatism: e.g. tendon or joint problems, back pain: back muscles hurt similarly to dislocation / muscle soreness (muscle rheumatism, muscle inflammation).
• Temporary toothache, inflamed gums or inflamed wisdom teeth
• Herpes simplex labialis (labial herpes, fever blisters) or herpes-like symptoms (e.g. angular cheilitis (Cheilitis angularis) = non-healing skin cracks in the corners of the mouth)

Nutrition

• Alcoholic beverages are incompatible or only tolerated in small quantities ("alcohol intolerance", "alcohol allergy")
• Binge hunger attacks, ravenous appetite, ravenous­ness
• Vitamin and nutrient deficiencies (especially iron deficiency, vitamin B12 deficiency) due to disturbed absorption mechanisms of the irritated / inflamed intestine

Miscellaneous

A persistently inflamed, irritable and weakened body may be more sensitive to minor environ­mental influences that go unnoticed by a healthy person.

• Weather sensitivity
• Electrosensitivity ??? [Belpomme, Campagnac and Irigaray 2015]
• Sensitivity to earth rays, water veins, force points, lattice structures and other phenomena of radiesthesia ???

Some more keywords

Other terms (most of which are not recognized by conventional medicine) that are often used for (or confused with) such “dubious” symptoms:

Somatisation disorder, somatoform disorders, multiple chemical sensitivity (MCS), chemical hyper­sensiti­vity syndrome, sick building syndrome (SBS), environ­mental allergy, ecological disease, idiopathic environ­mental intole­rance, eco-syndrome, allergic toxaemia, cerebral allergy, total allergy syndrome, 20th century disease, allergy to the 20th century. Civili­zation diseases of the industri­ali­zed countries, Burnout syndrome, Chronic Fatigue syndrome CFS, Chronic exhaustion syndrome, Fibromyalgia syndrome, electro­sensitivity (electrosmog sensitivity), amalgam poisoning, "detergent allergy", multi-organ dysesthesia, Alexithymia, psycho­somatist, psycho­somatic, hypochondria, internet-hypo­chon­driac, infection phobia, imaginary patient.

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References and bibliography

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