What is your Mast Cell Phenotype?

This conversation does overlap with our discussion of MCAs root causes, but I find it helpful to bring up the concept of “MCAS phenotypes” with clients to help them understand that someone with MCAS can be reactive to items beyond histamine and that reactions manifest differently for every MCAS patient.

1. The mold phenotype

Those with a history of mold exposure are likely to have antibodies to mold. In which case you would be sensitive to environmental exposures to mold as well as to food items that tend to have mold in them. If mold has not been detoxed this type of client may also have issues with salicylates, oxalates and bottlenecked detox pathways. They may be sensitive to many supplements and herbs. Consider sauna and oxygen therapy as support.

2. The yeast phenotype

Those with a history of yeast exposure are likely to have antibodies to yeast. In which case you would be sensitive to food items that tend to have yeast in them, such as bakers yeast in baked goods, yogurt, nutritional yeast. If yeast hasn’t been reduced this type of client may also have issues with oxalates, salicylates, yeast infections and bottlenecked detox pathways.

3. The Serotonin phenotype

One of the chemicals secreted by mast cells is serotonin. This means that you can actually end up with serotonin excess. This type of client might be prone to diarrhea, excitability, mood swings and higher pain tolerance. They would not do well with SSRI’s, 5HTP or tryptophan. They might have ADHD if serotonin is suppressing dopamine. An organic acids test or neurotransmitter test can confirm serotonin levels.

4. The histamine phenotype

This type of client will be responsive to histamine blockers and a low histamine diet. They may also benefit from increasing DAO production and working on HNMT and methylation. This client may be prone to itching, nausea, red cheeks and face, especially after exposure to a trigger, low blood pressure. Histamine elimination, serum homocysteine and histamine testing during a flare, or neurotransmitter testing may confirm. 

5. The prostaglandin phenotype

This type of client will be prone to brain fog, pain and cramping. They may find that their symptoms worsen according to where they are in their menstrual cycle. Prostaglandin testing is available through Labcorp in the USA.

6. The methylation phenotype

This client will be prone to mood swings, depression or anxiety, rigid thinking or addiction. They may have accumulated heavy metals or other toxins that need detoxing. They will be helped by testing DNA, methylation markers and working on methylation support, among other things. Sauna and Hyperbaric oxygen can also be useful here.

7. The gut phenotype

This client may be prone to bloating or diarrhea or visceral hypersensitivity. They may benefit from Sodium Cromolyn, Ketotifen, DAO enzyme support and promoting growth of DAO producing microbes. SIBO may be an issue.

8. The fatigue phenotype

This client would benefit from a full thyroid/adrenal panel, food/chemical sensitivity testing and a sleep tracker. Some of the mast cell mediators are excitatory and may disrupt sleep. But, so too would hormone imbalance. Constipation may be a symptom. If gut symptoms are present check that nutrients are not being sequestered by parasite or pathogens.

9. Detox Bottlenecks phenotype

This client would be sensitive to many herbs, supplements and foods. They may find that their stress response is highly sensitive. Consider DNA testing.