Mast Cell Activation Disorder

Once a diagnosis has been reached you can begin to work to manage the condition. MCAD can be managed by removing triggers that cause episodes. Eliminating/limiting foods that are high in natural chemicals such as histamines, amines, salicylates, glutamate and preservatives/additives has been shown to help manage symptoms of MCAD. There are over 200 mediators which can be released from mast cells, which can affect various processes within the body. Histamine has been found to be a trigger to multiple bodily functions. If histamine or other trigger food chemicals are consumed and mediators are released regularly this can cause bodily processes to be disrupted. As mast cells can migrate to different parts of your body, depending on which part of the body the mast cells are activated will depend which tissues, organs or organ systems will be affected.

Common symptoms experienced are:

• Hives/urticaria/swelling/itching
• Gastrointestinal discomfort: bloating, flatulence, diarrhea, nausea, constipation
• Respiratory type symptoms such as breathlessness, wheezing, asthma
• Neurological symptoms such as anxiety, depression, brain fog, fatigue, irritability, difficulty sleeping
• Flare ups of other inflammatory conditions such as interstitial cystitis, colitis, diverticulitis, arthritis, psoriasis etc
• Fertility issues, menstrual irregularity, severe cramping and abdominal pain, pre-menstrual dysphoric disorder
• Exercise intolerance
• Cardiovascular symptoms eg. Dizziness, low blood pressure, near syncope (fainting), tachycardia (fast heart rate), palpitations

Some foods that are common to trigger symptoms can include red wine, sparkling wine, fish especially tuna, seafood, meat, tomatoes, bananas, spicy foods, nuts, chocolate, fermented dairy like cheeses and yoghurts, convenience foods and preservatives/additives to name a few. When managing MCAD, following a low food chemical diet can be helpful to investigate your specific triggers. At Bites, you and your dietitian will create a therapeutic low chemical diet plan (using the RPAH elimination diet protocol or low histamine diet) which will be broken up into different stages. The first 4-6 weeks will consist of following a strict low chemical diet. Once the first stage is completed, we will reintroduce test foods containing the various food chemicals in different quantities to work out how much of different foods you can tolerate without triggering your symptoms.

The foods that did cause symptoms will be reintroduced slowly to find the amount of the food you can eat without causing symptoms (your threshold). This step is important as it allows you to enjoy a variety of foods and avoid cutting food groups out completely as we help you to establish the limit you can tolerate! It’s quite a restrictive diet and there is a risk of nutritional deficiency with prolonged use and so the liberalisation step is important and should be performed under guidance of an experienced Dietitian who can provide advice on supplementation if necessary.

By following a tailored dietary and exercise prescription you will establish limits of certain food and exercise quantities your body can tolerate without triggering symptoms. You will also discover which foods/triggers you need to avoid all together. From this your idiopathic episodes should become less frequent, you will also be able to prevent episodes through your diet and the foods you consume. Appropriate physical conditioning will improve your long term management of the condition through enhanced respiratory function, cardiovascular function and physical conditioning.