Cytokines and Cytokine Storms in Mast Cell Activation Syndrome and Histamine Intolerance
Let’s talk about cytokines and cytokine storms, especially how they relate to Mast Cell Activation and Histamine Intolerance. I’ve been getting a lot of questions about this.
I’m also going to talk about some immune modulating substances that can be helpful with cytokine balance.
I was very ill in January. I had taken a flight from Las Vegas, and the person next to me was very sick, coughing and coughing. A few days after I arrived home, I came down with the same thing. At first, I thought it was just a bad cold. But then it progressed to having difficulty breathing.
I ended up having to use a nebulizer at night, which made a huge difference.
I had a severe sore throat and lost my voice. Then a week later, I started having a lot of trouble breathing. I also was breathless and panting for about 4 weeks. Just walking across a room I was panting.
Gradually my symptoms improved. I’m documenting here what I did during that time.
Important note: This post is for information purposes. This is not meant to replace medical care. This post also isn’t meant to be used for diagnostic purposes, nor is it intended to prevent, cure, or treat any disease.
Every day I had trouble breathing, I used a nebulizer with Quinton saline, which made a huge difference.
Here is the nebulizer I used. This is something great to have on hand for a cold or flu.
I also used this saline solution in the nebulizer:
I kept an eye on my oxygen saturation levels with a Pulse Oximeter, like this one:
And I kept an eye on my blood pressure.
I also boosted a number of immune supports and followed the steps I outline below.
Before I get to those steps, let’s look at cytokines in more depth.
Cytokines and Cytokine Storms in Mast Cell Activation Syndrome and Histamine Intolerance
We don’t have any research saying that people who have Mast Cell Activation are more likely to have the most severe complications with viruses. What we do know is that viral infections will increase mast cell inflammation.
The immune system can get out of balance when there are chronic inflammatory issues. With immune imbalance, it can be difficult for people with Mast Cell Activation Syndrome / Histamine Intolerance to fight off any infection that would cause more inflammation.
This is why I invite you to think about modulating your immune system now, so that if you do catch this, or any other virus, your immune system will be in balance. And one of the ways to do that is to modulate cytokines in your system.
So what are cytokines?
Cytokines are cell signaling proteins. They’re one of the ways that cells communicate with each other. Hormones are types of cell signaling proteins, and cytokines are another type. Cytokines are used in immune signaling.
They look like this:
They can signal themselves to excrete still more cytokines, replicating themselves. This is called auto expression. It can also act on nearby cells and cells that are a long distance away. So, there’s a lot of range for these cytokines.
Examples of cytokines are:
These are the ones commonly talked about. There are also others. Interleukins are named by numbers and referred to as IL-1, IL-6, and so on. We’ll talk about that a little later.
So what is a cytokine storm?
A Cytokine storm is when the body’s response to an infection becomes extremely over-activated.
They occur in infections such as the flu, SARS, and MERS. There are also cytokine storms occurring with Covid-19. They also occur in non-viral infections or conditions, such as multiple sclerosis.
Mast cells produce cytokines. So do macrophages (which gobble up infections), B lymphocytes, and T lymphocytes. T and B lymphocytes help the body respond to pathogens. There are also a few others cytokine producing cells.
Below is a map that shows you some of these different cytokines, and how they can come from cells and act on cells. This map shows the macrophage releasing these cytokines and it acting upon itself, but also acting on mast cells. You can see all of the communication between mast cells and other immune cells, and how they are all interconnected.
Zhang, J. M., & An, J. (2007). Cytokines, inflammation, and pain. International anesthesiology clinics, 45(2), 27–37.
The mast cells are the major drivers and orchestrators of the immune system. This is through the different mast cell mediators in the way that they communicate.
Our bodies contain both pro inflammatory and anti-inflammatory cytokines. This means that some cytokines increase inflammation, while others decrease inflammation.
We don’t want to get rid of cytokines, because inflammation is a normal part of infection fighting. But not all cytokines are the same. They all have very different actions. And some cytokines help dampen down inflammation. Some help increase inflammation. Inflammation is a normal part of an infectious process.
We want the cytokines to be in the right balance.
Pro-inflammatory cytokines are important if you have Mast Cell Activation Syndrome and Histamine Intolerance
These are the cytokines that research has shown to be involved with Covid-19.
- Interleukin 1 (IL-1)
- Interleukin 1-beta, (IL1-b)
- Interleukins 6, 10, 12, 16 and 17 (IL-6, IL-10, IL-12, IL-16, IL-17)
- TNF-alpha, (TNF-a)
- Interferon gamma (INFy)
- Interferon alpha 2 (INF-a2)
One of the largest cytokine players is IL-6. This one is very involved in the cytokine storms. And it’s being shown to be elevated in people who are dealing with Covid-19. IL-6 is produced by mast cells as well other immune cells. And when interleukin aisle six is highly elevated, it can cause lung/respiratory issues, sepsis, and tissue damage.
Cytokine storms can cause Respiratory Distress Syndrome. Symptoms include:
- Shortness of breath
- Muscle and joint pain
Major changes in blood pressure can also occur. So, it’s a good idea to have a blood pressure cuff on hand.
And since breathing difficulty is involved, the levels of oxygen in the body can become too low. For that reason, it’s a good idea to make sure you have a pulse oximeter.
If your oxygen levels become lower, it means that your symptoms are worsening. And that you may need to see a medical professional. Low oxygen levels can occur with other illnesses, too, such as the flu or pneumonia.
I keep an Omron blood pressure cuff and a Pulse Oximeter at home.
In cytokine storms, changes in your body’s biochemistry occur:
- Albumin levels will be low
- C-reactive protein levels will be low
- Ferritin and LDH will be elevated
- Interleukin 6 will be elevated
These biochemistry changes can be detected through tests that your healthcare provider can perform.
So what are we supposed to do about these cytokine storms?
Again, we don’t want to get rid of all the cytokines, because they are important to the immune system. We want them to be at a balanced level, so that the immune system is not suppressed.
What we were looking for is balance. We want balance with the TH1 and TH2 cytokines.
Now, what are the Th1 and Th2 systems?
Th1 and Th2 Systems related to Mast Cell Activation Syndrome and Histamine Intolerance
The Th1 system is involved in that immediate pathogen response. Then the Th2 system gets activated when there’s long-term chronic inflammation.
And so what we want to do is for the body to be able to use the right cytokines and attack the pathogens. And then bring those cytokines back down when it needs to.
These TH1 and TH2 systems balance each other. So when TH2 goes up, TH1 pathogen process goes down.
Mast Cell Activation issues are highly TH2 dominant states. Also, autoimmunity is a TH2 dominance state. If the TH2 system is chronically elevated, it makes harder to fight off pathogens.
Sometimes people think that they never get sick. But you can catch viruses and not develop symptoms. This is because cold and flu symptoms are caused by the Th1 system.
If you can’t fight the pathogen off, you won’t get cold and flu symptoms. But you can still have infections.
Supports for Balancing the Immune System
So what can we do about cytokine levels?
I will list here some of the research-backed immune modulating supports that I recommend and use in my practice (and for myself!).
Fullscript: 15% off store-wide when you create an account and order through these links or click on the image below. If you are outside the US, scroll down for other ordering options.
(Private clients – you are already getting these discount when you order directly, plus other benefits.)
Step 1: Self-care
The biggest immune supports are getting enough sleep and making sure that you’re eating really clean. Avoid sugar – it increases inflammation.
In some places, I know, there are shortages of fresh food. Use frozen vegetables and fruits instead if you can’t find fresh ones.
Lack of sleep increases inflammation. And makes it easier to get sick.
But extra sleep has been shown in research to reduce inflammation. And it boosts the immune system.
Try to eat low histamine foods, and avoid processed and junk foods as much as you can. And working on stress relief is critical, critical, critical.
Stress reduces the pathogen response. This is why it is so important to make sure you are meditating. And breathing. And resting.
Along those lines, turn off the news, or at least strictly limit how much you watch or read it. TV news coverage of Covid-19 is being highly politicized and can be quite upsetting.
The news will still be there tomorrow.
Let’s be careful. But not be overly fearful.
And do what you need to do to help your immune systems be in top shape.
Shown below are mast cell/histamine friendly forms of these nutrients and herbs. If you are sensitive to supplements, add things in slowly. Check with your health care practitioner first, if you have any medical conditions or are taking any medications. These are for educational and informational purposes. They are not meant to diagnose, cure, prevent, or treat any disease or illness.
Step 2: Make sure you have enough of the Basic Immune Support Nutrients.
Zinc is an essential for a healthy immune system. The best sources of zinc are seafood. But if you have Mast Cell Activation or Histamine Intolerance, you likely can’t eat seafood.
I use picolinate or carnosine forms, around 25mg/day.
Vitamin D – as D3 with K2
D3 is another big immunomodulator support. I know there have been some concerns posted online about taking Vitamin D3. Super high doses of Vitamin D (around 50,000 IUs) may not be appropriate. but D3 at normal levels are beneficial. I am using vitamin D3 with K2 at normal levels, which is around 5,000 IUs.
I take 5000 IUs.
Or you can start with this one if you want to increase slowly. Then change to a D3/K2 when you know your dose:
Vitamin A – as Vitamin A Acetate
Vitamin A is also a good immune modulator support
This is the best low histamine version of Vitamin A. It is called Vitamin A Acetate. Most Vitamin A is either from cod liver oil (high histamine). Or it is the synthetic Vitamin A Palmitate. I find this one works well for us.
(If this is still on backorder, it is worth the wait.)
Vitamin C – as Camu Camu or Corn-free Sodium Ascorbate
Watch out for ascorbic acid forms of Vitamin C. They are almost all made from corn fermentation, which is high histamine.
This form has a corn-free blend sodium ascorbate and ascorbic acid. It is also not from fermentation.
Full Spectrum Vitamin E – with high gamma mixed tocopherols
Gamma E is the most important form of Vitamin E. But it is hard to find as a supplement. This is a full spectrum E. It is also histamine/mast cell friendly.
SPM Active Omegas
Fatty acid balance is critical for the immune system. Most of the time, Omega 3s are recommended for this. But Omega 3s come from fish oil and tend to be higher histamine.
Those Omega 3s are turned into SPMs in the body. SPMs stand for Special Pro-resolving Mediators. This refers to the role of resolving inflammation in the body.
SPM Active is made of these SPMs. I find it to be much less histamine triggering than fish oil Omega 3s. It does still have a little histamine, though. So make sure you are keeping your histamine bucket low in regards to your triggers.
Step 3: Specific Cytokine Balancing Supports
Berberine is an extract from certain plants like Barberry and Goldenseal. It has been shown in research to have a lot of immune support and balancing activity. It can also support the digestive tract.
Melatonin has shown more support properties than just helping sleep. It can support reduction of reactive oxygen species. It also supports inflammation balance in the lungs.
Be sure to use a pharmaceutical grade like the ones below.
This is a .5 mg one, if you are new to melatonin.
Here is a 3mg one for those who know they can take more.
Astragalus is a Chinese herb used to support the immune system. It has been shown in research to help with pathogen killing. While at the same time it can support reduction and balance of Th2 dominance.
Andographis is an herb that has synergy with Astragalus. In research, it has been shown to promote healthy Th1/Th2 balance.
Permine is Perilla extract. Perilla is an herb often used in Asian cooking. It has a light licorice herbal flavor. And it is very high in Luteolin and Rosamrinic. These acids are very good immune system modulators. Especially with balancing and supporting when the Th2 system is dominant.
Quercetin is well known for supporting healthy immune balance. Particularly in Th2 dominance. It is a great mast cell and histamine support.
Resveratrol comes from things like Japanese knot weed and is an immune system modulator support. It comes from Japanese knot weed. It is also what gives red wine is antioxidant effects.
Those of us with Mast Cell Activation and Histamine Intolerance tend not do well with red wine, and so we miss out on that resveratrol. But we can get it through taking supplements derived from Japanese knotweed.
These 2 products below are combo products that support healthy cytokine balance.
I especially love that they have baicalin. Baicalin is the Chinese skullcap extract. It’s not the full spectrum herb. It’s the extract. And the extract is more powerful than the full spectrum Chinese extract herbs.
I’m starting to pull away from the full spectrum herb use. Baicalin extract has been shown to be very safe. Research shows baicalin supports healthy Th1-type immune responses and Th2 balance, according to animal studies
Baicalin is found in both of these support products. These are both designed to support healthy immune and cytokine balance. They also contain several other Th1/Th2 balancing supports.
Step 4: Other Specific Supports
If you have high blood pressure or low potassium, it may be related to ACE-2 enzyme. This enzyme is being talked about a lot right now.
Make sure you get plenty of vegetables for potassium. You may want to supplement with potassium as well.
Glutathione is mostly known for its role in detoxification. But it also helps support the lining of the lungs. When I have respiratory issues, I take glutathione. It also helps with Th1/Th2 balance.
S-Acetyl-Glutathione is one of the best absorbed forms. It is more expensive because it costs more to make. But with the reduced glutathione forms, you may not be absorbing it at all.
If you have mold toxicity, go very slowly with this one.
What to have on hand in case you get sick and have Mast Cell Activation Syndrome or Histamine Intolerance
SPO2 Pulse Oximeter Oxygen Saturation meter
If you come down with COVID-19 Coronavirus, you want to keep an eye on your oxygen levels with Pulse-Ox oxygen saturation meter. This will help you know whether to go to the Emergency Room.
If it gets down below 90% saturation, go to an Emergency Room.
Or if you have a weak pulse or changes in blood pressure and oxygen saturation is between 90%-95% or below, also go to the ER immediately.
Blood Pressure Cuff
You also want to keep an eye on your blood pressure. You want to check your daily blood pressure is before getting sick. This way, if it is changing significantly, you can track that.
Accurate Digital Thermometer
A thermometer will allow you to track your temperature. Get one that goes under the tongue. If you have symptoms, take your temperature after resting. And at least 30 minutes after eating or drinking.
If your temperature is above 103 degrees Fahrenheit, contact the ER. Also, call the ER if your temperature lasts more than 7 days.
A nebulizer allows you to breathe a mist into the lungs. You can use it to breathe in saline.
Inhaling saline helps open the lungs. It also helps break up mucous so you can breathe better. Nebulizers are also sometimes called compressors.
Be sure to clean it after each use according to the directions. And leave it open to dry each time so you don’t get mold and bacteria buildup.
This is the one I have:
Saline is used in the nebulizer. You can get straight saline for nebulizers.
I used this saline solution in the nebulizer:
Humidifiers can help you breathe. When I’m sick, I run it only at night so I don’t get mold buildup in the room. Humidifiers are notorious for becoming full of mold and bacteria. You want a humidifier you can completely take apart to clean. And you want to be able to reach every nook and cranny.
This is the only humidifier I’ve found so far that you can completely clean.
I clean mine every 2-3 days when in use. Just wash it with soap and water.
Food Grade H2O2 3% for humidifier
If you can get H2O2 Food Grade, this can help with respiratory infections. I pour it into the base of the humidifier. And then dilute 50% with water. This is the brand I use.
When to go to the Emergency Room if you get COVID-19 and have Mast Cell Activation Syndrome or Histamine Intolerance
DO NOT go to the Emergency Room if your symptoms are mild.
If you develop mild symptoms, be sure to self-quarantine and call your physician for instructions. Call before you go to the office.
With mild symptoms, Do NOT go to a medical office without calling first. They need to be able to prepare for your arrival to reduce risk of spread of the virus.
Absolutely self-quarantine if you are sick. Here are CDC recommendations for protocols to follow if you or a family members gets sick: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html
When to go to the ER:
- If your blood pressure drops significantly or goes up significantly and you are having trouble breathing – go to the ER.
- If your oxygen saturation on a pulse ox is below 90% – go to the ER.
- If you are having trouble breathing, and your oxygen saturation is 91-94% – go to the ER.
- If your temperature is above 103 degrees Fahrenheit – contact the ER about coming in.
- If your temperature lasts more than 7 days – contact the ER about coming in.
Sourcing Supplements if you have Mast Cell Activation Syndrome or Histamine Intolerance
NOTE: Many people have reached out that they are having trouble sourcing supplements. I have now opened all my private supplement dispensary sources to all Mast Cell 360 blog readers.
(Private clients – you are already getting these discount when you order directly, plus other benefits.)
Fullscript: 15% off store-wide when you create an account and order through this link:
Go to: www.DSSOrders.com/BethOHara
Use Registration Code: BO1171
UK and EU:
We have an additional supplement dispensary available for the UK and EU we can open for readers in these areas. To get access to this dispensary, we have to add you individually. You can contact us and let us know you need help getting supplements in the UK or the EU. We will add you to that dispensary. You’ll receive an invitation email from Amrita Nutrition – you’ll need to check your inbox after you are added. https://mastcell360.com/contact/