Wednesday, April 30, 2014

Did my illness cause my children to have acid reflux as infants?

As I have learned more and more about mast cell activation disorders and the role of histamine in the body, I have pondered many things about my past.  I have breastfed all of my children and all of my children have had various levels of acid reflux or GERD.  No other babies in my or my husbands family had reflux.

Starting at two weeks, my first child began to projectile vomit continuously after nursing.  It got to the point that she could no longer sleep or be comfortable for longer than 45 minutes.  She would then demand to nurse again and she would projectile vomit more.  I took her in to the pediatrician and they prescribed Zantac for the pain.  There was nothing they could do about the projectile vomiting.  After talking to various other moms, I decided to remove dairy from my diet (dairy is an inflammatory food).  She stopped projectile vomiting after ten days.  She was still spitting up quite a bit so I took soy out of my diet (soy is a high histamine food).  There was a marked decrease in the amount of gassiness and spitting up.  Then I noticed that if I had anything fried, she would projectile vomit for a day.  I took fried food out of my diet (inflammatory and high histamine food).  She stopped projectile vomiting for good.

I also battled a systemic yeast infection from month one to month three and finally was prescribed Diflucan.  Twenty doses later I was much better and began a very strong probiotics regime.

By nine months she was spitting up much less and we weaned her off the Zantac.  At ten months I put those foods back in my diet one at a time for two weeks without her becoming ill.  At that point she was also only nursing three or four times a day instead of eight times a day.

Recall that histamine causes your stomach to release acid.  It can also cause stomach cramps and vomitting...

My second child also started with acid reflux at two weeks and was prescribed Zantac.  Removing foods from my diet did not improve his symptoms.  I had received antibiotics during labor and was still going strong on the probiotcs (I never want to deal with a systemic yeast infection again!) When he was four months old, I stopped using fabric softener and was using our own laundry machines.  My eleven years of chronic fatigue ended immediately.  My son never outgrew his Zantac dose despite growing much larger so we discontinued the medication soon after.

Since I was having an allergic reaction to the fabric softener my body was producing so much histamine that I had been very sick for eleven years straight....

Then I ate something that ended up having a benzoate in it.  I immediately broke out in a rash and by the next day my son had a rash all over his body, too.  I took him to the doctor and he checked out 100% healthy.  I was very concerned that he also had the same issue that I did with the benzoate but the doctor said that it was the histamine in my milk that gave him the rash.

So, my histamine can pass through to my baby through my milk!

My third child also started with reflux at two weeks and was put on Zantac.  By four months he was spitting up blood and only gained nine ounces since month two.  My happy child never even cried about the pain he was in.  He just ate less and less as time went on.  He was put on Prilosec and started gaining weight again. 

A few months later, I first learned about histamine intolerance, mast cell activation disorders and mastocytosis.  I match the symptoms so I know that I have very high levels of histamine in my body.  To make matters worse, the probiotics that I had been taking faithfully for over four years are histamine producing organisms thereby increasing the histamine present in my body.

I discontinued the probiotics immediately (early April).  My baby is now weaning off Priolosec with no issues.  He started  to sleep on his belly three weeks later for the first time ever (in the past he would scream on his belly )...You'll find out if anything else has changed this week for him when I post a summary of this first diet week on Monday.

It certainly seems to me that the histamine in my body which was in my breast milk did play a roll in the acid reflux symptoms of my babies.

Did my first child has issues with dairy, soy and fried foods or was it just that I had issues with those things and produced very high histamine milk?

What do you think?

Tuesday, April 29, 2014

What are the frequent symptoms of a mast cell activation disorder or mastocytosis?

The frequent symptoms of a mast cell activation disorder or mastocytosis are generally of an inflammatory nature and multisystemic.  The various manifestation of inflammation are often unusual or atypical as well.

Dr. Theoharides categorizes the symptoms this way:

Orophayngeal: burning pain, aphthae

Dermatologic: flushing, pruritus, urticaria pigmentosa, angioedema, dermatographism (sometimes)

Respiratory: wheezing, sore throat

Cardiovascular: chest pain, hypotension, tachycardia

Gastrointestinal: abdominal pain, nausea, vomiting, diarrhea, bloating, malabsorption, esophagitis

Naso-ocular: nasal stuffiness, pruritus

Neurologic: headache, memory and concentration difficulties/brain fog, paresthesia, peripheral neuropathy

Muscoskeletal: bone/muscle pain, degenerative disc disease, osteoporosis/osteopenia

Systemic: anaphylaxis, fatigue

Abdominal: abdominal pain, intestinal cramping and bloating, diarrhea and/or obstipation, nausea, non-cardiac chest pain, Helicobacter pylori-negative gastritis, malabsorption
Respiratory: cough, asthma-like symptoms, dyspnea, rhinitis, sinusitis
Ophthalmologic: conjunctivitis, difficulty in focusing
Hepatic: splenomegaly, hyperbilirubinemia, elevation of liver transaminases, hypercholesterolemia
Cardiovascular: tachycardia, blood pressure irregularity (hypotension and/or hypertension(, syncope, hot flush
Neuropsychiatric: headache, neuropathic pain, polyneuropathy, decreased attention span, difficulty in concentration, forgetfulness, anxiety, sleeplessness, organic brain syndrome, vertigo, lightheadedness, tinnitus
Cutaneous: uticaria pigmentosa, hives, efflorescences with/without pruritus, telangiectasia, flushing, angiodema
Abnormal bleeding

Musculoskeletal: muscle pain, osteoporosis/osteopenia, bone pain, migratory arthritis

Interstitial cystitis
Constitutional: fatigue, asthenia, fever, environmental sensitivities

As you can see, numerous areas of the body are impacted.  If you have many of these symptoms covering several different systems you, too, might have a cell activation disorder or mastocytosis.

Monday, April 28, 2014

Why does my body make so much histamine?

It seems that some of us make way more histamine than is necessary for typical bodily functions.  I personally have been told by numerous doctors over the years that I "just have a lot of histamine" and that antihistamines are "like a drop in the bucket" for me.  Another favorite phrase of the doctors I have seen is "come back if it gets worse."

I apparently am not alone.

There are several ways that a person can make too much histamine on a continuous or regular basis.  The first mechanism is fairly well understood:  you have allergies.  When your body encounters something like dust, or pollen, a cat, or you eat strawberries, peanuts, milk and your body produces histamine.  Allergists will then recommend that you receive allergy shots and take antihistamines.  When you avoid your various allergy triggers you generally feel pretty good.

For others, allergic like symptoms occur with no known cause or there seem to be a widely varying amount of causes.  In recent medical history mast cells have been determined to be the intimately involved in these phenomena.  Mast cells are a member of the immune system and store histamine and many other hormonal mediators.  When they are activated, mast cells release these components and start a wide variety of immune related processes.

Mast cells can cause too much histamine to be present in two related ways.  In one instance, the body makes too many mast cells, some of which are atypically formed, and those atypically formed cells can be activated in aberrant (not normal) ways. The classification of this disease process is referred to as mastocytosis.  For others, the appropriate amount of mast cells are present in the body but those mast cells can also inappropriately release their contents and activate the allergic pathway.  People in this camp are currently classified as having a Mast Cell Activation Disorder, Disease or Syndrome.

In both Mastocytosis and Mast Cell Activation Disorders, symptoms wax and wane over time for apparently no reason.  Various benign things (a scent, stress, heat or cold, etc) can cause a local or systemic "allergic" reaction.

What is all this about a Histamine Bucket?

People generally only think about histamine when they have an allergic reaction or seasonal allergies.  However, histamine has numerous other roles in the body.  Histamine is sent to a receptor in your stomach, for example, when you think about or eat food.  Your stomach then releases acid and other digestive enzymes to begin significant digestion of that food.  In fact, there are at least four different histamine receptors throughout your body.  Histamine is critical to many biological pathways and therefore necessary for typical bodily functions.  Without histamine, you would not be alive.

Many living things produce histamine.  Plants have varying levels of histamine present at different points of maturity and the more ripe the edible portion of a plant is the more histamine is likely to be present.  Some of this is due to the work of bacteria present inside and all over all just about everything.  Food which is intentionally aged or fermented in anyway is therefore high in histamine content.  Additionally there are histamine producing organisms living in your digestive system helping to digest what you have consumed.

The histamine present in your body then is related to how much histamine it has made, how much histamine the organisms in the digestive track have made and how much histamine was consumed.

Since the body makes and consumes histamine, it also produces two enzymes which degrade histamine: DAO (formerly known as histaminase) and histamine-N-methyltransferase (HNMT).  DAO is found in only particular areas of the body while HNMT is widely expressed in human tissues.  When these enzymes encounter histamine they degrade it.  Enzymes are finely tuned biological molecules.  Since there always has to be a baseline amount of histamine present for normal bodily function, DAO and HNMT are never supposed to totally eliminate histamine's presence in your body.

Now, consider your body's ability to degrade histamine to be represented as a bucket.  Inside that bucket is the amount of histamine in your body that has not yet been degraded.  The bucket can be mostly empty or mostly full but you feel the same - totally fine.  Histamine is doing what it is supposed to be doing in your body and you have not surpassed the capacity of the bucket.

What can make your bucket overflow?

- An allergic reaction.
- Consuming large quantities of histamine in your diet
- Producing more histamine than is needed for general bodily function
- Not having appropriate DAO and/or HNMT activity in your body

The crazy thing about this is that your histamine bucket can be rather large or rather small depending on the activity of DAO and HNMT at a given time.  Additionally, the histamine present comes from multiple sources and is additive.  So your bucket might be quite full on one day because you made a lot of histamine and ingested a lot of histamine.  It is likely on that day nearly anything else will cause your bucket to overflow.  On another day, you made very little histamine and ate very little histamine.  It would then take a much larger amount of histamine to cause your bucket to overflow.

Since I was ten years old I have often described my body as being in "freak out mode" for days, months and even years.  For some reason, my body's "histamine bucket" is often overflowing.

My next post will deal with what might cause you to make more histamine and what might decrease your body's ability to degrade histamine.