The MastAttack 107: The Layperson’s Guide to Understanding Mast Cell Diseases, Part 69

83. Are there any supplements that help manage mast cell symptoms?

  • Yes.
  • Mast cell patients are often vitamin or mineral deficient.
  • Iron deficiency is extremely common. This is likely due to anemia of chronic inflammation. Basically, if your body is inflamed long enough, your body hoards the iron and stops moving it from your GI tract into your bloodstream where it can be used. Iron supplements are pretty harsh so patients don’t always tolerate oral supplements. IV iron is an option if your iron is low enough. I personally like the Lucky Iron Fish for increasing iron. It’s pretty neat.
  • Many mast cell patients are magnesium deficient. The exact cause of this is unknown. Lots of us take magnesium supplements.
  • For reasons that aren’t clear, a lot of mast cell patients are vitamin D deficient. Vitamin D acts on mast cells. There is some evidence to suggest that vitamin D can decrease mast cell activation. I personally found that effectively supplementing vitamin D has helped me a lot. A lot of symptoms I blamed on mast cell disease were actually vitamin D deficiency.
  • A number of supplements can decrease mast cell activation or block the action of mast cell mediators. There are a ton of natural mast cell stabilizers. They are sometimes used to help patients manage symptoms, especially in Traditional Chinese Medicine, which in recent years has been studied in clinical trials. Quercetin and resveratrol are commonly used by mast cell patients.
  • I take turmeric daily to reduce inflammation. Turmeric or curcumin can decrease prostaglandin production.
  • Holy Basil is a popular supplement in the mast cell community. It also decreases prostaglandin production. It can also block the histamine H2 receptor. While I often see people say that holy basil is as effective as an H2 blocker as H2 antihistamines like ranitidine or famotidine, I have never been able to find any evidence that this is true. But it does definitely have some ability to block the histamine H2 receptor.
  • Vitamin B12 deficiency sometimes occurs in mast cell patients, especially those with mast cell activation syndrome. This can have some interplay with MTHFR mutations, which can affect the form of vitamin B12 best suited to your body.
  • Vitamin C decreases the amount of histamine released by mast cells. It is recommended by some prominent mast cell researchers and many patients respond well.
  • Alpha lipoic acid is sometimes used, particularly for neurologic symptoms and neurologic pain.
  • I’m not sure if CBD oil is considered a supplement but it is widely used with excellent results. Be aware that the popular notion that marijuana derivatives do not interact with any medications is inaccurate. It especially can interact with tricyclic antidepressants to cause dangerous tachycardia.
  • Keep in mind that all supplements have the potential to interact with medications or to affect a person adversely if they have certain diseases. Exactly how much this happens is hard to pinpoint because over the counter supplements are held to a much lower standard for this type of study than FDA approved medications.
  • Always discuss any supplements you plan to try with your managing provider. Vitamins and minerals can cause toxicity and too much can cause very serious side effects and complications.
  • Do not assume that just because something is derived from nature, or because it is available without a prescription, that something is automatically safer for you than medications.
  • This is not really in my wheelhouse so I would encourage you to ask other patients what has helped them or to consult with a nutritionist.

For additional reading, please visit the following posts:

Effect of vitamin D on mast cells
Naturally occurring mast cell stabilizers: Part 1
Naturally occurring mast cell stabilizers: Part 2
Naturally occurring mast cell stabilizers: Part 3
Naturally occurring mast cell stabilizers: Part 4
The MastAttack 107: The Layperson’s Guide to Understanding Mast Cell Diseases, Part 19
MTHFR, folate metabolism and methylation

Effect of vitamin D on mast cells

Vitamin D is an essential fat soluble vitamin that functions as a hormone. Its primary function is to promote intestinal absorption of calcium, magnesium, phosphate, iron and zinc. It also has a variety of anti-inflammatory and immunoregulatory effects. Deficiency of vitamin D3 has been linked previously to a number of inflammatory conditions, like asthma, diabetes mellitus, eczema and other atopic disorders.

A significant portion of vitamin D is produced in the skin when exposed to sunlight. The precursor 7-dehydrocholesterol in the skin is changed to form cholecalciferol, vitamin D3, when irradiated with UVB light. In the liver, cholecalciferol (vitamin D3) is metabolized to form 25-dihydroxyvitamin D3. In the kidney, it is further metabolized to 1,25-dihydroxyvitamin D3. Vitamin D2 and D3 supplements may also be taken orally.  They will be processed by the liver in a similar fashion. Vitamin D3 is much more active than vitamin D2.

Vitamin D3 can exert a number of effects on mast cells. Though the mechanism is unclear, vitamin D3 seems to regulate the action of COX, the enzyme that produces prostaglandins.  Accordingly, vitamin D3 can disrupt prostaglandin production.

It interferes with the production of cytokines, and chemokines, including Il-1, IL-6, IL-33, and TNF. It inhibits release of IL-6 and CRP.  It is thought that vitamin D affects the stability of the mRNA for these molecules.  This means that the genes for these molecules are not being used appropriately and so they cannot be made.

Vitamin D3 can also induce production of anti-inflammatory mediators. IL-4 and IL-10 are mast cell mediators that regulate inflammation.  Vitamin D3 is required for their production and release.  IL-10 can mitigate inflammation resulting from IgE activation.  A single application of vitamin D3 to the skin decreased the immediate skin response to an IgE allergen.  It decreased production of leukotrienes and histamine.  Mast cells have vitamin D receptors (VDRs) inside their cells and close to where the genes are stored.  Mast cell VDRs must be present to see these effects.

Long term use of vitamin D3 (30-40 days) was found to cause mast cell apoptosis (programmed cell death) in a cell model. Vitamin D3 also directly impeded the differentiation and maturation of mast cell precursors.

There is a lot we do not know about how vitamin D3 interacts with mast cells but it is generally considered to have an anti-inflammatory and anti-allergic effect.

References:

Yip KH, et al. Mechanisms of vitamin D3 metabolite repression of IgE-dependent mast cell activation. Journal of Allergy and Clinical Immunology 2014: 13395), 1356-1364.e14

Conti P, Kempuraj D. Impact of vitamin D on mast cell activity, immunity and inflammation. Journal of Food and Nutrition Research 2016: 4(1), 33-39.