The Possibility of Mast Cell Activation Syndrome as a Component of Fibromyalgia

My flatmate has chronic sinusitis and congested nose. He has had this for years. He’s also had insomnia and really bad quality sleep for years. He’s had all of this medically explored, he’s tried a lot of drugs, and nothing has really helped.

Until he found some mention of mast cells and decided to experiment with reducing his histamine levels. His nose cleared up and all of a sudden his sleep quality improved. His supplements arrived and his chronic sinusitis began to clear up, too. So he kept googling.

He found an article mentioning mast cell activation as a potential cause of central sensitisation – i.e. everything hurts and all sensory input is bad – which is one of the main components of fibromyalgia. So he passed the information off to me and, thinking this could be interesting, I started researching.

Mast cells are the harbingers of inflammation in our body. They release up to 200 different inflammatory mediators, known as cytokines, which do everything from increasing blood vessel permeability to depolarising nerve endings. Mast cells are everywhere in your body, all through your connective tissue, and they don’t care about the blood-brain barrier, either. When they activate, they can either fully degranulate (that is, release all of the granules they hold in their cytoplasm at once) or they can selectively degranulate. A full degranulation can result in anaphylaxis, while a selective degranulation can result in … any combination of symptoms, really. They respond to anything and everything, from an allergen in the environment (hello hay fever, yes, it’s mast cells that are causing that allergic reaction) to an infection (bacterial, viral, parasite, etc.), all the way through to emotional stress and temperature changes.

Inappropriate mast cell activation has been, as I mentioned earlier, linked with central sensitisation, one of the particularly nasty components of fibromyalgia. Mast cells have been linked with bloating and abdominal cramps associated with non-coeliacs gluten/wheat intolerance, neuropathic pain and fatigue … you think it and it’s probably on the list. It’s not incredibly well understood, as many things relating to the immune system are, and it seems like it may be a contributing factor (or the causative factor, in some cases) in conditions like fibromyalgia or chronic fatigue syndrome.

Fibromyalgia and chronic fatigue syndrome are a description of symptoms, rather than a description of the underlying disease process, which is what makes these conditions so varied, and therefore so difficult to manage and treat, because each person requires individualised treatment. In many cases, and especially in mine, the diagnosis of fibromyalgia is reached and that’s it. There’s no looking into any underlying causative agents, it just is.

But during my google-fu, I’ve realised that a lot of my symptoms, including my overreaction to vaccinations, suddenly make sense through the lens of an inappropriate mast cell activation component. All I need to do is too much one day, and the next day I have a sore throat and a bad post nasal drip on top of extra body pain.

While the diagnosis for mast cell activation disorder is a pain in the backside (and not always particularly accurate), the treatment is something I’m able to do myself … or at least a trial of a few things to see if there’s any improvement. So I have quercetin supplements on their way, which may help to stabilise mast cells, along with a combo supplement with chinese skullcap extract. These are the two supplements I have come across that seem to be the initial ‘go to’ for treatment, so I’ll give those a whirl and see what happens.

Excitingly, despite ordering them only last week, they should be here today! I’ll let you all know how it goes over the next couple of weeks.

A Little Bit of Magnesium Goes a Long Way!

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I have been feeling, as a general rule, more achy and grizzly these past few weeks.  I’d put it all down to the stress – both mental, emotional, and physical – of moving and getting set up in a new place, unpacking, and the terror of finding out my exam is this week, not next week as I had thought.

I asked my flatmate if I could borrow some of his epsom salts for a bath on one particularly painful day, and we got to discussing how the primary benefit of the epsom salts is the high magnesium content, and the absorption of it across the skin.  Well I hopped out of that bath feeling a million bucks!  The lovely non-achy feeling continued until the next day, but by the one after that I was a little bundle of aches again.

I finally got my hands back on some magnesium supplements.  Magnesium was something I was taking, along with numerous other supplements, a few months ago, but stopped due to the expense of maintaining the high level of supplementation and the need to spend that money on other things.  Stopping magnesium turned out to be a stupid move.

I’ve started back up with my relatively high dose of magnesium (I think it was 1000mg or something like that) and I think I’m feeling a difference already.  I may do another epsom salt bath in celebration after this exam just to really kick things off.

It just reiterated the importance of appropriate supplementation, especially of magnesium, when you have chronic pain.  So magnesium is a pretty awesome mineral.  It has an essential role in regulating muscle contraction, blood pressure, and insulin metabolism, among other things.  It helps with nerve transmission and neuromuscular coordination.  It also plays a protective role in preventing over excitation of the nerves, thus preventing neuronal death.

There was a study testing the administration of magnesium (300mg) and amitriptyline (10mg) or just magnesium across a small number of women with fibromyalgia, and all noted a reduction in tender points and reduction in pain.

Because of its wide ranging positive influences on the nervous system, magnesium is really something I should have kept on with, and it’s probably something you should try, as well.  It’s a good thing to have at night, as it also helps with sleep.  I always notice a reduced time between head hitting pillow and unconsciousness when I’m on magnesium.

Addition of Citicoline

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I have spent the last year playing with supplements.  The primary supplements I aim for is appreciable levels of Vitamin D, a good B blend, and Magnesium.  I don’t get a lot of vitamin D in my everyday life, so supplementing it helps me stave off seasonal depression.  A vitamin B blend helps to manage my stress levels.  Magnesium helps to keep me relaxed and sleep better.

Last week I went into a new pharmacy with a friend to pick up some more B vitamins, as I’d run out.  Said friend saw a thing about brain improvement, and impulsively, we split the cost and bought it.  It was citicoline 250mg.

Since taking citicoline, the fibro fog has lifted, I am more alert, my recall is superior (even for language things, which I’ve always found difficult).  It has improved my overall mental alertness throughout the day.  Waking up is still a pain to do, but once I’m up and moving, staying up and moving is easier.

It hasn’t assisted with the fibromyalgia pain at all, but that’s okay.  It’s moved a huge amount of mental fog and really helped with my ability to function.

At the moment I’m only on 250gm every morning.  I’ve ordered a larger pack (30 capsules was $40 at the pharmacy, but $40 for 150 capsules from a reputable online store), and once that’s here I’ll increase it to 500gm.  I’m really interested to see how doubling the dose affects my alertness – you can go up to 2,000mg without concern of toxicity.  I probably won’t go quite that high, but I’m definitely going to play around with it.