MCAS & Inflammation: It’s All In Your Head (no, really)

Are there mast cells in the brain?

This is a question my neurologist asked me on my third (and last) visit to see him. He has been practicing neurology for decades and did not know that we have mast cells in our brain (?!). I was a bit shocked, given that he’d told me he had another patient with mastocytosis. Needless to say, I didn’t feel like he was the right doctor for me and I won’t be going back.

Lucky for us there are doctors like my immunologist and Dr. Theoharides who know all about mast cells in the brain. According to his research into what he calls “brain allergy” they are found in high numbers there, just like everywhere else in our bodies. What piqued my interest is where they are most concentrated:

These unique tissue immune cells are located perivascularly in all tissues, including the thalamus and hypothalamus, which regulate emotions. MC-derived inflammatory and vasoactive mediators increase BBB (blood brain barrier) permeability.

The thalamus and hypothalamus are responsible for many functions other than emotions and when you understand them better then it’s easy to see why so many symptoms can crop up just from mast cell degranulation in these two areas alone:

The thalamus is involved in sensory and motor signal relay and the regulation of consciousness and sleep.

The thalamus may also be involved in the regulation of some types of memory. The thalamus and the cerebral cortex operate in a feedback loop, especially when it comes to the sleep/wake cycle. The thalamus not only sends signals to the cortex, but the cortex in turn sends signals back to the thalamus.

Damage to the thalamus can cause coma. The most common forms of injury to the thalamus cause central pain syndrome

If you click on the link for central pain syndrome, you might find that this explains the “everywhere but nowhere” pain some of us suffer from. I know I certainly get that, and now I know why.

The hypothalamus is even more interesting to me because it regulates things like:

  • Body temperature
  • Thirst
  • Appetite and weight control
  • Emotions
  • Sleep cycles
  • Sex drive
  • Childbirth
  • Blood pressure and heart rate
  • Production of digestive juices
  • Balancing bodily fluids

Our “flight or fight” reactions originate there. So do our POTS symptoms, or dysautonomia, as well as sleep problems, body temperature (mine is always low) and so much more, as you can see.

Worse is the fact that our mast cells in our brain are easily triggered by stress and because they compromise a portion of our BBB they are even implicated in diseases such as multiple sclerosis:

Stress and mast cells have been implicated in the pathophysiology of various inflammatory conditions, including some in the central nervous system, such as multiple sclerosis in which disruption of the bloodbrain barrier (BBB) precedes clinical symptoms.

It’s pretty clear that inflammation in the brain is a bad thing, but what can we do to target our brains specifically to combat it? Dr. Theoharides has helped to develop mast cell targeting products using quercetin and luteolin, two bioflavinoids that are supposed to really help us to keep our mast cells calm and the inflammation in our brain at a minimum.

I’ve personally tried quercetin with mixed results and will be trying it again once I trial the curcumin I ordered first. Until then, keeping my stress levels as low as possible seems to be key here, but that’s a difficult thing to do when the disease itself triggers anxiety (aka stress)!

Just thinking about it all stresses me out. I think I’ll stop here and go listen to some Jack Johnson instead…

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