MUDr. Dana Maňasková


Vyhledávání na medicinman.cz
 

Diferenciální diagnóza histaminové intolerance

Lektinova intolerance

  • Potentially problematic lectins include:
  • Certain grains
  • Beans and lentils
  • Certain nuts
  • Certain seeds, including seed-based spices
  • Plants in the cucumber family, including melons, squash, and cucumbers
  • Nightshade plants, such as tomatoes, peppers, and potatoes
  • Genetically modified foods (GMOs) – these are made with potentially concerning lectins
  • Cooking or pressure cooking can break down some lectin groups, though.
  • Lectins can be reduced in these foods by peeling, seeding (for vegetables with seeds), and pressure cooking:
    • Winter squashes (ie. spaghetti, acorn, butternut, etc)
    • Summer squashes (yellow, zucchini)
    • Potatoes
    • Rice
    • Oats
    • Beans
    • Lentils
    • Buckwheat
  • Lectins can break down the gut barrier.
    • Gluten found in wheat, rye, and barley can open the gut barrier
      • Can cause leaky gut.
      • Can cause more food sensitivities.
  • Lectins can contribute to autoimmunity.
  • Lectins can also affect the gut bacteria and throw them off-balance
    • Can also contribute to autoimmunity.
  • At low doses, wheat germ lectins seem to block insulin function.
  • Found in the brains of patients with psychiatric disorders
    • Some of these lectins bind to neurotransmitter receptors and affect brain functioning.
  • Some specific concerns for people with Mast Cell Activation Syndrome
  • histamine-intolerance/">mastcell360.com/lectins-low-lectin-foods-and-the-mast-cell-connection-for-those-with-mast-cell-activation-syndrome-or-histamine-intolerance/
  • Toll-like receptor on mast cells
    • Bacteria, viruses, molds, and even lectins.
    • Set off a lot of mast cell activation in sensitive people.
      • Overactivated, they trigger the mast cells to release mediators.
  • Problematic lectins can also cause leaky gut
    • Lectins to get absorbed into the bloodstream intact.
      • Activate all types of immune cells, especially mast cells
  • Immunoglobulin E (IgE) also has a role in lectin sensitivities.
    • IgE binding to allergens can activate mast cells
    • Lectins recognize a portion of IgE
    • Some allergies or pre-existing Mast Cell Activation, food lectins can make these worse.

Potato lectins

  • Can activate both mast cells and basophils in people with allergic tendencies
  • People with allergies should not eat a lot of potatoes.

Lectins can contribute to inflammation, especially for:

  • Mast Cell Activation Syndrome
    • Histamine Intolerance
    • Mold Toxicity
    • Autoimmunity

Factors that can make you sensitive to lectins

  • Genetic predisposition
  • Immune system triggers
    • Mold toxicity and infections
  • Stress or limbic system activation
  • Deficiencies of nutrients important for immune tolerance
    • Vitamins A and D, and Zinc
  • Mold Toxicity can lead to increases in lectin sensitivities.
  • Mold Toxicity can contribute to:
    • A leaky gut
      • Overall immune activation, including mast cells
      • Nervous system problems
  • Lectins can also worsen leaky gut and activate the immune cells
  • Many people with Mold Toxicity also have a leaky brain
    • Lectins can also worsen neurological and mental health issues.
  • Once I removed lectins, my joint pain and brain fog significantly improved
  • Every case of lectin sensitivity is different.
  • You may also tolerate some lectins but not others.
  • Or you may be able to tolerate some lectins in small doses.
  • Low-lectin trial
    • Low-lectin and low-histamine diet for 6 weeks
VEGETABLES – HIGH LECTIN
  • Bean Sprouts
  • Corn
  • Cucumber
  • Green Split Peas
  • Peppers – Bell or Hot
  • Potatoes
  • Squash, Butternut
  • Squash, Spaghetti
  • Squash, Summer
  • Squash, Winter
  • Squash, Yellow
  • Yellow Split Peas
  • Zucchini
FRUIT – HIGH LECTIN
  • Cantaloupe / Rock Melon
  • Honey Dew
  • Watermelon
LEGUMES – HIGH LECTIN
  • Beans
  • Lentils
NUTS & SEEDS – HIGH LECTIN
  • Chia Seeds
  • Pumpkin Seeds
  • Sunflower Seeds
GRAINS – HIGH LECTIN
  • Buckwheat – O
  • Buckwheat flour – O
  • Buckwheat noodles – O
  • Corn
  • Corn – Popped
  • Crackers – Gluten-free- containing lectin ingredients O
  • Oats – O
  • Pasta –Gluten free- contains lectin ingredients – O
  • Quinoa – O
  • Rice, black – O
  • Rice, brown – O
  • Rice, white (lower lectin than brown or black rice) – O

Salicylates

  • Salicylates are found in many plants, especially in mint.
  • Some people start to have trouble breaking down salicylates.
  • Salicylate Intolerance is very common in Mold Toxicity.
  • Can cause a variety of symptoms similar to MCAS.
  • mastcell360.com/mast-cell-activation-syndrome-diet/
  • With Salicylate Intolerance, tolerating herbal supplements can be a struggle.
  • Quercetin supplements (and many foods with quercetin) are high salicylate.

Colitis

Kalprotectin

  • Je možné, že osoba má kolitidu, i když jsou její hladiny kalprotektinu v normálním rozmezí.
  • Kalprotektin je bílkovina, kterou produkují bílé krvinky při zánětlivých procesech v trávicím traktu.
  • Zvýšené hladiny kalprotektinu mohou naznačovat přítomnost zánětu v trávicím traktu
    • Ale nízké hladiny kalprotektinu nemohou vyloučit zánětlivé onemocnění.

Ulcerózní kolitida nebo Crohnova choroba

  • Mohou být přítomny, i když jsou hladiny kalprotektinu v normálním rozmezí
  • Proto je důležité, aby lékař provedl důkladné vyšetření a stanovil diagnózu na základě různých klinických a laboratorních faktorů
    • Nikoli pouze na základě hladin kalprotektinu.

Jaké markery mohou ukazovat na pritomnost kolitidy?

  • Projevuje klinickými příznaky
    • Bolest břicha,
    • Průjem,
    • Krvácení z řiti,
    • únava
    • Ztráta hmotnosti

Endoskopie a biopsie

Krevní testy

  • CRP
  • Sedimentace erytrocytů (ESR)

Stolice testy

  • K detekci infekce nebo zánětu v trávicím traktu.

Rentgenové nebo CT vyšetření

  • K vizualizaci střeva a případné detekci zánětu.

Ultrazvukové vyšetření

  • K vizualizaci střeva a případné identifikaci zánětu.

Dg HIT

  • Stanovení diagnózy HIT = vyloučení ostatních možných příčin
  • A pozitivní klinický efekt nízkohistaminové diety
  • Diagnóza HIT = diagnosis per exclusione
  • Zvažovat při přítomnosti alespoň 2 HIT symptomů
    • Manifestují do 4 hodin po konzumaci potraviny
    • Zohlednit další diagnózy a používanou medikaci
  • www.casopisvnitrnilekarstvi.cz/pdfs/vnl/2023/01/05.pdf

FODMAPs (??)

  • mastcell360.com/mast-cell-activation-syndrome-diet/
  • Short chain carbohydrates and sugar alcohols found in foods
    • Beans
    • Onions
    • Garlic
    • Brussel sprouts
    • Cauliflower
  • FODMAP sensitivity when their gut flora gets out of balance
  • Can be tricky to track down sulfur and FODMAP sensitivities
  • Usually require elimination diets.

Intolerance to sulfites

  • Often get headaches,
  • Flushing,
  • Sinus problems
  • Skin issues
  • After consuming foods like
    • Deli meats, dried fruits, and red wine
      • Have sulfites in them

Sulfite oxidase (SUOX) enzyme

  • Enzyme that lowers sulfite in the body
  • Cofactor is molybdenum

Molybdenum

  • Essential micronutrient
  • Therapeutically to support sulfur metabolism
  • Crucial role in
    • Dental health,
    • Carbohydrate metabolism,
    • Kidney waste removal,
    • Iron transportation,
    • Release, and toxin breakdown in the liver

SulfiteX

Zánětlivé onemocnění střev

Gastritida

Crohnova choroba

Intolerance na laktózu, fruktózu či sorbitol

IgE mediované alergické reakce

Systémová mastocytóza

Sekundárně navozenou DAO insuficienci

  • Střevní zánětlivé onemocnění
  • Léčba

Primární insuficience DAO je geneticky podmíněná

  • Celá řada polymorfismů v genu pro DAO
    • Většina z nich má vliv smyslu snížení aktivity
    • Popsány i mutace se zvýšením aktivity

Mastocytoza x HIT

Mastocytóza

  • Mast cell reactions
    • Can show up almost immediately
  • Mast Cell Activation Syndrome tend to have sensitivities beyond just histamine foods

HIT

Oxalates

  • Tiny crystals that are also found in plants
  • People with dysbiosis, leaky gut, low B1 or B6, and certain genetic predispositions
    • Can have more trouble with oxalates than others.
  • Molds and candida feed on oxalates
    • People dealing with these issues can have more trouble with oxalates
  • You can have oxalate issues from leaky gut and Mold Toxicity as well.
  • oxalate issues in about 50% of clients with MCAS.
  • If there is joint pain, muscle pain (like fibromyalgia), urinary burning, interstitial cystitis, chronic UTI type symptoms with negative culture
    • May be worthwhile to explore Oxalate Intolerance.
  • mastcell360.com/mast-cell-activation-syndrome-diet/
  • Carrots
  • Radishes
  • Beets (Note: Very high oxalate)

SIBO


Sulfur intolerance

  • Can be difficult to distinguish the symptoms of histamine intolerance and sulfur intolerance.
  • Both can present with hives, itchiness, asthma, headaches, nausea, fatigue, flushing, and brain fog—and sometimes a problem with one can lead to a problem with the other.

The Methylation Connection - histamine intolerance and sulfur intolerance

  • You may be more predisposed to both sulfur intolerance, and to histamine intolerance
  • Mutations of MTHFR
  • Deficient in the vitamins that act as methyl donors (primarily folate and Vitamin B12)

Homocysteine

  • Breakdown product of the methylation pathway
  • Sulfur-containing compound
  • Inefficient methylation cycle leading to increased levels of homocysteine
    • May also trickle down into higher levels of sulfites
  • As long as the body can convert sulfites to sulfates
    • Detoxification pathways which require sulfur, this won’t lead to a sulfur problem
  • If this pathway is also compromised for whatever reason
    • Then sulfur sensitivity and histamine intolerance might coexist.
  • Low homocysteine corresponds to sulfur intolerance
    • All been funneled into sulfites
    • Cannot convert to sulfates from there

Causes for sulfur intolerance include

  • CBS mutation,
  • SUOX mutation
  • Molybdenum deficiency,
  • A magnesium deficiency,
  • vitamin B6 or B3 deficiency
  • Enzymes overwhelmed in cases of significant environmental toxicity
    • Sulfur is required for three of the liver’s six main pathways for detoxification.
  • Hydrogen Sulfide SIBO (H2S) also coexists as a compensatory mechanism
  • histamine-and-sulfur-are-related/">www.drlaurendeville.com/how-histamine-and-sulfur-are-related/
  • Inability to properly process sulfur
    • Is linked to a downstream inability to efficiently regulate histamine.
  • The body is able to use sulfur in the body as sulfate.
  • When the conversion of sulfur to sulfate is slowed or compromised
    • Concentrations of sulfate in the body are depleted,
    • Concentrations of sulfur and sulfite may remain elevated.

Asociované choroby

  • (Samsel and Seneff, 2013):
  • Allergic and inflammatory responses
  • Compromised gut integrity
  • Arthritis
  • Dysbiosis
  • Impaired cholesterol sulfate metabolism
  • Decreased gallbladder function and bile acid activity
  • Gallstones
  • Kidney stones and calcifications.
  • Metabolizes sulfur is the CBS gene
  • Disruption of sulfur metabolism, and any mutations
    • Depletion of the compound SAM-e
  • CBS gene is impaired is an excess accumulation of hydrogen sulfide gas (H2S)
    • That may lead to gut dysbiosis.
  • Normal levels of hydrogen sulfide help regulate
    • Gut inflammation and motility, oxidative stress,
    • Ulcer healing, apoptosis,
    • Vascular tone, and hormone secretion.

Imbalances in H2S due to gut dysbiosis may lead to

  • Crohn’s disease, IBS, IBD,
  • Ulcerative colitis,
  • Obesity,
  • Sepsis.
  • Too much hydrogen sulfide
    • May also be linked to adrenal insufficiency
      • Due to H2S helping to control mitochondrial function in the adrenal tissue (Wang et al., 2014).

H2S imbalances could be linked to

  • Stress,
  • Excessive meat consumption,
  • High sulfur diets,
  • Genetic predispositions that impair sulfur metabolism (Teigen et al., 2019).
  • Sulfate-reducing bacteria in the gut
    • Produce excess hydrogen sulfide gas when they ferment carbohydrates, further disrupting microbiome health, inducing an immune response, and increasing intestinal permeability and gut inflammation (Figliuolo et al., 2017).
  • bodybio.com/blogs/blog/histamine-sensitivity

O úroveň výše

Poslední aktualizace: 12. 12. 2023 1:00:30