Help for long Covid - foods to avoid - supplements to take - with Dr Tina Peers, specialist in MCAS

#brain_health #longcovid #diet #symptoms

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Background and Expertise of Dr. Tina Peers

• Expertise: Specializes in treating menopausal women and has extensive experience in diagnosing and treating 📁 Research 🧪/🤢 Main Diseases (Notes)/Mast Cell Activation Syndrome (MCAS) and histamine intolerance, initially sparked by her daughter's illness.
• Observation: Noticed a significant overlap between the symptoms of Long COVID and MCAS, which includes symptoms like chronic fatigue, headaches, skin rashes, and food intolerances.

Research and Data Collection

• App Usage: Utilized an app called "People With" to collect symptom data from nearly 2000 patients, finding a strong correlation between MCAS and long Covid symptom profiles.
• Patient Histories: Many long Covid patients had histories of symptoms suggestive of pre-existing MCAS or histamine intolerance, which seemed to have been exacerbated by the virus.

Treatment Approach

• Initial Steps: Patients are educated about the potential role of MCAS in their symptoms and the treatment approach is outlined.

• Dietary Changes:

  • Low Histamine Diet: Encouraging a diet low in histamine to avoid adding to the body's histamine burden.

  • Foods to Avoid:

    • Vegetables: Tomatoes, spinach, and avocados, despite being generally healthy, are high in histamine.
    • Fruits: Bananas and watermelon are high in histamine and should be avoided.
    • Teas: Avoid green tea as it can potentially increase histamine levels.
  • Foods to Include:
    • Fruits: Apples, pears, blackberries, blueberries, melon (except watermelon), passion fruit, pomegranate, nectarines, peaches, and grapes are low in histamine and are encouraged.
    • Teas: Herbal teas, (excluding green tea), and peppermint tea can be consumed.

• Medications:

  • Antihistamines: Prescribing type 1 and type 2 antihistamines to manage symptoms.
  • Mast Cell Stabilizers: Utilizing mast cell stabilizers to dampen the reaction of the mast cells.

Supplement Support

• Objective: To support liver function and aid in the metabolization of histamine.
• Supplements:

  • Vitamin D: Recommended for general health support.

  • Vitamin C: Advised to help in managing the symptoms effectively.

  • Vitamin B3 (Niacin):

    • Role: Critical in regulating physiological processes, including the functioning of NAD+ which is a crucial regulator in our body.
    • Synergy with Zinc: Works in tandem with zinc to facilitate numerous biochemical processes in the body.

  • Zinc:

    • Dosage: A daily dosage between 15 to 30 milligrams is recommended.
    • Role: Essential in supporting the function of NAD+ and managing inflammation effectively.

  • Selenium:

    • Dosage: A daily intake of 100 micrograms or consumption of three Brazil nuts is recommended.
    • Role: Helps in supporting the body's metabolic processes and managing symptoms effectively.

Treatment Progress and Recovery

• Recovery Time: Acknowledges that recovery is a slow process, potentially taking up to six months to replace overreactive mast cells with more stable ones.
• Patient Feedback: Some patients have reported dramatic improvements, being able to return to work and feeling significantly better.

Future Prospects and Hope

• Potential Breakthrough: Dr. Peers sees the potential for this approach to revolutionize the treatment of other inflammatory conditions linked to MCAS, including ME and IBS.
• Research: Emphasizes the need for randomized control trials to validate this treatment approach further.
• Centers of Excellence: Suggests the establishment of specialized centers for treating MCAS and histamine intolerance, leveraging the insights gained from treating long Covid patients.

Mast Cell Stabilizers

Dr. Tina Peers did not specify which mast cell stabilizers she uses in the treatment approach. However, in general, mast cell stabilizers are medications used to prevent or control certain allergic disorders. They block a calcium channel essential for mast cell degranulation, stabilizing the cell and thereby preventing the release of histamine and related mediators.

Here are some commonly used Mast Cell Stabilizers, which are often utilized in the management of MCAS and other allergic disorders:

1. Cromolyn Sodium (Cromoglicate): Often used as a first-line treatment in MCAS, it helps to stabilize mast cells and prevent the release of histamine and other inflammatory mediators.

2. Ketotifen: A medication that not only acts as a mast cell stabilizer but also has antihistamine properties, making it a dual-action medication useful in managing allergic symptoms.

3. Quercetin: This is a plant flavonol from the flavonoid group of polyphenols, which is sometimes recommended as a supplement for people with MCAS due to its potential to stabilize mast cells.

4. Luteolin: Like quercetin, it is a flavonoid with potential mast cell stabilizing properties, often found in supplements aimed at supporting mast cell health.

5. Nedocromil: Similar to Cromolyn Sodium, it is used in the management of chronic inflammatory diseases and has mast cell stabilizing properties.

6. Lodoxamide: While primarily used as an eye drop to treat allergic conjunctivitis, it has mast cell stabilizing properties.

7. Pemirolast: Often used in eye drops for allergic conjunctivitis, it works by inhibiting the release of histamines from mast cells.

Understanding Long COVID and 📁 Research 🧪/🤢 Main Diseases (Notes)/Mast Cell Activation Syndrome (MCAS)

• Introduction to Dr. Tina Peers: Dr. Peers is a leading expert in 📁 Research 🧪/🤢 Main Diseases (Notes)/Mast Cell Activation Syndrome (MCAS) with over five years of experience in treating patients with this condition.
• Connection between Long COVID and MCAS: Dr. Peers discusses the substantial evidence pointing to a connection between the symptoms experienced by long-haul Covid-19 patients and MCAS, a condition characterized by an overreaction of mast cells to various stimuli, including infections.

Symptom Profile

• Overlap with MCAS: Many symptoms of Long COVID closely resemble those seen in MCAS patients, including but not limited to:

  • Fatigue
  • Headaches
  • IBS symptoms such as bloating, wind, abdominal pain, diarrhea, and constipation
  • Insomnia and anxiety
  • Skin rashes (both itchy and non-itchy)
  • Palpitations, low blood pressure, and dizziness
  • Shortness of breath
  • Tinnitus and rhinitis
  • Weight loss and poor healing

• Exercise Intolerance: Both long Covid and MCAS patients often exhibit a poor tolerance to exercise, experiencing exacerbated symptoms after physical activity.

Treatment Approach (Dietary Changes)

Avoid High Histamine Foods

Dr. Peers emphasizes the necessity of avoiding foods high in histamine to manage symptoms effectively. These foods include:

• Avocados
• Tomatoes
• Spinach
• Bananas

Avoid Certain Drinks

Certain drinks can block the enzymes responsible for breaking down histamine, hence it is advised to avoid:

• Tea
• Coffee
• Green tea
• Alcohol

Avoid Processed and Reheated Foods

Processed foods, reheated foods, and leftovers can increase histamine levels in the body, exacerbating symptoms. It is advised to avoid:

Treatment Approach (Supplements)

Dr. Peers recommends a regimen of vitamins and minerals to support the body's system and reduce histamine levels. The detailed guidance includes:

Vitamin D

• Dosage: A reasonably high dose is recommended, although the exact amount is not specified in the transcript. It is generally advised to consult with a healthcare provider to determine the appropriate dosage.

Vitamin C

• Dosage: Slow-release vitamin C is recommended in the following dosages:
  • 750 milligrams a day, or
  • 1000 milligrams three times a day
• Benefits: Vitamin C can act as a good antihistamine, helping to lower histamine levels in the body.

Vitamin B3 (Niacin)

• Dosage: Daily intake is recommended, but the exact dosage is not mentioned in the transcript. It is advised to opt for the no-flush variety to avoid flushing associated with niacin intake.
• Benefits: Regular intake can support the body's system, although specific benefits are not detailed in the transcript.

Zinc

• Dosage: A daily dose of 15 to 30 milligrams is recommended.
• Benefits: Regular intake can support the body's system, although specific benefits are not detailed in the transcript.

Quercetin

• Dosage: It should be taken three times a day, but the exact dosage is not specified in the transcript.
• Benefits: Regular intake can help support the system, although specific benefits are not detailed in the transcript.

Selenium

• Dosage:
  • 100 micrograms a day through supplements, or
  • A couple of Brazil nuts daily, which have no histamine.
• Benefits: Regular intake can support the body's system, although specific benefits are not detailed in the transcript.

Treatment Approach (Medication)

Over-the-Counter Antihistamines (Type 1)

• Usage: Dr. Peers recommends starting with a small dose and gradually increasing based on individual tolerance. It is a trial-and-error process to find the most effective solution.
• Dosage: Although the packaging on these medications often suggests a once-a-day dose, Dr. Peers advises taking them two or three times a day to help manage the condition.
• Note: Patients are encouraged to try different brands if they suspect that additives in a specific brand's formulation are causing adverse reactions.

Prescribed Antihistamines (Type 2)

• Specific Medication: Vermotadine?? is currently available in the UK.
• Dosage: A daily dose of 40 milligrams is recommended.
• Prescription: This medication needs to be prescribed by a GP or a doctor.
• Usage: It is used alongside type 1 antihistamines to manage symptoms effectively.

Mast Cell Stabilizers

• Usage: Dr. Peers mentions the potential use of mast cell stabilizers in the treatment approach, although it is early in their exploration for this use.
• Note: The specific medications and dosages are not detailed in the transcript, indicating that this is a newer area of exploration in the treatment of MCAS and long Covid symptoms.

Individualized Approach

• Go Low and Slow: Dr. Peers emphasizes a "low and slow" approach to medication, advising patients to start with a small dose and gradually increase it, monitoring their reactions to find the most effective dose.
• Sensitivity to Excipients: She notes that many MCAS patients are sensitive to excipients (inactive substances in medications), and hence, they might react differently to various brands of the same medication.

Community and Medical Response

• Growing Awareness: Although MCAS is not widely recognized in the medical community, awareness is gradually increasing, partly due to resources such as the toolkit provided by the Royal College of General Practitioners (RCGP).
• Individualized Approach: Dr. Peers highlights the necessity of an individualized approach to treatment, as patients can react differently to various medications and supplements.

Research and Future Directions

• Potential Research Areas:
  • Investigating Virus Presence in Gut Cells: Dr. Peers suggests research to explore if the virus is present in the gut cells of the small intestine.
  • Genetic Studies: Understanding the genetics of long Covid patients could be a vital area of research.
• Patient App: Dr. Peers mentions an app that helps patients track their symptoms and lifestyle, which has been beneficial in understanding the symptom profiles of long Covid patients.
• Patient Advice:
  • Patience in Treatment: Dr. Peers advises patients to be patient, emphasizing a six-month period to foster the formation of better-behaving mast cells in a lower histamine environment.
  • Symptom Tracking: Utilizing the app to track symptoms and lifestyle can be a useful tool in managing the condition.