In many cases of interstitial cystitis, mast cells are raised in the bladder and play a big role in the unpleasant symptoms of an IC flare. Modern medicine likes to put names on symptoms but sometimes this may not describe the real issue well.
Interstitial cystitis is often a diagnosis of exclusion and similar to syndromes such as Irritable Bowel Syndrome (IBS) it is a functional disorder with an array of symptoms. The condition in itself could even be a symptom in itself. In the case of raised mast cells the question is whether it is really IC or could it be mast cell activation disorder (MCAD)?
In order to recover from chronic illness, finding the root cause of the illness is key. The question here is: why are the mast cells in the bladder?
What is Mast Cell Activation Disorder?
Mast cells are a type of white blood cell that are found on most human tissue, and especially where the body interacts with the environment. Mast cells play a big role in allergies. I have written all about mast cells here.
In mast cell activation disorder, mast cells (a part of the innate immune system) become hyperactive, releasing chemicals such as histamine that can affect every organ system in the body.
Mast cells are designed to sense invaders and as a response release chemicals to deal with them. But in the case of allergies this response is triggered to harmless invaders (such as pollen).
In MCAD there is an accumulation of mast cells that are either genetically altered (in this case we talk about mastocytosis) or there is an abnormal activation of mast cells, with the result of their chemicals being released when they shouldn’t be (mast cell activation disorder). This type of mast cell disorder is more common, although it is hard to diagnose and guidelines have only been published fairly recently.
MCAD generally presents as an allergic/inflammatory condition that can affect different body symptoms and express as IBS, depression, skin conditions and probably interstitial cystitis.
One sign could be an intolerance to histamine rich foods (aged foods).
MCAD and Interstitial Cystitis
As I have explored in this previous blog post, IC is often presents with a raised number of mast cells in the bladder tissue.
This could simply be a result of the inflammation in the bladder. In this case, IC may be the disease and mast cells a symptom of the disease.
But what if IC is a symptom and the raised amounts of mast cells are the root cause? The mast cells could be there for a different reason altogether.
In a patient that also suffers from an array of allergic conditions and IBS (amongst others), the bladder may just be another organ that is affected by an underlying root cause.
Conventional medicine likes to categorize diseases and label them. In functional medicine on the other hand, one would look at the common denominator of all the symptoms.
Chronic disease at the end of the day is a mismatch between our genetics and our environment that causes body systems to fail.
So what if interstitial cystitis is just a symptom and not a disease in itself? Would it not change the way we look at treatment options?
What causes Mast Cell Activation Disorder?
I am interested at looking at root causes of bladder conditions because I strongly believe that this is the way to tackle them. So in the case of IC my question is: why are mast cells raised.
Here are some potential causes for mast cell activation:
- Chronic infections: mast cells are part of the immune system that are designed to attack invaders. Constant infection could be one reason for chronic mast cell activation. This may be in the gut or in the bladder, or both. There is evidence that chronic hidden infections lead to the symptoms of IC (here and here). Parasites, bacteria, fungi and viruses can all cause mast cell activation [1, 2, 3]. In my opinion, this is one of the likely causes of mast cell accumulation in the bladder.
- Allergies: An over-reactive immune system can react to harmless particles such as pollen and foods, causing an allergic reaction. Mast cells play a role in allergies. Maybe the mast cells in the bladder are reacting to foods and maybe IC is just the symptom of allergies?
- Heavy Metals: Heavy metals have been shown to activate mast cells . Therefore, heavy metal toxicity may be a reason for chronic activation of mast cells.
I have looked at some potential treatment options here and will explore more options in future blog posts, so stay tuned.
Now I’d like to hear from you: Are you suffering from IC and allergic conditions? Do you thinks MCAD could be to blame? Let me know in the comments.
Pin it for later:
Kresser, Chris Could Your Histamine Intolerance Really Be Mast Cell Activation Disorder? November 2016 https://chriskresser.com/could-your-histamine-intolerance-really-be-mast-cell-activation-disorder/
Molderings, Gerhard J et al. “Mast Cell Activation Disease: A Concise Practical Guide for Diagnostic Workup and Therapeutic Options.” Journal of Hematology & Oncology 4 (2011): 10. PMC. Web. 19 June 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069946/
Anand P, et al Mast cells: an expanding pathophysiological role from allergy to other disorders. Naunyn Schmiedebergs Arch Pharmacol. 2012 Jul;385(7):657-70. doi: 10.1007/s00210-012-0757-8. Epub 2012 May 6. https://www.ncbi.nlm.nih.gov/pubmed/22562473/
Haenisch, Britta, Markus M Nöthen, and Gerhard J Molderings. “Systemic Mast Cell Activation Disease: The Role of Molecular Genetic Alterations in Pathogenesis, Heritability and Diagnostics.” Immunology 137.3 (2012): 197–205. PMC. Web. 19 June 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482677/
- Saluja, R., M. Metz, and Marcus Maurer. “Role and Relevance of Mast Cells in Fungal Infections.” Frontiers in Immunology 3 (2012): 146. PMC. Web. 19 June 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374363/
- Lee TD, et al Mast cell responses to helminth infection. Parasitol Today. 1986 Jul;2(7):186-91. https://www.ncbi.nlm.nih.gov/pubmed/15462834
- Afrin LB, et al Mast Cell Activation Disease and Microbiotic Interactions. Clin Ther. 2015 May 1;37(5):941-53. doi: 10.1016/j.clinthera.2015.02.008. Epub 2015 Mar 12. https://www.ncbi.nlm.nih.gov/pubmed/25773459
- Bent, S., Göttsch, C., Braam, U. et al. The effects of heavy metal ions (Cd2+, Hg2+, Pb2+, Bi3+) on histamine release from human adenoidal and cutaneous mast cells Agents and Actions (1992) 36(Suppl 2): C321. doi:10.1007/BF01997363 https://link.springer.com/article/10.1007/BF01997363