Quick start to 2 blogs and an analysis site

My primary concern for the last 20 years was been the condition known as Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). I deduced some seven+ years ago that the simplest explanation of the multitude of symptoms and abnormalities reported was a stable microbiome dysfunction. This explanation can also be applied to many other conditions. My focus is still on ME/CFS but I wish to make the data and algorithms available to people with any conditions. My old home page is here (dry technical).

The basic model that is supported by studies is:

  • DNA Snps that results in increased risk
  • Environmental changes of DNA (epigenetics) that further increase risk
  • Microbiome function that acts as a catalyst to the risk.

The microbiome is the simplest to alter technically — but very complex to alter because there are thousands of bacteria that interact with each other in the human body. DNA can also encourage some bacteria and discourage others. Example: Typhoid Mary is an excellent example of some one whose DNA and a nasty bacterial infection co-existed nicely.

Does changing the microbiome work for ME/CFS?

Answer is yes:

Open-label pilot for treatment targeting gut dysbiosis in myalgic encephalomyelitis/chronic fatigue syndrome: neuropsychological symptoms and sex comparisons , 2018

Recommended Site For Testing

With ME/CFS, there is always a nasty cost factor for testing. My usual recommendation is for the cheapest, high quality provider that provides information for upload to my analysis site. Some sites provide a mountain more of information — but the benefit from that extra information is almost nothing (and it adds $$$$ and complexity).

  • uBiome.com is shutting down. This had been my personal usual site because using a variety of techniques, the cost was $25/sample. Don’t order from there.
  • BiomeSight.com (EU based but serves the world) – discount code “MICRO” has integrated with my analysis site with automatic data transfer. For most people it is likely the best deal.
  • Thryve (US Based) is what I have used. Their reports may be processed here for independent suggestions. I would also recommend

Who am I?

I am a citizen-scientist with reasonable scientist credentials: taught Chemistry and Physics at College Level; Master of Science, accepted for the PhD program, certified data scientist with R, one of the top mathematics and physics competition students in Canada during my university years, etc.

I am a closet academic — so I give links to my source of information everywhere and usually keep them to the highest quality sources (PubMed, professional journals). I have even had a letter of mine published in the Lancet.

The Sites

  • This site — over 1200 blog posts published over the last 5 years. This is where I publish most. You can subscribe to get new posts by email.
  • Microbiome Prescription site – started in 2018. This is a massive data store with a variety of artificial intelligence algorithms applied to it. Almost 800 people have uploaded their microbiome results to it and many annotated it with their symptoms.
  • Microbiome Prescription Word Press – started recently. This is intended as a reference to the above site. Just essential pages and a bunch of homemade videos taking you through some features.
  • Facebook Site: Where I usually post new blog entries and the occasional odd note that is not worth a blog post. Make sure that you like it so you get notices of new posts.

Findings to Date

The assumption that bacteria shifts connect to symptoms appears confirmed using the upload microbiomes.

  • We have found statistically significant patterns of some bacteria to symptoms, see this post
  • We appear to have a high probability of correctly predicting symptoms from a microbiome report. See this post.

These findings can be independently confirmed by using the public shared data at: http://lassesen.com/ubiome/

Tools to Help

The Microbiome Prescription site is a theoretical site, that is, it works from the logical application of data and is not based on actual human experience. It does have the ability to create suggestions of things to take and to avoid to try reducing abnormalities in your microbiome. It supports multiple models and algorithms because we do not know which actually works best.

The site states that the suggestions should be reviewed by a medical professional. The source of the information is provided by links (hundreds of articles are cited).

Evolving Story

As more data comes in, and more insight happens, there will be more posts and more features (some labelled experimental — because I am unsure of their accuracy) will be added. This is citizen science.

Video to kickstart using your microbiome use

Acid Reflux/GERD – what is known

A reader asked me about this and I have not had to deal with it but I know it is common. Acid Reflux is also called gastroesophageal reflux disease (GERD). So I am doing a summary of my gold standard sources (a.k.a. PubMed). Internet legends are abundant; I know from prior posts that often they got established from some early study that did not replicate, or was even misread… and the legend just kept going on and on by being repeated. You may also wish to review my 2016 post on this topic

As a statistician, I found the following informative in terms of risk factors (hint: changing some of these habits may improve things.

  • non-Hindu religion (2.4% vs. 1.2% for Hindu) [2021]
  • non-vegetarian diet (15.5% vs. 4.2%) – which explains above nicely [2021]
  • lower socioeconomic class ( 31.5% vs. 20.9%) [2021]
  • carbonated soft drinks ( 72.5% vs. 49.8%),[2021]
  • For US women [2021] “The five factors include normal weight, never smoking, moderate-to-vigorous physical activity for at least 30 minutes daily, restricting coffee, tea and sodas to two cups daily, and a “prudent” diet”
  • “we identified 7 risk factors: overweight/obesity [GERD/erosive esophagitis (EE)/GERD symptom], central adiposity [EE], smoking [GERD], alcohol [GERD/EE/non-erosive reflux disease (NERD)], NSAID [GERD], coffee [EE], Helicobacter pylori eradication [EE], and 1 protective factor: physical activity [GERD], ” [2020]
  • “psychological distress were found to be risk factors for esophageal symptoms on multivariate analysis.” [2020]
  • Rotating night shift work is associated with an increased risk of gastroesophageal reflux disease (GERD) symptoms among workers in China: a cross-sectional study [2020]
  • “GERD is common throughout the world, and its epidemiology is linked to the Western lifestyle, obesity, and the demise of Helicobacter pylori.” [2020]
  • ” The represented logistic regression shows that family history of GERD, marital status (divorce), smoking, physical activity frequency, tomatoes/tomato-based foods, salty foods, acidic drinks, frequent use of analgesics, and nonsteroidal anti-inflammatory drugs (NSAIDs) consumption shows statistical significance and association (P < 0.05) with increased risk of symptomatic GERD.” [2020]
    • GERD takes NSAIDs more than controls
    • GERD eats chocolate less than controls
    • GERD eats Tomatoes/Tomato-based food more than controls
    • GERD drinks more citric drinks than controls
    • GERD drinks more tea than controls
    • GERD drinks less pop than controls
    • GERD smokes more than controls (note: smoking is often associated to stress)
  • Short Meal-to-Bed Time Is a Predominant Risk Factor of Gastroesophageal Reflux Disease in Pregnancy [2020]
  • “Sixty-one per cent of students who had a habit of midnight snack for more than three times a week were having GORD symptoms, in comparison to 47% of who did not have the habit.” [2020]
  • Sixty-one per cent of students who had frequent lack of breakfast for more than three times a week were having GORD symptoms, in comparison to 43% of who did not have the habit”[2020]
  • Sixty-three per cent of students who had inadequate sleep were having GORD symptoms, in comparison to 45% of who had an adequate sleep.[2020]
  • ” High BMI, family history, energy drinks and fried food were found to be statistically significant risk factors (p<0.05) by univariate analysis.” [2019]

Microbiome changes of the month (which acts as a reserve to bacteria in gastroesophageal) have been seen

Salivary microbiome with gastroesophageal reflux disease and treatment [2021]

Additional information on microbiome shifts can be found here:

Probiotics

  • “Most gastrointestinal benefits of probiotics have targeted the lower digestive tract, and limited data regarding the upper digestive tract have been reported, particularly for GERD….The aim of this systematic review was to examine the efficacy of probiotics in alleviating the symptoms, incidence, and severity of GERD in the general adult population, as this has not been done before.” [2020]
    • compared with the placebo, postprandial distress syndrome scores declined significantly with the L. gasseri LG21 intervention (37.5% vs. 17.8%)….the underlying mechanisms of L. gasseri LG21 for improving FD-associated reflux are linked to postprandial effects, involving improved protein indigestion and increased gastric emptying.

Hydrochloric acid (HCL)/betaine/pepsin

This is often suggested on blogging and personal opinion sites. I was unable to find any study supporting it’s use and some studies indicating that with some sub-types, it may make it worst.

  • Nutritional Interventions for Gastroesophageal Reflux, Irritable Bowel Syndrome, and Hypochlorhydria: A Case Report, 2016 – mentioned for Hypochlorhydria but not for GERD and this was a single person report.
  • “Decreased acid sensitivity in individuals with increasing body mass index may play a pathological role in symptomatic modulation of patients with GERD.” [2019]
  • “This study shows that a carbohydrate-free diet and/or highly hypoglycidal diet that is enriched with acid pH foods appears to lead to a decrease in the pH of the gastric contents, thus inhibiting the further production of hydrochloric acid with a reduction or disappearance of heartburn symptoms that are typical of gastroesophageal diseases.” [2018] So less HCL results in an improvement.

Herbs / Bitters / Herbal Tonics

While effectiveness is cited in two studies, only a kampo herbal medicine is explicitly named. It may be worth while to try different traditional digestive bitters (as opposed recently created ones)

Bottom Line

As stated above GERD tend to be a western diet disease (and that has been proposed also for the incidence of autism). In terms of life style, the following suggestions should be considered (all of these items appear to be associated to why GERD developed):

  • Early supper
  • No evening snacks
  • Decrease fat and meat content in the diet
  • No soft drinks, citric drinks or tomato based diet (sorry Pizza lovers!)
  • Increase chocolate – ideally 70% cacao or more
  • Daily exercise for 30 minutes
  • No coffee or tea with caffeine
  • Work on sleep — melatonin may help with this, and also the microbiome
  • Lactobacillus gasseri probiotics
  • REDUCE STRESS in your life — yes, it CAN be done. Stress is a state of mind (move on!).

Thus the whys…

  • Not having your digestive tract EMPTY by bedtime (think of circadian rhythm for digestive system being off)
    • Late suppers
    • Evening snacks
  • High fat and meat content in the diet (takes longer to digest — see above)
  • Soft drinks, caffeine(tea, coffee) citric drinks or tomato based diet (sorry Pizza lovers!) – alters bacteria
  • A lack of exercise (impacts microbiome)
  • Stress (impacts microbiome)
  • Sleep issue
  • Not having a good breakfast (think of circadian rhythm for digestive system being off)

On a bit of a speculative nature, given that the mouth microbiome may be a significant player, altering it may be beneficial. There are three items that I would look at:

There is one other approach worth considering, xylitol gum. There is evidence in a recent 2020 study that xylitol helps, Effectiveness of salivary stimulation using xylitol-malic acid tablets as coadjuvant treatment in patients with gastro-oesophageal reflux disease: early findings [2020]

Special Note for Autism

I have seen several children (and the literature agrees) with (very) high Bifidobacterium level, typically without an identified species. We not that there are both increases and decreases in Bifidobacteriaceae shown below. PPI should be use with caution.

acidreflux
This BMJ article had a nice graphic of what PPI’s do with red dots indictes higher growth and blue dot with decrease. 

Salicylate Sensitivity – What do we know

I have done a recent review of a child with salicylate sensitivity and in dialog with the parent, I realized that I need to get up to speed on this topic. One of the reasons is that we found that some of the recommendations were matches to some studies for salicylate sensitivity. So far the citizen science analysis at microbiome prescription has not found any specific bacteria associated (not sufficient samples). If you have uploaded a sample AND have salicylate sensitivity, please make sure you have updated you symptoms.

There are many web-sites/blog dealing with salicylates — which given the absence of actual studies, may be worth reading. As always, I will attempt to keep to “gold standard” data sources.

Salicylate poisoning can cause vomiting, tinnitus, confusion, hyperthermia, respiratory alkalosis, metabolic acidosis, and multiple organ failure. Diagnosis is clinical, supplemented by measurement of the anion gap, arterial blood gases, and serum salicylate levels. Treatment is with activated charcoal and alkaline diuresis or hemodialysis.

Merck ASPIRIN AND OTHER SALICYLATE POISONING
  • “Alkalinisation, the mainstay of therapy for salicylate and phenobarbital poisoning over many decades, is effective, although no more so than charcoal, and less than dialysis” [1990]
  • “Forty-four adults with aspirin poisoning were treated with oral fluids only, standard forced alkaline diuresis, forced diuresis alone, or sodium bicarbonate (alkali) alone. Alkali alone was at least as effective and possibly more effective than forced alkaline diuresis in enhancing salicylate removal. ” [1982]
  • “One of the more popular and successful treatments has been forced alkaline diuresis to encourage excretion. This technique, however, is not without risk and has now been replaced with alkalinisation alone, which has been shown to be safer and equally successful. The use of activated charcoal as an acute absorbing agent for drug still in the upper gastrointestinal tract is beneficial in minimising further absorption. ” [1992]
  • “When the urine pH increases to 8 from 5, renal clearance of salicylate increases 10-20 times. Raising the urinary pH level from 6.1 to 8.1 results in a more than 18-fold increase in renal clearance by preventing nonionic tubular back-diffusion, which decreases the half-life of salicylates from 20-24 hours to less than 8 hours. ” [MedScape]

Treatment of severe salicylate poisoning by forced alkaline diuresis. [1969]

The concept of an alkaline diet is popular.

CFS/ME and COVID Vaccines

A reader ask me to do a post on the COVID vaccines and people with Chronic Fatigue Syndrome / Myalgic Encephalomyelitis. The risk of death is a significant factor in making a personal decision. This is different than most vaccinations; we need to look afresh at this decision and not run off pro forma decisions for things like measles or extremely low risk-of-infection diseases (polio)

  • Measles risk of death 2 in 10,000 or 0.02%
  • For flu: [cdc]
    • 18-49: 0.02%
    • 50-64: 0.05%
    • 65+: 0.85%

There are possible side-effects, which appear to be transitory for typical people.

 A review of unblinded reactogenicity data from the final analysis which consisted of a randomized subset of at least 8,000 participants 18 years and older in the phase 2/3 study demonstrates that the vaccine was well tolerated, with most solicited adverse events resolving shortly after vaccination. The only Grade 3 (severe) solicited adverse events greater than or equal to 2% in frequency after the first or second dose was fatigue at 3.8% and headache at 2.0% following dose 2. Consistent with earlier shared results, older adults tended to report fewer and milder solicited adverse events following vaccination

PFIZER AND BIONTECH CONCLUDE PHASE 3 STUDY OF COVID-19 VACCINE CANDIDATE, MEETING ALL PRIMARY EFFICACY ENDPOINTS 18 Nov, 2020

I did a prior post on POTS as a consequence of vaccination. Fortunately, that is moot since most people with ME/CFS already have POTS! It is important to note that positive benefit can happen with some vaccines: Effects of  vaccine on pain and fatigue in patients with fibromyalgia/chronic fatigue syndrome.[1998] that “Fifty percent [of ME/CFS] were rehabilitated successfully and resumed half-time or full-time work.”

There is concern on aluminum in vaccines and ME/CFS as documented in this 2016 post. With subsequest studies

More Recent Studies

Which Vaccine has Aluminum?

For people in the US, we have a list of all vaccines and their ingredients here. You will see Human Papillomavirus (HPV) (Gardasil 9) cite above, contains amorphous aluminum hydroxyphosphate sulfate.

Bottom Line

The key issue is whether there is aluminum in the vaccine. If there is, it may worsen existing symptoms (especially neurological issues). The bad news is that appears that the current COVID-19 vaccines some contains aluminum (alum) and others do not.

So the traditional and documented issue with vaccines (the aluminum in it) does not apply to two of the Covid vaccines. This implies that for FM, CFS/ME, there is not a supportable evidence-based reason to decline it.

For all ages, the risk of death is significantly higher than for the flu: [see cdc numbers above]

  • 18-49: 0.02% vs 0.1 to 0.4% i.e. 20x greater risk
  • 50-64: 0.05% vs 0.5 to 3.6% i.e. 72x greater risk
  • 65+: 0.85% vs 6.3% to 20%, i.e. 24x greater risk
Covid cfr by age
From https://ourworldindata.org/mortality-risk-covid

The side effect risks are low and appear to be transient. “Long Covid” – the name given to a CFS-like syndrome after a COVID infection is likely to make any existing ME/CFS or FM much worst. This is estimated that 10% of people are prone. The probable model is that long covid has resulted in a stable gut bacteria dysfunction (for a similar documented-over-several-years similar scenario see this post)

One study of people hospitalized with COVID-19 in Italy found that 87.4% reported experiencing at least one symptom, often fatigue or shortness of breath, 2 months after discharge. Among people with milder infections, however, the prevalence of long COVID has been unclear. Data from the COVID Symptom Study app suggest that 1 in 10 people with the illness experience symptoms for 3 weeks or more

COVID-19 Symptoms: Longitudinal Evolution and Persistence in Outpatient Setting [2020]

Get the vaccine — there is no evidence-based reason not to (especially if there is no aluminum in it). Not taking the vaccine means significant risk of death and likely more severe CFS/ME or FM.

Post Script – I had COVID… Should I get the vaccine?

Answer is a simple yes. Protection with the vaccine is expected to last longer… Think of it as a booster shot!

University of Washington study: Immune memory in mild COVID-19 cases lasts 3 months [Jan 7, 2021]

Histamine and Mast Cell Stabilizers

Recently I have seen a lot of difference of opinions on social media on these issues. There are several blogger who write on this, for example:

I was well trained at University to always work from primary sources (hence the joys of learning at least some greek, latin, french, german, danish for history courses). Bloggers are secondary and often tertiary sources – with the risk of reading more into stuff then there may actually be, or spinning the data to gain readers.

On the flip side, some of their advice comes from experience. The unfortunate aspect of experience is that there is no control for placebo effects, or anti-placebo effects, or effects due to other factors with the person.

You may also wish to read DAO and Probiotics, a prior post

To me, the primary sources are two grades:

  • Individual specific studies (which suffer from a variety of bias risks)
  • Review Articles (unlike bloggers, these are peer reviewed)

Wikipedia lists the following as Mast Cell Stabilizers, most are prescription drugs

The drug bank list of Histamine H1 Antagonists, Non-Sedating provides a similar link with the KEGG providing nice diagrams here, with the following enzymes:

07216 Catecholamine transferase inhibitors
07219 Cyclooxygenase inhibitors
07024 HMG-CoA reductase inhibitors
07217 Renin-angiotensin system inhibitors
07218 HIV protease inhibitors
  • “Aspirin enhanced histamine release from basophils via increased Syk kinase activation” [2013]

 There is no evidence to suggest that sensitization against drugs occurs more frequently among patients with presumed histamine intolerance compared to patients with normal tolerance to histamine. However, preclinical data suggest interactions between some drugs and histamine catabolism. Nevertheless, the clinical relevance of these findings remains unclear as histamine in humans can be catabolized by different pathways[Editor: DAO and HNMT]. There are no drugs for which induction or worsening of histamine intolerance has been established clinically.

Drug hypersensitivity in patients with presumed histamine intolerance and mast cell activation disease [2019]

In terms of citizen science, we find some strong statistical associations for some bacteria shifts

From: https://microbiomeprescription.com/Explorer/ToSymptomsSummary?id1=133

The Review

Mast Cell Stabilizers

  • Twenty-first century mast cell stabilizers [2013] See Table 1 “Naturally occurring mast cell stabilizers”
    • I have a page that links to what contain various flavonoids here, with the amount (and mast cell stabilizers labelled)
      • Often people work off “contains” only, ignoring the amount, for example
        • Apigenin: Kumquats has 21 mg/gram and mangos 0.01 mg/gram — a 2000x difference!
    • Example: Apigenin
  • PubMed reports nothing for probiotics that have this effect. Nor for bifidobacterium, nor lactobacillus
    • For Bacillus, we find evidence of histamine release [1975], exactly the wrong response

DAO Response

There are chemicals/vitamins that DAO and  Histamine N-methyltransferase (HNMT) ( the key natural histamine removers) need to act upon histamines. These include:

  • “Vitamin B6 is a collective term for all 3-hydroxy-2-methylpyridines which act as vitamins. Vitamin B6 substances like pyridoxine, pyridoxal, pyridoxamine, and their phosphorylated metabolites are all equally effective. Pyridoxal-5-phosphate and pyridoxamine-5-phosphate fulfill the functions of a coenzyme in the organism [for activation of DAO].” [2014]
  • Impact of oral vitamin C on histamine levels and seasickness [2014]
    Note: “Histamine (p < 0.01) and DAO levels were increased after the intake of vitamin C (p < 0.001)”
    • The p values suggests that DAO increased significantly more than histamine.
    • This may be the source of QAnon belief that citric fruits/vitamin C is bad.
  • “A cross-over study in former East-Germany on patients who had infection-related asthma found that 5 g/day vitamin C decreased the proportion of participants who had bronchial hypersensitivity to histamine by 52 percentage points (95% CI: 25 to 71).” [2013]
  • “copper …. did significantly increase two enzyme activities (SOD and DAO)” [1997]
  • “diamine oxidase (DAO) activity were both increased (linear, p = 0.0004, 0.001, respectively) with Defatted Rice Bran…” [2019]

Negative Impacts

Caution: DAO production seems to increase with gut permeability issues (GPI). Thus something that improves GPI may not actually decrease DAO production, the change of DAO may be a side effect.

  • “selenium-enriched yeast …significantly decreased the serum concentrations of diamine oxidase (DAO)” [2020] – unclear if the yeast or the selenium was the primary cause.
  • “Tannic acid … reduced diamine oxidase (DAO) activity”  [2020] ( Tea, coffee, wine, chocolate)
  • ” Antimalarial drugs that inhibit histamine N-methyltransferase also inhibit putrescine catabolism in vivo and DAO activity in vitro” [1981]
  • “putrescine supplement…. increase in putrescine at 1 h and in diamine oxidase (EC 1.4.3.6) activity within 3-6 h” [1986]
    • “putrescine is found in virtually all foods of plant origin, and is particularly abundant in fruits and vegetables, notably citrus fruits (1,554 nmol/g) and green peppers (794 nmol/g) (961). There are also high amounts of putrescine in wheat germ (705 nmol/g) and soybean sprouts (507 nmol/g) (3770).” [2019]
Drugs that inhibits DAO The structure and inhibition of human diamine oxidase [2009]

Histamine Production

Many probiotics produce histamines, for a list see our commercial probiotic list. For many probiotics, we could not find PubMed studies. Lactobacillus buchneri has been implicated in histamine-poisoning[1991].

See this post to see why strain is often not sufficient, L.Reuteri may or may not produce histamine depending on specific strain.

Foods

Fermented foods are usually uncertain for which bacteria are fermenting it. As we see above, many produce histamine. Studies of commercial Kefir have found that the listed bacteria and the actual are usually in disagreement. Bottom line: no fermented food. This includes sauerkraut, soy, miso, red wine and salami[2020] [1991] .This usually extends into no left-overs, most items left in the fridge (or out) indefinitely– get covered in furry green/black coats. This extends to many cheeses [2020][1995], with Feta Cheese being a possible exception [2020]. For cheese, the same cheese name (like Stilton and Camembert cited below), from one producer may be fine and from another bad — the difference is which strains (not species) of bacteria was used. This also applies to yogurts. For “wild Culture cheeses” it is Russian Roulette for histamines.

Very fresh fish can be safe, but they are prone to producing histamine quickly once skinned [2020].

This also applies to items like nuts and beans that are not fresh.

Citrus fruits are high in histamines” [Internet Legend?] – alas, I could not find any usable studies. I did find this

In this study, aqueous extracts of peels of best known citrus fruits namely grapefruit (Citrus paradisi), lemon (C. limon), lime (C. aurantifolia) and orange (C. sinensis) were used. Depending on polyphenols content, the extracts were graded as orange > lemon > lime > grapefruit. Effects of the extracts on the release of histamine from rat peritoneal exudate cells (PECs) was measured to know anti-allergic activity. All extracts inhibited the release of histamine from rat PECs induced by the calcium ionophore A23187

Anti-histamine release and anti-inflammatory activities of aqueous extracts of citrus fruits peels [2013]
  • “Nasal spray from lemon and quince (LQNS) is used to treat hay fever symptoms and has been shown to inhibit histamine release from mast cells ” [2016]

Other Histamine Producing Foods

In researching another possible internet myth, pineapples and banana. I found a summary of a study which could easily be misread to imply histamine issues. After some effort, I found the full text of the article and shows the results of their lab tests below. The summary statedHistamine, tyramine, noradrenaline, serotonin and other pressor amines occur in fruits and fermented foods such as bananas, pineapples, cheese and wine. ” It does not state that each is found in every fruit and fermented food

Naturally Occurring Toxic Factors in Plants and Animals Used as Food [1966]
Grasping for straws?

“Abnormal association between mast cells and nerve fibers, and increased release of tryptase and histamine have also been described in IBS patients [7],” [2017] has led to the not-demonstrated belief that what improves IBS also improves histamine. i.e. Beneficial effects of Saccharomyces boulardii CNCM I-745 on clinical disorders associated with intestinal barrier disruption [2019]

Highest Mast Stabilizer Foods

As mentioned above, we should not ignore the amount, fortunately the database behind Microbiome Prescription, allows us to compute across all natural mast cell stabilizers and get concrete numbers.

By amount of Mast Cell Stabilizers

Foodmg/gram
Spices, parsley, dried4523.25
Spices, celery seed841.05
Capers, canned303.89
Spices, saffron205.48
Dill weed, fresh68.48
Thyme, fresh47.75
Elderberries, raw27.35
Kumquats, raw21.87
Peppermint, fresh18.05
Cranberries, raw16.15
Cranberries, dried, sweetened12.83
Blueberries, cultivated (highbush), raw9.53
Blueberries, frozen, unsweetened7.55
Cranberry sauce, whole, canned, OCEAN SPRAY6.51
Pitanga, (surinam-cherry), raw6.2
Acerola, (west indian cherry), raw5.79
Figs, raw5.47
Currants, european black, raw5.16
Raisins, golden seedless5.11
Prickly pears, raw5.04
Apples, raw, with skin4.27
Apples, Red Delicious, raw. with skin3.87
Blackberries, raw3.85
Apples, Gala, raw, with skin3.8
Apples, Golden Delicious, raw, with skin3.69
Spices, marjoram, dried3.5
Lemons, raw, without peel3.07
Olives, ripe, canned (small-extra large) – May be high in histamine [2000]2.8
Rosemary, fresh2.55
Apples, Granny Smith, raw, with skin2.54
Cherries, sweet, raw2.53
Mulberries, raw2.47
Cranberry sauce, canned, sweetened2.44
Apples, Fuji, raw, with skin2.36
Apricots, raw2.26
Gooseberries, raw2.11
Applesauce, canned, unsweetened, without added ascorbic acid (includes USDA commodity)2
Juice, lemon, canned or bottled1.83
Plums, dried (prunes), uncooked1.82
Kiwifruit, green, raw1.81
Cherries, sour, red, raw1.71
Strawberries, raw1.61
Raspberries, raw1.48
Jujube, raw1.26
Raspberries, frozen, red, unsweetened1.14
Juice, pomegranate, bottled1.11
Apples, raw, without skin1.07
Strawberries, frozen, unsweetened0.98
Grapefruit, raw, pink and red, all areas0.94
Dates, deglet noor0.93
Sauce, pasta, spaghetti/marinara, ready-to-serve0.92
Watermelon, raw0.91
Oranges, raw, navels0.91
Plums, raw0.9
Peaches, raw0.88
Pears, raw0.84
Oranges, raw, all commercial varieties0.77
Juice, grape, canned or bottled, unsweetened, without added ascorbic acid0.75
Melons, cantaloupe, raw0.72
Nectarines, raw0.69
Juice, apple, canned or bottled, unsweetened, without added ascorbic acid0.58
Olives, pickled, canned or bottled, green May be high in histamine [2000]0.56
Juice, lime, raw0.51

By Number of different Mast Cell Stablizers

Different flavonoids may have different responses, hence the most varied should also be considered.

FoodFlavonoids Counts
Raspberries, raw6
Strawberries, frozen, unsweetened3
Oranges, raw, all commercial varieties3
Apples, raw, with skin3
Blueberries, cultivated (highbush), raw3
Blueberries, frozen, unsweetened3
Cranberries, raw3
Kiwifruit, green, raw3
Lemons, raw, without peel3
Mangos, raw2
Melons, cantaloupe, raw2
Oil, olive, salad or cooking2
Cranberry sauce, canned, sweetened2
Currants, european black, raw2
Dill weed, fresh2
Elderberries, raw2
Gooseberries, raw2
Grapefruit, raw, pink and red, all areas2
Capers, canned2
Cherries, sour, red, frozen, unsweetened2
Cherries, sour, red, raw2
Cherries, sweet, raw2
Cranberries, dried, sweetened2
Apricots, raw2
Bananas, raw2
Blackberries, raw2
Oranges, raw, navels2
Peaches, raw2
Peppermint, fresh2
Pitanga, (surinam-cherry), raw2
Prickly pears, raw2
Raisins, golden seedless (because of age, histamine risk)2
Raspberries, frozen, red, unsweetened2
Strawberries, raw2
Thyme, fresh2
Watermelon, raw2
Rosemary, fresh2
Spices, celery seed2
Spices, parsley, dried2
Acerola, (west indian cherry), raw2

Bottom Line

I will gladly take comments citing gold standard sources (PubMed with full test), please do not add comments about so-and-so saying something is bad. I dislike QAnon medicine.

The above should give a framework for diet and cooking, as points

  • Use items high in mast cell stabilizers
  • No fermented foods or left overs
  • No ‘old raw’ ingredients (i.e. nuts, beans, etc) – unfortunately, most of these do not have “Picked dates” on them. Bad storage (i.e. high humidity, temperature) is also a factor.
    • Dried fruit/vegetables have significant histamine risk
    • Canned food is unclear, but there are cases of problems from some manufacturers[2010].
  • Fresh frozen is usually fine. We buy blueberries originating at a far 4 miles away. We know that the temperature is cool when they are harvested and thus the risk of bacterial growth on them is low. Likely much lower than “fresh blueberries” at the market that was shipped from Chile and have been on display for 3 days.
    • Find out when fruit, vegetables etc are delivered to your market, you want to shop the next day — avoiding all old looking items
  • Peel fruits etc, immediately before consumption. Skins evolved to protect the contents from bacteria (i.e. histamine producing) growths

Whenever you hear an avoid (example list)— do your homework on it. Use PubMed exclusively. One of the best items for mast cell stabilization is Kumquats, which is on many avoid lists because it is in the citric family…. another QAnon recommendation.

IBS/Gut permeability appears to be a significant co-factor.

Evidence please! Studies, not the volume of people repeating rumors!

Child Anxiety and Microbiome

A reader with an autism child who has seen increasing anxiety asked for me to do an update on Anxiety. Given that it is a child, I raise my selection criteria to human studies, ideally on children. I have excluded Cognitive Behavior Therapy and Drug studies. My prior posts (often citing mice studies) are:

“Gut bacteria influence behavior, and both depression and anxiety symptoms are directly associated with alterations in the microbiota.” [Psychobiotics: Mechanisms of Action, Evaluation Methods and Effectiveness in Applications with Food Products 2020] It supplies a list of studies where depression or anxiety is reduced by probiotics. Probiotics that cites anxiety improvement include:

  • Bifidobacterium longum
  • Bifidobacterium breve
  • Lactobacillus casei Shirota (Yakult)
  • Lactobacillus plantarum
  • Lactobacillus rhamnosus
  • Faecalibacterium prausnitzii

Vitamins

  • Vitamin D supplementation improves anxiety but not depression symptoms in patients with vitamin D deficiency [2020]
  • Tryptophan supplements lacks clinical human studies, but appears to be a low risk item, especially if serotonin levels are lower. [2017] [2020]
    • Note: Walnuts are a source for tryptophan and magnesium [WebMD] — Walnuts and Magnesiums are on this child suggestions list from Microbiome Prescription.
  • “Root of the Ayurvedic drug W. somnifera (Aswagandha) appears a promising safe and effective traditional medicine for management of schizophrenia, chronic stress, insomnia, anxiety, memory/cognitive enhancement, obsessive-compulsive disorder” [2020]
  • ” herbal combination containing St. John’s Wort, Valerian, and Passionflower….
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Herbal triplet in treatment of nervous agitation in children [2013]
  • “Exercise as an intervention for anxiety and depression has been demonstrated in both of the animal studies and human clinical trials. “[2020]

Bottom Line

Vitamin D supplement will not show short term improvement, it takes time to raise the level. (Lots of )Fresh walnuts and Aswagandha would be my first choice for my child. Then keeping Yakult handy, available on request, to the child. Lots of walks (since playground play is likely not viable in this age of Covid)

Yakult product information and nutrition facts | Yakult & Yakult Light |  Probiotic Drink

As with all medicines, natural or otherwise, please consult with experts who are experienced in their actions, interactions, contraindications and potential side effects before starting this or any other supplement program.