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All Things Mast Cell with World-Renowned Clinical Researcher Dr. Theoharides


Senior Member

I felt it was absolutely necessary to share this chat between Dr Theoharides & Dr Fitzgerald for any others dealing with mast cell issues who want to keep up to date with the latest golden nuggets on MCAS.

Theoharides in this radio show reveals a seriously impressive amount of interesting insights on things from how most chronic conditions have mast cell involvement, fake mainstream luteolin supplements, possible complications from consuming too higher dose of flavonoids, to the pattern of microglia activation in various disorders such as post lyme, MCAS, ME/CFS and even autism. I came out feeling very inspired and reassured that I was getting the most legit info I could get moving forward with these frustrating & highly complex issues.

On a personal note, it could be due to how information dense the chat was but it seems like since the positive response I've got from fexofenadine and an even better one since I've doubled the dose, it didn't feel like a chore to listen through 1hr40 mins of his chat with Dr Fitzgerald on her radio show last night.

Anyway, I hope this helps some peeps like it did for me. I look forward to hearing others thoughts on it all! :)
There's some really good info about flavonoids dosing - towards the end of the podcast. It's complicated, so it helps to follow the transcript.

Relevant part on flavonoids (from transcript):
Dr. Theoharis Theoharides: Number one, I never give more than one gram a day, flavonoids of any combination for two reasons. Number one, if you actually … The flavonoids are absorbed less than 10% from the gut. Let’s say we prescribed three grams a day quercetin. What will happen is it will basically stay in the gut primarily. It will shut down every enzyme in your gut. You’re literally destroying your bioflora or the microbiota, if you wish. On the one hand, we’ll be giving probiotics. On the other, we’re basically killing all the enzymes. We’re basically just shooting ourselves in the foot.

Dr. Kara Fitzgerald: Well, why is it killing the enzymes? What enzymes are you talking about? The menthyl transferases and stuff? Which……

Dr. Theoharis Theoharides: The first round of enzymes on anything that we absorb is in the gut. Then it goes into the liver. Many of the vitamins have to be actually metabolized before we absorb them. I don’t want to affect gut enzymes. One of my colleagues here, David Greenblatt has published many papers that even juice from citrus, whether it’s oranges or grapefruit or whatever, inhibits basically the gut enzymes and then it causes problems.

Dr. Kara Fitzgerald: Okay.

Dr. Theoharis Theoharides: I would rather give smaller amounts and increase the absorption rather than giving high amount, hoping that that will do it. Moreover, if, let’s say, most of what we give, let’s say we give three grams a day and 10% is absorbed, so 300 milligrams or whatever, that will also inhibit liver enzymes.

Dr. Theoharis Theoharides: This is why in all the supplements we created, we mix them up with olive seed extract. Olive seed extract, if you take the olive oil, you’re left with a pit, basically. If you crush the pit, you get a little thicker oil. In Europe, that’s used for salad dressing. It’s nothing exotic. It’s 10 times cheaper than olive oil. I actually import olive seed oil from Greece to Long Island, New York. What happens is if you mix a powder with any oil, basically, and you give it energy, let’s say you shake it or your centrifuge it or you sonicate it, you create basically lyposomes. The oil becomes little lipid spheres. It traps the powder inside. We increase the absorption about three to five fold that way.
Dr. Kara Fitzgerald: Wow.
Dr. Theoharis Theoharides: This way …
Dr. Kara Fitzgerald: You’ve demonstrated that? You’ve demonstrated that?
Dr. Theoharis Theoharides: Oh, yeah. We’ve published that in animals, not in humans. It’s well known that that’s what happens.
Dr. Kara Fitzgerald: Yeah, okay.
Dr. Theoharis Theoharides: Basically, I prefer to have … For instance, one of the products that’s called fibroprotect, and we called it that because I give it a lot of fibromyalgia, chronic fatigue patients, contains, actually about 200 milligrams of luteolin and quercetin. That way, if you mentioned, let’s say you have about 500 milligrams total, but you absorb about 50% of that, that’s 250 milligrams. If you give one gram, not only are you actually screwing up your gut, but you will absorb less than 10%. You’re basically the same amount, but you’re having problems. You see where I’m going?
Dr. Kara Fitzgerald: Yes.
Dr. Theoharis Theoharides: From the cancer field, not from us, there are many publications that if you give quercetin and luteolin together, you get better activity. That’s why I combine the two. Now two things that I also want to stress with flavonoids, it’s the cheapest source or quercetin and luteolin, because luteolin comes, basically, from the same source, because it’s only one hydroxyl group different is actually peanut shells. However, as you know, unfortunately dietary supplements are not regulated. There’s no indication of the purity or the source. Most of the cheaper sources would be about 80% pure. If one of your patients has peanut allergy and they get it from peanut source, they’ll have a reaction, and you’ll never know it.


Senior Member
Dr. Theoharis Theoharides: We published two papers, one in the Journal of Allergy Clinical Immunology and the other Journal of Pharmacology Experimental Therapeuticscomparing cromolyn to luteolin and to methoxyl luteolin. Let me get you the result, then I’ll compare those flavonoids in second. Clearly luteolin was better inhibitor than cromolyn, both antihistamine and tryptase, and it blocked cytokines and chemokines, methoxyl luteolin was even better.

Dr. Kara Fitzgerald: Wow.

Dr. Theoharis Theoharides: Having said that, let me go back to the flavonoids. The flavonoids are basically three benzene rings. They have hydroxyl groups attached to them. Whenever we have a hydroxyl group attached to a benzene ring, we call that a phenolic compound. The reason I’m starting with that is about 15% or so of the general population and as many as 30% of the people that we’ve been talking about have phenol intolerance. I will ask patients or the families if someone gets hyper when they eat chocolate, strawberries, berries, grape seeds, that means they’re phenol intolerant. Therefore, I worry how much flavonoids of any kind that I would give them.

One reason to find out, of course, is to do genetic analysis, which I ask for pretty much every one of the patients we’re dealing with, because I ask for diamine oxidase. If they don’t have enough diamine oxidase, then we can give them a supplement to decrease histamine in the gut. In fact, I’m sure you know, there’s a wonderful site called Healing Histamine. It used to be called a Low Histamine Chef by Yasmina that gives you all kinds of good recipes and tips about foods with histamine. In case our colleagues, ripe tomatoes, ripe avocado is loaded with histamine. Cheese, of course, especially smoked cheeses, nectarines, peanuts, pretty much all the spices have lots of histamine, so be careful.

Now, going back to the enzymes, a COMT, catecholamine-ortho methyltransferase basically metabolize pretty much all the biogenic amines including histamine. Then there’s some additional enzymes for histamine. It’s so easy now to do a general analysis for those enzymes, because as you know, now we categorize patients in slow metabolizers or fast metabolizers. If any patient is on two or more drugs, especially psychotropic drugs, I will do all the CYP-3 enzymes. Those are the ones that break down pretty much everything as you know.

Now, coming back to the phenolics. None of you should have to remember the structures, but for instance, pycnogenol, which is very plentiful in grapes, has 15 phenolic groups. Quercetin has five. Luteolin has four. Methoxyl luteolin has none, because basically methoxyl luteolin has four methyl groups in place of the four hydroxyl groups that luteolin has. If you’re looking at phenolin intolerance, luteolin will be the least likely to cause a problem as compared to the others.

Have people here checked their own genetics?
this link is about histamine genes https://www.geneticlifehacks.com/histamine-intolerance-genetics-part-2/
likely called it the wrong thing...
I have two - + and one I don't have on my 23 and me... COMT did not get that far...

tried to look at comments which seemed to be trouble lost the plot there.
any thoughts on this supplement

Seeking Health | Histamine Block | DAO Supplement Enzyme | Food Intolerance | Histamine Intolerance | GI Tract


Senior Member
This should be here if only for me...

looking up COMPT

Search for specific genes and markers (SNPs) of interest.* You can view or download your data at anytime in its raw, uninterpreted format (your A's, T's, G's, and C's).

Genes Marker (SNP) Genomic Position Variants Your Genotype
COMT rs737866 19930109 C or T C / T
COMT rs737865 19930121 A or G A / G
COMT rs737864 19930159 C or T C / T
COMT rs9332316 19930274 C or T C / C
COMT rs1544325 19931668 A or G G / G
COMT rs174675 19934051 C or T C / T
COMT rs5993882 19937533 G or T G / T
COMT rs5993883 19937638 G or T G / G
COMT rs7290221 19942680 C or G C / G
COMT rs4646312 19948337 C or T C / T
COMT rs35919169 19948679 A or G G / G
COMT rs5748492 19948751 G or T G / G
COMT rs34686565 19948845 A or G A / A
COMT rs165656 19948863 C or G C / G
COMT rs165722 19949013 C or T C / T
COMT rs6269 19949952 A or G A / G
COMT rs6270 19950150 C or G G / G
COMT rs4633 19950235 C or T C / T
COMT rs6267 19950263 G or T G / G
COMT rs740602 19950268 A or G G / G
COMT rs2239393 19950428 A or G A / G
COMT rs740601 19950763 G or T G / T
COMT rs769223 19951201 A or G G / G
COMT rs4680 19951271 A or G A / G
COMT rs769224 19951804 A or G G / G
COMT rs165631 19951816 C or T C / C
COMT rs4646316 19952132 C or T C / T
COMT rs165774 19952561 A or G G / G
COMT rs174696 19953176 C or T T / T
COMT rs174699 19954458 C or T T / T
COMT rs9306235 19955157 A or G G / G
COMT rs9332377 19955692 C or T C / C
COMT i6033218 19956180 A or C C / C
COMT rs14968 19956433 C or T C / C
COMT rs11544667 19956434 C or T T / T
COMT rs165599 19956781 A or G A / A
COMT rs165728 19957023 C or T T / T