Here's How You Treat Long Covid | Lessons From MCAS - Dr Tina Peers

if you've been suffering from long covid the chances are you've had pretty much every man and his dog telling you that what you really need to be taking to make yourself better is vitamin d or probiotics or some other god-awful supplement you've never heard of well it's pretty hard to know what to take when you don't know what's causing the problem isn't it and generally speaking most long haulers have been throwing just about every vitamin and supplement at the wall to see what sticks and unfortunately the answer is not much in this film i talked to dr teen appears one of the leading pack of doctors with a special interest in mast cell activation syndrome she's been successfully treating patients with mcas for five years might you have some tips i suspect so if you've been watching my films on the subject you'll know long coved is a bit of a puzzle but we may just have found one of the larger pieces there's a growing amount of evidence that mast cells may be heavily implicated in many of the symptoms long-haulers are experiencing i asked dr pears if in her clinical experience and opinion if the connection of mcas with long coved made sense when you consider our immune response to any infection is through our mast cells predominantly i mean there are lots of other cells involved but it's predominantly through our mast cells and um they are activated by infections uh and then release over a thousand different mediators into the body to help the body respond uh and fight that infection so that's what we do when we have infections and then with mcas or mast activation syndrome we have patients who have dysfunctional mast cells which overreact to all sorts of stimuli including infections so when a patient who's got mcas gets an infection they're always ill from the infection and then ill afterwards from the effects of that infection on their mast cells so it would seem to fit very well with the long covered picture that patients are you know they have covered but then they grumble on and on and have all these symptoms which they're left with afterwards so what kind of symptoms are you seeing with the long covered patients that you've seen which is similar to those that you might see with patients with mcas gosh well their profiles are so similar it's um it's just so compelling that the data is is right you know that it's telling us that these patients have got mcas so predominantly fatigue that's a big one that almost everybody seems to complain about um headaches is another one lots of different ibs symptoms so that can range from bloating to wind and abdominal pain or diarrhea and constipation and fluctuations between the two um and then we've got insomnia and anxiety rashes they can have all sorts of different kinds of rashes on the skin some are itchy some are not but a lot of itchy skin is another complaint palpitations low blood pressure feeling faint and dizzy um shortness of breath a lot of patients it seems to be their chest that's predominantly troubled by it um things like tinnitus rhinitis um yeah so many weight loss poor healing yeah i've seen it all this is huge one of the most common things that we see um with long covid is this um resistance to exercise or rather poor tolerance of exercise is this something that you see in mascara activation syndrome or do you think that might be something else no it's something we definitely see in mast cell activation syndrome and they the patients find that if they accept themselves too much it releases histamine and other mediators into the body from the mast cells and then they they pay for their exercise later um and it can be it can be immediate or it can be later than that so sometimes it's the next day that people are absolutely wiped out because they've had a bit of exercise do people with um with mcas presents as what you know with as differently as people with long coverage do so obviously there's this sort of this smorgasbord of symptoms um but it's almost like okay pick five pick ten you know and said do patients you know with mcas sort of appear in the same way where some might appear with a different set from this sort of list and as well as others yes absolutely it's totally typical that they are sort of completely different from each other so and also the same patient can have different symptoms at different times uh and it's almost like sometimes when they're younger they get certain set of symptoms and then as they get older it morphs into something slightly different but this is very typical of what we see um so yes and i think the long covered patients have found the same thing certainly the long covered patients that i've been seeing their profiles definitely fit with mcas and not only that um i was desperate to sort of talk to some non-coveted patients um because i wanted to know what their health was like before they had the coveted infection and then experience the long coverage and all of them i've spoken to i've had about 15 16 patients so far come through my clinic and they've all got a previous history to suggest that they had mcas before the covet to what degree is mcas now accepted by the sort of the general medical community well um it's getting better but it's not great so so um most of most of the patients i've been seeing over the last five years with mcas and diagnosing coincidentally most of the time so they've come to see me for contraception or for menopause advice and then when i take full history i say well i think you've got something else going on here and go into into that history and then i write to their gps and so often 99.9 percent of the time the gp's never actually heard of it um and that creates a little bit of difficulty for the patient sometimes trying to get the medication and to get it right but gradually over the last five years that is improving as pots is discussed more and early stand loss is discussed more and the rcgp have actually got a um a toolkit now uh for ernest danlos and inside that toolkit it mentions mcas and it has some references to it so that that is brilliant if the gps are aware of that document then they can go and have a look at that so things are improving but it's very very slow what treatments have you seen provide the best results for the patients you've seen who've had mcas right so there's the basic first thing that it's important for patients to do i believe is to get off high histamine foods because one of the um one of the amines that are released by the mast cells is histamine and when histamine goes up it causes a big inflammatory response in the body and unfortunately not only do we make and store histamine in our mast cells in our basophils our platelets and our neurons and also in some cells in our stomach which help release acid and that helps with protein digestion so not only are we making and storing it but we're also eating it in various foods and some foods are very very high in histamine and there are certain drinks that can also block the enzymes that actually break down the histamine to prevent you overdosing on histamine from your food now some quite a few of my patients they get into difficulty with mcas because they are trying to get healthy and they're eating healthy food which of course it is but it's full of histamine and so it's not tripping them up so in particular things like like avocados tomatoes spinach bananas um and then if they drink tea and coffee and green tea and alcohol that actually blocks the one of the enzymes that breaks down the histamine so they can get into real difficulties processed food is no good reheated food leftovers is no good um you know tb dinners are no good so i'm afraid it's that's the first thing we need to address is the diet to try and reduce the amount of histamine that's coming in the body so we're not constantly adding to this already high histamine level which is so toxic um and then the next thing is for them to um to take quite a few vitamins and minerals and um and i've told you about these already so that you you know what i mean it's quite a few but they really are helpful so things like uh reasonably high dose vitamin d are very important we um vitamin c a slow release vitamin c 750 milligrams a day or a thousand milligrams three times a day vitamin c is actually a very good antihistamine so it helps to start to lower that uh in the in the body um to take niacin vitamin b3 and it has to be the niacin type um by the no flush variety otherwise it makes you sort of flush when you take it and that should be taken every day that's very important also zinc 15 to 30 milligrams a day and quercetin which should be taken three times a day now these are all things that patients can buy over the counter selenium is also good um and that could be a couple of brazil nuts a day which are actually have no histamine in them which is great or um or to get a zinc sorry a selenium supplement and that would be 100 micrograms a day so it's really important that patients can do this straight away and they can get themselves on these supplements to help support their system and their methylation pathways and the way they handle uh waste waste in their body and so on so that's very important and then they combine over-the-counter antihistamine and um it's trial and error with all the mcas patients it's trial and error um so it's we have this sort of um we say go low and slow so start with a small dose if you're okay with it and you've taken it once that day and it's okay the next day if the dose is to take it twice then take it twice the next day and so on so you do it gradually we find that a lot of mcas patients are very sensitive to excipients contained in various different preparations so they're fine with the actual drug it's that make of the drug maybe that has certain additives that are upsetting them so um it's worth their while trying different makes if they feel that one mate doesn't suit them and the over-the-counter antihistamines are type one antihistamines and they um they should they on the box it'll say take once a day but actually we need them to be taken two or three times a day um to help with the with this condition and then it's good if they can also get an anti a type 2 antihistamine which has to be prescribed by a gp or a a doctor um and that would be at the moment vermotadine is the one that's available in the uk that would be 40 milligrams a day of that and then also there are some mast cell stabilizers which can help which would need a prescription so they do need to see a doctor about those um there are a few other things that we can try um but they are sort of for you know if those initial that initial approach hasn't worked so well but a lot of it's trial and error have you seen a difference between the mcas people and the long covered people in terms of how they've responded to this um it varies uh is the answer to that i think the long covered patients are taking longer to respond that's my feeling but it's early days yet so i'm not sure um i have had a few of the long covered patients who felt very much better just for changing their diet and taking some vitamins um so we're all going to i think everyone is different in their response to how bad they are some people have got more minor symptoms than others um and obviously the more seriously um sick patients are going to take longer for their systems to settle down the other worry i have is that actually some of them could still have the virus present as you know we saw that paper didn't we um which suggested that 50 of the patients six months after getting over covered still had it in cells in their gut and that's of concern because if that is the case that's going to be keeping their mar cells activated and it could be a longer road to recovery can you tell me a little bit about this app that you've recently been involved in rolling out and how it helps patients yes the the app is called people with and that's written as one word and it's a i was using it in my clinics for my menopause patients and my patients with mcas and histamine intolerance because it is a very very useful tool for patients to be able to track their symptoms so that it it's um they can download that put their symptoms in and then every day they can check in or sort of check in every day or every other day and say what was the headache like and so on and you can also put in your lifestyle and supplements and it will remind you to take your medication and um etc so patients have found it very useful it can they can also download a report and then send it to their doctors to look at to see how things are improving or otherwise and so it's been very very helpful from that point of view um we we start we started using the app specifically for long covered patients as well because we felt we wanted to see what their profiles and whether their profiles did match the mcas patient profile and over 2 000 have downloaded it for which i'm very grateful because it has allowed us to see that absolutely the list of symptoms that they have put into the app absolutely match mcas patients symptoms um and actually on average they have seven symptoms each which is you know terrible but that fits with mcas too we see people with multiple symptoms so it's been very very useful from that point of view um and um and i'm hoping as we go forward that we might be able to sort of see if there's any chance that there are different profiles which can be helped in different ways um and that's another sort of piece of work to be done really because it may be that whilst um everyone does seem to have variable symptoms there is a there could be a pattern that we could pick up and say well actually these patients responded really well to this particular vitamin or this particular combination of treatments and actually that's the kind of profile they had i don't know that may not be the case but it'd be very interesting to see um so finally if you could commission a research project into long covid's tomorrow what would it be right well i've got two actually i hope you guys think that's fine yeah so one would be to see if it still is present in gut cells of the small intestine so i'm afraid that means some biopsies for some people but i think it's a piece of work that we really need to do to try and understand what's going on as best we can and the other one would be to actually look at the genetics of the long covered patients and see whether um they have got any sort of similar traits going on between them just one more thought is there anything you can say because obviously you know the life cycle of a mast cell is sort of six months um is there anything that you can say about the way that when you've seen people with mcas before how when it comes to recovery or managing this is there something tied into that period of time that you see as well yes definitely so marcel's do last about six months so that means every month you're replacing one-sixth of them now if in the mcas and hit patients if we can give them a lower histamine environment a calmer environment that isn't stimulating their mast cells quite so much the new ones that are being made seem to behave better than the old ones who have been really sort of hypersensitized by the high histamine environment and so six months on if we can be good with the diet and we can do the treatments and do the vitamins and minerals and so on six months later often the patients are in a much calmer patch which makes you know their lives and the quality of their life much much better so as we've already probably figured out there is no magic bullet my personal feeling is that long covid is not entirely mcas but for many long haulers it may be a very large part of the puzzle and treating it correctly could lead to a significant improvement in symptoms the fact is as i've previously shown with my research there is a very high incidence of atp and autoimmune conditions amongst long haulers and those conditions are inherently mast cell related so for those of you who do have hay fever asthma eczema arthritis and potentially ibs and gi conditions too some of these measures could really be quite beneficial so just to recap it's kind of a four point process firstly diets avoid high histamine foods and minimize the intake of drinks or food that stop your body breaking the histamine down unfortunately for me that means no more mainlining tea secondly supplements here are the main ones it's possible that even with no pharmacological interventions these supplements could make quite a big difference by themselves thirdly over-the-counter drugs such as antihistamines uh it might be a little bit of trial and error to find uh the right type that work for you uh and it's okay to take a one a day antihistamine two or three times a day and in fact you should fourthly prescription drugs h2 antagonists and mast cell stabilizers or inhibitors you'll need to speak to your gp about those and then finally patience don't expect to be better tomorrow but create the conditions for those new mast cells to be formed in a somewhat karma environment and in the meantime uh i'll keep digging into the research and perhaps hopefully fairly soon we'll have an answer to that persistent virus question too until next time [Music]

Channel: Gez Medinger

Views: 231,646

Keywords: coivd, corona, virus, vaccine, mitkovits, plandemic, pandemic, coronavirus, covid19

Id: sICD0Kn6pR4

Length: 18min 25sec (1105 seconds)

Published: Tue Nov 24 2020