The Histamine Code for Professionals

Participants will learn to:

• Differentiate MCAS from mastocytosis, histamine intolerance, and common allergic conditions
• Identify the wide-reaching symptom patterns tied to mast cell dysregulation across bodily systems
• Understand histamine metabolism, receptor pathways (H1–H4), and enzyme activity (DAO & HNMT)
• Interpret key diagnostic tests: serum tryptase, urinary methyl-histamine, prostaglandins, and beyond
• Apply international consensus criteria and diagnostic algorithms for MCAS
• Design layered treatment protocols using diet, pharmaceuticals, nutraceuticals, and lifestyle strategies
• Integrate insights from genetics, microbiome science, and hormone health into clinical care
• Manage challenging, refractory, or sensitive patients through advanced case mapping

Educate and advocate for patients navigating a misunderstood and under-recognized syndrome

MCAS is under-diagnosed, misunderstood, and often debilitating. Many of your most complex patients — with diagnoses like IBS, anxiety, chronic fatigue, dermatographism, interstitial cystitis, and migraine — may actually be living with an unrecognized mast cell disorder.

This course helps you see the full picture, empower your patients, and provide validation through clarity

Course Outline

1 Introduction to Histamine & MCAS

• The explosion of histamine awareness post-COVID

• Why mast cells matter now more than ever

• Our clinical evolution: from anecdote to algorithm

2 The Mast Cell Spectrum

• Definitions: MCAS, mastocytosis, HαT, and related syndromes

• Primary, secondary, and idiopathic MCAS — and why it matters

• Real-world cases that don’t follow textbook rules

3 Histamine Pathways & Physiology

• Histamine's roles: immune, neurological, GI, reproductive, cardiovascular

• H1–H4 receptor distribution and activity

• DAO vs. HNMT: where and how histamine is broken down

• Mast cells: responders vs. overreactors

4 Clinical Symptom Mapping

• Why patients present with "everything and nothing"

• Explosive vs. leaky mast cell degranulation

• Why symptoms shift day-to-day (and what to do about it)

• Urticaria, angioedema, migraines, GERD, anxiety, flushing, hypotension — and more

5 Diagnostic Frameworks & Consensus Criteria

• WHO and international diagnostic criteria: strengths and pitfalls

• The “20% + 2” tryptase rule and when to use it

• New MCAS algorithm walkthrough

• Secondary and idiopathic presentations in non-anaphylactic patients

6 Testing – What Works, What Doesn’t

• Serum tryptase: gold standard…with caveats

• Urinary methyl-histamine, PGD2, heparin, chromogranin A

• DAO blood testing: why it fails clinically

• Prick testing, histamine-50 test, and food challenge controversies

• Interpreting false negatives, low IgE, and the role of adsorption

7 The Anti-Histamine Diet & Food Triggers

• SIGI list: strengths, limitations, and clinical utility

• Histamine-rich vs. histamine-liberating vs. DAO-blocking foods

• Why one strawberry can ruin a day (or not)

• Microbiome influences: histamine-producing bacteria

• Longitudinal improvement with dietary intervention — case-supported

8 Clinical Management & Treatment Protocols

• H1/H2 blockers: strategic timing and duration

• Mast cell stabilizers: quercetin, luteolin, cromolyn, ketotifen

• NSAIDs, leukotriene inhibitors, steroids, antihistamines

• DAO supplementation: when (and when not) to use it

• Gradual reintroduction strategies and tolerance-building

• Non-pharma approaches: environmental, nervous system, and trauma-based care

9 Genetics & Epigenetics in MCAS

• KIT mutations, HαT, DAO polymorphisms, and receptor SNPs

• Why genetic predisposition ≠ symptom guarantee

• Using genetic data to guide individualized treatment

10 Case Studies, Clinical Reasoning & Practice Integration

• Structured walkthroughs of diverse patient scenarios

• Tryptase-negative MCAS: how to confidently diagnose without labs

• How to build standing orders, navigate life labs, and communicate with specialists

• Collaborative care, EpiPen decisions, and writing advocacy letters