15 Natural Anti-Histamines & Mast Cell Stabilizers

In functional medicine, we always want to be looking upstream and trying to gather as many clues and evidence through testing and intake to determine what is at the root cause of the chronic symptoms in question.

We then work to treat and resolve the underlying problem(s) and this helps to reduce symptoms and restore health long term. But what happens when someone is reacting to or not tolerating the treatment needed to resolve their root cause problems?

This is the biggest challenge I see for those who have MCAS and histamine intolerance.  Their immune systems are so hyper-reactive and overly sensitive that they will often have trouble tolerating the treatment needed to resolve the root cause issues like parasites, lyme, SIBO, retroviruses, or mold. 

I experienced this personally when I was being treated for Lyme disease and mold illness aggressively for 2 years before knowing that MCAS was playing a role in my symptoms. My MCAS manifested as extreme body pain, even after 2 years of Lyme disease treatment my pain wasn't getting any better, in fact, it was getting worse!!  I also found myself becoming very sensitive and reactive to foods, smells, chemicals, EMF's, and even most of the medications and supplements that were treating my illness.  I could not tolerate treatment and was just getting sicker and feeling worse. 

​Figuring out I had MCAS and adding in both pharmaceutical and natural anti-histamines and mast cell stabilizers was a game changer for me. My pain levels dropped slowly, my energy improved, my rashes disappeared and my food reactions lessened. Overtime I finally started to be able to tolerate the treatment I needed to resolve my root causes. 

After my personal experience and professionally working with lots of mast cell clients, I now understand that its imperative to get the immune system to calm down and be less reactive before you will be able to tolerate treatment for and resolve what's at the root cause of your MCAS.

My practice is now 90% MCAS patients and every client is unique in what combination of anti-histamines and mast cell stabilizers work to calm down the immune response and be less reactive.

I use special lab testing to help give me clues about each clients bio-individual triggers, metabolism, and root cause issues. This helps me make educated recommendations in the area of natural anti-histamines and mast cell stabilizers that will work for each personal individually. 

There are some nuances to choosing the right combination of supplements and it often takes some trail and error. This is why I highly recommend working with a practitioner who knows and understands this well to help guide your choices.

You will want to choose clean formulations with minimal or no fillers.  I suggest single active ingredient items so that you know what is helping or hurting you.

If you are someone who has food reactions, you will want to time these items to be taken 15-30 minutes prior to meals. This timing can help to reduce post meal time mast cell reactions. 

Lastly, never try more than one of these at the same time.  Always try anything that is new to you alone with no other changes or adjustments in food or medications, titrate up to the recommended dose (or your tolerated dose) slowly and then add the next item. I typically recommend a 3 day trial before increasing the dose or adding the next supplement. 

Here are the natural options that I use most in my practice...

15 Natural Anti-Histamines & Mast Cell Stabilizers:

1. Quercetin - a bioflavonoid that is likely the most used and well known anti-histamine and natural mast cell stabilizer. It is sourced from either citrus or onion & garlic family.  Tip: People who have salicylate intolerance will sometimes not tolerate quercetin well. 
   Recommended Brands: Pure Encapsulations Quercetin
   Recommended Dose: Start with 250mg once/day and work up to 500mg 3 times/day
   
   
2. Luteolin - a bioflavonoid that is usually extracted from artichokes that is a potent mast cell stabilizer and natural anti-histamine. I find it works well to reduce neurological symptoms like anxiety, insomnia, irritability, fatigue and brain fog. 
   Recommended Brands: Young Nutraceuticals Mirica, Mirica Advanced, & Luteolin Complex*
   Recommended Dose: Start with 25mg once daily and work up to 25-50mg 3 times/day
   
   *To order Mirica, Mirica Advanced, or Luteolin Complex, click here.
   
   
3. Perilla Extract - comes from perilla seed and the extract contains two potent ingredients: luteolin and rosmarinic acid that have the ability to modulate Th2 cytokines to reduce hyper-sensitivity. You already know that luteolin is an effective mast cell stabilizer but did you know rosmarinic acid is a potent anti-viral?  In fact, rosemarinic acid has been shown to be effective against COVID-19. Perilla seed extract works on mucus membranes, so it can help with lung inflammation and asthma as well other mucosal membranes like the sinuses and gut. It has also been shown to help people sweat and can help reduce muscle spasms. 
   Recommended Brand: Pure Encapsulations Perilla Extract
   Recommended Dose: Start with  150mg once daily and work up to 300mg 3 times/day
   
   
4. Pycnogenol - is pine bark extract, another bioflavonoid that can be effective as a mast cell stabilizer and anti-histamine. This is often a good choice when quercetin and/or luteolin are not tolerated well which is fairly common as this uses a different liver pathway compared to quercetin and luteolin so those who are phenol sensitive may tolerate this better. 
   Recommended Brand: Pure Encapsulations Pycnogenol
   Recommended Dose: Start with 50mg once daily and work up to 100mg 3 times/day
   
   
5. Fisetin - another potent bioflavanoid that is a mast cell stabilizer but also has anti-coagulant properties. This means it can help to improve blood flow which helps to oxygenate your cells, improves nutrient absorption, and makes detoxification more effective. It has been shown to help reduce neurological inflammation and is neuro-protective.
   Recommended Brand: Life Extension Bio-Fisetin
   Recommended Dose: Start with 1 capsule/day and work up to 1 capsule, 3 times/day
   
   
6. Stinging Nettles Leaf- has been shown to inhibit leukotriene release from mast cells. Leukotrienes are a mediator that often gets triggered from salicylate and phenol sensitivity. It can also help to reduce lung inflammation and asthma as well as skin rashes and itching. I've also clinically observed that it tends to help with irritability and anxiety as well!
   Recommended Brand: Gaia Nettle Leaf
   Recommended Dose: Start with 250mg once daily and work up to 500mg 3 times/day
   
   
7. Vitamin C - can be effective as an anti-histamine, however I find that ascorbic acid products are not often well tolerated by MC patients so I typically recommend that clients try a Vitamin C sourced from tapioca.
   Recommended Brand: Ecological Formulations Vitamin C-1,000
   Recommended Dose: 1,000mg up to 3 times daily
   
   
8. Evening Primrose Oil - has been shown to lower prostaglandins which are another mediator that gets released from mast cells. I find it helps with sleep, anxiety, and sometimes pain. 
   Recommended Brand: Body Bio Evening Primrose Oil
   Recommended Dose: 1,500mg once daily at bedtime
   
   
9. DAO Enzyme or Xylanase Enzyme - while these enzymes are not mast cell stabilizers or anti-histamines, they do help to break down histamine and phenol based compounds in the gut and can be effective in reducing reactions to foods especially.
   
   DAO is used for those who have histamine intolerance and a mutation on their DAO or HNMT enzymes. I like Diem Histamine Digest**, formerly called Umbrellex brand DAO. I find this formulation to be the cleanest of all the DAO products out there.
   Recommended Dose: 1 capsule prior to each meal. 
   
   **To order Diem Histamine Digest, click here. 
   
   Xylanase is an enzyme used to help break down phenol based compounds like salicylates that many mast cell people are reactive to.
   Recommended Brand: Houston Enzymes No-Fenol (available on Amazon)
   Recommended Dose: 1 capsule prior to each meal
   
   
10. Milk Thistle - is a natural mast cell stabilizer, also helps to support liver and gallbladder detox.  This is not recommended for those that have a ragweed allergy. 
    Recommended Brand: Gaia Brand
    Recommended Dose: 400mg twice daily
    
    
11. Butterbur - this is a natural anti-histamine that works similarly to H1 blockers Zyrtec or Allergra. This can be especially helpful for brain related symptoms like brain fog, anxiety, and migraines. 
    Recommended Brand: Integrative Therapeutics Petadolex
    Recommended Dose: 50mg 2-3 times daily
    
    
12. Feverfew - this is a natural mast cell stabilizer that supports healthy mucous membranes and can improve cranial blood vessel integrity. It can be very effective for headaches and migraines related to mast cell and histamine issues.
    Recommended Brand: Vital Nutrients Feverfew
    Recommended Dose: 1-2 capsules up to twice daily
    
    
13. Baical Skullcap (Chinese Skullcap)- This herb can be very helpful in lowering neurological inflammation and can help with insomnia, anxiety, and depression. It is a natural mast cell stabilizer and helps to de-activate retroviruses which I find to be a big root cause of MCAS. 
    Recommended Brand: BioPure Chinese Skullcap, Liftmode Biaclin, & Secrets of the Tribe Huang-Qin Alcohol Free Tincture (you can find these all on Amazon)
    Recommended Dose: Work up to 1 dropper full twice daily or 1 scoop 2-3 times daily
    
    
14. L. theanine or GABA - l. theanine is an amino acid that is a precursor to GABA, a calming neurotransmitter. While these are not directly natural anti-histamines, they do help to calm and balance the nervous system which in turn helps to lower MCA.  These are excellent tools to reduce anxiety, irritability, depression, insomnia, and nervous system overstimulation. 
    Recommended Brand: Pure Encapsulations GABA or L-theanine
    Recommended Dose: GABA - 700mg up to 3 times/day; l-theanine - 250-500 up to 3 times/day
    
    
15. Licorice Root or DGL - either of these forms of licorice root can provide natural anti-histamine support, they work on H2 receptors and can be helpful for symptoms like: flushing, GERD/reflux/heartburn, and throat inflammation.
    Recommended Brand: Designs for Health DGL Synergy Chewable Tablets, Vital Nutrients DGL Powder, or Pure Encapsulations DGL Plus
    Recommended Dose: Up to 1 chewable just after each meal + at bedtime or 1 scoop powder 3 times daily
    
    

You can order these supplements at 20% off retail pricing by accessing my online supplement dispensary and setting up an account - just click the button below.  

CLick here to Access my online supplement dispensary

These go-to,  natural mast cell stabilizers can be used in combination with pharmaceuticals like ketotifen, cromolyn, singular, and over the counter anti-histamines like Benadryl if needed. I highly recommend working with an experienced practitioner who can help you choose the products that meet your needs best.

Always keep in mind these anti-histamines and mast cell stabilizers are not going to fix the underlying, or root problem(s) that are causing the MCA symptoms. They will simply help to lower reactions and calm the immune response down so that you can start to treat the underlying reasons your mast cells are over-stimulated in the first place. 

If you want to learn more about my approach for reducing MC reactions and improving root cause treatment tolerance and effectiveness, check out my free online webinar. ​

References:

1. SharmaSC, Sharma S, Gulati OP, “Pycnogenolinhibits the release of histamine from mast-cells,”PhytotherRes. 2003 Jan;17(1):66-99
2. Kimata M, ShichijoM, Miura T, Serizawa I, Inagaki N, Nagai H. Effects of luteolin, quercetin and baicalein on immunoglobulin E-mediated mediator release from human cultured mastcells.ClinExpAllergy. 2000b;30:501–508. [PubMed]
3. Park HH, Lee S, Son HY, Park SB, Kim MS, Choi EJ, et al. Flavonoids inhibit histamine release and expression of proinflammatory cytokines in mast-cells. Arch Pharm Res. 2008;31:1303–1311.[PubMed]
4. Kim B-R, SeoH-S, Ku J-M, et al. Silibinininhibits the production of pro-inflammatory cytokines through inhibition of NF-κB signaling pathway in HMC-1 human mast-cells. Inflammation. Research. 2013;62(11):941-950. doi:10.1007/s00011-013-0640-1.
5. ChapowalA. PetasitesStudy Group. Randomisedcontrolled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ 2002;324:144-6.
6. Hayes, N. A. and Foreman, J. C. The activity of compounds extracted from feverfew on histamine release from rat mast-cells. J Pharm Pharmacol1987;39(6):466-470
7. Hsieh et al. Baicalein inhibits IL-1ß- and TNF-a-induced inflammatory cytokine production from human mast-cells via regulation of the NF-?B pathway. ClinMolAllergy. 5: 5. 2007.
8. TheoharidesTC, Patra P, Boucher W, et al. Chondroitin sulphateinhibits connective tissue mast-cells. British Journal of Pharmacology. 2000;131(6):1039-1049. doi:10.1038/ sj.bjp.0703672.
9. Ro JY, Lee BC, Kim JY, et al. Inhibitory mechanism of aloe single component (alprogen) on mediator release in guinea pig lung mast-cells activated with specific antigenantibodyreactions. J PharmacolExpTher. 2000;292:114–121. 73.
   
10. Kim B-R, SeoH-S, Ku J-M, et al. Silibin ininhibits the production of pro-inflammatory cytokines through inhibition of NF-κB signaling pathway in HMC-1 human mast-cells. Inflammation. Research. 2013;62(11):941-950. doi:10.1007/s00011-013-0640-1.
11. Kim NH,JeongHJ, Kim HM. Theanine is a candidate amino acid for pharmacological stabilization of mast-cells. Amino Acids. 2011;42:1609–1618.
12. Theoharides,TheoharisC., and Leonard Bielory. “Mast-cells and mast-cell mediators as targets of dietary supplements.” Annals of Allergy, Asthma & Immunology 93.2 (2004): S24-S34.