It is extremely important for patients to respect their illness, learn their individual symptoms and identify what triggers each symptom for them.  

When mast cells degranulate, they dump a host of chemicals at once, triggering the patient's symptoms.  These chemicals include histamine, heparin, prostaglandins, neutral proteases, acid hydrolases, chemokines and cytokines, just to name a few.1  So it is vitally important for patients to avoid triggering mast cell degranulation to lessen their suffering and preserve their quality and length of life. 

For each patient, each symptom may each have a unique trigger or a cluster of triggers.  Some patients may have only a few triggers, some may have many, and some may be susceptible to nearly all known triggers.  The best way to identify your symptoms and triggers is to keep a daily record and identify any correlations between trigger and symptom.  

When symptoms occur, it is common for patients to have difficulty thinking clearly, restricting their ability to help themselves.  Mast cells are in every organ of the body, including the brain.  When symptoms occur, many patients experience problems speaking or articulating their needs, understanding what  is happening to them, and what they need to do about it.   

Listed below are the most common triggers of mast cell degranulation.  We recommend keeping this list handy and sharing it with any health care professionals you consult with prior to undergoing any tests or treatments (i.e. family physician, specialists, dentist, optometrist/opthalmologist, nuclear medicine/x-ray technicians, paramedics).

Note:  This is not a complete list.  Also, many of these triggers may be applicable to one patient but not another.  

 

Nonimmunologic Histamine Releasers and Other Degranulation Triggers2
 
Polymers
Bacterial Toxins
Dextran
Calcium ionophore A23187
Compound 48/80
Snake venoms
 
Biologic Polypeptides
Ascaris species
Jellyfish
Moths
Nettles
Portuguese man-of-war
Spines & hairs of Caterpillars
 
Foods
See Diet and Nutrition for further information about food.
Dairy products
Egg Whites
Histamine rich food (i.e. fermented or aged food)
Gluten
Leftover food
Nuts (peanuts, walnuts etc.)
Preservative, additives & colorings
Salicylates rich food (i.e. some plant foods)
Soy
Shellfish
Strawberries
Tomato
 
Chemicals & Drugs
Alcohol
Amphetamines
Aspirin
Benzoic acid
Chlortetracycline bisulfate
Cinnamaldehyde
Cinnamic acid
Colistin sulfate
Dextromethorphan (cough suppressant)
Dipyridamole (Persantine)
Fungal infection drugs
Gallamine triethiodide
Hydralazine hydrochloride
Iodine based radiographic dyes
Latex
Local anesthestics: lidocaine,etc.(any amino amide-type)
Neuromuscular blocking agents (all):eg. Dexamethonium, Gallamine triethiodide
NSAIDs (Non-steroidal anti-inflammatories: Advil,Motrin,etc)
Opiates (Codeine,Morphine,Percocet/Oxy etc)
Papaverine
Polymyxin B sulfate
Quinine sulfate
Scopolamine hydrochloride
Sodium benzoate
Stilbamadine isethionate
Thiamine hydrochloride
Tolazoline hydrochloride
Trimethaphan and Trimetaphan
Tubocurarine chloride
Tyramine
 
Physical Agents
Cholinergic agents
Cold
Dermatographia (darier's sign)
Emotional stress
Exercise
Fever
Heat
Hot baths/showers
Infections
Insect bites (wasp, hornet, bee, mosquito)
Occlusive dressings
Pressure
Solar light waves
Spicy foods
Vibration
Water
 
Inhalants
Chemicals
Man-made materials
Perfume
Scented products
Scents/Odors
Smoke (wood burning, cigarette, marijuana)
 

References:

  1. Sever,A; Sibbald,G; D'Arville,C: Thousand Faces of Mastocytosis: Mistaken Medical Diagnoses, Patient Suffering & Gender Implications University of Toronto Press: 7. 2009. [View PDF]
  2. Burrall,B; Halpern,G.M; Huntley,A: Medical Progress: Chronic Urticaria West J Med March 1990;152:268-276