dr afrin protocol

With a chronic illness such as MCAS, it is possible to live a full lifethe treatment just requires a careful, comprehensive approach. Nosebleeds: First aid - Mayo Clinic Benzodiazepenes Addresses the inhibitory mast cell benzodiazepine receptors. Histamine andalcohol metabolic pathwaysshare common enzymesaldehyde oxidase and aldehyde dehydrogenase. This was a fantastic discussion with clinician and researcher in Mast Cell Activation Syndrome (MCAS), Dr. Lawrence Afrin. This is Dr. Ruscio. It is getting more often now too. Such doctors like you are currently still rare in Germany. Patients will have to work closely with their compounding pharmacists to help identify a list of offending ingredients in drug formulations. Also, if you opt for natural treatments for MCAS and mast cell activation disorder, always be sure to disclose everything you are taking to your doctor so he or she has a clear idea of what is going on. As is the Vitamin C and some others all cross over. None. And Id like to mention along that line too that mast cell patients seem to have quite a propensity for reacting to various medication products too. Liebe Gre. Its been a scary time and I am thankful for a fantastic doctor who eventually helped by putting me on an exclusion diet (1 week of potatoes and rice only and building up food items every 2-3 days), H1 and H2 anti-histamines and finally after a few weeks debate Xolair. Inhibits inflammatory moleculesinterleukin-4 and tumour necrosis factor -? So you take that list of 200 mediators and you cone it down quite a bit based on whats available for testing in the clinical laboratory. So youve got Claritin. So the little bit extra that has to be spent to actually make a firm diagnosis, based on the lab testing, in these very complicated patients, its really a drop in the bucket compared to whats already been spent on their behalf over the years and the decades. But in mast cell activation syndrome, marrow biopsies are usually unrevealing. And then, you have much less symptoms present, and that may give you a more definitive window that can get you to that diagnosis. Theres the cardiovascular system with all sorts of autonomic issues, a lot of variability in pulse and blood pressure, palpitations, tachycardia. Thank you for some positive information, my brother has been diagnosed recently and the little Information you find out there is so bleak and scary. Thatll get folks. Also wanted to say thank you to Kettle & Fire. If you want him to consult with your local doctors, then have your doctor contact him. She is patient, understanding and very detail oriented. I feel like theyre probably opposite ends on one spectrum. PDF Presentation Diagnosis and Management of Ast Cell Activation Syndrome I have recently returned from a most stimulating conference/think tank with Dr. Afrin and 30 other leading clinicians on Mast Cell Activation Syndrome (MCAS) at Commonweala cancer retreat centre in northern California. Understanding Mast Cell Activation Disorder with Dr. Afrin Were nowhere close to being able to cure it. Over the counter H1 and H2 blocker. Mast cells actually produce more than 200 mediators, each of which has a huge array of effects throughout the body: direct effects, indirect effects, acute effects, chronic effects, local effects, remote effects. And I would love to have you back on for maybe a part two, because Im sure many of the practitioners following this are going to have their interest piqued. This was a fantastic discussion with clinician and researcher in Mast Cell Activation Syndrome (MCAS), Dr. Lawrence Afrin. You just usually dont see anything helpful. These doses are general recommendations. Everything else, we dump and we move on. PDF OXYMETAZOLINE (Afrin) Protocols: UP 9-Epistaxis Mechanism of Action I want to try your natural remedies. The more you can narrow it down, the more you can pay attention to living the life you desire. But once my patients are diagnosed, then we get started on the H1 blockers at standard over-the-counter doses twice a day and identify which one is best and then move onto the H2 blockers. Please contact the clinic at 403-206-2333 if you would like to book an appointment. But because the disease presents so differently from one patient to the next and even can vary a good bit in its behavior within the same patient from one point in time to the next, its really difficult to say that, oh, its just this one or these two mediators that you can get away with testing. Thank you for your inquiry. There was an error which is now rectified. You mentioned bone marrow biopsies. It is always hard to find information when youre explicitly seeking it, but when you come across something new a solution always feels so much closer! Dr. Patel was personally involved in the care of the patient. And one of the things thats been helpful for me in sorting out how do we choose which potential differential diagnosis to pursue, when many of these potential differentials have so many wide varying symptoms they can present as, so one of the things Ive found helpful to do in that case is to start with foundational therapies and foundational treatments first. Low-dose Naltrexone (LDN) Used in a step-up dosing at night. In a study published in the August 2020 issue of Arthroscopy: The Journal of Arthroscopic & Related Surgery, Dr. Okoroha and colleagues demonstrated that a similar protocol resulted in low levels of pain and minimal use . Disclaimer: (1) The information provided on this website is for educational purposes only and is not intended to diagnose or treat any disease. And by the time youre done doing all that coning down, youre left with roughly eight or nine mediators. No patient should be taking one more milligram of one more medication than is clearly significantly benefiting them. Please read and agree to the disclaimer before watching this video.. Dr. Lawrence Afrin Discusses Mast Cell Activation Syndrome (MCAS)We are honored to have . So thats right: the mast cells produce histamine. And to my way of thinking, kind of unlikely that if you look at all the problems that a patient with so-called histamine intolerance has, it just seems kind of unlikely that all of those problems would be attributable to just an excessive responsiveness to histamine alone. You have to be sure the patient doesnt have any heart failure or renal failure or hasnt use any proton pump inhibitors in the last few days. He is a certified Functional Medicine Practitioner (IFM), is board certified with a fellowship in anti-aging (hormones) and regenerative medicine (A4M), a certified Shoemaker Mold Treatment Protocol Practitioner (CIRS) and ILADS trained in the treatment of Lyme disease and co-infections. Methods We retrospectively analyzed living-donor kidney transplantation patients from two Korean centers . I was scripted Cromyln Sodium (in vials). They make a very clean and a very healthy line of bone broth products that are organic, grass-fed. We usually see tryptase levels elevated at least double the upper limit of normal and quite often much higher than that in mastocytosis. DrMR: All right, Larry. Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption. And I think theres definitely a gut tie-in to this. Mast Cell Activation, Part 2 with Dr. Lawrence Afrin I really dont want to go tooting my own horn here, but I did publish a book last year on MCAS that was intended for the public, the lay community. In my experience, for most mast cell patients, its a pretty small number of medications they need to gain optimal control over their disease. And Id like to, if we can, organize these down into natural treatments. Its the skin. MCAS is something to consider when you haven't responded to anything else: diet, lifestyle, gut treatments, thyroid. So all four of the commonly available non-sedating H1 blockers in the US are all available over-the-counter. Theres the GI tract; all sorts of issues in the GI tract with reflux and nausea, sometimes vomiting and diarrhea or constipation or, even more commonly, sort of an alternating back and forth between diarrhea and constipation, which is just one example of the many opposites you can see with this disease. Its a good marker of inflammation, but if I find an elevated IL-6 level, that doesnt tell me that the excess IL-6 in the patient is coming from the patients mast cells. (3) Amazon and the Amazon logo are trademarks of Amazon.com, Inc, or its affiliates. DrMR: Because Im assuming theres going to be people out there who are not going to have a doctor whos going to be willing to humor them with this, is there an easy way to take maybe the nasal preparation and ingest that orally or to convert that to a dosing form that you think would be effective? (Institute of Medicine Committee on Assessing Improvements in Cancer Care in Georgia) (2005). Z=_N`P38_/r5gg.Q }4@SYUE.Cp)\|"L5?7b0{V*?v5oN4?5 5_Op%~^oh? Are there any of those that you find more effective? Your information contains quite a number of things I have despite excessive research not come across yet. So its certainly a good idea to check a tryptase level. And because the state of the science in this area is so immature, we dont yet have any ways to predict which treatments are most likely to help which patients, I tend to go in order of cost. Do not take anymore than is beneficial, Best practice, start with less expensive drugs first. The first part of the title is Never Bet Against Occam. Your thoughts? Do you think that tincures in alcohol (Herb Pharm) present a problem? So many bloggers online offer their course to help and charge hundreds of dollars. Theres the part of the iceberg you can fairly easily see above the waterline, a waterline of relatively easy clinical recognizability, if you will. So I usually describe this mast cell activation syndrome as a chronic, multi-system illness of general themes of inflammation plus/minus allergic-type phenomena, plus/minus abnormal growth and development in assorted tissues. And then the genitourinary tract is another environmental interface. Incorrect collection of specimens may also lead to false negative testing. You can see the blog post here. DrLA: Youre very kind. Now, Im assuming that when we look to third-world countries that dont have anywhere near the sterile-type hygiene that we have, we probably see quite a lower incidence of this. DrMR: Sure. Please check your spam folder and let us know if you have not yet received it. Theres supplementation with DAO enzymes. Thank you a million times over for this information, I keep in close to me when Im getting discouraged looking for a doctor in CA who understands MCAS. Histamine is a natural part of us. When you drink alcohol, histamine is released from your mast cells and DAO is simultaneously inhibited. in computer science at Clemson University in 1984 and then an M.D. Dr. Jannatun Afrin, MD | Havertown, PA | Internist | US News Doctors %PDF-1.3 Thats searchable out there. -AR\>'z2-Sfx'z:5{9,vP}\myZz"(bx[7jdYHYMJ8M4g#cY3]}l4S Tu3ja\'[#2YYyp~{fwkUihrEsUBl&[M9hHIZJt,/p$?lFElo%CNys+rGEU/FxwDOqNO43=8A=P]B\/v+.=2J}Ab>8GF Now, lets be clear on this. Does your clinic offer any financial aid options for low or no income patients? Pretty tough molecule to accurately measure because of how what we call thermolabile, or heat-sensitive it is. Quite often, you dont even have to have a conversation with them because its so obvious that this drug is a keeper. Would you agree with that, disagree, modify that? You just have to understand these labs may not be actually running all of these tests in house. And the only other mast cell diseases we knew about were the rare disease of mastocytosis that oncologists dealt with and an allergy that any primary doctor and allergist, too, can manage. xr#u} Re$IY#C'sP 84c}XMRXeSUeGl&zbVGd^I1RzVG(oweUbEQF]_`eU\[jM]5q0LwzJ\(GY>A| `ZW3V$p1 cy~./Y1,]@bjZSRr:m:w7i1nyQ)?RzFf Thank you Carola! So I absolutely appreciate your thinking here. My son was diagnosed with MCAS and has suffered most of his young life. Youve really got to take care to keep the specimen for that test continuously chilled, all the way from when its drawn to the point where its finally assayed at some distant reference laboratory. And above the waterline of this iceberg, at the very tip youve got the rare disease of mastocytosis, sort of a cancerous overgrowth of mast cells together with inappropriate mast cell activation. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you! Dont peanuts have high histamine levels and green tea lowers the natural DAO in your body along with cummin and tumeric? Its a good thing when I can help an individual patient with this. And then, there are the H2 blockers. And some patients even get or make compounded cromolyn cream for application on the skin. DrLA: There are various and sundryI think thats the phrase, various and sundryof these tests which are available at different reference laboratories. Introduction to Mast Cell Diseases - Principles of Healing Widely used in cancer and joint inflammation, Reduces the expression of inflammatory markers IL-6 and IL-8, Research has shown that when Vitamin C levels fall in the blood, histamine levels increase exponentially. Theres alsoyou can measure histamine in the urine, but you can also measure histamines principal and mediate metabolite N-methylhistamine in the urine. My style is I like to really nail down the diagnosis before getting started on treatment. The protocol comprises preoperative analgesics, intraoperative local infiltration analgesia and a postoperative pain regimen. Thats really the suite of what I measure when doing the initial diagnostic work in these patients. That looks like a pretty good treatment protocol to start with. Glutamine, Immunolin, vitamin C (timed release), natural antihistamine blends, quercetin. We are only able to answer medical questions if you are a patient and we have a medical history and are working with Dr. Hoffman as a patient. Listen to new research which states what can optimize your Every product is science-based, validated by real-world use, and personally vetted by Dr. Ruscio, DC. Biiig very big thanks). Dr. Bruce Hoffman, MSc, MBChB, FAARM, IFMCP is a Calgary-based Integrative and Functional medicine practitioner. And you know, Michael, that when the immune system isnt working right, theres a wide range of possible consequences, including increased susceptibility to infection and increased difficulty with healing or recovering from infections and wounds and increased risk for malignancies and even increased risk for autoimmunity of potentially any sort. You mentioned in the musculoskeletal system a lot of pain, diffusely migratory pain. But again, its probably better to try to go with the non-sedating H1 blockers if you can. So instead, we need to go looking in the blood and the urine for elevated levels of various mediators that are relatively specific to the mast cell. Be sure to eat a low histaminic diet if MCAS is a problem. Conventional Treatments 00:39:28Non-Sedating H1 Blockers 00:44:25Sedating H1 Blockers & H2 Blockers 00:45:46MCAS Treatment Response Rates 00:48:27Proper Medication Dosages 00:52:58Cromolyn & Other Medications 00:56:02Finding a Qualified Physician 00:58:17Episode Wrap-up 01:01:45, Download this Episode (right click link and Save As). Dr. and Ms. Sackler died in 2017 and 2019, respectively. There are natural agents like vitamin C and B6. Non-steroidal anti-inflammatory (NSAIDS) Helpful in some, a trigger in others. We recently discussed Mast Cell Activation Syndrome with Dr. Lawrence Afrin. And I hadnt figured out a shorter way to describe it yet. And although not all of them are going to be open access, a good number of them are. But lets keep in mind that histamine is just one of a huge range of very potent signaling molecules in the body. Hopefully she will investigate further to help me and establish a practice that recognizes this diagnosis in our area. Dr. Lawence Afrin and Dr. Theoharides are excellent with MCAS. DrLA: Well, I think probably the most important point about what youre trying to get at here is that there really is no system in the body which is immune, so to speak, to potentially being affected by this disease, not even the immune system. And so, to the point of time, Im curious about time and dose. Hey, everyone, in case youre someone who is in need of help or would like to learn more, I just wanted to take a moment to let you know what resources are available. My daughter has salicylate sensitivity so low histamine foods are often triggers for low sals. So I ask my patients to try to stay alert to what their triggers are anytime they suffer a flare of symptoms. For example, the Mastocytosis Society has some information about this. And the numbers, the permutations, very quickly just get mind boggling. (Mass market hardback/softback/e-book, explaining mast cell disease to the lay community. You can just start imagining just how many permutations there might be of mast cell activation syndrome with just different patterns of inappropriate mast cell mediator expression together with inappropriate patterns of inappropriate mast cell reactivity. Famotidine is chosen most often because it has fewer drug interactions than Tagamet. The recommendations above mainly help to stabilise the immune system and reduce inflammation, though there are a few other effective methods: Many patients will need to experiment with various therapeutic options at different doses until they find the right combination of medications that helps with their particular symptoms. My dna test tells me I have a dao deficiency as well. He has one of the cleanest line of protein powders and pre- and post-workout powders that I think really is around. Youve got to think of what diseases might fit the symptoms. Start steroid nasal spray AND anthistamine nasal spray use. Theyre getting excessively activated when histamine docks with those cells. View Dr. Ruscios, DC additional resources. As I said, the mast cell puts out more than 200 mediators. Dr. Lawrence B. Afrin is a Oncologist in Armonk, NY. Prior to your appointment you will be asked to fill out some forms and send all of your blood work and reports. DrLA: Actually, the dosing is pretty close to normal. I am having a hard time adding food to my grocery list and I hard these things were not good to add in. Most of what Ive seen has been relative to really histamine and histamine intolerance. Has anyone come up with a list of Mast Cell Activation Disease Specialists in Functional Medicine for the United States yet in a Directory Form? DrMR: I completely appreciate that. Thats a terrific insight. https://www.ncbi.nlm.nih.gov/pubmed/21390145 Take 2 three times per day for maximum effect, Be careful of citrus-based Vitamin C and be aware that high does can cause diarrhoea. Mast cells are located throughout your body in many different tissues, primarily including dermatological, gastrointestinal, neurological and respiratory tissues. P.S. So it just doesnt make sense to not take the time to figure out which H1 blocker and which H2 blocker is going to serve the individual patient the best. DrLA: Its a lot more complicated than that. Conflict of interest Drs. Larry, please. DrLA: Yeah. And theres nebulized cromolyn, and that, like the oral cromolyn, is prescription-only. Our Disclaimer and Privacy Policy. FODMAPs alter symptoms and the metabolome of patients with IBS, Effects of glutamine on markers of intestinal inflammatory response and mucosal permeability in abdominal surgery patients, How to Identify and Treat a Sluggish Thyroid, Promising Research Shows Thyroid Medication May Not Be Needed, Cold Exposure is Backed by ScienceHow it Benefits Health, An Effective, Gut-Friendly Meal Replacement Shake, The Two Most Effective Supplements For Your Gut Microbiome, Umbrella term for the full realm of Mast cell diseases, Allergies, Urticaria, Angioedema, Anaphylaxis, Inappropriate activation of the Mast cells, More nebulous conditions that dont fit squarely within a named condition, Possible to see any and all systems in the body affected, General themes include inflammation and allergic reactions, Neurological: fatigue, motor and sensory, irritability, brain fog, Central nervous system: depression, anxiety, Dermatological: rash, flushing, hives, runny nose, issue with hair, teeth, nails, Cardiovascular: autonomic, tachycardia, variable heart rate, blood pressure, palpitations, Musculoskeletal: pain, osteopenia, osteoporosis, GI Tract: reflux, nausea, diarrhea, constipation, Urinary tract: irritation, pain, inflammatory problems, Immune system: increased susceptibility to infection, risk for malignancies, autoimmune disease, Histamine intolerance is part and parcel of what is going on in a Mast cell activation, Histamine intolerance might be a low level of MCAS. So what they will do with the specimen is sort of ricochet the specimen out to the boutique reference laboratory that actually runs that test. Rx histamine blockers and mast cell stabilizers. Are you giving them prescriptions? If the patient comes back after a month and the best that they can say about a given drug is, Well, I kind of sort of. But as long as the physician is willing to learn about this, and there is literature out there for physicians to read and they can learn about this, but as long as the physician is willing to learn and willing to at least try to help the patient. That phenomenon, it strikes me as just part and parcel of the totality of what is going on in a mast cell activation syndrome setting. DrLA: Grossly excessive medication list. *Inquiries relevant to the practice only. You need to back off to the lower dose or frequency. That doesnt mean that the impacts of oral cromolyn are necessarily limited to just GI tract symptoms. Doses listed are taken directly from "Presentation, diagnosis and management of mast cell activation syndrome" by Lawrence B. Afrin. Am desperate to find an MCAS aware FM doctor but have been bounced through the system with no success so far. And the more I began treating it, the more folks began getting better, previously sort of unimprovable patients. 95%. A low histamine diet, as you alluded to earlier, certainly can be helpful. Im glad that that resource is there for people. Thank you for your comment! So, neurologically, you already hit on a lot of things like fatigue and cognitive dysfunction that a lot of patients describe as brain fog. There can be a lot of other motor and sensory neurologic issues. The download was just a link to this site & contact info. DrMR: Sure. But at the same time, again, cromolyn is not absorbed to any significant extent. Hello! For those who would like to become a patient, you can find all that information atdrruscio.com/gethelp. Because otherwise, if you keep a drug in the regimen just because it kind of sort of maybe makes a patient feel a little bit better, and you will so rapidly that to the point of utterly unmanageable, unsustainable polypharmacy. But actually, even before I get into the testing, I just want to loop back to a brief comment you mentioned in that question about the treatments. OXYMETAZOLINE (Afrin) Protocols: UP 9-Epistaxis Type of drug: Nasal Decongestant Mechanism of Action: Constricts blood vessels in the nostrils and dilates the air passages Indications: Nasal Intubation and Epistaxis Contraindications: Relative contraindication is significant hypertension Precautions: Route and Dosage: Adults - 2 Sprays inaffected nostril. Cromolyn is a fantastic remedy for many with MCAS and food reactions. You might just find yourself taking the plunge after hearing this news: cold exposure therapy isnt just a fad. If you have another nosebleed, try first-aid steps again. MCAS: Treatment - Mast Attack Thank you for mentioning that. If a patient has a strange reaction to medications (e.g. https://www.ncbi.nlm.nih.gov/pubmed/24477254 Its very unlikely youre going to find local physicians who are familiar with this. I really cannot thank you enough. Amazon.com: Customer reviews: Never Bet Against Occam: Mast Cell

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