#REDIRECT [[MEpedia talk:Pacing]]

2018-08-08T20:28:39Z

Juliajt:

Glucose is a carbon polymer that requires an input of energy as well as several steps to produce usable energy.

Glycolysis

2018-08-08T20:26:20Z

Juliajt:test

[[Glycolysis]] is the first step in a process known as [[cellular respiration]]. Glycolysis is the process of breaking down (-lysis) glucose (glyco-), a sugar molecule that provides energy in the human body. Glucose is a polymer (made up of a chain of carbons) and therefore it takes multiple steps to break it down into usable energy. There are a total of ten steps in glycolysis. After the final step, the broken down glucose molecule will enter the next step of cellular respiration.
[[File:Example.jpg]] <a href="https://commons.wikimedia.org/wiki/File:D-glucose-chain-2D-Fischer.png#/media/File:D-glucose-chain-2D-Fischer.png"><img src="https://upload.wikimedia.org/wikipedia/commons/2/27/D-glucose-chain-2D-Fischer.png" alt="D-glucose-chain-2D-Fischer.png"></a> By <a href="//commons.wikimedia.org/wiki/User:Benjah-bmm27" title="User:Benjah-bmm27">Ben</a>; <a href="//commons.wikimedia.org/wiki/User:Yikrazuul" title="User:Yikrazuul">Yikrazuul</a> - Own work, Public Domain, <a href="https://commons.wikimedia.org/w/index.php?curid=1019158">Link</a>

==Learn More==
*https://www.khanacademy.org/science/biology/cellular-respiration-and-fermentation/glycolysis/v/glycolysis

==See Also==

==References==

2018-06-13T00:07:47Z

Juliajt:/* Comorbidities */

'''Mast cell activation disorder''' (MCAD) is a spectrum of disorders that involve an immune response from a non-pathogenic source. All MCAD are characterized by similar symptoms that result from overactive mast cells.<ref>{{Cite journal|last=Frieri|first=Marianne|date=2015|title=Mast Cell Activation Syndrome|url=https://link.springer.com/article/10.1007%2Fs12016-015-8487-6|journal=Allergy and Immunology|volume=|pages=|via=}}</ref>. Symptoms of MCAD are generally similar although each disorder can be characterized individually.
Primary MCAD is a condition in which too many mast cells are being created by the bone marrow<ref name=":0">{{Cite journal|last=Akim|first=Cem|date=August 2017|title=Mast Cell Activation Syndromes|url=|journal=The Journal of Allergy and Clinical Immunology|volume=|pages=|via=}}</ref>; Secondary MCAD would be that the body's [[mast cell]]s are being created normally, but are over-responsive to dietary or environmental triggers. Both of these situations might lead an individual to have excess [[histamine]] in circulation. Excess histamine can cause severe inflammation and a wide variety of symptoms. Almost any organ system in the body can be affected by MCAD<ref name=":0" />. Because a variety of symptoms can be present MCAD is commonly misdiagnosed. The symptoms of MCAD can also be very similar to that of [[myalgic encephalomyelitis]] (ME) and therefore is often confused.

==Signs and Symptoms==

A confounding element in diagnosing MCAD is that signs and symptoms occur in almost all areas of the body. The symptoms might disappear and then suddenly reappear.

Most patients experience fatigue, fevers, and sensitivity to individualized environmental "triggers." Other commonly identified signs and symptoms are as follows<ref>{{Cite journal|last=Molderings|first=G|date=2011|title=Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069946/|journal=J Hematol Oncol|volume=|pages=|via=}}</ref>:

-hot flashes, irregular heartbeat, high or low blood pressure (hypotension and/or hypertension)

-vertigo, dizziness, forgetfulness, depression or anxiety, headaches, insomnia, restlessness

-hives or other visible skin rashes

-arthritis, muscle pain, bone pain, osteoporosis/osteopenia

-anaphylaxis (a severe allergic reaction)

-Malabsorption and gastrointestinal distress leading to low iron and low Vitamin D and low B12

==Diagnosis==
MCAD can be difficult to diagnose as the cause of the syndrome is still considered to be idiopathic (unknown). In 2010, a criteria for diagnosing MCAS was proposed by Dr. Cem Akin and collegues<ref>{{Cite journal|last=Akin|first=Cem|date=2010|title=Mast Cell Activation Syndrome: Proposed Diagnostic Criteria|url=|journal=J Allergy and Clinical Immuno|volume=|pages=|via=}}</ref>. This criteria suggests that two or more organ systems must be affected; this can include gastrointestinal, cardiovascular, skin, or respiratory. If given histamine or mast cell therapy, the patients symptoms must improve. Thirdly, the patient should be tested for serum tryptase (an enzyme secreted by mast cells) levels during a peak of a symptomatic episode. Urine and blood tests should be collected more than once to confirm a positive diagnosis. Prostaglandin and histamine levels can be also be tested.

==Comorbidities==

MCAD is often diagnosed in patients that have been previously diagnosed with [[Ehlers-Danlos syndrome]] (EDS) or [[postural orthostatic tachycardia syndrome]] (POTS), a form of [[orthostatic intolerance]]<ref>Milner, Joshua, Dr. "Research Update: POTS, EDS, MCAS Genetics." 2015 Dysautonomia International Conference & CME. Washington DC. Dysautonomia International Research Update: POTS, EDS, MCAS Genetics. Web. <https://vimeo.com/142039306>.</ref>. Both of these conditions are also commonly co-morbid with [[ME/CFS|ME]]. The overlap between EDS, POTS, and MCAD is thought to be due to increased tryptase production.

An extra copy of the gene TPSAB1 has been noted as a possible cause for increased tryptase production''.''<ref>{{Cite news|url=http://mentalfloss.com/article/87506/one-gene-mutation-links-three-mysterious-debilitating-diseases|title=One Gene Mutation Links Three Mysterious, Debilitating Diseases|last=Horowitz|first=Kate|date=October 17, 2016|work=Mental Floss|archive-url=|archive-date=|dead-url=|access-date=April 22, 2018}}</ref><ref>{{Cite journal|url=http://www.jacionline.org/article/S0091-6749(14)02927-3/abstract|title=A New Disease Cluster: Mast Cell Activation Syndrome, Postural Orthostatic Tachycardia Syndrome, and Ehlers-Danlos Syndrome|last=Cheung|first=Ingrid|date=February 2015|journal=The Journal of Allergy and Clinical Immunology|volume=|pages=|via=}}</ref> It has also been implicated in many other immunological diseases including autism, [[fibromyalgia]], and chronic Lyme disease.

==Treatment==

=== Common treatments ===
Over the counter [[Antihistamine|antihistamines]] such as [[Allegra]] and [[Zyrtec]] and [[Claritin]] are a common treatment for MCAD.{{Citation needed}} Some patients also use herbal antihistamines and supplements such as [[quercetin]] and [[diamine oxidase]] (DAO), an enzyme normally produced by the body that breaks down histamine.{{Citation needed}} [[Vitamin C]], which reduces blood histamine levels<ref name="clemetson1980">{{Citation| issn = 0022-3166| volume = 110| issue = 4| pages = 662–668| last = Clemetson| first = C. A.| title = Histamine and ascorbic acid in human blood| journal = The Journal of Nutrition| date = April 1980| pmid = 7365537}}</ref><ref name="johnston1992">{{Citation| issn = 0731-5724| volume = 11| issue = 2| pages = 172–176| last1 = Johnston| first1 = C. S.| last2 = Martin| first2 = L. J.| last3 = Cai| first3 = X.| title = Antihistamine effect of supplemental ascorbic acid and neutrophil chemotaxis| journal = Journal of the American College of Nutrition| date = April 1992| pmid = 1578094}}</ref><ref>{{Cite journal|last=Yazdani|first=Shaik|date=2016|title=Relationship Between Vitamin C, Mast Cells, and Inflammation|url=https://www.omicsonline.org/open-access/relationship-between-vitamin-c-mast-cells-and-inflammation-2155-9600-1000456.php?aid=66895|journal=J Nutr Food Sci.|volume=|pages=|via=}}</ref>, may also be helpful along with [[magnesium]], a cofactor for producing DAO.

Dr. Afrin highly recommends [[sodium cromolyn]] in compounded oral form, as well as the use of the anthistamine and mast cell stabilizer [[ketotifen]].{{Citation needed}} Both of those medications are available over the counter only as eye drops and must be specially requested from pharmacies. Other [[antihistamines]] include [[hydroxyzine]] and [[levocetirizine]]. Many patients have also found the moderate use of [[benzodiazepines]] like [[lorazepam]] to be effective.{{Citation needed}}

=== Experimental treatments ===
There is some limited evidence that [[sauna]] may be useful in antihistamine resistant [[urticaria]], an allergic skin condition that involves mast cell activation and the production of excess histamine.<ref>{{Cite journal|last=Magen|first=Eli|date=2014|title=Beneficial Effect of Sauna Therapy on Severe Antihistamine-Resistant Chronic Urticaria|url=http://www.espalibrary.eu/media/filer_public/5e/18/5e180886-9aa4-4d26-9ff2-158689f0fbcc/38034.pdf|journal=Israeli Medical Association Journal|volume=|pages=|via=}}</ref>

[[Omalizumab]] has been proposed as a possible mast cell stabilizer and is used in allergic asthma and chronic [[urticaria]].

===Doctors===

There are a very few mast cell specialists working in the United States. An expert is Dr. [[Lawrence Afrin]] formerly at the University of Minnesota now in in Armonk, NY. Drs Clem Akin and Mariana Castells run a mastocytosis clinic at Brigham and Women's in Boston but their focus is on mast cell disorders as opposed to mast cell activation disorders. More integrative doctors are beginning to be aware of mast cell activation syndrome, but it remains elusive in both treatment and diagnosis.

==Triggers==

Emotional or physical stress, many foods, and environmental factors can trigger mast cell degranulation.

===Food triggers===

There are many food lists detailing common triggers but individual reactions will vary. Some individuals will react to all foods while others only to some.

Some foods containing high levels of histamine include salmon, avocado, red wine, strawberries, raspberries, cherries, spinach, and leftovers (especially fish and meat). Anything aged or process will be high in histamine and should be avoided (processed meats, aged cheeses, 36-hour chicken bone broth, etc.)

===Environmental triggers===

[[Mold]], air pollution, and car exhaust are common environmental triggers.

==Learn more==

*[http://thelowhistaminechef.com/ Low Histamine Chef]
*[https://en.wikipedia.org/wiki/Mast_cell_activation_syndrome Mast cell activation syndrome], Wikipedia
*Molderings GJ, Brettner S, Homann J, Afrin LB. Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options. Journal of Hematology & Oncology. 2011;4:10. doi:10.1186/1756-8722-4-10. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069946/)

==See also==

*[[Mast cell]]
*[[Theoharis Theoharides]]

==References==

[[Category:Diagnoses]]
<references />

Mast cell activation syndrome

2018-06-12T22:51:01Z

Juliajt:diagnosis

'''Mast cell activation disorder''' (MCAD) is a spectrum of disorders that involve an immune response from a non-pathogenic source. All MCAD are characterized by similar symptoms that result from overactive mast cells.<ref>{{Cite journal|last=Frieri|first=Marianne|date=2015|title=Mast Cell Activation Syndrome|url=https://link.springer.com/article/10.1007%2Fs12016-015-8487-6|journal=Allergy and Immunology|volume=|pages=|via=}}</ref>. Symptoms of MCAD are generally similar although each disorder can be characterized individually.
Primary MCAD is a condition in which too many mast cells are being created by the bone marrow<ref name=":0">{{Cite journal|last=Akim|first=Cem|date=August 2017|title=Mast Cell Activation Syndromes|url=|journal=The Journal of Allergy and Clinical Immunology|volume=|pages=|via=}}</ref>; Secondary MCAD would be that the body's [[mast cell]]s are being created normally, but are over-responsive to dietary or environmental triggers. Both of these situations might lead an individual to have excess [[histamine]] in circulation. Excess histamine can cause severe inflammation and a wide variety of symptoms. Almost any organ system in the body can be affected by MCAD<ref name=":0" />. Because a variety of symptoms can be present MCAD is commonly misdiagnosed. The symptoms of MCAD can also be very similar to that of [[myalgic encephalomyelitis]] (ME) and therefore is often confused.

==Signs and Symptoms==

A confounding element in diagnosing MCAD is that signs and symptoms occur in almost all areas of the body. The symptoms might disappear and then suddenly reappear.

Most patients experience fatigue, fevers, and sensitivity to individualized environmental "triggers." Other commonly identified signs and symptoms are as follows<ref>{{Cite journal|last=Molderings|first=G|date=2011|title=Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069946/|journal=J Hematol Oncol|volume=|pages=|via=}}</ref>:

-hot flashes, irregular heartbeat, high or low blood pressure (hypotension and/or hypertension)

-vertigo, dizziness, forgetfulness, depression or anxiety, headaches, insomnia, restlessness

-hives or other visible skin rashes

-arthritis, muscle pain, bone pain, osteoporosis/osteopenia

-anaphylaxis (a severe allergic reaction)

-Malabsorption and gastrointestinal distress leading to low iron and low Vitamin D and low B12

==Diagnosis==
MCAD can be difficult to diagnose as the cause of the syndrome is still considered to be idiopathic (unknown). In 2010, a criteria for diagnosing MCAS was proposed by Dr. Cem Akin and collegues<ref>{{Cite journal|last=Akin|first=Cem|date=2010|title=Mast Cell Activation Syndrome: Proposed Diagnostic Criteria|url=|journal=J Allergy and Clinical Immuno|volume=|pages=|via=}}</ref>. This criteria suggests that two or more organ systems must be affected; this can include gastrointestinal, cardiovascular, skin, or respiratory. If given histamine or mast cell therapy, the patients symptoms must improve. Thirdly, the patient should be tested for serum tryptase (an enzyme secreted by mast cells) levels during a peak of a symptomatic episode. Urine and blood tests should be collected more than once to confirm a positive diagnosis. Prostaglandin and histamine levels can be also be tested.

==Comorbidities==

MCAD is often found in patients with [[Ehlers-Danlos syndrome]] (EDS) and [[postural orthostatic tachycardia syndrome]] (POTS), a form of [[orthostatic intolerance]]<ref>Milner, Joshua, Dr. "Research Update: POTS, EDS, MCAS Genetics." 2015 Dysautonomia International Conference & CME. Washington DC. Dysautonomia International Research Update: POTS, EDS, MCAS Genetics. Web. <https://vimeo.com/142039306>.</ref>, two conditions commonly co-morbid with [[ME/CFS]]. The overlap between EDS, POTS, and MCAD is thought to be due to increased [[tryptase]] production owing to an extra copy of a gene called [[TPSAB1]]''.''<ref>{{Cite news|url=http://mentalfloss.com/article/87506/one-gene-mutation-links-three-mysterious-debilitating-diseases|title=One Gene Mutation Links Three Mysterious, Debilitating Diseases|last=Horowitz|first=Kate|date=October 17, 2016|work=Mental Floss|archive-url=|archive-date=|dead-url=|access-date=April 22, 2018}}</ref><ref>{{Cite journal|url=http://www.jacionline.org/article/S0091-6749(14)02927-3/abstract|title=A New Disease Cluster: Mast Cell Activation Syndrome, Postural Orthostatic Tachycardia Syndrome, and Ehlers-Danlos Syndrome|last=Cheung|first=Ingrid|date=February 2015|journal=The Journal of Allergy and Clinical Immunology|volume=|pages=|via=}}</ref>

It has been implicated in many other immunological diseases including [[autism]], [[fibromyalgia]], and [[chronic Lyme disease]].

==Treatment==

=== Common treatments ===
Over the counter [[Antihistamine|antihistamines]] such as [[Allegra]] and [[Zyrtec]] and [[Claritin]] are a common treatment for MCAD.{{Citation needed}} Some patients also use herbal antihistamines and supplements such as [[quercetin]] and [[diamine oxidase]] (DAO), an enzyme normally produced by the body that breaks down histamine.{{Citation needed}} [[Vitamin C]], which reduces blood histamine levels<ref name="clemetson1980">{{Citation| issn = 0022-3166| volume = 110| issue = 4| pages = 662–668| last = Clemetson| first = C. A.| title = Histamine and ascorbic acid in human blood| journal = The Journal of Nutrition| date = April 1980| pmid = 7365537}}</ref><ref name="johnston1992">{{Citation| issn = 0731-5724| volume = 11| issue = 2| pages = 172–176| last1 = Johnston| first1 = C. S.| last2 = Martin| first2 = L. J.| last3 = Cai| first3 = X.| title = Antihistamine effect of supplemental ascorbic acid and neutrophil chemotaxis| journal = Journal of the American College of Nutrition| date = April 1992| pmid = 1578094}}</ref><ref>{{Cite journal|last=Yazdani|first=Shaik|date=2016|title=Relationship Between Vitamin C, Mast Cells, and Inflammation|url=https://www.omicsonline.org/open-access/relationship-between-vitamin-c-mast-cells-and-inflammation-2155-9600-1000456.php?aid=66895|journal=J Nutr Food Sci.|volume=|pages=|via=}}</ref>, may also be helpful along with [[magnesium]], a cofactor for producing DAO.

Dr. Afrin highly recommends [[sodium cromolyn]] in compounded oral form, as well as the use of the anthistamine and mast cell stabilizer [[ketotifen]].{{Citation needed}} Both of those medications are available over the counter only as eye drops and must be specially requested from pharmacies. Other [[antihistamines]] include [[hydroxyzine]] and [[levocetirizine]]. Many patients have also found the moderate use of [[benzodiazepines]] like [[lorazepam]] to be effective.{{Citation needed}}

=== Experimental treatments ===
There is some limited evidence that [[sauna]] may be useful in antihistamine resistant [[urticaria]], an allergic skin condition that involves mast cell activation and the production of excess histamine.<ref>{{Cite journal|last=Magen|first=Eli|date=2014|title=Beneficial Effect of Sauna Therapy on Severe Antihistamine-Resistant Chronic Urticaria|url=http://www.espalibrary.eu/media/filer_public/5e/18/5e180886-9aa4-4d26-9ff2-158689f0fbcc/38034.pdf|journal=Israeli Medical Association Journal|volume=|pages=|via=}}</ref>

[[Omalizumab]] has been proposed as a possible mast cell stabilizer and is used in allergic asthma and chronic [[urticaria]].

===Doctors===

There are a very few mast cell specialists working in the United States. An expert is Dr. [[Lawrence Afrin]] formerly at the University of Minnesota now in in Armonk, NY. Drs Clem Akin and Mariana Castells run a mastocytosis clinic at Brigham and Women's in Boston but their focus is on mast cell disorders as opposed to mast cell activation disorders. More integrative doctors are beginning to be aware of mast cell activation syndrome, but it remains elusive in both treatment and diagnosis.

==Triggers==

Emotional or physical stress, many foods, and environmental factors can trigger mast cell degranulation.

===Food triggers===

There are many food lists detailing common triggers but individual reactions will vary. Some individuals will react to all foods while others only to some.

Some foods containing high levels of histamine include salmon, avocado, red wine, strawberries, raspberries, cherries, spinach, and leftovers (especially fish and meat). Anything aged or process will be high in histamine and should be avoided (processed meats, aged cheeses, 36-hour chicken bone broth, etc.)

===Environmental triggers===

[[Mold]], air pollution, and car exhaust are common environmental triggers.

==Learn more==

*[http://thelowhistaminechef.com/ Low Histamine Chef]
*[https://en.wikipedia.org/wiki/Mast_cell_activation_syndrome Mast cell activation syndrome], Wikipedia
*Molderings GJ, Brettner S, Homann J, Afrin LB. Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options. Journal of Hematology & Oncology. 2011;4:10. doi:10.1186/1756-8722-4-10. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069946/)

==See also==

*[[Mast cell]]
*[[Theoharis Theoharides]]

==References==

[[Category:Diagnoses]]
<references />