0:07

Hey, this is Ari. Welcome back

0:09

to the Energy Blueprint podcast. With

0:11

me today is Dr. Kelly McCann,

0:14

and she is a functional and

0:16

integrative physician. She lectures

0:18

regularly all over the world at

0:20

professional conferences on the subject of

0:22

mass cell activation syndrome. She is

0:24

on the board of directors for

0:27

two professional organizations. She holds board

0:29

certifications in integrative medicine and functional

0:31

medicine. She's also got a master's

0:33

degree in spiritual psychology, and she's

0:35

been the host of many previous

0:37

iterations of the mass

0:40

cell activation syndrome summit, as well

0:42

as co-host of the Allergy and

0:44

Asthma Summit. She's a wonderful expert

0:47

on this topic of mass cell

0:49

activation syndrome, which affects, as you'll

0:51

hear in the podcast, roughly 20%

0:54

of people. So listen closely to the

0:56

symptoms, see if maybe this helps

0:59

explain some of what you have going

1:02

on. And there's lots of

1:04

different interesting areas we delve into here and

1:06

some of the root causes of this condition,

1:08

some of the drivers or

1:10

the mechanisms behind some of the symptoms,

1:13

and most importantly, how to

1:15

get better. So enjoy this interview

1:17

with Dr. Kelly McCann. Hi,

1:20

Dr. McCann. Welcome to the show. Thank

1:23

you so much for having me, Ari. So

1:26

first of all, not everyone is

1:28

familiar with this term mass cell

1:30

activation syndrome. So can

1:32

you define exactly what it is and

1:35

what's going on in the body that

1:37

causes this? Absolutely.

1:40

Let me give you a little bit of

1:42

information about what mass cells are first. Mass

1:46

cells are a normal part of our immune

1:48

system. They are related to our

1:50

white blood cells and our red blood cells.

1:54

And after they're born, they

1:56

move to the areas we

1:59

call of interface between

2:01

ourselves and the outside world.

2:03

So they line our respiratory

2:05

tract, our entire

2:08

gastrointestinal tract, they're

2:10

in any of our mucous membranes, they

2:13

actually have a high affinity for

2:16

what's called the perivascular system. So

2:19

they hang out around the blood

2:21

vessels, they like our nerves, there

2:23

are some in the brain and

2:25

the meninges, and their

2:27

job is to constantly

2:30

survey for foreign invaders. So

2:33

they're very old, they've been around for 500

2:35

million years, they're

2:38

in humans and vertebrates, as

2:40

well as many of the

2:42

invertebrate species, and they

2:44

have been around a lot longer than

2:47

the rest of our immune systems. And

2:50

so they're like the first line

2:52

of defense for our bodies, when

2:55

we get an infection, when

2:57

we get exposed to a toxin, they

3:01

have a response that happens

3:03

very, very quickly, where they

3:05

can release these different packages

3:08

of information called mediators,

3:10

and the release is

3:12

often inflammatory or sometimes allergic

3:15

in nature, they are filled

3:17

with hundreds if not

3:19

thousands of different mediators, and

3:22

the packages of mediators that get

3:24

released vary from person to person,

3:27

and from organ to organ system,

3:29

and from different tissues. And

3:34

this is their normal job, that's what they're supposed

3:36

to do. What happens

3:38

in lucky

3:40

people who have a genetic

3:42

susceptibility, or whose muscles

3:44

decide to become a little bit

3:47

rogue, is they get

3:49

what's called muscle activation syndrome, and

3:52

when that happens, the muscles now

3:54

are starting to perceive things that

3:56

are not necessarily foreign invaders, like

3:59

our food. like fragrance,

4:02

like light

4:05

or sound or vibration, these

4:08

things can be perceived as

4:10

foreign and dangerous and then

4:13

the muscles start to release

4:15

their inflammatory mediators and we

4:18

get allergic inflammatory responses

4:20

in different

4:22

systems in the body. So the

4:25

definition of muscle activation syndrome is

4:27

actually a clinical definition of

4:30

multi-system, multi-symptom,

4:33

inflammatory allergic and

4:35

sometimes growth related

4:37

conditions. It's

4:40

a mouthful. Okay

4:43

so what what are the common symptoms?

4:45

What would indicate to someone

4:47

that they actually have mast

4:49

cell activation syndrome going on

4:52

chronically? So

4:55

really the key is in

4:57

the multi-system, multi-symptom. So if

4:59

somebody just has allergies they

5:01

probably don't have muscle activation

5:04

but if they have

5:07

allergies and gastrointestinal issues

5:09

and chronic fatigue and

5:12

migraines and interstitial cystitis

5:14

and asthma they

5:17

may want to start to suspect

5:19

that there's an underlying link there

5:22

between these different conditions or

5:24

these lists of diagnoses that

5:27

could be explained by

5:29

muscle activation syndrome. Many

5:32

people with long-haul COVID

5:34

for example may have

5:36

a muscle activation component

5:38

to their symptoms because

5:41

we know that it's a

5:43

inflammatory dysregulated state for example.

5:47

Other symptoms that can show up in patients

5:50

who have muscle activation they

5:52

can have autonomic nervous system

5:54

problems so they could have

5:57

blood pressure issues like orthostatic

5:59

intolerance. or they could

6:01

have postural orthostatic tachycardic syndrome,

6:03

otherwise known as POTS, where

6:06

they stand up and the

6:08

heart rate shoots up and

6:11

they feel very uncomfortable and have to sit

6:13

down. That's commonly

6:16

associated with muscle activation.

6:19

We also can see some associations

6:21

with endometriosis, for

6:23

example, or other hormone

6:25

dysregulated issues. We can

6:28

see issues with hypermobility.

6:30

So if people are

6:32

extra flexi bendi, that

6:35

they can sometimes have issues with

6:38

muscle activation syndrome. And

6:40

really fatigue is a very,

6:43

very common symptom with muscle

6:45

patients. And people don't- Why

6:47

is that? What is the connection between, because

6:49

this is an immune component that you're talking

6:51

about here. This is a response to foreign

6:56

non-self stuff. This is part of our

6:58

body's immune reaction to it. How

7:00

does this connect to energy levels in your

7:02

view? I

7:05

think it's multifactorial. I mean, I think

7:07

when the body is inflamed in general,

7:10

it's going to cause that fatigue when

7:14

we're trying to fight something. And this

7:16

is the sickness response that we get,

7:18

right? So when you get the flu,

7:21

what do you wanna do? You wanna hibernate.

7:23

That's because the body sends

7:25

itself into sickness, cell

7:28

danger response, and then we want

7:30

to rest and recover. And

7:33

so I do think that fatigue and

7:35

energy, or

7:37

lack of energy, are

7:39

very, very common presenting symptoms

7:41

with muscle activation syndrome. Okay,

7:45

so is

7:47

this, in your view, is this a

7:49

true binary of

7:52

sort of you have it or you don't? Or

7:55

is this more like a continuum

7:57

where Different people... Fall

8:00

in different places on the

8:02

spectrum as far as being.

8:05

Prone. To over active

8:07

vs under active mouse cells.

8:11

I. Absolutely think it's a

8:13

spectrum Am. I

8:15

have some patients who can eat

8:18

like five or ten foods

8:20

to feel terrible all the time.

8:22

Course, we're getting them better so

8:24

they're starting to feel much better.

8:27

but but they're starting. Place is

8:29

extremely sensitive. Maybe they can

8:31

take a handful of supplements if

8:34

they're lucky. All their medications has

8:36

to be compounded because they

8:38

react to virtually everything. And

8:41

those are very severe Height what

8:43

I recall hyper sensitive muscle patients

8:46

and then I have people who

8:48

are fairly robust to they may

8:50

not have any allergy symptoms and

8:52

all but they could have more

8:54

exercise, intolerance and fatigue and kind

8:57

of chronic viral issues on they

8:59

don't even look like a mass

9:01

all patients. And

9:04

you know everything in between. Ah,

9:06

you don't have to have every

9:08

system involved in order to have

9:11

muscle activation, but it's multiple said.

9:13

Symptoms: Arm. Is

9:15

really the presentation? There

9:18

is thought to. Be a genetic component

9:20

Says there was some research that

9:22

was done in Germany. And

9:25

what the literature shows

9:27

is that these are

9:30

not necessarily on. There

9:33

are so magic mutations, not germline

9:35

mutations some people can have on

9:37

a variety of different presentations. The

9:40

expectation is that it's about seventeen

9:42

percent of the population, so one

9:45

in. Six. Of

9:47

the population. but I do think

9:49

with Cove Ed I'm those. statistics

9:52

have increased and so it looks

9:54

like it's more twenty twenty five

9:57

percent of the population thought about

9:59

one of

12:00

the biggest root causes are

12:02

mold exposure. Mold

12:05

exposure in the vast

12:07

majority of my professional colleagues

12:10

experience is one of

12:13

the primary triggers. And we

12:16

know mold causes

12:19

oxidative stress. It

12:22

causes inflammation. It can

12:24

trigger autoimmune

12:26

conditions. It can

12:28

trigger allergy symptoms. And so

12:31

I think in some people,

12:33

it's also triggering muscle activation

12:35

syndrome. That's

12:38

been one of the biggest drivers in terms

12:40

of our root cause. Probably

12:44

the second root cause that

12:46

I see is

12:49

a Bartonella infection. Bartonella

12:51

is otherwise known as cat

12:53

scratch fever. It's

12:57

lumped together with Lyme disease,

12:59

even though they're not always

13:02

seen in tandem. We

13:04

can see Lyme disease without Bartonella and

13:06

vice versa. But that tends to

13:08

be a very big trigger. And

13:11

again, those mast cells, their

13:13

job is to survey for

13:16

foreign invaders. And so they're

13:18

seeing these foreign invaders and

13:21

having that triggered response. I

13:23

don't know why exactly it's happening. I

13:25

don't know if we have the details

13:27

of why that happens. But that's clinically

13:30

what myself and

13:32

my colleagues are seeing. And

13:34

this often translates into a

13:36

loss of immune tolerance, where

13:38

someone stops being

13:40

able to tolerate lots of other things. Well,

13:43

like you described earlier, people

13:45

being limited with their diet to only

13:47

a handful or a

13:49

dozen foods or something and not

13:51

being able to tolerate other kinds of foods

13:54

or various supplements, having very negative reactions to

13:56

that, presumably because of

13:58

their immune system. being overly reactive

14:01

to these substances that it should

14:03

be able to tolerate but it's

14:05

now reacting to them as though

14:07

they are pathogenic foreign

14:09

substances. So what's

14:13

going on there? Can you take

14:15

me deeper into understanding why the

14:17

body loses immune tolerance? Because

14:22

it's seeing those as foreign

14:24

invaders, the mast cells

14:27

are degranulating and releasing

14:30

inflammatory mediators. These inflammatory

14:32

mediators may be histamine,

14:35

they could be other

14:37

cytokines or chemokines and

14:40

though the combination of things as I

14:43

mentioned is it varies from person to

14:45

person and tissue to tissue but when

14:47

we have an increase in our inflammatory

14:50

mediators it gets really uncomfortable. When you

14:52

have an over abundance of histamine you

14:55

can have skin reactions, you can have

14:57

gastrointestinal distress reactions and

14:59

so for example if somebody is

15:01

eating foods that are high

15:04

in histamine and they have

15:07

mast activation syndrome

15:10

and they may have a histamine intolerance

15:12

where they don't have adequate

15:14

enzymes to break down the

15:17

histamine they're going to feel

15:19

flushed, they may develop hives, they could

15:21

get diarrhea, they're going to have abdominal

15:23

pain, they could have gas and bloating

15:26

and those symptoms are so uncomfortable that

15:28

they're not going to want to eat

15:30

those foods. So

15:32

that's the loss of tolerance and

15:35

there definitely are some things that we

15:37

can do to help restore that tolerance.

15:39

It's multifactorial

15:42

though I think

15:44

that there are layers. It's like there

15:46

are symptoms, there's causes, there's

15:49

triggers and these are all

15:52

interweaving together to create that picture

15:54

that the person is experiencing. Got

15:56

it. So is there any

15:59

kind of understanding of like

16:01

the underlying physiology

16:03

of loss of

16:05

immune tolerance and regaining immune tolerance, like

16:08

what are the needle movers as far

16:10

as that? So I mean,

16:12

when we consume food, for example, I

16:16

just drank a smoothie here

16:18

with some matcha green tea powder

16:20

and some bananas. These

16:23

are non-self substances. Right.

16:26

Okay, so these are not substances that

16:28

are part of my cells. And

16:31

yet my immune system can tolerate

16:33

them and recognizes them as nutrients,

16:35

as food that's beneficial for my

16:37

body. Whereas other people with

16:40

different differently wired immune systems might

16:42

react to those same substances and

16:44

try to with the immune system

16:46

attacks them. Right. What

16:49

what what is what is going

16:51

on with what's influencing the immune

16:53

system to behave one way versus

16:55

another? Well, the

16:59

body starts to see these allergies. No,

17:01

so I'm not an allergist, right? But

17:04

the idea is that mass

17:06

cells can be triggered by IgE mediated

17:09

reaction. So true allergy. So the

17:13

allergen, the

17:15

body makes IgE antibodies

17:18

to an allergen, they match up and then

17:20

that combination of

17:22

things triggers a receptor on a

17:24

mass cell. Right. Now,

17:26

if it's non IgE mediated,

17:28

there could be it

17:31

could be IgG mediated, it could

17:34

be another cell

17:36

in or another molecule

17:39

in the immune system. Combining

17:44

with that receptor

17:48

to cause a degranulation of

17:50

the mass cells. And

17:52

then you get all the symptomatology. So

17:55

there are in your mass

17:57

cells, you've got all these mediators,

17:59

you also have a whole host

18:01

of receptors on the mast cells

18:04

as well. There are

18:07

corticotropin-releasing hormone

18:09

receptors on the mast cells. So

18:12

stress can trigger mast

18:14

cell degranulation if you have

18:17

extra cortisol running around. If

18:19

you have different kinds of

18:22

cytokines and chemokines, IL-6,

18:26

TNF-alpha, those things also

18:28

have receptors on the

18:30

mast cells. Those inflammatory

18:33

meteors themselves can trigger mast

18:35

cell degranulation. It's

18:38

multifactorial and multilayered

18:43

physiology that's happening. It's

18:45

almost like the biochemical milieu

18:47

of the body, inflammatory

18:50

cytokines and perhaps different

18:52

toxins and psychological stress

18:55

is creating a hypersensitivity

18:57

or an overactivity

19:00

of these mast cells where they're much more

19:03

prone to degranulating more

19:05

easily. Correct.

19:08

Got it. What

19:12

do treatments look like? How do we

19:14

start to reverse this and recover from

19:16

it? Lots

19:20

of different ways. Super

19:23

important to look

19:25

at the causes, the root cause

19:27

of it, of course. When we're

19:29

talking about helping stabilize those mast

19:31

cells, we have a variety of

19:34

different tools in the toolkit. If

19:39

histamine and allergy is a

19:41

common presentation for somebody, we

19:43

can use things

19:45

like over-the-counter antihistamines. That

19:48

would be Claritin, Zyrtex,

19:51

Xizol, Allegra. Those are

19:53

H1 blockers. We can also

19:55

use H2 blockers like Pepcid. to

22:01

break down histamine in the gastrointestinal

22:04

tract, we can use different kinds

22:06

of low histamine probiotics to help

22:08

stabilize things. So a lot of

22:11

different tools in the toolkit for

22:13

stabilizing mass cells, and because of

22:15

the unique presentation of each individual

22:18

person, we have to find the

22:20

combination that works for that person.

22:24

So that's stabilizing mass cell,

22:26

and then we need to deal with the

22:28

nervous system, but I can answer that question

22:31

next. Okay,

22:33

so let's go there. So stabilizing

22:35

mass cells is number one, just

22:37

decrease the amount of mass cell

22:40

degranulation, bring symptoms down, and then

22:42

you're now taking on

22:44

the next layer of trying to go deeper

22:46

into the root causes of the

22:49

physiology that's driving this. Yes.

22:52

Actually, before I even go to root

22:54

causes, I do want to talk about

22:58

what I think is the role

23:00

of the interplay between the immune

23:02

system and the nervous system. So

23:06

what happens when people find that they're

23:08

reactive to so many things is that

23:10

they become more and more fearful and

23:14

worried about ongoing reactions. The

23:16

longer people don't feel well,

23:19

the more

23:21

trauma and kind of

23:24

upset and worry they have about the fact

23:26

that they are not feeling well, the

23:29

more dysregulated the nervous system gets

23:31

as well. And so

23:33

we find that in patients who

23:35

have mass cell activation, they

23:37

also have limbic

23:40

system activation. Limbic

23:42

system is the ancient part of the brain

23:44

that takes our emotions and turns them into

23:46

memory. And

23:49

if we don't deal with the

23:51

limbic system activation piece of the

23:54

puzzle for patients with mass cell

23:56

activation, we don't get them fully

23:58

better. get you better on Zyrtec

24:01

and pepsin and a bunch of

24:03

quercetin. We really have to help

24:07

the nervous system find

24:09

a place of safety because

24:12

the muscles and

24:14

the nervous system now perceive the world

24:16

as a very dangerous place. And

24:18

so retraining the limbic

24:20

system is also key to

24:23

helping people recover. And

24:25

then the third piece is really the

24:28

autonomic. Quick question. Actually, the

24:30

autonomic nervous system probably ties in. So I'll

24:32

let you complete before I ask that. OK.

24:36

So autonomic nervous system, that's the

24:38

part of our body that enables

24:40

us to digest our food, our

24:42

heart to pump, our blood pressure

24:45

to be regulated without us having

24:47

to think about it. It's

24:50

also the part of the nervous

24:52

system that either puts us into

24:54

fight or flight or freeze or

24:57

can help us be in

24:59

parasympathetic or rest and digest.

25:02

And truly, we can't heal

25:04

unless we're in the

25:06

parasympathetic nervous system. And

25:11

again, when you feel terrible

25:13

all the time, you're usually

25:15

stuck in the sympathetic overdrive,

25:18

either fight or flight or freeze. And

25:20

a lot of people have not heard

25:22

about the freeze response. And

25:24

they don't recognize that that is

25:27

part of sympathetic overdrive. So

25:29

fight or flight, we kind of understand we're

25:31

running away from the bear or

25:34

we're fighting the bear with freeze.

25:36

We're standing still. We're hoping

25:38

that the bear ignores us. And

25:41

usually, this

25:44

can overwhelm as

25:46

depression, as fatigue, again,

25:49

kind of

25:51

an inability to move forward. And

25:54

many people who are chronically ill bounce

25:56

back and forth between fight or flight

25:58

and freeze. Fight or flight and freeze.

26:01

And the truth is we have to

26:03

get into parasympathetic in order to heal.

26:05

And so vagus nerve stimulation devices that

26:08

get us into that parasympathetic rest

26:11

and digest sense of joy

26:13

and safety is where we

26:15

really need to help patients

26:17

get in order to heal.

26:22

So you describe both of

26:24

those things, the limbic system

26:26

and the autonomic nervous system

26:28

being shifted towards sympathetic overactivation.

26:31

Kind of from the starting point

26:34

of a person feeling bad first

26:36

and then going

26:39

into sympathetic overactivation or limbic system

26:41

overactivation. But I wonder how much

26:43

is going on in the other

26:45

direction, meaning especially

26:48

because you spoke earlier

26:50

about psychological stress leading

26:53

to contributing to

26:55

mass cell overactivity

26:58

or increased susceptibility for

27:01

degranulating. How

27:04

much do you think

27:06

is explained by personality types

27:09

that are prone

27:13

to chronic psychological stress? So

27:16

in chronic fatigue syndrome, there's a

27:18

body of literature and in clinical

27:20

burnout syndrome and stress related

27:23

exhaustion disorder. There's

27:26

a lot of research linking self

27:29

critical perfectionism, that personality

27:32

trait to a propensity

27:34

for these conditions. Meaning

27:37

you can have a type of personality

27:40

that maybe leads to a chronic level

27:42

of baseline and

27:45

level of overactivation of cortisol or other stress hormones.

27:47

You can have a type of

27:49

personality that's more or less prone to

27:51

chronic psychological stress. And

27:55

I'm just wondering how much you perceive

27:57

maybe mass cell activation to overlap with

28:00

personality types who are more oriented in

28:02

those directions. I don't

28:04

know of any literature that has

28:06

linked those, Ari, but I absolutely

28:08

see this in the patients. And

28:11

I think that, you

28:13

know, we can talk

28:15

about genetics, but, you

28:18

know, my beef with conventional medicine is

28:20

that we only deal with the physical

28:22

body. And even in my

28:24

discussion so far, I've only talked

28:26

about the physical body, right? We're talking about

28:29

the immune system and the nervous system. The

28:31

truth is our minds

28:33

and our bodies, even our spirit,

28:35

our being are totally connected. And

28:38

so who we are as people, how

28:40

we talk to ourselves, what

28:42

we believe about ourselves absolutely

28:45

plays a role. And that is

28:47

part of the healing journey too. I

28:49

can't ignore that if

28:52

I'm actually going to get somebody 100%. So,

28:56

you know, maybe we get 40 to 50% better doing

28:58

simply biological mass stabilizing treatments. And

29:05

then we'll get a few more, you know, percentage

29:07

points improvement. Maybe we get to 70 or even

29:10

80% improvement. But

29:15

if we don't deal with the

29:18

psychology, with the

29:21

personality traits, with the way people are

29:23

and how they perceive themselves in

29:25

the world, if we don't deal with that,

29:27

we won't get them 100%. Let

29:30

me tell you a story. So I have

29:32

a mold patient,

29:35

and mold and mast cell

29:37

patient. And when he first came in, he

29:40

was probably 15, 20 pounds underweight.

29:44

He looked gaunt, gray.

29:46

He had scabs all over his head

29:48

because he was so malnourished and so

29:52

inflamed. And

29:54

we worked really hard to get him better.

29:57

You know, he had to move out. remediate

30:01

it and get rid of all these belongings. And, you know,

30:03

there was a lot of steps, lots

30:06

of supplements and IVs.

30:09

And eventually he got to the point where

30:12

now he's running seven to 10

30:14

miles a day. He's doing,

30:16

you know, two and three hour yoga

30:18

classes. He feels great. He looks great.

30:21

He's gone back to work. And

30:23

then it started raining in Southern

30:25

California. And

30:28

his job site was a

30:31

fat-roof building and

30:33

there was mold in the building.

30:37

And then he got mold exposed

30:39

also in his apartment and

30:42

he got sick again. And he got

30:44

to the point where he was so sensitive, he would not

30:46

be able to go into buildings because any

30:49

building that had any sort

30:51

of chemical, any mold

30:53

exposure, he was terrified. And so he was

30:55

living in a tent in his backyard and,

30:59

you know, he was miserable. And

31:02

I finally said to him, I'm like, look, you know what? We

31:04

did all the physical stuff and we got

31:06

you all almost all the way better. But

31:09

we never addressed the mental, emotional, spiritual side

31:11

of why you got sick in the first

31:13

place, and that's where we need to go. And

31:16

since addressing that, he's

31:20

now like 80, 90

31:22

percent better and really making

31:24

huge strides. At not

31:27

only becoming a healthier person

31:29

physically, but becoming a full

31:31

and happy human being who

31:34

has joy in his life, who has purpose in

31:36

his life. Yeah, beautiful. Debating

31:47

which direction we should go from here. So.

31:52

I'm curious, have you stumbled

31:55

across any research on exercise

31:57

or are you Personally

31:59

aware? Where from from your experience with

32:01

patients. Of. The role

32:04

in exercise in or lack

32:06

of exercise in creating a

32:08

propensity for mass cell activation

32:10

syndrome or the role of.

32:12

Doing. Exercise and recovering from it.

32:17

I have also arm.

32:19

I do find that

32:22

most patients who are

32:24

Marcel have difficulty exercising

32:26

because he'd often triggers

32:29

Marcel D granulation, Sometimes

32:31

sweating triggers it to

32:33

and so. Adds

32:36

another. It's another

32:38

thing that that people often

32:40

become limited by. I'm in.

32:45

A. And often times they'll develop. Some

32:47

of you, can you repeat that one more time you you

32:49

cut out there for sec? I just wanna make sure we

32:51

got it. And so

32:53

often times. And people have

32:55

Martha Activation Syndrome. They also have

32:57

a lot of fatigue. They may

32:59

have exercise intolerance and so. We're

33:03

really working less that energy envelope and

33:05

trying to make sure that they are.

33:08

Not overdoing it, causing flares

33:11

in there are symptom at

33:13

all indeed and so exercises

33:15

pass out. For some people,

33:18

it's It gets layered and

33:20

minutes later than my main

33:22

man, a patient. I was

33:25

just sharing about on but he didn't

33:27

start out the she Will to fun

33:29

you know seven to ten miles he

33:31

can barely come into the office. So

33:35

that it definitely took I don't hour

33:37

two three years for him to get

33:39

to that point. And it was a

33:41

slow, slow, steady. ah, incremental thing I

33:44

don't I don't know of ah lot

33:46

of literature and looking at an exercise

33:48

in mass. Iterations A good question.

33:53

Mean. one of the things that

33:55

that comes to mind for me in

33:57

my back from being in in exercise

33:59

physiology is

34:04

there are adaptations that take place with exercise

34:06

that you know there's many and depends

34:08

on the types of exercise that you

34:10

do but it's not just

34:12

limited to muscles growing stronger or you

34:14

know the cardiovascular system making

34:17

adaptations to grow bigger ventricle or something

34:19

like that. Some

34:22

of the adaptations are more biochemical in

34:24

nature and the autonomic nervous

34:27

system is involved. The

34:30

inflammatory cytokines are involved, cellular

34:32

defense capacities are involved, the

34:35

immune system is heavily involved and

34:40

there's a sort of paradoxical or counterintuitive

34:42

nature to this because as you said

34:44

exercise can also be a trigger but

34:48

I would I would

34:50

bet that the adaptations induced

34:52

by exercise are also protective

34:54

against things

34:57

that are triggers for it. So

34:59

in other words it's inducing

35:02

adaptations that increase the buffering

35:05

capacity and probably help stabilize

35:07

mass cells and make them

35:09

less prone to degranulation in

35:12

from a number of triggers as

35:15

long as presumably one does the exercise regimen

35:17

in a way that doesn't create more triggers

35:19

in the first place meaning you do a

35:22

dose that's appropriate for that individual at that

35:24

point in time. Yeah

35:27

it's a great point and I

35:30

will make sure that I include

35:33

more kind of incremental

35:35

exercise to help

35:37

build resilience and treatment plans.

35:39

Thanks for that Ari. You

35:42

know some of the things that we may want to talk about

35:45

and you know I'll let you guide

35:47

this but I also think That

35:51

there's an interesting relationship between muscle

35:54

and clotting and hypercoagulability. So I

35:56

Don't know if you want to

35:58

go there next as a person.

36:00

Possibility: Please? Yeah, tell me about it. I

36:02

don't know anything about it, so educate me. Okay,

36:06

from. Hyper quagga

36:08

ability is this fancy medical

36:11

term A We also call

36:13

it clotting sensational and the

36:15

body is a beautiful balance.

36:18

We wanna be able. To clot

36:20

only cut ourselves and we

36:22

want that should be dissolved.

36:24

ah I'm the fancy term

36:26

for dissolving a clot is

36:28

called fibernet Lysis. We want

36:30

the clock to dissolve or

36:32

be life when the the

36:34

healing has happened. And.

36:38

You know again, cove it really

36:41

brought. To this whole idea

36:43

of clotting to the for

36:45

front because so many people

36:47

who had. Covered

36:49

issues often died of micro cloths, arm

36:51

and in other is really not a

36:54

lot of a great understanding as to

36:56

why. And.

36:59

It. Turns out

37:01

to that. Triggers

37:05

the clotting cascade

37:07

and. A way no one left

37:09

and say that when we're time, you could you

37:11

cut brief, know what triggers the cloning casket? Information.

37:15

Pamphlet Nation triggers the

37:17

clotting cascade to occur

37:20

in people who had

37:22

a. Propensity

37:24

to make class and

37:26

I've been recently. We.

37:30

Looking at this and moved

37:32

greater detail in my patient

37:34

population. Know

37:36

I have a functional Madison practice. I have

37:38

a lot of mass okay since but not

37:40

everybody is a mouthful. Pacers. Ah,

37:42

some people have cancer and

37:44

some people have auto immune

37:46

conditions in a variety of

37:49

different patients. Ah, I'm at

37:51

and some have Lyme Disease

37:53

and I've been doing odds

37:55

and attic testing looking for

37:57

calling disorders and patients and

37:59

I have. And that

38:01

are probably eighty Five Ninety

38:03

percent. My piece of have

38:05

some sort of genetic predisposition.

38:07

For clotting. That's Huge.

38:10

No, statistically, it looks like

38:12

it should be more like

38:14

twenty percent of the population.

38:17

Course we just said that. You

38:19

know muscle activation is seventeen to

38:22

twenty percent is officer some ground

38:24

weird overlap there. But

38:27

if we think about. Body.

38:30

And energy. Oxygen

38:33

The lever A nutrient delivery.

38:35

If you have sludgy, blind

38:37

rage, you can't really carry

38:40

oxygen and nutrients to the

38:42

tissues very efficiently. As somebody

38:44

who doesn't have sludgy blood

38:47

right. Let

38:49

us Midori a special medical

38:51

term flood was plus she

38:53

before for sticky blood right

38:55

arm so I I do

38:57

think that those I have

38:59

a relationship between this increase

39:01

inflammatory response that people are

39:03

having whether it's muscle activation

39:06

or exposure so environmental toxic

39:08

and that can be leading

39:10

to a sticky sludgy blood

39:12

kind of situation that would

39:14

potentially mass. Effect. In

39:16

a different impacts in their

39:18

their health. Oxygen carrying

39:20

capacity new to and delivery to

39:23

tissues. That's important

39:25

to know about. Okay,

39:27

so. The. Hyper

39:29

coagulate ability? You think?

39:33

Predisposes. To Marcel

39:35

over activity. Or. I'm

39:37

not saying. That I'm not

39:39

saying I'm saying that. Genetic

39:46

predisposition to clotting.

39:49

Sent somebody up. To. Have.

39:52

More. Problems with an inflammatory.

39:55

response whether they have

39:57

muscle activation are nods

40:00

So they're going to get more severe symptoms from

40:02

mast cell activation? Correct.

40:06

Okay. Correct. And, you know, say somebody

40:08

just gets COVID and they have

40:10

an underlying predisposition for clotting.

40:12

They may not shift

40:15

into mast cell activation, but now

40:18

they have an inflammatory response because

40:20

of COVID or the flu or

40:22

whatever, and now they have sticky

40:25

blood. They may have a

40:27

harder time recovering. They may have more

40:30

significant symptoms of

40:33

not just hypoxia, like inability to

40:35

get oxygen to the lungs, but

40:39

inability to get that oxygen to

40:41

the tissues because of,

40:44

you know, something

40:46

in terms of health and

40:49

energy would

40:51

be important to know about. Is

40:55

there something on the practical

40:57

level, like dealing with patients

40:59

who have that once you've

41:02

identified, okay, you've got a

41:04

genetic predisposition to blood clotting

41:06

and hypercoagulability? Therefore,

41:10

in this situation of you've

41:12

got mast cell activation

41:15

syndrome and you have this genetic

41:17

predisposition to clotting, we're going

41:19

to use anti-clotting. We're going to put you on

41:21

fish oil or we're going to put you on

41:24

medication to thin the blood or

41:26

something like that. What do you do

41:28

on a practical level in that situation? There

41:31

are specific kinds of enzymes.

41:33

We call them fibrinolytic enzymes.

41:36

You probably have heard of them,

41:38

things like nadokynase or

41:40

lumbarokynase. Those

41:42

are probably the best things

41:45

for this sticky blood situation.

41:48

Whether somebody just has the

41:50

genetic predisposition or

41:52

they have markers that

41:55

show me that they're actually

41:57

making more fibrinolytic.

42:00

Brand which is a building block

42:02

of excited and having difficulty breaking

42:04

that that fi bring down so

42:07

there are biomarkers that we can

42:09

look at him blood work on

42:11

that will help guide my choices

42:13

if they had the genetic predisposition

42:16

but no evidence of our current

42:18

have Roka you ability or probably

42:20

put the my net okay nice

42:23

and and if they. Have

42:25

obvious signs of the sticky blood

42:27

or biomarkers that are elevated and

42:29

I'll put them on Lumber Train

42:31

Ace in particular. And like a

42:33

product called the Luke, it's interesting

42:35

that. Some

42:38

people of the Reserve: A

42:40

recent article written about. Out.

42:45

Long haul, cool vid and

42:47

using as a foundation. Out

42:51

I'm not okay. Nice

42:53

Bramall Lane and Curcumin.

42:55

For treatment of

42:57

ah. Long Haul cove

42:59

it? Well, those are my cell

43:02

treatments and. Quite elation treatments.

43:05

And mission. Yeah

43:08

yeah. I saw that said he the

43:10

you're free to their sort of a

43:12

protocol I think that several physicians are

43:14

now promoting for that, were there. You

43:16

know it's it's the protocol of those

43:18

those compounds that you just mentioned that

43:20

seems to have a lot of efficacy

43:23

in those those long covert patients. Are

43:26

there any other and of but. What's

43:29

up? And the and it and

43:31

this is why this is the

43:33

explanation as to why those specific.

43:36

Added. Perk and nutraceuticals are

43:39

helpful. What would you think's

43:41

going on? And Long Cove it is. it. That.

43:43

You know, I know you mention the

43:45

spike protein earlier and you are also

43:47

very cautious in your language around the

43:49

different ways that people can get. Lots

43:52

of spike protein in their body. But.

43:56

What? What? What do you think's what's your best

43:58

guess? I mean I haven't really. Kept up

44:00

with the the latest literature and

44:02

thinking on. The Physiology of Long Cove.

44:05

But what? What do you think's going on there? I

44:08

been a My sense is that.

44:11

It is. Often

44:13

a muscle activation tire syndrome that

44:15

gets triggered an can be all

44:17

the things that we've been talking

44:19

about so far today. Ah, I'm.

44:23

In. Iowa at I Will.

44:25

I will share with you.

44:27

Up until recently I had

44:30

one on. October.

44:32

Pisa. I had no deaths

44:34

amongst my patients. I had no half.

44:37

The. Elevation Ah Oxide

44:39

patients because. We were

44:41

doing all the things we were treating

44:43

them all. They were treating lamb or

44:45

treating all the root causes I'm and

44:47

then. Ah, I'm.

44:50

Using preventative treatment using

44:52

ah. Ah, aggressive outpatient

44:54

therapies to help keep the

44:57

ball says ah now I

44:59

have more hour long haul

45:02

Kobe patients. Because mean people are

45:04

coming into the practice. And

45:07

and I do think it's a combination

45:09

of these sorts of ideas. They

45:12

could have been like I mentioned in

45:15

a moldy house and previously healthy and

45:17

tolerating the mole that with their they

45:19

could have had. You know, a

45:21

chronic. Chronic infection

45:23

like Lyme Disease, but they didn't

45:26

know it until you add that

45:28

that inflammatory and fans of covert

45:30

and it just spit and now

45:33

they can't. Recover and.

45:36

Consists. Of the of immune system

45:38

bomb. It just went off in their bodies. Yeah,

45:40

yeah are interesting. Are there any

45:42

other. More. Medical aspects

45:44

that people should be aware of

45:47

when it comes to muscle activation

45:49

syndrome. Any Any other aspects to

45:51

this that you know effect a

45:54

subset of people or are important

45:56

to test for and to address.

46:00

Let's see. So

46:03

in terms of, I

46:05

can talk a little bit about testing,

46:07

you know, to get a diagnosis that

46:12

sound like you. Yeah,

46:14

absolutely.

46:17

There are two camps with

46:21

the diagnosis of muscle activation.

46:24

One camp we, my

46:27

colleagues and I call Consensus One.

46:29

These are going to be your

46:31

conventional allergists and immunologists. They

46:33

have a very strict criteria. There's

46:36

one marker called Triptase. Triptase

46:39

is a rough

46:41

measure of the amount of muscle that

46:43

people have in the body. And

46:47

their diagnostic criteria is you have

46:49

to have a baseline Triptase that

46:51

gets elevated a certain percentage when

46:53

you have a flare. And

46:56

if you don't make those criteria, then you

46:59

don't have massive activation. Very

47:02

rigid, narrow definition

47:06

that excludes a lot of different patients who might

47:08

not have Triptase or might not be able to

47:10

capture the difference

47:13

between a flare and normal

47:16

that is any degree different for

47:18

a lot of these patients. So

47:21

I am in the Consensus

47:23

Two camp along with Dr.

47:25

Larry Afrin, Dr. Thea Raries,

47:27

Dr. Tanya Dempsey, et

47:29

cetera. There's a whole host of

47:32

my colleagues. And we wrote

47:34

a Consensus Two paper. I

47:36

was one of many different other

47:38

co-authors on this paper that

47:41

outlined the criteria that's much

47:44

broader that really takes into

47:47

clinical experience and clinical presentation

47:49

to meet that diagnostic

47:51

criteria. And in

47:53

addition to the clinical criteria, there are

47:56

also laboratory values that we can look

47:58

at beyond Triptase. including

48:01

histamine levels, heparin levels,

48:03

leukotriene E4, prostaglandin D2.

48:07

And these markers give us a

48:09

rough idea as to what

48:13

the activity of those mast cells are.

48:16

But again, I told you that there are

48:18

hundreds, if not thousands of mediators, and we

48:20

can test for half a dozen. So

48:23

the likelihood of getting a positive test

48:26

can be pretty low for people. So what you're

48:28

saying is we know everything there is to know

48:30

about it, and we can test for everything perfectly.

48:33

Exactly. Yeah. Yeah,

48:38

it's, you know,

48:40

we love getting laboratory values and

48:42

having that definitive diagnosis. And for

48:44

some patients, that's really necessary. You

48:48

know, I kind of vacillate back and

48:50

forth between, okay, let's do some more diagnostic

48:52

work up and then let's not worry about

48:55

it because it's ridiculously

48:57

expensive and we might miss the mark

48:59

on a regular basis. But

49:01

I do think it's important for patients out

49:03

there if they do suspect that

49:06

maybe mast cell is a component,

49:09

you want to make sure that you're

49:11

going to find somebody who is more

49:13

consensus to, who's going to listen to you, who's

49:15

going to have more tools in their toolkit, who's

49:18

going to look at root causes and not

49:21

dismiss you and gaslight you. Yeah,

49:24

it's always important. I think with

49:26

most things these days. What

49:31

does the differential diagnosis look like in

49:33

terms of, you know, let's

49:35

say someone comes in complaining of these types

49:38

of symptoms that you're talking about. You

49:41

might suggest doing those types

49:43

of tests to determine, okay,

49:45

it's mast cell activation syndrome

49:47

or it's this, this or this.

49:50

What's the this, this or this in

49:52

the case of this scenario? Well,

49:56

one, you could have mastocytosis,

49:58

which is pretty. rare. Mastrocytosis

50:01

is an overabundance

50:07

of cancer and it's probably one in

50:09

ten thousand

50:14

epidemiologically. So really, really

50:17

rare but possible. One in ten

50:19

thousand cases of this type

50:21

of symptoms or it's one in ten

50:23

thousand cancers or? One in

50:26

ten thousand people

50:29

is how frequent that exists,

50:32

right? So for example,

50:34

I have one patient with mastocytosis in

50:36

my practice and I diagnosed

50:39

him because I knew about muscle activation.

50:41

We happened to check a bunch of

50:43

markers and his tryptase level was 80.

50:46

Normal is less than like 12

50:50

and so repeated that a couple times

50:52

and sent him off to the oncologist

50:54

and there you have it. But

50:57

all the symptoms were

50:59

very similar to muscle

51:01

activation. That's one possibility,

51:03

very rare. There

51:07

are some genetic,

51:11

predispis, genetic elevated

51:14

tryptase. So

51:16

it's called alpha hypertryptoecemia, which

51:19

again pretty rare. You

51:22

know, most people who have muscle

51:25

activation come in with a laundry

51:28

list of other diagnosis.

51:30

So they might have

51:32

migraine headaches, endometriosis, interstitial

51:34

cystitis. They might have

51:36

fibromyalgia. They might

51:38

have an ECSF. They might

51:40

have irritable bowel

51:43

symptoms. They might have SIBO.

51:45

They might have an autoimmune

51:47

condition, any sort of neurologic

51:49

degenerative disorder. They could

51:52

have some dementia or brain fog.

51:55

They can have Lyme disease. They

51:58

can have, you know. toxic

52:00

mold exposure. And

52:02

there could be a muscle component in

52:04

any number of those things. So

52:07

it's really on the

52:09

part of the clinician to

52:13

have that suspicion that, hey, you've

52:16

got all these things and all

52:18

these different systems of the body.

52:20

Maybe there's something that's underlying all

52:22

those things. What

52:25

would you say is the most important

52:28

thing that people should do if they

52:32

suspect that they have this going

52:34

on based on the symptoms that

52:36

you've described and based

52:38

on everything we've talked about. What should be

52:40

step one? Okay, yeah, this sounds like me.

52:43

What do I do now? Couple

52:47

things. You know, if

52:50

we can boil it down into really

52:52

simple things, we wanna deal

52:55

with the symptoms and we wanna

52:57

look for root causes. And then of course you

52:59

wanna find somebody to partner with to

53:01

help you through all this because it's

53:04

not a straight path by

53:06

any stretch of the imagination. In

53:10

terms of looking

53:12

at the symptoms, you

53:15

could start with some basic antihistamines,

53:17

right? You could start to think about

53:19

like, what are things that are triggering

53:21

me? What could be making me feel

53:24

worse? And

53:26

avoiding the things that are triggering you and

53:29

trying some of the over the counter

53:31

stuff that's really simple. You

53:34

could try some of the supplements and

53:37

then you bring that information to the

53:39

provider and say, okay, well this worked

53:41

and this didn't and this worked and

53:43

maybe I got like 10% better

53:46

with this. And sometimes

53:48

that's what we're looking for is

53:50

we're looking for, are you

53:53

a little bit better? Actually the

53:55

first thing that we look for is, did that make

53:57

you feel worse? Okay, if it made you feel worse,

53:59

stop. If

54:01

you don't notice anything, great, we'll keep. A

54:05

benefit fantastic will stay on that. If you

54:07

don't see a benefit, then we let it

54:09

go to because obviously we want things that

54:12

are helpful. And

54:15

then, in terms of looking at root

54:17

causes. You

54:20

know, since mold is a big 1,

54:22

does your house smell moldy? Do you

54:25

have have you had a water leak? You

54:28

know, you have to kind of go down

54:30

that pathway and think about the possibility that

54:33

mold in your home or in your office

54:35

space that you

54:37

were exposed to. Could

54:40

have set set things off. And

54:44

then looking for a provider that may

54:46

be a little bit trickier, but there

54:48

are a couple of professional organizations that

54:50

I'm affiliated with. That would be a

54:52

good place to start. 1

54:55

of them is the International Society

54:57

for environmentally acquired illness. I.

55:00

S. E. A. I. dot org.

55:02

You can look for a practitioner

55:05

through that organization. There's

55:07

also an organization called the American

55:10

Academy of environmental medicine. So that's

55:12

a E. M. online dot org.

55:14

They've been around since 1965. The

55:18

original. The

55:22

original practitioners who founded were

55:26

often allergist doctors who

55:28

are taking care of

55:32

patients and they were

55:34

like, the grandfather's a functional medicine. They did

55:36

it. They call themselves environmental medicine doctors. They

55:39

dealt with a lot of patients with

55:42

chemical sensitivity, and so they

55:44

have a lot of tools in their toolkit

55:46

to help modulate the immune system to calm

55:48

people down. And so those

55:50

are some great organizations that might have

55:53

resources and practitioners for patients. Wonderful.

55:57

Any final words you want to leave people with? and

56:00

let people know where they can get in touch

56:02

with you, work with you, or follow your work,

56:04

wherever you want to send them. Okay.

56:09

I think the most important thing to take

56:11

away from this is that there

56:14

is hope, and

56:16

there are lots of tools and resources to

56:18

get people better. I

56:20

never accept that this is your

56:22

diagnosis, therefore this is your life.

56:28

We just need to find the right keys to

56:32

unlock the locks that have

56:36

gotten triggered and are not

56:38

working, not functioning optimally, and it's gonna

56:40

be a journey, and you're gonna have

56:43

to participate, but if you're willing to

56:45

do the work, you

56:47

are absolutely gonna get better. So

56:52

that's the most important thing. And

56:55

then in terms of working

56:57

with me, I do have

56:59

a clinic in Southern California. I'm

57:03

accepting patients. You can

57:05

find me at thespringcenter.com.

57:08

I do see patients from other

57:11

states, but they do have to

57:13

come to California based

57:15

on where I'm licensed and do

57:17

follow-ups. I'm also on

57:21

Instagram at Dr. Kelly

57:23

McCann, and Facebook,

57:26

and I have recently co-hosted

57:30

a Mass Cell Activation Summit with Beth

57:32

O'Hara. You can find more information

57:34

on my personal website. That's drkellymccann.com.

57:38

Thank you so much, Dr. McCann, for coming on the

57:40

show, and I look forward to speaking with you again.

57:44

Thank you so much for having me, Ari. Hey

57:54

there, this is Ari again. Thank you so much

57:56

for listening to this episode. I hope you enjoyed

57:58

it. If you did, if you- If you found

58:00

it valuable, please share it with your friends, share it

58:02

with your family, help me get the word out there.

58:05

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