Long Covid and Mast Cell Activation: Part 2

In this episode I talk about Mast Cell Activation (MCAS) as experienced by Long Covid sufferers. This is Part 2 of my talk on MCAS. In the first part I talked about the symptoms, medical assessment, the diagnosis and causes of MCAS in Long Covid. In this part I will talk about the specific and general treatments, as well as the recovery, time lines and possible outcomes.
I am Dr Tim Robinson, formerly a GP for 30 years, retired as planned at the start of the Covid pandemic. Since then I have become involved in the world of Long Covid. Currently I am GP clinical lead for Long Covid NHS in South West England, as well as GP lead for three NHS Long Covid Services - Dorset, Bristol and South Devon. I am also Clinical Lead for Hope for the Community CIC. I have research involvement as co-investigator in a study on breathlessness in Long Covid, University of Bristol.
Long Covid Doctor is an educational series for Long Covid sufferers; each talk covers the many aspects of Long Covid, the symptoms, causes, treatments, management and expected outcomes.
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Disclaimer: Long Covid Doctor is an educational series. Any advice, diagnosis, treatments mentioned should only be considered after discussion with your own GP or qualified professional health provider.
References, links, resources:
NICE Covid-19 rapid guideline:
www.nice.org.u...
General resources for Long Covid recovery:
Your Covid Recovery: NHS England website self-help patient resource for symptoms information and self-management. www.yourcovidrecovery.com
Royal College of Occupational Therapists: How to manage post viral fatigue after Covid-19. www.rcot.co.uk/how-manage-post-viral-fatigue-after-covid-19-0
NICE Covid-19 rapid guideline: www.nice.org.u...
Douaud G 2022: doi.org/10.103...
Proal AD 2021: doi.org/10.338...
Weinstock, L. B. et al. Mast cell activation symptoms are prevalent in Long-COVID. Int. J. Infect. Dis. 112, 217-226 (2021).
Nurek M, Rayner C, Freyer A, Taylor S, Järte L, MacDermott N, Delaney BC. Recommendations for the recognition, diagnosis, and management of long COVID: a Delphi study. British Journal of General Practice 2021; 71 (712): e815-e825.
Glynne, P., Tahmasebi, N., Gant, V. & Gupta, R. Long COVID following mild SARS-CoV-2 infection: characteristic T cell alterations and response to antihistamines. J. Investig. Med. 70, 61-67 (2022).
Bruttmann, G., Pedrali P. Loratadine (SCH29851) 40 mg Once Daily versus Terfenadine 60 mg Twice Daily in the Treatment of Seasonal Allergic Rhinitis. J Int Med Res. Mar-Apr 1987;15(2):63-70.
www.ucl.ac.uk/...
Sale ME et al 1994. Clinical Pharmacology and Therapeutics (1994) 56, 295-301; doi:10.1038/clpt.1994.140
www.NHS.uk ‘Dangers of buying medicines online’

[@nataliiazhukova9624]

I totally confirm, that deslloratadin decreases dramatically my brain fog after each covid infection, i had it three times, after first long COVID was developed. There were rather severe symptoms, under supervision of neurologist I started deslloratadin. Famotidin decreases also dramatically my body fatigue, I can't exclude it from my scheme for two year. And also LDN(low dose of naltrexon) is very helpful at MCAS, yes, off label, but very helpful. I've discovered, many patients with long COVID still doesn't have good medical advice in order to have some relief of their symptoms. I was lucky to find a specialist at long COVID department at one vienesse hospital. That's why shere also my experience. Dr.Robinson, thank you very much for your time, clear short explanations, which many people can't get at their GP. Best wishes to you.

[@behnamkhaki4986]

what mcas symptoms did LDN help you with? I have pins and needles, burning, and internal vibration in my feet post Covid V, and I was diagnosed with MCAS (elevated PGD2)

[@bethdixon6399]

Wow, this has been so helpful, thank you for posting this… My twelve year old is currently off school with long covid and we recently saw a private Dr who has given us an action plan which is exactly the same meds you have just talked about, so vey reassuring. Thanks again

[@mscathyaz]

I wish I found you months ago. The holistic approach is what we are doing with an intergrative Doctor here in the USA. I will be listening to all your videos , podcasts etc. Thank you, Doctor ❤

[@Dennis_510]

I would discuss with my GP but most of them don't know squat about LC

[@sallyweiner4180]

I wish every doctor would watch your series though I know this is only one of many illnesses doctors deal with

[@Yazzie101]

Medication sensitivities I can’t take anything .. xyzal 1/2 tab every 3-4 days and that finishes me off the next day I sleep badly! Loratadine dies me out so much!

[@reggie5]

I read that beef kidney can be good for mopping up DOAs... I've ordered some tablets to try. I don't have visible MCAS symptoms, my main issues are lazy fatigue and muscle aches, so my doctor is sceptical histamine is an issue, but I'm running out of options so giving it a go alongside a trial of clarytin. cheers for the videos.

[@maryannemckay3606]

….my best response occurred from going on low histamine diet!

[@mishmaoul2052]

Excellent presentation thank you. One question. Does COVID infect the mast cells or is mcas a reaction to the infection?