Burning mouth syndrome: How Histamine and Mast Cell Activation Syndrome could be the cause

Burning mouth syndrome: How Histamine and Mast Cell Activation Syndrome could be the cause

Burning mouth syndrome (BMS) is painful and we have customers describe it as "imagine eating a bag of chilli's and not being able to drink something cool to soothe it". In 2005 Giuseppe et.al [1] suggested that a possible primary cause could be damage to the tongue's nervous system which triggered the 'burning' sensation. 

Despite becoming more common, particularly among postmenopausal women, the cause of BMS remains unclear. Many argue it could be a hormone imbalance. However, a study done in 2010 showed the potential link between Mast Cell Activation Disorder (MCAS) and BMS [2].

What is Burning Mouth Syndrome

It is a painful condition and many sufferers have described it as a scalding or tingling feeling around their mouth and especially on their tongue. Many feel like their mouth is constantly dry and they can't taste flavours properly. It can also be intermittent, and some even find certain foods can trigger it. Could it be that histamine being released is triggering the symptoms?

We started reading the research, and most importantly looking at the research from the National Institute of Dental and Craniofacial Research and other research available [4]. We looked at the research and analysed that these are the most common 10 potential causes of burning mouth syndrome [7,8]:

12 potential causes of burning mouth syndrome according to the research

  1. Allergies
  2. Hormone changes (low oestrogen especially with menopause)
  3. Medications, in particular, blood pressure medication
  4. Mouth infections (oral thrush/halitosis and caries)
  5. Acid reflux
  6. Dry mouth
  7. Vitamin deficiency, in particular, iron, zinc, and b vitamins
  8. Anxiety & Depression 
  9. Underactive thyroid
  10. Dental procedures i.e. trauma in the mouth
  11. Lichen planus
  12. Mouth infections

It's interesting, all of these conditions are not only linked with the immune system but all of them are triggered by histamine! This does make you think, how can it be that histamine causes burning mouth syndrome? The research shows as the immune system becomes more over reactive, it releases more histamine which then triggers symptoms of Burning Mouth Syndrome.

What is histamine?

Histamine is interesting, it is essential and plays a significant role in our bodies. It helps regulate acid, creates inflammation when we are wounded, and also protects us from viruses.

Histamine is classed as a biogenic amine meaning it is a biological chemical. To put it into layman's terms it's part of the biology of humans (us), animals, and plants. Hence, we always say histamine isn't bad but too much histamine is!

Why is histamine important?

Histamine is crucial to our existence as it plays a major role in our body, as mentioned it controls our acid, sleep, and wake cycle to even how we react to food. 

Histamine attaches to four known histamine receptors, think of these as receptors as messengers. These receptors, tell our body what and how to respond. The four histamine receptors are:

  1. H1 Receptor (H1R): Located in our muscle, skin, and blood vessels. Controls allergies, skin reactions, and blood flow.
  2. H2 Receptor (H2R): Located in the cells in our stomach and intestines. Responsible for stomach acid, and heart rate, and when triggered can make us feel nauseous and even have abdominal pain
  3. H3 Receptor (H3R): Located in our central nervous system. Helps us to wake up. Controls our appetite and even our behaviour.
  4. H4 Receptor (H4R): Located in our small intestine, colon, and most importantly our immune system. Helps control our entire immune system and helps respond to disease. [5]

Let's be honest. How awesome is it that this small little chemical can control and do so much?

The level of histamine in the body at any given time can dictate how helpful it is or how much of a hindrance it can be for the functioning of the areas above. Histamine is usually kept in check by the body’s natural detoxing system. This means it is being broken down and removed by enzymes and specific processes in the body.

However, if this is interrupted and histamine levels increase beyond what the body can process. This triggers histamine symptoms, one of which is Burning Mouth Syndrome.

What about MAST Cell Activation Syndrome (MCAS)?

What is MAST Cell Activation Syndrome?

MCAS is a complicated immune disorder. MAST cells are a type of white blood cell and are located all around your body. MCAS is a condition whereby your MAST cells become extremely sensitive and most importantly over reactive. Allergens such as pollen, foods, and even perfumes which won't affect most people will trigger an MCAS individual.

MAST Cell Activation Syndrome and Histamine Explained

To explain it simply, MAST cells contain histamine alongside other cytokines (small proteins which tell our immune system 'to do its job'). 

MAST Cell Activation Explained (img.1)

If you look at the image (img.1) above we are going to break it down and explain MCAS and histamine in 4 steps:

  1. Allergen is released and enters your body through your nose, mouth, and skin. The body releases IgE as it thinks the allergan is 'bad'. The IgE are located around MAST cells which as mentioned are located all around your body.
  2. Allergen attaches to the IgE and activates the MAST cells to degranulate. This then triggers and begins the release of histamine.
  3. MAST cell breaks down releasing histamine which circulates and attaches to histamine receptors such as the H1 receptor located in your skin and blood vessels.
  4. H1 receptor is triggered creating the histamine symptoms.

This means that MCAS, histamine and the symptoms of histamine are not only all linked but play a major role with one another.

zeolite clinoptilolite products to detox histamine quickly and safely from your body to reduce symptoms of histamine intolerance and MCAS. Check out even more educational articles and videos.

What are the 12 most common symptoms of MAST Cell Activation Syndrome MCAS:

  1. Skin issues: Flushing, itching, hives, and rashes are common due to histamine's effects on blood vessels and skin tissues.

  2. Gastrointestinal problems: Diarrhoea, abdominal pain, bloating, and nausea can occur as histamine stimulates the release of stomach acid and affects gut motility. It also triggers a leaky gut, as histamine creates inflammation in the intestines and colon.

  3. Respiratory issues: Asthma-like symptoms, shortness of breath, and nasal congestion are common, as histamine can cause bronchoconstriction and increased mucus production. Extremely common with seasonal allergies/hay fever.

  4. Cardiovascular symptoms: Rapid or irregular heartbeat, low blood pressure, and dizziness can result from histamine's effects on blood vessels and heart rate.

  5. Fatigue: Chronic fatigue and exhaustion are common with MCAS patients due to chronic inflammation and its impact on the body's energy levels. You have to remember, when histamine triggers the H3 Receptor it can make us feel alert, anxious, and awake. So sleep is hard, meaning we are awake for longer.

  6. Headaches: Migraines and tension headaches can occur due to histamine vasodilatory effects on blood vessels in the brain. This means the blood vessels expand putting more pressure on the brain.

  7. Anxiety and depression: The release of histamine and other mediators can affect mood and neurotransmitter balance, leading to anxiety and depressive symptoms. Think about it, your histamine goes up triggering your cortisol putting you in flight or fight mode. Imagine being on the edge constantly.

  8. Cognitive issues: Brain fog, memory problems, and difficulty concentrating can result from chronic inflammation and its effects on the nervous system. Too much histamine, stress, and exhaustion further triggers 

  9. Muscle and joint pain: Inflammation in the muscles, and expanding of blood vessels can cause pain and discomfort in muscles and joints. As the inflammation expands it puts pressure on your joints causing further pain.

  10. Allergic reactions: Increased sensitivity to environmental allergens, foods, and even supplements lead to even more frequent and severe allergic reactions or should we say histamine reactions.

  11. Sensitivity to temperature changes: As temperatures change it can play a massive role in not only inflammation but MCAS. As your immune system is over-reactive, when the weather changes i.e. too hot or even too cool it can trigger MAST cells which then lead to other histamine symptoms.

  12. Anaphylaxis: In rare cases, severe and life-threatening allergic reactions called anaphylaxis can occur due to massive histamine release.

These are the 12 most common symptoms of MAST Cell Activation Syndrome. However, you should know there are many more. This list is not fully exhaustive!

How are histamine, MCAS, and Burning Mouth Syndrome linked?

The cause of Burning Mouth Syndrome also known as Burning Mouth Disorder is still unclear, but as we have been through the research, could histamine be the culprit for the symptoms? 

According to research conducted by Afrin et.al [2] it affects women more then affects men on a ratio of 7:1. Interestingly, one of the main reasons why this figure is so high for females may be because of menopause [7] research done by Dahiya. P in 2013.

Reading the research, it's very interesting if you look at the common symptoms of burning mouth syndrome, and most importantly the causes of burning mouth syndrome. We can see that histamine is linked to inflammation. Based on the evidence, could detoxing histamine and reducing inflammation potentially be a solution to treating burning mouth syndrome?

When our immune system is overreactive whether it be from food allergies, menopause, medication, and even stress, our body releases histamine. This histamine triggers the four different receptors. When these receptors are triggered in particular the H1 receptor which is located in the mouth. This can then trigger pain in the mouth. 

Our conclusion

Looking at the research, symptoms of MCAS and histamine intolerance. It is clear that they are linked to inflammation and the sensation felt with burning mouth syndrome. The cause or aetiology of burning mouth syndrome may be unknown, but we can definitively look at binding and detoxing histamine as a solution for burning mouth syndrome. By detoxing histamine, you can not only bring your immune system into balance but take away the symptoms felt by burning mouth syndrome.

Enjoyed this article? Now read...

Histamine and menopause: How are they linked?
Histamine: what is it and why is it important?
What is histamine intolerance?

Scientific references

  1. Lauria G, Majorana A, Borgna M, Lombardi R, Penza P, Padovani A, Sapelli P. Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome. Pain. 2005 Jun;115(3):332-337. doi: 10.1016/j.pain.2005.03.028. PMID: 15911160.
  2. Afrin LB. Burning mouth syndrome and mast cell activation disorder. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Apr;111(4):465-72. doi: 10.1016/j.tripleo.2010.11.030. PMID: 21420635.
  3. Dahiya P, Kamal R, Kumar M, Niti, Gupta R, Chaudhary K. Burning mouth syndrome and menopause. Int J Prev Med. 2013 Jan;4(1):15-20. PMID: 23411996; PMCID: PMC3570906.
  4. National Institute of Dental and Craniofacial Research. Sept 2022. Burning Mouth Syndrome. 24/04/2023 (https://www.nidcr.nih.gov/health-info/burning-mouth)
  5. Zampeli E, Tiligada E. The role of histamine H4 receptor in immune and inflammatory disorders. Br J Pharmacol. 2009 May;157(1):24-33. doi: 10.1111/j.1476-5381.2009.00151.x. Epub 2009 Mar 20. PMID: 19309354; PMCID: PMC2697784.
  6. Theoharides TC, Tsilioni I, Ren H. Recent advances in our understanding of mast cell activation - or should it be mast cell mediator disorders? Expert Rev Clin Immunol. 2019 Jun;15(6):639-656. doi: 10.1080/1744666X.2019.1596800. Epub 2019 Apr 22. PMID: 30884251; PMCID: PMC7003574.
  7. Dahiya P, Kamal R, Kumar M, Niti, Gupta R, Chaudhary K. Burning mouth syndrome and menopause. Int J Prev Med. 2013 Jan;4(1):15-20. PMID: 23411996; PMCID: PMC3570906.
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