This is an excellent article on the role of histamine in exercise. Worth reading for anyone with an interest in #MECFS or #MCAS. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5161583/

. @itsanginLA, a #longCOVID patient, shared the article with me. Her insight and personal experience make me realize I need to be doing far more to manage my #MCAS, even when I am not having obvious symptoms. https://twitter.com/itsanginla/status/1295468467101896704?s=21

Note antihistamines or mast cell stabilizers alone are not going to resolve exercise intolerance or PEM in people with #CCI or #MECFS. However, they may reduce some of the negative metabolic and inflammatory consequences of exertion, in those with comorbid #MCAS.

Argument for H1/H2 blockers: “...antihistamines had a beneficial effect on preservation of muscle strength and reduced pain perception, most notably at 24 h after the end of exercise.“

Argument against H1/H2 blockers: “ Blocking histamine receptors may impair this process by delaying the migration of immune cells to the damaged muscle tissue, thus prolonging the exercise recovery and remodeling associated with exercise adaptation.”

Histamine has significant effects on 25% of the genes involved in the body’s response to exercise.

“...transcriptome-level changes suggest that there is indeed cross-talk between histaminergic and inflammatory signaling, and also many other systems within skeletal muscle (e.g., metabolism, cell maintenance, vascular function) in response to a bout of aerobic exercise.”

Oh wow. Did you know that athletes take antihistamines at a high rate than the general population?

“The emerging evidence on histamine and exercise is that much of the early inflammatory response to exercise may be driven by this primordial signal molecule.”