GLP-1 receptor agonists (GLP-1 RA) are a class of medications originally developed to treat type 2 diabetes, but have since gained widespread attention for their effects on weight loss and metabolic health. These drugs work by mimicking a natural hormone called GLP-1 (glucagon-like peptide-1), which helps regulate blood sugar, appetite, and digestion.
Emerging research suggests that GLP1-Receptor Agonists could be supportive in managing inflammatory symptoms associated with Mast Cell Activation Syndrome (MCAS). Although research is currently limited, this is what we know so far.
What is MCAS?
Mast cells are a type of white blood cell that are found in connective tissues throughout the body. Typically, mast cells are located in the boundaries between the internal and external environment, they are the first line of defence at mucosal surfaces such as the lungs, digestive tract and the skin. They can also be found near blood vessels, lymph vessels and in nerves.
Mast cells, when activated, produce a variety of inflammatory molecules, one of which being histamine. Histamine is an immune signalling protein that causes allergies and swelling. It affects many different organ tissues in the body, and therefore it is not always
immediately obvious that symptoms are histamine driven or mast cell driven.
Mast cells have lots of different receptor sites which means that they can become triggered by many different things and as a consequence, illicit an inflammatory response.
Mast Cell Activation Syndrome (MCAS) is when mast cells become overly responsive and easily triggered and therefore, release a lot of histamine. This is usually a consequence of frequent or long term activation due to ongoing infections, allergic reactions or toxin exposure or even chronic stress i.e. an overflowing bucket.
Constant mast cell activation across time means the mast cells may struggle to differentiate between what is “safe” and what is “unsafe” and therefore, may become highly reactive to foods, supplements, light, noise, heat, exercise, smells, skin care products etc.
Not everyone who experiences a Chronic Illness will have MCAS, but it is estimated that 50% of people with Chronic Illness have MCAS or histamine intolerance and therefore it can be common territory for those with chronic fatigue, post-viral fatigue, long covid or other energy limiting illness.
How do GLP-1 Receptor Agonists Work?
As the name suggests, GLP1-RA mimics the action of a peptide known as (glucagon-like peptide-1). GLP-1 is a hormone naturally produced in the gut, primarily released after eating.
It plays a key role in regulating blood sugar levels and appetite.
GLP-1 works in the following ways:
- It stimulates the pancreas to release insulin (which lowers blood glucose), suppresses the release of glucagon (a hormone that raises blood glucose). This helps to bring blood sugar down when blood sugar is high.
- It suppresses appetite and increases signals of satiety.
- It slows down stomach emptying which slows down the release of sugar into the blood stream but also helps you to feel fuller for longer.
- It may also increase the function of beta cells which are the cells on the pancreas that produce insulin.
Mast Cells and GLP-1 Receptors
GLP–1 receptors are present on many different cell types including mast cells. Some prescribing professionals have noted that when prescribing GLP1-RA for individuals with diabetes and MCAS, that the individuals also experienced improvements in inflammatory symptoms connected to MCAS.
A recent retrospective case series – which is a type of research which looks back on a group of people who have already been diagnosed or treated for a particular condition – reported on 47 subjects who had been selected and definitely diagnosed with MCAS.
Of these 47, 89% saw multi-system improvement within days of taking the GLP1-RA and in some cases improvements were observed within a 24 hour period, These improvements were related to symptoms that were inflammatory in nature.
The study concluded that there may be clinical benefit to the use of GLP1-RA in MCAS but as this was an observational study, there were no controls. Therefore, more research, specifically randomised controlled trials would be needed to determine the efficacy and optimal dosage. However, the results are promising.
What does this mean for you if you have or suspect you have MCAS?
If you are someone who is impacted by MCAS you may want to consider discussing this study with your prescribing practitioner.
As with any medication it is important to be aware of risks of side effects. GLP1-RAs are commonly used as a weight loss drug and side effects may include gastrointestinal issues such as nausea, vomiting, diarrhea, constipation and abdominal pain.
If you already experience some digestive imbalances, if you are underweight or struggle with episodes of hypoglycemia (low blood sugar), you may need to be cautious.
Experience in practise
I have limited experience with clients taking these medications in practice, however I do have some experience. Where it has been useful is in individuals who have weight to lose and perhaps struggle with higher blood sugar and poor food compliance, which makes sticking to a low histamine diet (or any more restrictive diet) more challenging.
GLP1-RAs have been helpful to support better dietary habits which in turn is supportive of reducing inflammation and overall health.
Remember Your Foundations
Remember that there will always be a certain amount of trial and error when working with a chronic illness. Although the results look promising and have potential for a positive impact, there is always a chance that a change in medication could make you feel worse.
It is always best to make changes from a place of stability, which means that you want to have the “Foundation Five” in place. If you aren’t sure what this means, you can learn more about the Foundational Five Methodology here and take the FREE QUIZ to see which areas you may still need to master.
