Mast Cells, Histamine, and Perimenopause Explained: MCAS, Anxiety, Estrogen

In this bonus episode of unPAUSED, Dr. Mary Claire Haver is joined by Dr. Zachary Rubin, double board certified allergist and immunologist and New York Times bestselling author of All About Allergies, to dig into the connection between histamine, mast cells, and women's hormonal health.

Dr. Rubin breaks down what mast cells are, how histamine works across multiple organ systems, and why women are disproportionately affected by mast cell related conditions including mast cell activation syndrome (MCAS). The two dig into the estrogen and histamine connection, why perimenopause can trigger or worsen symptoms like anxiety, brain fog, and histamine intolerance, and what MCAS actually is and how it is diagnosed. Dr. Rubin also addresses the viral H1 and H2 blocker combination that has been circulating online, explaining the real science behind why it may be helping some women with PMDD, endometriosis, and perimenopausal symptoms, while being honest about what we still do not know.

They also cover quercetin, DAO supplements, low histamine diets, and how to think about self experimentation safely. If you have been wondering whether histamine could be a piece of your hormonal health puzzle, this conversation is a great place to start.