One common gift of having Long Covid is having autonomic problems like POTS (Postural Orthostatic Tachycardia Syndrome) isn’t just about getting dizzy when you stand up—though, let’s be real, that alone would be enough. When you throw in MCAS (Mast Cell Activation Syndrome) and histamine intolerance, things get trickier. Suddenly, your body starts reacting to things you didn’t even know were things. It’s like playing “How Many Weird Reactions Can My Body Have Today?” Spoiler: There’s always a surprise round.
Hydration: The Salty, Refreshing Lifesaver
When you’re managing POTS, MCAS, or Long COVID, staying hydrated isn’t just a suggestion, it’s a survival tool. Dehydration can cause a POTS flare-up, send histamine levels soaring, and make your blood pressure swing like a rollercoaster. It’s not cute.
1. DIY Electrolyte Drink
Why it helps: When you sweat, you don’t just lose water—you also lose essential salts. For people with POTS, that can mean dizziness, fatigue, and brain fog. For those with MCAS, overheating can provoke histamine release. A homemade mix of water, salt, a splash of juice, and maybe a pinch of baking soda can help replenish what you’ve lost—without the additives found in commercial drinks.
2. The “Salty” Life
Why it helps: Salt can help expand blood volume, which may reduce dizziness and lightheadedness in POTS. For some, it also helps with blood pressure regulation. (Always speak with your doctor first, especially if you have hypertension.)
3. Hydrating Foods That Love You Back
These low-histamine foods are high in water content and gentle on sensitive systems:
- Cucumber & Watermelon – Packed with water and cooling nutrients.
- Coconut Water – Naturally rich in electrolytes and generally well-tolerated.
- Zucchini – Mild, hydrating, and versatile.
- Apples – Contain quercetin, a natural antihistamine.
- Lettuce & Leafy Greens – Gentle on digestion and high in water.
- Pears & Blueberries – Low in histamine and antioxidant-rich.
- Fresh Herbs – Like parsley, basil, and cilantro—flavorful and usually safe.
MCAS & Histamine Intolerance: Managing the Mystery Reactions
Living with MCAS can feel like you’re stuck in a game of “Guess What’s Going to Set Me Off Today?” You might experience flushing, rashes, headaches, or even POTS flares after eating certain foods or being exposed to triggers. Keeping a symptom and food diary is often a helpful first step.
1. Low-Histamine Foods
- Fresh Meats: Think chicken, turkey, or fish—nothing aged or processed.
- Fruit Favorites:Â Apples, pears, and blueberries are generally well-tolerated.
- Flavorful Herbs:Â Basil and oregano offer taste without histamine overload.
- Frozen = Fresh (Sort Of): If you’re cooking ahead, freeze leftovers right away. Histamine builds up the longer foods sit.
2. Smaller, Frequent Meals
Why it helps: Large meals can divert blood to the digestive system, worsening POTS symptoms. Smaller meals help regulate digestion and reduce histamine release.
Supplements & Meds: Always With Medical Guidance
Please note: This isn’t medical advice—it’s a lived-experience perspective. Always talk to a healthcare provider, especially a specialist familiar with MCAS or POTS.
1. Antihistamines
- H1 Blockers: e.g., loratadine (Claritin), fexofenadine—for skin and sinus symptoms.
- H2 Blockers: e.g., famotidine (Pepcid)—for gut-related issues like acid reflux.
2. Mast Cell Stabilizers
- Cromolyn Sodium (Gastrocrom):Â Especially for GI symptoms.
- Ketotifen:Â A combo antihistamine and stabilizer.
- Montelukast (Singulair):Â Helps block mast-cell-related inflammatory chemicals.
Some people with MCAS also explore low-dose aspirin, but this should only be done under a doctor’s supervision, as it may not be safe for everyone.
3. Natural Support
- Vitamin C:Â Supports immune function and may reduce mast cell activation.
- Quercetin: A bioflavonoid with mast cell–stabilizing properties.
- DAO Enzyme:Â For histamine intolerance, DAO supplements can help break down histamine in food, though effectiveness varies.
Lifestyle Tweaks That Make a Difference
1. Compression Garments
Why it helps: Compression socks or tights can help prevent blood from pooling in your legs, improving circulation and reducing symptoms of POTS.
2. Cooling Hacks
- Ice Packs:Â On your neck or wrists can help quickly cool down your core.
- Portable Fans:Â Surprisingly helpful during heat waves or in crowded spaces.
3. Gentle Movement
Why it helps: Light activity supports circulation without overloading your system. Try slow yoga, stretching, or short walks—especially on days you’re not dealing with Post-Exertional Malaise (PEM).
The Big Picture
Managing POTS and MCAS isn’t easy—but it’s possible. Hydration, diet, medication (when prescribed), and simple daily habits can help make life more manageable. And while it may not feel like it some days, you’re not alone.
Disclaimer: This article is based on personal experience and available research at the time of writing. It is not a substitute for medical advice. Always speak to a healthcare professional before making changes to your treatment plan or trying new supplements or medications.
Long Covid Journey 