Before You Begin
This screener asks about your symptoms, home environment, work history, diet, and life exposures. It is designed for people with HIT or MCAS who may be struggling despite following standard protocols- and who suspect environmental toxins are part of the picture.
Answer honestly and instinctively. Do not over-think your answers. The system is designed to interpret symptom patterns. We will ask about things like crawl spaces, peanut butter, bug spray, and old paint- this is intentional. Scroll through and answer all questions, then click Submit My Answers at the bottom.
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Biochemistry-Aware
Accounts for Phase I/II detox, glutathione depletion, and methylation burden
⏳
Historical Exposure
Asks about past exposures still impacting you — including childhood and occupational history
⚡
Cumulative Load
Multiple exposures hitting the same pathways are weighted accordingly
📋
Actionable Report
Free PDF report with your scores, tests to consider and next steps, sent to your email
Core
Core Symptom Patterns
Help us understand how your body responds- don't worry about naming the cause
Section 1 of 14
After eating, do you feel worse in the next 30 min to 3 hours? (flushing, itching, brain fog, bloating, feeling "off")
This can be subtle. Think about times you felt worse after a seemingly normal meal.
Yes, often
Sometimes
Rarely / No
Post-meal reactions are a key HIT/MCAS marker. Toxins that compete with histamine for DAO enzyme activity or impair HNMT worsen this significantly.
Do you get unexplained flushing, redness, or a sensation of heat in your face, neck, or chest?
Yes, regularly
Occasionally
No
Spontaneous flushing suggests mast cell degranulation. Heavy metals (arsenic, mercury) and organophosphates are known mast cell degranulators.
Do you experience headaches or migraines that seem to have no clear trigger?
Yes, frequently
Sometimes
Rarely / No
Mercury, lead, and mold toxins impair methylation pathways needed to break down histamine in the CNS. Histamine is a potent cerebral vasodilator.
Do you struggle with brain fog- difficulty concentrating, word-finding problems, or feeling mentally slow?
Yes, significantly affecting my life
Some days, yes
Not really
Neuroinflammation from mast cell activation + blood-brain barrier disruption from heavy metals = cognitive impairment. Lead and mercury preferentially accumulate in neural tissue.
Do you have skin symptoms— hives, rashes, itching, or eczema— that come and go without obvious cause?
Yes, frequently
Sometimes
No
Skin is mast cell-rich tissue. Nickel, formaldehyde, and pesticides trigger dermal mast cell activation independent of IgE pathways.
Do you have gut symptoms— bloating, cramping, alternating constipation/diarrhea, or nausea— disproportionate to what you eat?
Yes, GI issues are a major problem
Moderately
Minimal GI issues
The gut has the highest mast cell concentration in the body. Mercury and mycotoxins directly damage intestinal tight junctions, worsening histamine absorption.
Does your nervous system feel "on high alert" — anxiety, palpitations, startling easily, or poor sleep?
Yes, frequently
Sometimes
Not really
Histamine is a stimulatory neurotransmitter. Toxins that impair HNMT lead to excess central histamine, producing CNS hyperactivation and autonomic instability.
Do you react to things most people tolerate— smells, foods, medications, supplements, or environmental conditions?
Yes, I'm extremely sensitive to many things
More sensitive than average
About normal sensitivity
Multiple chemical sensitivity reflects glutathione depletion and Phase II saturation. When one toxin depletes detox reserve, ALL other thresholds drop simultaneously— the key concept in cumulative toxic load.
Home
Home Environment: Mold and Water Damage
Mycotoxins are among the most potent mast cell activators known
Section 2 of 14
Does your home have a crawl space, basement, or utility area that is damp, musty-smelling, or has had water intrusion?
Even a crawl space you never enter can circulate mycotoxins via the "stack effect" — air pressure differentials pull crawl space air upward through living areas continuously.
Yes, visibly wet or musty
Has been in the past / unsure of current state
Dry crawl space or sealed
No crawl space / slab foundation
Wet crawl spaces harbor Stachybotrys, Chaetomium, and Aspergillus — prolific mycotoxin producers. Trichothecenes, ochratoxin A, and aflatoxins from these molds are direct MCAS triggers and glutathione depletors.
Have you noticed visible mold, dark spots, or discoloration on walls, ceilings, window frames, or under sinks?
Yes, actively visible mold currently
Was "cleaned" but unsure if properly remediated
Occasional spots
No visible mold
Visible surface mold is the tip of the iceberg. "Cleaning with bleach" kills surface spores but does NOT remove mycotoxins — which are chemical compounds, not organisms, and survive standard disinfectants.
Has your home ever had a flood, roof leak, plumbing leak, or water intrusion — even years ago?
Building materials retain moisture for years. Mold can grow behind drywall long after the original leak was "fixed."
Yes, significant flood or leak history
Minor leaks, seemed resolved
No water damage history I know of
Water damage repaired 10 to 20 years ago can leave mycotoxin-contaminated materials in walls, subfloor, and HVAC ductwork. Historical exposure matters for long-term body burden.
Do your symptoms improve noticeably when you spend significant time away from home — traveling, camping, or staying elsewhere?
Even partial improvement within 24 to 72 hours is meaningful. Think about vacations, hospital stays, or extended visits.
Yes, I feel significantly better away from home
Somewhat better, yes
Hard to tell / haven't paid attention
No difference
The "away from home" test is one of the most clinically useful CIRS screening questions. Significant improvement suggests your primary exposure source is your building, not just your internal body burden.
Do symptoms get worse in humid weather, after rain, or during high-mold-count seasons?
Yes, clearly worse in humidity / after rain
Possibly — I've noticed some correlation
No
Have you worked or spent significant time in a building with known or suspected mold problems — offices, schools, hospitals, older buildings?
Yes, and I know or suspect mold was present
Possibly — older, musty-smelling building
No, buildings have been clean
Working 40 hrs/week in a moldy building can create greater exposure than your home environment. Cumulative occupational mycotoxin load is underestimated in standard MCAS workups.
Food
Food-Based Toxins
Aflatoxins, ochratoxin A, histamine in food, pesticide residues in diet
Section 3 of 14
Do you eat peanuts, peanut butter, or peanut products regularly?
Peanuts grow underground and are highly prone to Aspergillus contamination, which produces aflatoxins — one of the most potent liver carcinogens and Phase I/II detox disruptors known.
Yes, I eat peanut products often
Occasionally
Rarely / Never
Aflatoxin B1 induces CYP1A2 while simultaneously depleting glutathione — creating a "toxic metabolite storm." More reactive intermediates, less capacity to neutralize them.
Do you consume corn, corn products (grits, tortillas, polenta, corn syrup), or conventional grain-fed meat frequently?
Yes, regularly
Sometimes
Rarely / No
Corn is a top aflatoxin and fumonisin host. Fumonisin B1 blocks sphingolipid synthesis, disrupting cell membrane integrity and immune signaling important to mast cell regulation.
Do you eat aged cheeses, cured meats (salami, pepperoni, prosciutto), fermented foods, or vinegar-based condiments regularly?
Yes, these are regular parts of my diet
Occasionally
I avoid these
These foods contain high histamine AND biogenic amines (tyramine, putrescine) that further saturate histamine degradation pathways. They are simultaneously the most reactive food triggers AND a marker of how overwhelmed your DAO/HNMT system is.
Do you notice you react specifically to leftover foods, slow-cooked foods, or foods that have been sitting at room temperature?
Yes, leftovers or slow-cooked food clearly makes me worse
Possibly
No issue with this
Histamine formation in food is time- and temperature-dependent. Fresh-cooked food has negligible histamine; the same food stored 24 hrs can have 10–100x more — especially animal proteins. This is diagnostic of DAO insufficiency.
Do you eat conventional (non-organic) produce, or have a diet high in conventionally grown wheat and oats?
Yes, mostly conventional
Mixed organic and conventional
Mostly organic
Glyphosate is used as a pre-harvest desiccant on wheat and oats, leaving direct residues. It chelates manganese and zinc (needed for DAO) and disrupts gut bacteria critical for histamine regulation.
Do you consume alcohol, and if so, do you have disproportionate reactions — flushing, instant headache, nasal congestion — even from small amounts?
Yes, even small amounts cause significant reactions
Some reaction, manageable
I don't drink / No unusual reactions
Alcohol provides histamine AND blocks DAO enzyme activity AND depletes glutathione via acetaldehyde. This triple hit is diagnostic of borderline DAO/HNMT reserve. Red wine and beer are the highest histamine sources.
Pesticides
Pesticides, Herbicides and Bug Control
Organophosphates, pyrethroids, DEET, glyphosate — shared detox pathways with histamine
Section 4 of 14
Do you use, or have you used, bug spray on yourself or around your home? This includes mosquito repellents with DEET, permethrin sprays, or bug bombs/foggers.
Yes, I use these regularly or used to heavily
Occasionally / seasonally
Rarely / Never
DEET inhibits acetylcholinesterase and increases CNS histamine release. Permethrin disrupts voltage-gated sodium channels and is a known endocrine disruptor. Both require Phase I CYP450 enzymes — the same enzymes that process histamine metabolites.
Has your home, yard, or neighborhood been professionally sprayed by pest control, or do you live near farmland or orchards that are regularly sprayed?
Yes — professional spraying and/or adjacent to farmland
Occasional pest control or some distance from farms
No
Agricultural spray drift can expose nearby residents to organophosphates at levels that chronically suppress acetylcholinesterase. In genetically susceptible individuals (PON1 variants), this creates accumulating neurological and immune effects.
Do you or did you use weed killers — Roundup/glyphosate, 2,4-D, or any herbicide — in your yard or garden?
Yes, I've used herbicides regularly
Occasionally in the past
No
Glyphosate disrupts the gut microbiome, impairs manganese-dependent enzymes, and inhibits CYP enzymes essential for both detox AND histamine metabolism. 2,4-D causes mitochondrial dysfunction affecting energy-intensive detox pathways.
Have you treated yourself, your pets, or your home for fleas, ticks, head lice, or termites?
Think: flea bombs, pet spot-on treatments (Frontline, etc.), lice shampoos with permethrin or malathion, termite treatments.
Yes, multiple times or heavily
Once or twice
No
Chlorpyrifos (termites), malathion (lice), and permethrin (fleas/ticks) all require glutathione for Phase II detox. In GSTM1-null individuals (~50% of population), these compounds accumulate to toxic tissue levels at "safe" exposure amounts.
Did you grow up on or near a farm, or in an agricultural community where chemical spraying was routine?
Yes, significant childhood agricultural exposure
Some, but limited
No agricultural childhood environment
Childhood organophosphate exposure causes neurological, immune, and epigenetic changes that persist into adulthood. The developing immune system is particularly vulnerable to programming errors from pesticide exposure — these can manifest as MCAS decades later.
Heavy Metals
Heavy Metal Exposure
Mercury, lead, arsenic, cadmium — direct DAO/HNMT inhibitors and mast cell activators
Section 5 of 14
Do you have, or have you had, mercury amalgam ("silver") dental fillings?
Mercury amalgam fillings are ~50% elemental mercury by weight and release mercury vapor continuously — especially with chewing, hot liquids, and teeth grinding.
Yes, I have multiple amalgam fillings currently
Had them, removed — but possibly not by SMART protocol
Had them, safely removed (SMART/IAOMT protocol)
Never had amalgam fillings
Mercury directly inhibits both DAO and HNMT enzymes, blocks glutathione synthesis by binding cysteine residues, and triggers mast cell degranulation via oxidative stress. It is one of the most potent MCAS amplifiers identified. Unsafe removal causes a massive acute mercury spike.
Do you eat larger fish — tuna, swordfish, shark, king mackerel, Chilean sea bass — more than 2 times per week?
Yes, I eat large fish very frequently
Occasionally, 1–2x per week
Rarely, or I eat only small/low-mercury fish
Methylmercury from marine fish bioaccumulates in neural and immune tissue. Unlike inorganic mercury, methylmercury readily crosses the blood-brain barrier without needing active transport.
Do you live in, or did you grow up in, a home built before 1978?
Lead-based paint was banned in US residential housing in 1978. Older homes often have lead paint under subsequent layers, releasing dust from friction surfaces (doors, windows) or renovation.
Yes, currently living in pre-1978 home
Grew up in older home / past exposure only
Newer construction throughout
Lead displaces zinc at DAO enzyme active sites and disrupts heme synthesis needed for CYP enzyme iron-porphyrin centers. Both effects impair histamine clearance. Lead in bone has a half-life of decades and releases into blood during physiological stress.
Have you had occupational exposure to heavy metals — construction, welding, auto repair, battery manufacturing, jewelry making, ceramics, shooting ranges, or printing?
Yes, significant or prolonged occupational exposure
Brief or limited occupational exposure
No
Cadmium from welding galvanized metal accumulates in the kidneys with a half-life of 15–30 years, permanently impairing zinc reabsorption. Zinc is essential for DAO function. This is a mechanism by which decades-old occupational exposure still impairs your histamine metabolism today.
Do you drink unfiltered well water, or city water through older plumbing without a quality filter?
Yes — unfiltered well water or old plumbing
Some filtering but not full heavy metal removal
Filtered (reverse osmosis or quality carbon block)
Well water in agricultural areas can contain arsenic from natural geological sources and fertilizer runoff. Older plumbing uses lead solder at joints. Many municipal supplies contain low-level lead, arsenic, and chlorination byproducts that accumulate over years of daily consumption.
Have you received multiple vaccines in a short period, or received childhood vaccines before 2001 (when thimerosal was commonly used)?
Likely yes — born before 2001 / received many vaccines close together
No or uncertain
In individuals with reduced glutathione capacity, even small amounts of thimerosal may not be efficiently excreted. This is a minor contributor compared to amalgam or dietary mercury but relevant in cumulative load assessment.
Have you ever been tested for heavy metals (hair tissue mineral analysis, urinary metals panel, or blood metals)?
Yes, tested — I had elevated heavy metals
Yes, tested — results were normal
Never been tested
Air
Indoor Air Quality and Chemical Exposure
VOCs, formaldehyde, PFAS, synthetic fragrances, off-gassing materials
Section 6 of 14
Do you react to perfumes, scented cleaning products, candles, air fresheners, or fabric softener — with headaches, nausea, or feeling unwell?
Yes, I strongly react to fragrances
Some sensitivity
No
Fragrance sensitivity is a clinical marker of Phase II detox insufficiency and VOC intolerance. Commercial fragrances contain phthalates, terpenes, and benzene derivatives — all requiring glutathione-S-transferase enzymes for detoxification.
Do you have new or newer furniture, carpets, mattresses, or flooring (laminate, engineered wood, vinyl) installed in the last 3–5 years?
New materials off-gas volatile organic compounds (VOCs) including formaldehyde, benzene, and styrene for months to years.
Yes, significant new furnishings or flooring in recent years
Some newer items
Mostly older, well-off-gassed items
Formaldehyde from MDF, particleboard, and laminate flooring is a potent Phase II substrate that saturates glutathione. Many imported flooring products exceed CARB Phase 2 formaldehyde emission standards.
Do you use conventional household cleaners, laundry detergents with optical brighteners, or dry-clean your clothes?
Yes, I use conventional products regularly
Mostly natural/unscented/non-toxic products
Perchloroethylene (dry cleaning solvent) is a confirmed carcinogen and potent glutathione depleter. Quaternary ammonium compounds ("quats") in conventional cleaners trigger mast cell activation directly, even at low concentrations.
Does your home have gas appliances (stove, furnace, water heater), and have you ever had combustion byproduct testing done?
Yes — gas appliances, no recent combustion testing
All-electric, or recently tested and clear
Gas stoves produce nitrogen dioxide, formaldehyde, and benzene during normal combustion. Indoor gas cooking without adequate ventilation can produce VOC levels exceeding outdoor air pollution standards. Combustion gases deplete glutathione peroxidase.
Do you use non-stick cookware (Teflon/PTFE), or stain-resistant products on furniture, carpets, or clothing (PFAS treatments)?
Yes, non-stick cookware and/or stain-resistant products
Occasionally
No — stainless, cast iron, or ceramic only
PFAS ("forever chemicals") have organ half-lives of 3–8 years in the human body. They directly impair Phase II glucuronidation (UGT enzymes), suppress immune regulation, and are associated with elevated IgE and increased mast cell burden.
Have you ever remodeled, sanded floors, or done demolition work in an older home without respiratory protection?
Yes, significant DIY or renovation work in an older home
Minor work
No renovation, or used proper protection throughout
Renovation of pre-1978 homes releases lead dust, asbestos fibers, and historical pesticide residues (chlordane was used under foundations until 1988). Even brief high-level lead dust exposure significantly increases body burden in adults.
Work
Occupational and Industrial Exposure
Work history and industrial chemicals — past exposures still impact you today
Section 7 of 14
Have you ever worked in any of these industries? Select the closest match to your highest-risk job.
Chemical plant, refinery, or plastics manufacturing
Auto body, painting, or spray coatings
Hairdressing, nail salon, or cosmetology
Healthcare with chemical exposure (anesthesia, sterilization, chemo handling)
Agriculture, landscaping, or pest control
Printing, dry cleaning, or janitorial
None of the above / office / remote work
Hair salon workers have elevated urinary formaldehyde, toluene, and aromatic amines. Nail salon workers absorb toluene, methacrylates, and acetone through fingertip skin — one of the body's most absorptive surfaces — for hours daily.
Have you worked in construction, carpentry, or manufacturing with exposure to solvents, adhesives, paints, or industrial cleaners?
Yes, significant solvent/paint/adhesive exposure
Some exposure but limited
No
Benzene, toluene, xylene (BTX solvents) competitively inhibit CYP2E1, creating a traffic jam in Phase I detox. These effects can persist for years after cessation of exposure — the enzyme damage outlasts the exposure period.
Have you lived near a landfill, dry cleaner, gas station, major highway or bus depot, power plant, or industrial facility?
Yes — within 1 mile, prolonged residence
Somewhat nearby / past exposure
No significant industrial proximity
Proximity to industrial facilities correlates with elevated PFAS, benzene, PM2.5, and heavy metal exposure independent of occupation. Children who grow up near freeways show altered CYP enzyme expression patterns that persist into adulthood.
Have you worked with plastics manufacturing, epoxy resins, or BPA/BPS-containing materials?
Yes, significant exposure
Some exposure
No significant exposure
Bisphenol A is an estrogen mimic that upregulates mast cell CRH receptors, directly lowering the mast cell activation threshold. It also disrupts COMT — an enzyme shared by estrogen and catecholamine metabolism with direct histamine crosstalk.
Water
Water and Soil Contamination
PFAS, nitrates, arsenic, cyanotoxins, military site contamination
Section 8 of 14
What is your primary water source, and has it been professionally tested?
Well water, never professionally tested
Municipal water, no personal testing done
Tested recently and results were clean
Do you live in an agricultural area, or has your well or local water shown any history of contamination?
Yes — agricultural area and/or known contamination history
Agricultural area but testing unknown
Urban/suburban, no known contamination
Agricultural wells commonly contain nitrates, atrazine, and organophosphate residues. Nitrate conversion by gut bacteria generates reactive nitrogen species that deplete glutathione and impair mitochondrial function in intestinal cells.
Do you swim in lakes, rivers, or ponds regularly, particularly in agricultural or industrial areas?
Yes, frequently in potentially contaminated water
Rarely, or only in tested/clean water sources
Cyanotoxins from harmful algal blooms are potent mast cell activators. Agricultural runoff creates blue-green algae blooms that produce microcystins — hepatotoxic, immune-disruptive compounds increasingly common in warm freshwater bodies.
Do you live near a military base, airfield, or area with known PFAS contamination (often near fire training sites or airports)?
AFFF (aqueous film-forming foam) used at military and airport fire training sites has contaminated groundwater with PFAS in hundreds of communities. PFAS half-lives in the human body are 3.5–8 years and accumulate in the liver, disrupting bile acid metabolism and immune regulation.
Medications
Medications and Medical Exposures
Drugs that block DAO, deplete glutathione, or disrupt methylation
Section 9 of 14
Do you take or have you taken NSAIDs (ibuprofen, naproxen, aspirin) regularly?
Yes, daily or near-daily use
Occasional use
Rarely / Never
NSAIDs directly inhibit DAO enzyme activity and irritate intestinal tight junctions, increasing histamine permeability. This is why many HIT patients flare when they take standard pain relievers.
Do you take or have you taken proton pump inhibitors (PPIs) — omeprazole, Prilosec, Nexium, Prevacid, Protonix?
Yes, current long-term use
Past use / occasional
Never
PPIs suppress stomach acid needed for B12 absorption. B12 is essential for methylation, and methylation is required for HNMT (histamine degradation in tissues). Long-term PPI use also disrupts histamine-degrading gut bacteria.
Have you had repeated courses of antibiotics — multiple times per year, or prolonged courses?
Yes, frequent or prolonged antibiotic use
Occasional antibiotic use
Minimal antibiotic history
Antibiotics eliminate histamine-degrading bacteria (Bifidobacterium, Lactobacillus) while enriching histamine-producing bacteria (Clostridium, Enterobacteriaceae). This can permanently alter the gut microbiome's role in histamine regulation.
Are you on, or have you been on, methotrexate, chemotherapy, or other drugs that affect folate metabolism?
Folate antagonists block the MTHFR pathway, directly impairing histamine methylation. HNMT requires SAM, which requires a functioning methylation cycle. These drugs can unmask subclinical HIT by dropping histamine clearance below the symptom threshold.
Do you take hormonal contraceptives (pill, patch, ring, hormonal IUD) or hormone replacement therapy?
Yes, currently on hormonal contraception or HRT
Past use
No / N/A
Estrogen upregulates mast cell histamine receptors AND simultaneously downregulates DAO expression. More receptors to stimulate, less capacity to clear histamine. This is why many women with HIT/MCAS notice cycle-tied flares — and why synthetic estrogens can be particularly problematic.
Lifestyle
Lifestyle, Diet and Daily Habits
Factors that affect detox capacity and histamine metabolism every day
Section 10 of 14
How is your protein intake? Do you eat sufficient protein (meat, fish, eggs, legumes) consistently?
Low protein — vegetarian, vegan, or I avoid most protein
Moderate but inconsistent
Good, consistent protein intake
All Phase I and Phase II detox enzymes are proteins. Glutathione requires glycine, cysteine, and glutamate. Without adequate dietary protein, the body cannot produce sufficient detox enzyme quantity regardless of genetic status.
Do you take supplements containing folic acid (synthetic folate) or multivitamins with iron?
Yes, I take folic acid-containing supplements
No, I use methylfolate or no folate supplement
In individuals with MTHFR variants, unmetabolized folic acid (UMFA) accumulates and competitively blocks folate receptors — paradoxically worsening methylation. This directly reduces SAM availability for HNMT activity, worsening histamine clearance.
Do you exercise, and if so, do your symptoms worsen significantly during or after exercise?
I exercise and it clearly worsens my symptoms
Some worsening, manageable
I don't exercise / exercise doesn't worsen things
Exercise-induced histamine release is normal, but in MCAS patients with depleted detox reserve, this triggers systemic reactions. Heavy metal accumulation in muscles also reduces mitochondrial efficiency, worsening exercise tolerance.
Do you wake between 1–4 AM with flushing, anxiety, rapid heart rate, or inability to return to sleep?
Yes, this is a consistent pattern for me
Sometimes
No, I sleep well
2–4 AM is when cortisol reaches its nadir — and cortisol suppresses mast cell activity. When cortisol drops, histamine levels rise. Mercury and other metals disrupt HPA axis function, amplifying this normal circadian dip into a symptomatic event.
Do you smoke, or do you have significant secondhand smoke exposure currently or historically?
Yes, current smoker or significant ongoing secondhand exposure
Former smoker / historical SHS exposure
Never / Minimal
Tobacco smoke contains cadmium, lead, arsenic, benzene, formaldehyde, and PAHs — all simultaneously depleting glutathione. Historical smoking sustains cadmium body burden for decades because cadmium's renal half-life is 15–30 years.
Immune
Infection History and Immune Triggers
Viral, bacterial, and parasitic factors that sensitize mast cells and impair detox
Section 11 of 14
Did your symptoms begin or significantly worsen after a viral infection — mono, Lyme, COVID-19, or another notable illness?
Yes, clear onset or worsening after an infection
Possibly, but hard to say definitively
No clear infectious trigger
Viral infections trigger mast cell activation and can permanently alter mast cell populations and responsiveness. EBV, Lyme spirochetes, and SARS-CoV-2 spike protein all directly activate TLRs on mast cells, lowering the activation threshold for subsequent exposures — including environmental toxins.
Have you tested positive for or been treated for Lyme disease, bartonella, babesia, or other tick-borne illnesses?
Yes, confirmed or strongly suspected tick-borne illness
No
Borrelia biofilms trigger chronic mast cell activation AND sequester/concentrate heavy metals, raising body burden. Chronic Lyme co-infections increase heavy metal toxicity risk through this biofilm mechanism.
Do you have, or have you been tested for, SIBO (small intestinal bacterial overgrowth), H. pylori, or intestinal parasites?
Yes, confirmed SIBO or H. pylori
Suspected but not confirmed
Tested negative or never tested
SIBO organisms produce histamine directly in the small intestine where it is maximally absorbed. H. pylori suppresses DAO expression. Intestinal parasites (Giardia, Blastocystis) trigger eosinophil activation and mast cell proliferation — directly increasing reactive mast cell populations.
Have you experienced significant trauma, PTSD, or chronic psychological stress that changed how your body handles physical symptoms?
Yes, significant trauma or chronic stress history
Some, but manageable
No significant trauma or stress history
CRH (corticotropin-releasing hormone) from chronic stress is the most potent known activator of mast cells — more potent than IgE. Adverse childhood experiences permanently alter HPA axis function in ways that lower the mast cell activation threshold for ALL subsequent toxic exposures.
Radiation
Radiation and Non-Ionizing Exposures
Radon, ionizing radiation, and EMF considerations in the MCAS context
Section 12 of 14
Have you tested your home for radon gas, or do you live in a known high-radon geological area?
Radon is a naturally-occurring radioactive gas that seeps from soil and rock. It is odorless, invisible, and the #2 cause of lung cancer in non-smokers.
Never tested, or live in a known high-radon area
Tested — borderline levels found
Tested — levels acceptable, or low-radon geology
Radon decay products cause DNA strand breaks and oxidative damage in lung tissue, depleting local glutathione reserves and creating a pro-inflammatory environment that can amplify mast cell sensitivity in airways.
Have you had significant radiation exposure — radiation therapy for cancer, multiple CT scans, or occupational radiation?
Yes, radiation therapy or significant medical/occupational radiation
Multiple CT scans over the years
Only standard dental X-rays / minimal exposure
Ionizing radiation causes mast cell degranulation via ROS generation. Radiation therapy can permanently increase mast cell reactivity in affected tissue areas. Multiple CT scans represent cumulative doses that compound glutathione depletion over time.
Do your symptoms worsen in locations with high EMF density — near power lines, in certain buildings, or with heavy WiFi/cellular exposure?
This remains an evolving area of research. We include it because some MCAS patients report strong correlations.
Yes, I notice a clear correlation with EMF environments
No / Unsure
Emerging research suggests radiofrequency EMF may activate VGCC (voltage-gated calcium channels) on mast cells, triggering degranulation. The evidence base is still developing, but EMF sensitivity co-occurs with MCAS at rates above chance in clinical practice.
Personal Care
Personal Care and Product Exposures
Parabens, phthalates, aluminum, PPD, and dermal absorption of toxins
Section 13 of 14
Do you use conventional antiperspirants or deodorants containing aluminum compounds?
Yes, standard aluminum-containing antiperspirant
No, I use aluminum-free products
Aluminum chlorohydrate absorbs transdermally and accumulates in lymph nodes and breast tissue. Aluminum inhibits glutathione synthesis, mimics estrogen signaling, and may directly trigger mast cell activation at higher tissue concentrations.
Do you use hair dye, chemical relaxers, or keratin/Brazilian blowout treatments?
Yes, regularly
Occasionally
No
PPD (para-phenylenediamine) in permanent hair dye is a potent mast cell sensitizer. Keratin treatments release formaldehyde when heated by flat irons. These compete directly for Phase II detox capacity (N-acetyltransferase and glutathione S-transferase).
Do you use nail polish, gel nails, acrylic nails, or nail polish remover regularly?
Yes, regularly
Rarely / Never
Toluene (nail polish), methacrylates (acrylics/gels), and acetone (removers) are absorbed transdermally from fingertip beds — one of the most absorptive skin areas. These are potent glutathione depletors at low chronic exposures.
Do you use chemical sunscreens (oxybenzone, avobenzone, or other UV filters) regularly?
Yes, chemical sunscreens regularly
No / Mineral sunscreen only (zinc oxide / titanium dioxide)
Oxybenzone absorbs transdermally in measurable quantities and competitively inhibits CYP1A2 enzymes. It has been detected in breast milk and amniotic fluid, suggesting significant bioaccumulation potential in genetically susceptible individuals.
Genetics
Family History and Genetic Context
Patterns that suggest reduced enzymatic reserve from birth — your baseline capacity
Section 14 of 14
Do other family members (parents, siblings, children) have similar symptoms — allergies, food intolerances, chemical sensitivities, or autoimmune conditions?
Yes, multiple family members affected similarly
Some family history of allergies or intolerance
No significant family pattern
MTHFR, COMT, MAOA, AOC1 (DAO gene), HNMT, and GSTM1/GSTT1 null polymorphisms are all heritable. A strong family pattern suggests lower-than-average baseline enzymatic capacity — meaning toxic exposures that cause minimal issues for others can be threshold-breaking for your family.
Have you had genetic testing (23andMe, AncestryDNA, or clinical genetics)? If so, were any variants identified?
Yes, tested — known MTHFR, COMT, or other relevant variants
Yes, tested — no significant variants found
Never had genetic testing
Are you of Mediterranean, Middle Eastern, Southeast Asian, or African descent — or does anyone in your family have G6PD deficiency?
Yes, relevant ancestry / known G6PD deficiency
No / Other ancestry
G6PD deficiency impairs the pentose phosphate pathway — the primary source of NADPH needed to regenerate reduced glutathione. G6PD-deficient individuals have dramatically reduced ability to respond to oxidative stress from toxin exposures.
Does your body seem to struggle with detoxification broadly — reacting badly to many medications at low doses, feeling worse when you try to "detox," or struggling with supplements others tolerate easily?
Yes, I am clearly a "poor detoxifier" — many things make me worse
Some, but not extreme
No, I generally tolerate things well
This is the most important clinical context question. Pre-1950s synthetic biology, we didn't need Phase I/II enzymes to run at high speed — we simply didn't encounter this variety and volume of xenobiotics. Many people are operating at or near the maximum speed their enzyme variants can achieve, with zero reserve for additional toxic load.
Do you have any of these diagnosed conditions? (You may select more than one by clicking each that applies)
Celiac disease or confirmed gluten sensitivity
Hashimoto's thyroiditis or other autoimmune condition
Inflammatory bowel disease (Crohn's / Ulcerative Colitis)
Ehlers-Danlos Syndrome (EDS) or hypermobility spectrum
POTS or dysautonomia
None of the above
EDS, POTS, and MCAS form a clinical triad with significant genetic overlap. EDS connective tissue defects impair barrier function (gut, skin, blood-brain barrier), increasing toxin absorption. Autoimmune conditions share immunological pathways with MCAS that amplify each other in the presence of environmental toxins.
Once you have answered all questions above, click the button below to see your on-screen summary, then add your details and submit.
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Your Environmental Toxin Report
Based on your responses, here is your personalized assessment of environmental toxin exposures and their likely impact on your histamine and mast cell burden.
This report is for educational purposes only and does not constitute medical advice. Please work with a qualified healthcare provider.
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