Protein Powder for MCAS & Hypermobility - An Australian Guide

Protein supplements can be a nutritious, versatile and accessible option for people who struggle to meet their protein needs through food alone. Over the last few years, many new options have been introduced to the Australian market!

The use of protein supplements in Hypermobility & Co

In the context of Hypermobility & Co, there are many reasons why we may explore using protein supplements:

• Muscle strength to support joint stability - in Hypermobility conditions, our joints tend to be more unstable due to lax connective tissue. Specific exercises can help here, by building up certain muscles to stabilise the joints better. For muscle growth to occur, we need to be consuming enough overall food and protein.

• Textural and flavour preferences - co-existing neurodivergence, including Autism and ADHD are very common with Hypermobility & Co and can impact our what sensory elements, such as taste and texture, we enjoy and dislike. In particular, protein containing foods are one area where people with strong sensory preference tend to struggle with the most.

• Mast Cell Activation Syndrome (MCAS) & histamine intolerance - dietary histamine sensitivity seems to be very common in Hypermobile folk. Histamine is produced as a result of protein breakdown over time, and as a result, higher protein foods like animal proteins require more careful preparation. As a result, many people avoid or reduce how much of these foods they eat due to the hassle, cost and executive functioning burden. Well tolerated protein supplements can help to fill this gap.

• Altered gastrointestinal motility, chewing and swallowing issues - liquid protein supplements can be much more accessible than animal or wholefood protein sources for people with differences in anatomy or motility (e.g. gastroparesis, abdominal vascular compressions, upper cervical instability).

• Blood sugar regulation - due to a variety of factors, it seems that people with Hypermobility & Co may be more susceptible to insulin resistance and altered blood sugar regulation, and/or more sensitive to blood sugar fluctuations, which can trigger POTS/MCAS/other symptoms for some. Aiming for slightly more protein than the Australian Recommended Daily Intake (RDI) can often help here.

Which protein powder will I tolerate best?

It's important to note that while there's a general set of dietary considerations that seem to work for people with Mast Cell Activation Syndrome, when we factor in individual microbiome health, gut motility changes, micronutrient deficiencies, hypermobile anatomy, metabolic health and more can all result in so much more individual variability to our immune response, impacting what MCAS folk can tolerate in practice.

Ensure you consult with a Dietitian or Medical Clinician before trialling new foods if you are cautious about this.

Factors to consider when choosing a protein powder:

• Flavours

  • Usability - most people opt for vanilla or unflavoured as these tend to be the most versatile flavours. Saying this, if you're a sensory seeker and enjoy new and different flavours, these are worth exploring as there are some wonderful brands like Botanika Blends and White Wolf creating unique, delicious flavoured protein supplements.

  • Tolerance - if you are histamine sensitive, keep in mind that you may need to avoid chocolate and coffee based flavours, or other flavours made from foods that you do not tolerate, e.g. strawberry.

• Heavy metal content - it is important to choose a brand with available data confirming LOW levels of heavy metals in their products. Australia has fairly strict regulations on this thanks to the Therapeutic Goods Administration (TGA), however if you are sourcing your protein powder from overseas please keep this in mind

• Price and value - you don't always get what you pay for. Many of the more boutique brands with appealing marketing are just as good quality as cheaper, comparable products. Saying this, there are some brands with a higher price tag which are genuinely very high quality too.

• Texture - depending on your sensory likes and dislikes, it may take a few tries to find a product that you enjoy from a texture perspective. I have tried to highlight the general profile of various products below, but even within one category of protein powder (e.g. pea protein) - some can be very smooth and blend seamlessly into milk/liquid, however others can have a more gritty texture.

Australian protein powder round up for MCAS & Hypermobility:

IMPORTANT NOTE: There will always be an element of trial and error when it comes to trialling or re-introducing new foods with MCAS. It is important that you know the signs of a mild versus a severe reaction, and know how to respond medically. For many people the thought of this can increase anxiety as well, which can also increase MCAS reactions for some. Your medical and dietetic team can assist with this and support you through this process if you are hesitant.

Best options for sensitive clients

Organic Plain Brown Rice Protein Isolate

• Pros: usually easy to digest, and very well tolerated by most people. Plain organic rice protein is often affordable compared to other protein powders.

• Flavour: mild rice-y, nutty flavour

• Texture: slightly powdery, often adds bulk when mixed with liquid. If not enough liquid is used, it can be a bit 'sludgy'

• Considerations:

  • Strong rice flavour - for many, this is easy to mask by making it into a smoothie or adding it into a soup or stew. If you can tolerate vanilla, either purchasing a vanilla flavour, or adding a few vanilla beans to infuse in the protein powder bag can help.

  • Incomplete protein source - rice protein often lacks enough of the essential amino acids Lysine and Threonine, meaning that if rice protein is your only or main protein source, you will be at risk of protein deficiency.

• Product suggestion: Bulk Nutrients '100% Organic Brown Rice Protein'. - $33 per 1kg.

Unflavoured Collagen Protein

• Pros: Very versatile - works well in liquids, smoothies, porridges, savoury dishes and more. Is well tolerated by many people with MCAS, especially those with mould sensitivity who have previously tolerated carnivore style diets well, or those who are looking to re-introduce foods after this. For people with MCAS who are only mildly histamine sensitive, you can make a wonderful collagen hot chocolate (or flavoured with carob or Vital Zing Chocolate Milk Drops, if more histamine sensitive) with 20g of protein that looks and tastes like hot chocolate.

• Flavour: very neutral and fairly tasteless. Can have a slight 'brothy' or 'savoury' note on it's own.

• Texture: fully dissolves into liquids when blended, or when dissolved into a bit of hot water first. Can add a certain 'glossiness' to some foods (e.g. porridge). Does not add bulk in the same way that vegan proteins do.

• Cons:

  • Incomplete protein - as above, caution using collagen as your only protein source as it lacks Tryptophan, Cysteine and Methionine essential amino acids.

  • MCAS reactions - can be reactive for some people. In these cases, people tend to notice reflux, stomach irritation or flushing after consuming collagen protein.

• Products: Protein Supplies Collagen Peptides, Bulk Nutrients HCP, Designs for Health Whole Body Collagen

My favourite all rounders

Mixed vegan protein isolates

• Pros: these are usually made with a mix of legume and rice protein isolates, making them a complete source of protein containing all essential amino acids in sufficient levels. Usually tolerated very well in mild MCAS. Most people enjoy having these.

• Flavour: most mixed vegan proteins come flavoured. Vanilla is often a good versatile flavour which is reliable. Many brands are branching out into more adventurous flavours, such as Strawberry, Vanilla Chai, Lemon Cheesecake and more!

• Texture: Adds bulk to liquids. Depending on the product - some have more of a silky texture, whereas others can be more gritty or chalky. Works well in porridges, shakes and smoothies.

• Cons: it can take a few tries to find a product that you enjoy the taste and texture of, and tolerate. Many brands offer single serve sachets. Many of the flavoured proteins use stevia as a sweetener, and some people find the taste of this a bit overpowering.

• Products

  • Coles PerForm $3 Vanilla Plant Protein - this is quite similar to most other vegan proteins on the market, so it can be a good, accessible place to start. It is a bit more chalky and stevia-y than other mixed plant proteins such as Bulk Nutrients or Botanika Blends.

  • Bulk Nutrients Earth Protein - good range, affordable and well tolerated.

  • Botanika Blends Plant Protein - a great option if you are after a fun, unique flavour and quality product. They have some great ready-to-go snacks like protein cookies, porridge and more too.

  • White Wolf Nutrition Natural+Lean Protein - a bit more pricey, but good quality, very smooth texture, and some great base flavours.

  • Raw Amazonia Protein Isolate - often has sample sachets available at Chemist Warehouse, and often is on sale here too.

What about whey and dairy protein products?

Dairy and MCAS is a tricky area. Many people tolerate it well, but a decent proportion of folk with MCAS feel like dairy products can worsen MCAS and histamine reactions for them. We're still not 100% sure of the mechanism here - there are some thoughts around non-IgE allergic reactions to specific proteins in dairy being more prevalent, but more time and research is needed in this space.

It's undeniable that dairy-based protein powders and drinks often have the best taste and texture profile. At Savvy Dietetics, we often offer dairy-based protein options for people who are known to tolerate dairy well, or have experienced sensory aversions to vegan/collagen products.

Here are some of the options we commonly consider:

Whey Protein Isolate

• Pros: unflavoured WPI has a very neutral taste and texture, which dissolves well into many liquids and foods. It is often affordable as well. WPI is lactose free.

• Cons: if you feel that dairy products containing protein (e.g. milk, cheese, yoghurt) can worsen MCAS for you, it may be best to avoid WPI.

• Products

  • Bulk Nutrients WPI

Rockeby Farms Protein Smoothies

These are ready-to-go high protein drinks, which have been made by filtering extra protein from milk back into milk, to boost the protein content. Rockeby have a variety of flavours in their 'Protein Smoothie' range, and have also launched a 'Fit Milk' more recently, which is an unflavoured high protein milk base. All of their products contain lactase enzyme, so do not tend to cause issues for lactose sensitive folk.

• Texture: smooth and homogenous, similar to a thin milkshake

• Taste: will depend on whether you choose the full sugar range (white lid), or reduced sugar and added stevia (blue lid) range. Flavours include crowd favourites like chocolate, vanilla, strawberry and choc-honeycomb.

To wrap up...

While it seems like a small decision, trialling a new protein supplement can require quite a bit of consideration for Hypermobile people with co-existing MCAS. We hope this round-up can give you a starting point to work from when looking a trialling a new protein supplement with your team.

If you are looking support around navigating food reintroductions with MCAS, meal planning and/or non-dietary management of MCAS - Savvy Dietetics can help! All of the Dietitians on our team are trained in evidence-based approached for working in this space. Romy and Aleisha are currently accepting new clients.

In health,

Savvy

Savvy Dietetics is a special-interest Nutrition & Dietetics clinic passionate about helping people with invisible illness and complex gastrointestinal concerns, including Hypermobillity & Co. Consult information and bookings can be found here, and if you have any specific questions, feel free to email us at admin@savvydietetics.com.au.