MCAS 101

(Mast Cell Activation Syndrome)

In people affected by MCAS, chemicals called mast cell mediators are released too frequently or abundantly, and/or in response to triggers that are not typically considered to be harmful. This can lead to a MCAS which causes a wide range of symptoms that affect many organ systems. Triggers can include foods, chemicals, viruses, wounds, fragrance, exercise, stress and changes in temperature. MCAS symptoms can come and go and may often change over time within the same person. This can make it difficult to identify specific triggers, and the number of triggers and severity of symptoms may continue to increase as the condition progresses.

What is happening with MCAS?

The body detects what IT PERCEIVES AS A DANGEROUS STIMULI (but is benign to people not affected by MCAS) and the body releases chemical mediators to “fight” the “foreign” invader.


Diagnosis

  • Elevated tryptase level during a flare

  • Observation of pathological mast cell under microscope/with pathology: 

    • Ask the pathologist to look at: MCs: CD117, anti tryptase; MC activation markers:CD2, CD25, CD30

  • Symptoms improve with MCAS medications

Symptoms

Chronic runny nose, hives, GI distress, fatigue, headache, itching, anxiety, flushing, swelling of tissues, brain fog, body pain, constipation/diarrhea, irritability, bloating, lightheadedness, hoarse voice, reflux

Treatment suggestions

  • Avoid known triggers!

  • Trial “low histamine” diet (also considered an anti-inflammatory diet), omit if there is a history of disordered eating

  • HI blocker (antihistamines such as Zyrtec, Xyzal, Allegra, Claritin)

  • H2 blocker (famotidine)

  • Mast cell stabilizers (Ketotifen, Cromolyn Sodium/Gastrocrom)

  • Mediator blockers: Antileukotrienes (Singulaire)

  • Mediator blockers: Antiprostaglandins

  • Antibody therapy (Xolair)

  • Vitamins (C, D, magnesium)

Wendy’s beginning 2 week MCAS protocol:

(This is a recommended protocol and should only be done with physician approval as it is a medical treatment plan. Please contact your doctor and review this plan before you begin.)

  1. H1 blocker like Allegra/Zyrtec/Xyzal/Claritin (one AM/one PM)

  2. H2 blocker (20-40 mg famotidine AM and 20-40 mg famotidine PM)

  3. D-Hist (2 capsules, three times a day)

  4. Vitamin C (1000mg daily)

  5. Follow “Low Histamine Diet” as best as you can





Please note: Wendy4Therapy is not a medical doctor and is not licensed to provide an official medical diagnosis or prescribe medication. Education provided here is for your information only, and it is expected that you visit a medical practitioner who is licensed to provide a diagnosis for further exploration. Wendy4Therapy can take you through the diagnostic criteria but cannot formally diagnose EDS or related conditions. Please do  not reproduce without permission. This is GENERAL and not intended to be customized for individual patients. Please follow consultation and recommendations of your healthcare provider for specific treatment protocols.