AUTOIMMUNE CLINIC
LONDON
Mast Cell Activation Syndrome
What is Mast Cell Activation Syndrome (MCAS)?
These symptoms can affect multiple organ systems and range from mild to severe, often resembling allergic reactions like skin rashes, digestive issues, breathing difficulties, and even anaphylaxis.​
UNLIKE TYPICAL ALLERGIES, MCAS CAN BE TRIGGERED BY MANY DIFFERENT FACTORS, INCLUDING CERTAIN FOODS, ENVIRONMENTAL ALLERGENS, STRESS, AND PHYSICAL ACTIVITY.
The main challenge in treating Mast Cell Activation Syndrome (MCAS) is the mast cells' heightened sensitivity, which causes them to release excessive amounts of chemical mediators, either spontaneously or in response to harmless triggers. This overactivity can result in widespread inflammation and allergy-like symptoms that vary greatly in severity and presentation. For instance, an excess release of histamine may cause skin rashes, gastrointestinal issues such as abdominal pain and diarrhoea, neurological problems like headaches, and even cardiovascular instability. The diverse nature of these symptoms makes diagnosing and managing MCAS particularly difficult.
Mast Cell Activation Syndrome (MCAS) is a chronic immune system disorder where mast cells release an excessive amount of chemical mediators, such as histamine and cytokines, leading to a wide variety of symptoms.
WHAT ARE MAST CELLS?
Mast cells are a crucial component of the immune system, serving a key role in the body's defence. Distributed throughout the body, particularly in areas exposed to the external environment such as the skin, lungs, and digestive tract, mast cells act as first responders. Their main function is to detect foreign invaders or injury, triggering an inflammatory response that helps protect and heal the body.
"When your body always overreacts, think MCAS"
When mast cells encounter allergens, they release substances like histamine, which increases blood flow and vessel permeability, allowing immune cells to target the affected area. While this response is vital for fighting infections, it also causes common allergic symptoms such as itching, swelling, and redness. This dual role of mast cells—promoting healing and triggering hypersensitivity—shows their importance in health and the complications that arise when they malfunction.
What are the symptoms of Mast Cell Activation Syndrome (MCAS) ?
BECAUSE MCAS AFFECTS MULTIPLE SYSTEMS IN THE BODY, ITS SYMPTOMS OFTEN MIMIC OTHER CONDITIONS, WHICH CAN MAKE THE DIAGNOSIS MORE DIFFICULT.
MCAS symptoms are highly varied, mirroring the broad distribution of mast cells throughout the body and the many different triggers that can activate them.
Individuals with MCAS may experience skin issues such as hives, redness, and itching, while also dealing with gastrointestinal problems like nausea, abdominal discomfort, and diarrhoea.
Respiratory symptoms, such as wheezing or difficulty breathing, are also common, and cardiovascular issues can include palpitations or fluctuating blood pressure and heart rate. Neurological symptoms may present as headaches, cognitive challenges, or mood disturbances.
Theirs bodies are damaged and they are left with a wide range of health conditions, some life threatening.​
What about the remaining 75% of the population you ask? These individuals' immune system, when exposed to mould toxins, respond by binding with the invading poison that allows its cells to filter the biotoxins through the liver, kidneys, and other organs. No ongoing symptoms persist and the inflammatory process returns to normal.
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MCAS Symptoms
BY ORGAN SYSTEMS
SKIN: Flushing, hives, angioedema (skin swelling), itching, skin rashes, dermatographism (red welts from scratching), chronic itching, urticarial pigmentosa (hive-like spots), easy bruising, reddish or pale complexion, cherry angiomas (skin growths), patchy red rashes, red face in the morning, slow-healing cuts, fungal infections, and lichen planus.
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RESPIRATORY: Asthma, wheezing, shortness of breath, air hunger, dry cough, chronic obstructive pulmonary disease (COPD), difficulty breathing deeply, and chronic interstitial fibrosis.
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GASTROINTESTINAL TRACT: Abdominal pain (especially in the left upper abdomen), splenomegaly (enlarged spleen), epigastric tenderness, nausea, vomiting, diarrhea, constipation, bloating, abdominal cramping, GERD/acid reflux, non-cardiac chest pain, cyclic vomiting syndrome, colonic and gastric polyps, and malabsorption.
​EYES: Red, irritated, dry eyes; burning sensation; difficulty focusing vision; and conjunctivitis (pink eye).
words.​​
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NOSE: Nasal congestion, sinusitis, postnasal drip, hoarseness, laryngitis, nosebleeds, and intranasal sores.
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THROAT: Throat swelling, mouth or tongue sores, itchy throat, burning mouth, and difficulty swallowing.
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EARS: Tinnitus (ringing in ears) and Eustachian tube dysfunction (blocked or popping ears).
NEUROLOGICAL: Numbness and tingling (especially in the hands and feet), headaches, migraines, tremors, tics, seizures (pseudo or true), brain fog (waxing and waning), memory loss, poor concentration, difficulty finding ​
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CARDIOVASCULAR: Fainting, dizziness, lightheadedness, increased pulse rate (tachycardia), palpitations, hot flashes, postural orthostatic hypotension syndrome (POTS), blood pressure spikes or drops, fainting when standing, high pulse or temperature.
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MUSCULOSKELETAL: Muscle pain, fibromyalgia, joint pain, osteopenia, osteoporosis, and weakness.
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GENITOURINARY: Interstitial cystitis, recurrent bladder infections, sterile bladder infections, and frequent urination.
HORMONAL: Low libido, painful or heavy periods, infertility, and reduced sperm counts.
PSYCHIATRIC: Anxiety, depression, panic, obsessive-compulsive disorder (OCD), attention deficit/hyperactivity disorder (ADHD), short attention span, forgetfulness, and insomnia.
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ANAPHYLAXIS: Breathing difficulties, hives, flushing or pale skin, warmth after exposure, weak or rapid pulse, nausea, vomiting, diarrhoea, dizziness, and fainting.
Triggers of MCAS
INDIVIDUALS WITH MCAS OFTEN EXPERIENCE SYMPTOMS TRIGGERED BY A WIDE RANGE OF FACTORS.
Certain foods, particularly those rich in histamine like fermented products, aged cheese, and alcohol, as well as food additives such as preservatives and artificial colours, are common culprits.
Environmental factors like pollen, mould, dust mites, and pet dander can also provoke reactions.
Temperature changes, whether due to extreme heat, cold, or rapid fluctuations, frequently activate mast cells.
Both emotional and physical stress, as well as trauma and even early life trauma and Chronic Inflammatory Response Syndrome (CIRS), can serve as significant triggers for MCAS symptoms.
Certain medications, such as NSAIDs, opioids, some antibiotics, and beta-blockers, may also worsen symptoms.
Infections, including viral, bacterial, and fungal, are known to cause flare-ups. Additionally, vigorous exercise or overexertion, exposure to chemicals like strong perfumes, fragrances, cleaning products, or cigarette smoke, and hormonal fluctuations during the menstrual cycle or pregnancy can all lead to symptom exacerbation.
Finally, insect stings or bites from bees, wasps, or mosquitoes are known to trigger severe mast cell reactions in some individuals.
Conditions Associated with MCAS
Mast Cell Activation Syndrome (MCAS) is often linked to several health conditions that involve chronic inflammation, immune system dysfunction, and hypersensitivity. These related conditions can either contribute to the development of MCAS or coexist due to shared biological mechanisms.
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Below is a list of conditions associated with MCAS we commonly see in clinic :
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Kharrazian Institute with Dr Datis Kharrazian:Male and Female Hormone Imbalance Throughout the Lifespan Chronic Infections Clinical Strategies and Treatment Applications Mood and Anxiety Disorders Clinical Strategies and Treatment Applications​ Cardiovascular and Neurovascular Syndromes Clinical Strategies and Treatment Applications Childhood Development Disorders Clinical Strategies and Treatment Applications Chronic Fatigue and Pain Syndromes Clinical Strategies and Treatment Applications Cognitive Decline and Dementia Clinical Strategies and Treatment Applications Infertility, Prenatal Care, and Maternal Health Clinical Strategies and Treatment Applications Diabetes and Dysglycemia Clinical Strategies and Treatment Applications Neuroinflammation Clinical Strategies and Treatment Applications Hashimoto’s Clinical Strategies and Treatment Applications Autoimmunity Clinical Strategies and Treatment Applications Gastrointestinal Clinical Strategies and Treatment Applications Plus: Clinical Mastership Program: 100 hours of education with Dr Datis Kharrazian
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Institute for Functional Medicine (IFM):Applying Functional Medicine in Clinical Practice - AFMCP​ Biotransformation Advanced Practice Module Cardiometabolic Advanced Practice Module GI Advanced Practice Module Immune Advanced Practice Module
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The Shoemaker Protocol for Biotoxin illness:Certified Proficiency Partner
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The SIBO Doctor (Dr. Nirala Jacobi):The SIBO Mastery Program with Dr Nirala Jacobi Navigating the Pediatric Gut with Dr Whitney Hayes & Dr Megan Taylor
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Cogence Immunology with Dr Yannuck:Most comprehensive training on functional immunology
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Autoimmune Paleo Diet (AIP) CertificationAIP Certified Health Coach
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Apex Seminars:Mastering Blood Chemistry with Dr Eric Dorninger Mastering Brain Chemistry with Dr Eric Dorninger
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Dr Jason Hawrelak:Gastrointestinal Health Masterclass
What can you do to manage MCAS?
LET'S FIRST ACKNOWLEDGE THAT MCAS IS A COMPLEX CONDITION.
It involves identifying and avoiding triggers such as specific foods, environmental factors, medications, or stress.
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A low-histamine diet can be beneficial by avoiding foods such as fermented products, aged cheeses, processed meats, alcohol, and certain fruits and vegetables. The carnivore diet may also be helpful in reducing potential histamine triggers as well as inflammatory food proteins that may be exacerbating symptoms,.
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Medications, including antihistamines (H1 and H2 blockers), mast cell stabilisers like cromolyn sodium, and leukotriene inhibitors, are often used to control symptoms in individuals who need the extra support. Supplements can also be really helpful to stabilise mast cells and reduce histamine levels.​
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Understanding and managing co-existing conditions like Chronic Inflammatory Response Syndrome (CIRS), autoimmune disease, Small Intestinal Bacterial Overgrowth (SIBO) or Postural Orthostatic Tachycardia Syndrome (POTS) is essential.
It is also important to consider the impact of stress, whether as a trigger or as a contributing factor. Stress reduction techniques like mindfulness, limbic system retraining or yoga can minimise activation due to emotional stress. ​
