Mast Cell Activation Syndrome (MCAS)

Listen to Dr. Risk's Radio Show on Mast Cell Activation Syndrome.

What are Mast Cells?

Mast cells are part of the immune system that are found in connective tissue throughout the body, especially where the body meets the environment at places of entry of antigens (gastrointestinal tract, skin, respiratory tract). Mast cells release histamine and other substances during inflammatory and allergic reactions. This reaction, when acting in a normal way, is necessary for our survival, and our bodies' defense to disease, allergens, and toxins.

What is Mast Cell Activation Syndrome?

Mast Cell Activation Syndrome is when the mast cells become defective or overactive, often releasing too much histamine or being triggered into an over-stimulated allergic response at the wrong time. Too many mast cells are produced and build up in tissues and body organs, releasing substances such as histamine, leukotrienes and cytokines that cause inflammation and symptoms. This over activation process of the mast cells can occur in anyone whether or not there is a history of disease or a genetic component. MCAS has become more recognized, and now it’s estimated that 10-30% of the population may indeed be suffering from the condition, and many don’t realize it. 

What Does Mast Cell Activation Syndrome Look Like?

To add to the confusion, disorders manifested by mast cell activation are a broad variety of diseases that can range from very rare to very common. People with MCAS can have clear allergic reactions, sometimes so severe they suffer from chronic anaphylactic reactions. Others don’t necessarily have clear obvious disease and can just suffer from chronic inflammatory symptoms. Symptoms can be constant, or can come and go over time.

What Conditions are Related to Mast Cell Activation Syndrome?

Conditions that are related to MCAS are, but not limited to: 

What are the Symptoms of Mast Cell Activation Syndrome?

Symptoms of MCAS may include, but are not limited to the following: 

  • Eyes: itchy, watery, red, dry, discharge, hay fever symptoms
  • Nose: itchy, running, sneezing, chronic sinusitis, rhinitis 
  • Mouth and throat: dry, itchy, hoarseness, swelling in tongue or lips, swelling in throat that blocks air from getting to your lungs (anaphylaxis)
  • Skin: itchy, flushing, hives, eczema, sweating, rashes, pimples, angioedema (swelling)
  • Lungs: trouble breathing, wheezing, asthma, shortness of breath, burning aching sensations
  • Heart and blood vessels: low or high blood pressure, rapid heart rate (tachycardia), slow heart rate (bradycardia), palpitations, chest pain, blood clotting
  • Gastrointestinal: cramping, diarrhea, constipation, nausea, vomiting, abdominal pain, bloating, food sensitivities, gastroesophageal reflux disease (GERD), malabsorption
  • Nervous system: headaches, migraines, dizziness, difficulty concentrating, cognitive dysfunction, brain fog, fatigue, adrenal fatigue, problems with word find, sensitivity to hot or cold (often causing hives), syncope (fainting)
  • Endocrine system: hormone imbalances, sweating, thyroid disorders, menstrual cramps, uterine cramps or bleeding, vaginal inflammation, vulvodynia/vulvar vestibulitis, endometriosis, premenstrual syndrome (PMS)
  • Hepatic system: splenomegaly, hyperbilirubinemia, elevation of liver transaminases, hypercholesterolemia
  • Mental health: anxiety, depression, bipolar disorder, insomnia
  • Musculoskeletal: joint pain, muscle aches, pain and cramping, osteoporosis/osteopenia, bone pain
  • Urogenital: interstitial cystitis (IC), overactive bladder (OAB), painful bladder syndrome (PBS), prostatitis
  • Immune system: chronic allergies, food sensitivities, anaphylaxis, asthma, overactive immune responses, autoimmune diseases

What are Triggers of Mast Cell Activation Syndrome?

Since MCAS symptoms can wax and wane, some sufferers report certain triggers for their symptoms including but not limited to: 

  • Sudden temperature changes in the body or environment
  • Stress (emotional, physical, including pain, or environmental)
  • Exercise (especially cardiovascular exercise)
  • Certain food or beverages (including alcohol)
  • Certain drugs (opioids, NSAIDs, antibiotics and some local anesthetics)
  • Contrast dyes
  • Natural odors
  • Chemical odors
  • Perfumes and scents
  • Venoms (bee, wasp, mixed vespids, spiders, fire ants, jellyfish, snakes, biting insects, such as flies, mosquitos and fleas, etc.)
  • Mold exposure
  • Infections (bacterial, parasitic or fungal such as candida, Lyme Disease, COVID or other viral infections)
  • Mechanical irritation
  • Friction
  • Vibration
  • Sun/sunlight

What Causes Mast Cell Activation Syndrome?

Although the exact cause of MCAS is not truly known, there are many related factors that can trigger the illness. Most cases are related to a random change (mutation) in the KIT gene. Typically, this flaw in the KIT gene is not inherited. Other factors that can trigger the syndrome are heavy metal toxicity, infections ((bacterial, parasitic or fungal such as candidaLyme Disease, COVID or other viral infections), chronic and acute prolonged mold exposure, exposure to chemicals and pesticides, chronic exposure to allergens and triggers among others.

What Testing is There for Mast Cell Activation Syndrome?

Lab tests can be done to check for mast cell mediators but are limited and often not run in Canada. Tryptase is a protein that comes from mast cells and it is usually elevated in two circumstances. The first is after a severe allergic reaction (anaphylaxis) and the second is if you have too many mast cells in your body (mastocytosis).

What is the Treatment for Mast Cell Activation Syndrome?

There is no cure for MCAS, but there are ways to manage your symptoms that can help determine the cause. At Ananta Health, we first begin with a thorough intake and consultation that includes BioScan SRT testing. The first appointment will consist of discussing diet and lifestyle changes, as well as suggested supplements and herbs to treat the condition. There are often layers to MCAS and it can take a few months to a few years to get under control; a management strategy will be put into place once symptoms are under control.

Can Acupuncture Help Treat Mast Cell Activation Syndrome?

Acupuncture is extremely helpful in the treatment of MCAS as it can help to calm the immune system down, as well as calm down common symptoms of MCAS including digestive complaints, insomnia, depression and anxiety.