Mast Cell Activation Syndrome (MCAS)

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

What are Mast Cells?

Mast cells play an important role in the immune system by releasing histamine and other inflammatory mediators in response to allergens and other triggers. They are found in connective tissue throughout the body, including the skin, respiratory tract, and gastrointestinal tract. These cells help to protect the body from disease, allergens, and toxins, but when they malfunction they can cause allergic reactions such as hives, asthma, and anaphylaxis. Understanding the role of mast cells in the immune system can help to provide insight into the causes and treatments of various immune-mediated conditions.

What is Mast Cell Activation Syndrome?

Mast Cell Activation Syndrome (MCAS) is a condition in which mast cells, which are a type of immune cell, become overactive or defective. This can lead to the release of excessive amounts of histamine and other inflammatory mediators, causing symptoms such as itching, hives, and difficulty breathing. MCAS can occur in anyone, whether or not there is a history of disease or a genetic component. It is estimated that 10-30% of the population may be suffering from MCAS, and many people may not be aware of it. Symptoms can vary widely and mimic other conditions, making MCAS a challenging condition to diagnose. However, with an accurate diagnosis and proper treatment, it is possible to manage symptoms and improve quality of life.

What Does Mast Cell Activation Syndrome Look Like?

Mast Cell Activation Syndrome (MCAS) can present in a wide variety of ways, making it a challenging condition to diagnose. Symptoms can range from clear allergic reactions, such as hives, itching and difficulty breathing, to more chronic, inflammatory symptoms that can mimic other conditions.

Some common symptoms of MCAS include:

Skin rashes or hives -Itching
Difficulty breathing
Anaphylaxis
Gastrointestinal symptoms such as abdominal pain and diarrhea
Fatigue
Headaches
Anxiety and depression
Muscle and joint pain
Flushing or feeling hot and/or cold Symptoms can come and go over time and can be different in severity and frequency, making it difficult to diagnose.

What Conditions are Related to Mast Cell Activation Syndrome?

Conditions that are related to MCAS include:

Hypermobile Ehlers-Danlos syndrome (hEDS)
Postural orthostatic tachycardia syndrome (POTS)
Post-COVID-19 illness (Long COVID)
Asthma
Anaphylaxis allergies and other allergies
Chronic Lyme disease
Mold toxicity
Heavy metal toxicity
Chronic inflammatory response syndrome (CIRS)
Many skin conditions (rashes, hives, eczema)
Lupus
Interstitial cystitis (IC)
Fibromyalgia
Chronic fatigue syndrome
Inflammatory bowel disease
Food and environmental allergies and sensitivities

It is important to note that these conditions are related to MCAS and may share similar symptoms but they are not the same thing. A proper diagnosis should be made by a medical professional and proper treatment should be sought. Understanding the relationship between MCAS and other conditions can help to provide insight into the causes and treatments of various immune-mediated conditions.

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

Symptoms can vary widely and change over time, making MCAS a challenging condition to diagnose. However, with an accurate diagnosis and proper treatment, it is possible to manage symptoms and improve quality of life.

What are Triggers of Mast Cell Activation Syndrome?

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

It is important to note that triggers can vary from person to person and that not all triggers may cause symptoms to occur. Understanding individual triggers can help to manage symptoms and improve quality of life. It is best to work with a medical professional to identify and manage the triggers.

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

Mast Cell Activation Syndrome (MCAS) is a condition in which mast cells, which are a type of immune cell, become overactive or defective. The exact cause of MCAS is not fully understood, but there are several factors that may contribute to its development. Some of the most common causes of MCAS include:

Mutations in the KIT gene: Most cases of MCAS are related to a random change (mutation) in the KIT gene, which controls the growth and development of mast cells.
Toxicity: Exposure to heavy metals, chemicals and pesticides can lead to toxicity, which can trigger MCAS.
Infections: Chronic or acute prolonged infections such as candida, Lyme Disease, COVID or other viral infections can trigger MCAS.
Mold exposure: Long-term exposure to mold can trigger MCAS symptoms.
Chronic exposure to allergens and triggers: Continued exposure to allergens and triggers, such as dust, pollen, or certain foods, can lead to the development of MCAS.

It is important to note that the cause of MCAS can vary from person to person and that it may be multifactorial. Understanding the underlying causes of MCAS can aid in the proper diagnosis, treatment, and management of the condition.

What Testing is There for Mast Cell Activation Syndrome?

Diagnosing Mast Cell Activation Syndrome (MCAS) can be challenging as symptoms can be wide-ranging and vary from person to person. However, there are several tests that can be performed to help diagnose the condition.

Tryptase test: A tryptase test is a blood test that measures the level of tryptase, a protein that is released by mast cells. Elevated levels of tryptase can indicate the presence of too many mast cells in the body, which is a hallmark of MCAS.
Other Mast Cell Mediators: Other lab tests can be done to check for other mast cell mediators such as histamine, prostaglandin D2, and leukotrienes. These tests can be done to support the diagnosis of MCAS.
Skin biopsy: A skin biopsy can be performed to check for the presence of excessive numbers of mast cells in the skin, which is a characteristic of MCAS.
Other tests: Depending on the symptoms, other tests such as blood tests, skin tests, and imaging scans may be performed to rule out other possible causes of symptoms.

It is important to note that these tests are not always available in Canada, and that the diagnosis of MCAS can be a process of exclusion of other conditions with similar symptoms. It is best to work with a medical professional to identify the cause of symptoms and to determine the appropriate testing and treatment.

What is the Treatment for Mast Cell Activation Syndrome?

The treatment for Mast Cell Activation Syndrome (MCAS) focuses on managing symptoms and identifying triggers to reduce their occurrence. 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. It is important to note that MCAS can have multiple causes and it may take several months to a few years to gain control over symptoms, a personalized management plan will be established once symptoms are stabilized.

Can Acupuncture Help Treat Mast Cell Activation Syndrome?

Acupuncture Acupuncture is a form of traditional Chinese medicine that involves the insertion of thin needles into specific points on the body to promote healing and balance. Some studies suggest that acupuncture may be beneficial in the treatment of Mast Cell Activation Syndrome (MCAS) as it has the ability to reduce inflammation and regulate the immune system. Additionally, acupuncture can help to alleviate common symptoms of MCAS such as digestive complaints, insomnia, depression and anxiety.