UNRAVELING THE MYSTERY UNDERSTANDING MAST CELL ACTIVATION SYNDROME
Are you experiencing symptoms of mast cell activation syndrome (MCAS)?
Are you experiencing symptoms of mast cell activation syndrome (MCAS)? Perhaps you just received a new diagnosis ore feel that this could be the root of all of your mystery symptoms. It’s natural to have questions. MCAS is such a complex and often misunderstood condition. There is still not enough information out there on how to manage and treat it.
If you are full of questions and want to know how to regain your health and live your life without being held back by MCAS symptoms, worry no more. I created this comprehensive guide that aims to provide you with valuable information to understand MCAS and begin your healing journey.
Meet Dr. Meg
I’m Dr. Meg Mill, like you, I've walked a long, tough road with my own health. For years, I battled chronic allergies, skin problems, GI issues, sensitivities, and anxiety. I moved from one specialist to another, always seeking answers, yet left with none.
The turning point came when I found functional medicine. I realized the true healing power lies in understanding and addressing the root causes of our symptoms. Through this journey, I not only healed myself but also discovered a profound passion for helping others facing similar battles.
Now, with hundreds of success stories under my belt, I want to extend this lifeline to you. My approach isn't just about managing symptoms; it's about transforming lives. I’ve developed a unique, compassionate method that combines the best of functional naturopathy and genetic approaches, tailored to each individual's needs.
I put together this guide because when you're having mystery symptoms and you're not feeling like yourself, having answers from a trusted source can be the catalyst that helps kick-start your healing.
So, let's dive in!
Xo Meg
Mast cells and the Immune system
Let's start at the beginning, at its core, MCAS is a disorder characterized by the abnormal activation and release of mast cells in the body. Mast cells play a crucial role in the immune system's response to allergens and pathogens. They are part of your innate immune system, born in the bone marrow, and migrate to places in the tissue near areas of the interface between the body and the outside world, like our gut, skin, and airways, where they can monitor for perceived threats.
Mast cells are in almost every cell in your body, in mucosal membranes, like the GI tract and respiratory tract, near the surface of the skin, near blood vessels and near nerve cells, and even in the brain They contain hundreds of chemical messengers known as mediators, including histamine, heparin, serotonin, and other inflammatory chemicals called cytokines.
Your mast cells play a very important role in your health. But when your mast cells are not functioning properly and become dysregulated, it can cause a problem in your system.
Expression of Mast Cell Activation
In individuals with MCAS, mast cells become hyperresponsive and overly sensitive to a wide range of triggers. When your body is exposed to an infection, a toxin, an allergen, or encounters some other trigger, your mast cells will come to your rescue. They will let your immune system know about the danger. Mast cells signal other aspects of the immune system by releasing their mediators in a process called degranulation.
Each individual experience of MCAS is different. The type and severity of symptoms, underlying problems, and co-occurring conditions vary from person to person.
The exact cause of MCAS remains unknown, but research suggests a combination of genetic predisposition and factors such as underlying infections, viruses, mold, toxin exposure, or stress play a role. It is important to note that MCAS can coexist with other conditions, making it essential for individuals experiencing symptoms across multiple systems to consider MCAS as a potential underlying cause.
Experts suspect that due to the COVID pan demic, rates of MCAS in the general popu lation are about 25%. And estimate are that 75% or more of people with chronic health conditions have Mast Cell Activa tion Syndrome.
The Difference Between MCAS and Histamine Intolerance
Histamine intolerance arises when there is an excess of histamine from various sources such as a diet rich in histamine, stress, toxins, infections, or the release of histamine from mast cells and basophils. This issue is compounded when the body struggles to eliminate this surplus histamine.
Two key enzymes are responsible for metabolizing histamine in our bodies. The first is Diamine Oxidase (DAO), which is synthesized in organs like the kidneys and thymus, and is abundant in the gut's lining. This enzyme's activity can be supplemented (click here) to help manage histamine levels after eating.
The second enzyme is histamine N-methyltransferase (HNMT), which detoxifies histamine by methylating it, allowing for its safe removal through urine.
A common root cause of histamine intolerance is a DAO enzyme deficiency. The most common reason this enzyme is depleted is underly gut issues. Therefore gut healing protocols are a foundation piece of resolving histamine overload.
Mast Cell Activation Syndrome (MCAS) can precipitate histamine intolerance due to the heightened release of histamine. However, the presence of histamine intolerance does not necessarily indicate MCAS.
While the two conditions often occur together, and many patients with MCAS also suffer from histamine intolerance, this is not universally the case.
Some individuals with MCAS may not experience histamine intolerance. For those showing signs of either condition, it's advisable to consult a practitioner with expertise in both areas to ensure accurate diagnosis and effective treatment.
Understanding Why Your Mast Cells Become Overactive
In order to effectively manage mast cell activation syndrome (MCAS), it is crucial to understand how and why your mast cells become overactive.
Mast cells, a vital part of our immune system, play a significant role in protecting our body from harmful substances. However, in individuals with MCAS, these mast cells become overly sensitive and reactive to otherwise harmless triggers. This results in the release of excessive amounts of various chemical substances, such as histamine and cytokines, leading to a wide range of symptoms and complications.
One key factor contributing to mast cell overactivity is genetic predisposition. Environmental factors, including exposure to parasites, yeast, bacteria, toxins, infections, viruses, mycotoxins, allergens, chemicals, EMF, heavy metals, mediations, hormonal changes, and stress, can also trigger mast cell activation.
Understanding how and why mast cells become overactive is crucial for individuals with MCAS. By exploring the connections between MCAS and various symptoms such as allergic rhinitis, chronic fatigue syndrome, autoimmune disorders, gastrointestinal disorders, skin conditions, environmental triggers, neurological disorders, and hormonal imbalances, you can gain valuable insights and work towards effective management strategies.
Triggers of MCAS may include
Underlying Gut Dysbiosis like SIBO or Leaky Gut
Mold and mycotoxins
Allergens, including food allergens, environmental allergens and insect bites
Infections, including viruses like COVID-19, or bacterial infections like Lyme disease, Bartonella, or other pathogens
Chemicals and other toxins, including chemicals in conventional cleaning, personal hygiene products, toxins in the air and water, and toxins in synthetic clothing and home furnishings
Pesticides, glyphosate, plastics, solvents, and other volatile organic compounds
Toxic metals
EMF fields such as wifi, 5G, or electrical fields and screens
Hormonal changes, including hormonal fluctuations during your menstrual cycle
Physical or psychological stress from anxiety, lack of sleep, pain, rapid temperature changes, or exercise
Smells, such as perfumes and other conventional beauty products
Medications, including antibiotics, ibuprofen, opiate pain relievers, and other
Symptoms of MCAS
Mast cells are in most of your body, so the symptoms of MCAS can be diverse and vary from person to person, making it a challenging condition to diagnose. Common symptoms include allergic rhinitis, chronic, autoimmune disorders, gastrointestinal disorders, skin conditions like eczema and psoriasis, neurological disorders such as migraines and fibromyalgia, and hormonal imbalances.
Having MCAS does not mean that you will have all of these symptoms; it simply means that if you have MCAS, you have an increased likelihood of their occurrence. Symptoms may range anywhere from mild to severe. They may vary based on the day, your diet, lifestyle, stress, triggers, and an array of other factors.
Symptoms of MCAS may include:
Skin issues: rashes, hives, itching
Headaches and migraines
Fatigue
Weakness Dizziness
Heart palpitations, chest pain, blood pressure fluctuations
Diarrhea, nausea, and other digestive issues
Weight changes and poor appetite
Brain fog and cognitive problems
Neuropathy, tingling, numbness, and pain
Cough, shortness of breath, asthma
Allergy symptoms
Hormonal imbalances, PCOS, PMS
Joint pains, muscle pains
Anxiety and depression, other mood and psychiatric disorders
Defining MCAS
Individuals with MCAS may experience a wide range of symptoms, which can vary in intensity and presentation. These symptoms can affect multiple organ systems, making it challenging to pinpoint the exact cause. Common symptoms include allergic reactions, such as hives, itching, and swelling, as well as respiratory symptoms like wheezing, coughing, and nasal congestion. Chronic fatigue, brain fog, and migraines are also prevalent among individuals with MCAS, often overlapping with other conditions like chronic fatigue syndrome and fibromyalgia.
Furthermore, MCAS can manifest as gastrointestinal issues, including abdominal pain, bloating, diarrhea, and nausea. Skin conditions like eczema and psoriasis may also be linked to MCAS, highlighting the systemic nature of this syndrome. Additionally, hormonal imbalances, such as irregular menstrual cycles and thyroid dysfunction, have been reported in individuals with MCAS.
Diagnosing MCAS can be challenging due to its overlap with other conditions and the lack of standardized diagnostic criteria. However, healthcare professionals experienced in mast cell disorders can perform specific tests, including blood and urine tests, to measure mast cell mediators and identify abnormal mast cell activation.
One of the challenges with diagnosing MCAS is that it a ects multiple body systems, yet conventional medicine is divided into di erent specialties.
You may visit various specialists like allergists, dermatologists, gastroenterologists, neurologists, and more to address individual symptoms. But these specialists only view their part of the problem, missing the bigger picture behind MCAS.
Additionally, many conventional doctors are still not familiar with MCAS, even though it reached o cial diagnosis status in 2016. This makes getting properly diagnosed very difficult.
Functional medicine providers are a great option for those with MCAS, as they take a holistic approach. We look at the whole person including symptoms, lifestyle, diet, environment, stress levels, and detailed health history. Understanding the intricate interplay of various bodily systems and external factors is key to e ective treatment.
Specific laboratory tests may be conducted to confirm a diagnosis of MCAS. These tests aim to measure the levels of mast cell mediators, such as histamine and tryptase, in the blood or urine. Elevated levels of these mediators, along with a history of compatible symptoms, can support a diagnosis of MCAS.
It is important to note that MCAS is a complex condition, and its management requires a comprehensive approach. Identifying and avoiding triggers, such as certain foods, medications, or environmental factors, can help minimize symptom flare-ups.
Environmental triggers, such as underlying infections, SIBO, Parasites, Candida, mycotoxins, viruses, foods, chemicals, or stress, can exacerbate MCAS symptoms. Treatment for MCAS primarily focuses on identifying and remediating underlying triggers.
Conditions That May Be Connected with MCAS
Mast Cell Activation Syndrome (MCAS) is often found at the crossroads of various medical conditions, with its role ranging from a solitary issue to a thread in a complex tapestry of health challenges. Understanding the intricate dance between MCAS and its companion conditions requires more exploration.
Some conditions that may be connected to, or co-occur with, MCAS include:
Irritable Bowel Syndrome (IBS)
Gastroparesis and SIBO
Ehlers-Danlos Syndrome (EDS):
Autoimmune conditions
Chronic Fatigue Syndrome
Postural Orthostatic Tachycardia Syndrome (POTS)
Fibromyalgia
Allergies and Asthma
Histamine Intolerance
Multiple Chemical Sensitivity
Having MCAS does not mean you will have all or any of these conditions. Each individual's expe rience with MCAS is different.
Managing MCAS
MCAS is considered by some people to be a chronic condition. The progression and severity of the condition varies from person to person. The long-term outlook of your condition depends on a long list of factors, including underlying causes and issues, co-occurring conditions, your response to treatment, and following your treatment protocol.
Identifying and avoiding triggers and underlying cause can be a key strategy to reduce your symptoms. Other strategies, including dietary changes, supplements, and medication, can help stabilize your mast cells.
With the appropriate investigation and treatment, you can improve your health and regain your quality of life.
Learning strategies to manage MCAS and reduce your symptoms can be seen as a gateway to unlocking the person you are meant to be.
It will require effort to identify your root cause, address nervous system dysfunction, heal underlying traumas, restore a sense of safety in the body, and oftentimes reframe your life experience.
Getting to the root causes (most often there is not just one) of your mast activation is the key to lasting healing and living a life with reduced symptoms. While mast cell activation syndrome is not necessarily something we “solve,” you can live a life that does not revolve around your symptoms. Here are steps to take on that journey to a
1. Gut Healing:
Gut imbalances play a pivotal role in Mast Cell Activation Syndrome (MCAS) due to a complex interplay of factors. The misplacement of gut bacteria, as seen in conditions like SIBO, can lead to an ecosystem disruption within the digestive tract, exacerbating MCAS symptoms. Structural irregularities in the GI tract and nerve damage can impair motility, leading to bacterial overgrowth. Moreover, the vagal nerve, essential for regulating gut movement, can be affected in MCAS, necessitating a balanced approach to encourage proper digestion. Intestinal permeability allows undigested food particles, toxins, and bacteria to pass through the intestinal lining into the bloodstream, triggering an excessive immune response and mast cell activation. Furthermore, Diamine Oxidase becomes impaired, and your body is no longer able to break down the excess histamine exacerbating symptoms. Addressing these multifaceted gut issues through targeted treatments and lifestyle modifications is key to managing MCAS effectively.
2. Reduce Triggers:
Toxins and environmental pollutants can exacerbate symptoms of MCAS. Identifying and reducing triggers is crucial in managing MCAS. Common triggers include allergens, mold and mycotoxins, heavy metals, environmental toxins, stealth infections, and viruses.
The test-not-guess approach helps to enlighten yourself on your triggers and accelerates your healing. Click here for my most recommended test.
3. Identify foods that trigger and support:
In the complex world of Mast Cell Activation Syndrome (MCAS), understanding the role of food triggers and supportive options can be an important piece to reduce symptoms.
It is worth noting that the relationship between food and MCAS is highly individualized. What triggers one person may not affect another. Keeping a food diary and working with a healthcare professional or registered dietitian experienced in MCAS can help pinpoint specific trigger foods unique to your situation.
4. Low Histamine Diet:
Histamine is a chemical released by mast cells, and individuals with MCAS often have difficulty breaking it down. If you are experiencing histamine symptoms from overactive mast cells, adopting a low-histamine diet can help reduce symptoms like allergies, headaches, and gastrointestinal issues. However, remember that while this is to reduce symptoms and overall histamine load. You still need to treat the root cause of the mast cell activation. For symptom relief, avoid high histamine foods such as aged cheeses, fermented foods, alcohol, and dried fruits. Instead, focus on fresh, low histamine options like fresh meat, vegetables, and gluten-free grains.
5. Anti-inflammatory Diet:
An anti-inflammatory, low-sugar diet can help reduce chronic inflammation and MCAS due to dietary triggers. By avoiding processed foods, refined sugars, and unhealthy fats, and instead opting for whole, nutrient-rich foods, you can reduce inflammation in the body. Incorporate anti-inflammatory foods like fruits, vegetables, fish, nuts, and seeds into your diet.
Low oxalate, salycilate and FODMAP diets. Some people need to go deeper to reduce sympt
It is worth noting that the relationship between food and MCAS is highly individualized. What triggers one person may not affect another. Keeping a food diary and working with a healthcare professional or registered dietitian experienced in MCAS can help pinpoint specific trigger foods unique to your situation.
5. Unplug Detox Pathways:
As we said, identifying and removing toxins and reducing your overall toxic burden is essential. Detoxifying your body through methods like infrared saunas, lymphatic drainage massage, and the use of supplements like milk thistle can also support your body's natural detoxification processes but is often not the first step until we have your immune system calmed down as you may be highly sensitive.
5. Rewire Your Nervous System:
Your autonomic nervous system (ANS) is deeply involved in your body's stress response. If you've experienced prolonged stress or trauma, this can lead to a dysregulated ANS, which in turn can exacerbate your MCAS. Your mast cells, which are sensitive to stress signals, may release more histamine and other mediators when your ANS is on high alert, intensifying your MCAS symptoms.
Your body feels like it is in danger at all times, and we need to restore the sense of safety. Working on nervous system retraining will addressing other root causes is a key component for long-term success.
Techniques that help shift your body from a 'fight or flight' state to a 'rest and digest' state can be particularly beneficial. Practices like deep breathing, meditation, and yoga can calm your nervous system, potentially reducing mast cell overactivity and alleviating some of your MCAS symptoms. However, often we need to work on deep exercise to restore the body’s sense of safety.
Supplement Sensitivity
Many MCAS patients are more sensitive to supplements or supplement fillers than other people. The chronic release of histamine and other inflammatory chemicals may lead to hyperactive signaling between mast cell receptors and your nervous system. This may increase sensitivity to supplements.
The tricky part is that supplements are often an important element in addressing underlying issues and natural recovery.
Look for the highest quality and purest forms of supplements with the least amount of fillers from trusted brands.
Start supplements one at a time. You can start with a lower dose and increase the dose, and adding new supplements as tolerated.
Supplements for MCAS?
There are dozens and dozens of MCAS supplements, and specific recommendations are based on your unique root cause. Here, are a few recommendations that may help to calm your mast cells:
Quercetin: Quercetin, a potent compound found in a variety of plant foods like apples, berries, cherries, grapes, and a range of vegetables from peppers to kale, acts as a significant anti-inflammatory agent and a treasure trove of antioxidants. Not only does it enrich your diet with health-promoting flavonoids, but it also functions as a stabilizer for mast cells, potentially reducing histamine levels and offering natural relief from related symptoms. Click here for my favorite quercetin.
Vitamin C: help stabilize the release of histamine from mast cells. Histamine is a compound released by mast cells during immune responses, which can lead to inflammation and other symptoms associated with MCAS. By stabilizing mast cells, vitamin C may help to reduce the excessive release of histamine and alleviate some of the symptoms associated with MCAS. Click her for Vitamin C
DHist - Ortho Molecular: DHist is a fantastic blend of flavonoids, antioxidants, proteolytic enzymes, and botanicals. It is great for mast cell activation, histamine intolerance, and allergies. Click here for D-Hist.
DAO Enzyme: Diamine oxidase (DAO) is an enzyme that your body uses to break down histamine. When your body doesn't produce enough DAO, or if there's an excess of histamine due to severe mast cell activation or intolerance, supplementing with DAO may be necessary to assist in histamine clearance. Click here for my favorite DAO enzymes
Low Histamine probiotic: Some bacteria in the gut have the capability to produce histamine, which can exacerbate symptoms in individuals with histamine sensitivity or conditions such as Mast Cell Activation Syndrome (MCAS). This is why it's critical for those sensitive to histamine to choose probiotics that are specifically labeled as low in histamine-producing species. CLICK HERE for a low histamine probiotic.
Next Steps
Functional medicine practitioners dig deeper than mere symptoms; we consider the entirety of your being—physical, emotional, and psychological health.
We take into account aspects such as diet, lifestyle, stress levels, social interactions, and other elements that could influence your well-being, aiming to uncover and address the root causes and underlying factors of your health concerns.
Recognizing the interconnected nature of these factors is crucial to providing personalized treatment plans, which may include dietary changes, lifestyle adjustments, stress management techniques, nervous system regulation, and specific supplements.
If you're ready to make this change and discover the root causes of your MCAS, I invite you to book a discovery call with me.
On this call, we'll discuss your unique situation and begin formulating a plan tailored to your needs. Let's work together to turn your symptoms into a story of the past and guide you toward a life brimming with energy, vibrancy, and confidence.
Book your discovery call today, and start your journey to a life filled with the vitality you deserve.
In Health,
Meg