What is Mast Cell Activation Syndrome?
Mast cell activation syndrome is a complex condition but one that is becoming more well-known. Mast cell activation syndrome (MCAS) involves many different body systems which can cause many different symptoms. Many of the symptoms are related to the cardiovascular, gastrointestinal, respiratory, and neurological systems as well as the skin.
Mast cell activation syndrome can also be classified as either being primary secondary or idiopathic meaning there is really no identifiable cause of this condition.
So what exactly is MCAS? To understand this condition better, it’s important to understand the role mast cells play in our body. Mast cells are in most of our body tissues, and they are present in order to help protect the body from injury and are intricately involved in our bodies allergic response. When the body responds to threats or foreign invaders, these cells will secrete things such as histamine, prostaglandins, cytokines, among other chemical mediators. Many of these chemicals will increase inflammation, cause an increase in heart rate, and even congestion. While these don’t sound like pleasant symptoms, they are actually highly protective when our body is responding to a foreign invader, and they help our body heal.
While mast cells play an important role in response to things like allergic reactions, it's been found that these cells are closely linked to the development of autoimmune diseases and many other disorders. (1)
While we need mast cells to survive, overactive mast cells can cause mast cell activation syndrome and can lead to a handful of symptoms. More and more people are being diagnosed with MCAS and part of the problem may very well have to do with the number of environmental as well as food chemicals we as humans are exposed to on a daily basis. It throws these mast cells into overdrive and can lead to some serious problems.
The symptoms associated with mast cell activation syndrome are due to a large amount of histamine in the body as a result of the activated mast cells.
Other Diseases Associated With Mast Cell
More times than not there are other diseases associated with mast cell activation syndrome. Some conditions can go hand in hand with MCAS meaning that if you have one you may be more likely to develop the other. Here are some of the diseases linked to mast cell activation:
- Autoimmune diseases
- Irritable bowel syndrome
- Celiac disease
- Chronic fatigue syndrome
- Eosinophilic Esophagitis
It is also important to know that MCAS can be developed at any time it’s not something you are born with. However, women are more likely to develop this and it’s affecting more people than ever before.
What are the Symptoms of Mast Cell Activation Syndrome?
Mast cell activation syndrome comes with a plethora of symptoms. The symptoms are so vast that it can make diagnosis a little complicated without working with someone who has experience with this condition.
Many of the common symptoms are ones you would associate with an allergic reaction, while others you may not be able to pinpoint to one specific cause. Here are some of the symptoms to watch out for:
- Gastrointestinal complaints
- Shortness of breath
- Heart palpitations
- Low blood pressure
- Brain fog
Mast Cell Diagnosis
One of the diagnostic factors when trying to uncover mast cell activation syndrome involves looking at symptoms. This involves looking at symptoms that are in line with mast cell mediator release that will affect two or more organs and may present with the following symptoms:
- Low blood pressure
- Heart palpitations
There are also a handful of diagnostic lab tests that can be run to help diagnose mast cell activation syndrome including serum tryptase, plasma histamine, PGF2a, N-methylhistamine. A 24-hour urine test to detect the presence of mast cell mediators can be very helpful as well. (2)
It’s also important to work with a skilled practitioner who has experience with MCAS as diagnosis can be tricky. Many times blood panels come back normal which is why it’s recommended that they are run twice when you are symptomatic.
I often see clients come to my practice dealing with mast cell activation syndrome and often times there’s a trigger for why it is occurring. Some common triggers would include environmental toxins and chemicals, medications, certain reactive foods or foods high in histamine, and of course stressors.
The biggest give away to me that someone has MCAS is when they have been sick for a long time with very unexplained symptoms that no one can figure out.
If you’ve been diagnosed with mast cell activation syndrome, there are some treatment options to help keep your symptoms at bay.
There are many medications that are commonly used with MCAS with some of the more popular options including antihistamines, leukotriene inhibitors, and mast cell stabilizers. Antihistamines are often the first line of defense as histamine is released by activated mast cells in very large amounts. The Antihistamines work to block the histamine receptor. Keep in mind that there are different types of histamine receptors, so you will want to work with a practitioner who knows which antihistamines work against which receptor for proper treatment.
A low-histamine diet is also an important step in controlling mast cell activation syndrome as well as cutting out gluten and controlling both physical and emotional stressors. There are also some natural supplements that work as natural antihistamines such as quercetin, and omega-3 fatty acids.
While working to stabilize the mast cells I then look for underlying triggers of these attacks like gut infections, HPA-axis dysfunction, heavy metal toxicities and others. Finding these triggers can really help to keep this disease at bay, as medication is not the long term answer.
Having mast cell activation syndrome can make you feel overwhelmed and unsure of how to start your healing journey. The first step is to uncover the trigger so that healing can begin. Adding the proper supplements, starting a low-histamine diet, and reducing stress levels are excellent places to start. If you want to read more specifically about histamine, read my article on histamine intolerance here.
click here for more information.
- Jill. Mast Cell Activation Syndrome (MCAS): When Histamine Goes Haywire…
- Lisa Klimas (2015). Initial diagnosis and treatment of mast cell activation disease: General notes for guidance.