MCAS: Allergies with a Twist

I have had a rash of patients (pun intended) dealing with very annoying histamine problems. Yesteryear we talked about “bad allergies,” and we all know someone who struggled with every allergy medication and inhaler invented. Some of those same people went on to get allergy shots weekly for years to retrain the immune system to settle down and stop releasing all this histamine. Asthma, allergies, and the skin manifestations of eczema are interplayed with this histamine problem, but did you also know that gut and brain are affected as well? And is there truly a new diagnosis of mast cell activation syndrome (MCAS), or is this on the severest end of the allergy spectrum? It should be coined “allergies with a twist!”

How do MCAS patients look, and do they look like whom we have originally assigned to the “bad allergy” category? Does this look like you, and should you do more or different to quiet this down? These mast cells are part of the immune system that are found all throughout the body at the bone marrow, blood vessel, and skin. They release their contents, and one of the most troublesome ones is histamine. Well, that is everywhere, and no wonder the symptoms are so varied and initially hard to pin down to this condition.

The symptoms can include:

· Brain-related: headaches, brain fog, fatigue

· GI system: abdominal pain, bloating, nausea, or diarrhea

· Cardiovascular system: rapid heart rate and symptomatic low blood pressure

· Lungs: wheezing and shortness of breath

· Upper Airway: tongue, face, or lip swelling, throat feeling tight

· Nasal: runny mucus or itchiness

· Ocular: watering, itchiness, redness

· Skin: eczema, flushing, hives (urticaria), sweating

· Unexplained weight gain

The triggers typically are a combination of things and I have described it as a cup that is filling up, little by little over time, then full to the point where it overflows and the body is overwhelmed by all this histamine, and hence, full-blown, MCAS. We take our daily lives and habits for granted, so some of these triggers may be slipping by you.

· Stress-induced: pain, anxiety, rapid changes in environmental temperatures, vigorous exercise, intense fatigue

· Environment: Smells or particulates in the air (smoke, smog), noxious fumes, molds, and mold toxins

· Drug induced: ibuprofen, opiates, some antibiotics, ACE-inhibitors

· Classic allergy: pollens, bee, and insect stings

· Electromagnetic Field Bombardment: computers, 4G, 5G, 3G, electricity, Wi-Fi, cellphones

· Infections: COVID-19, viruses, bacteria, fungi, Lyme

· High histamine foods: fermented, certain alcohols, cheeses, fishes, shellfish, certain vegetables

Diagnosing this may be tricky and may require some innovative ways in addition to traditional antihistamines to quiet this down and get you moving toward a more comfortable optimal health. Look to a functional and integrative approach. This condition is the “poster child” for diving into your root triggers to remove them and stabilize your mast cells. Find your fellow sufferers on Facebook groups and media platforms. We physicians are here to help and are just a click away to helping you find solutions to your problems.