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Treating Mast Cell Activation Syndrome (MCAS)

Holtorf Medical Group

Signs of Mast Cell Activation Syndrome

Many of us know the discomfort of allergy season, but the common symptoms of itchy eyes and a stuffy nose can actually be caused by a deeper issue: Mast Cell Activation Syndrome (MCAS).

MCAS is a condition in which the patient experiences repeated episodes of the symptoms of anaphylaxis (allergic reaction symptoms). These episodes consist of hives, swelling, low blood pressure, difficulty breathing, and severe diarrhea. Episodes occur when mast cells produce high levels of mediators as they incorrectly identify an allergen due to faulty signaling.

Similar to seasonal allergies, people with MCAS also experience daily symptoms as the condition affects many bodily systems and functions. These symptoms can include itchy or watery eyes, congested or runny nose, wheezing, skin rashes and redness, and more.

Diagnosing Mast Cell Activation Syndrome

Traditionally, in order to be diagnosed with MCAS, the patient must meet three separate criteria:

  • The symptoms affect at least two separate bodily systems and are recurrent. There will likely be a blood and urine test to rule out any other cause of these symptoms.
  • Blood and urine tests will also be conducted during an anaphylatic episode in order to confirm there are high levels of mediators in the patient’s system.
  • The patient responds positively to medications that inhibit their mast cells’ production of mediators.

Treating Mast Cell Activation Syndrome

The main priority when treating someone with MCAS is to provide relief to their symptoms. This chronic condition can be incredibly draining and demoralizing so it is crucial to minimize the symptoms as soon as possible.

Patient speaking to doctor

Following an anaphylatic episode, treatment should consist of epinephrine, if indicated by the severity of symptoms.

Outside of episodes, treatment of MCAS can include:

  • Histamine Type 1 and Type 2 receptor blockers: Inhibit the effects of histamines, which minimizes or eliminates symptoms of itching, skin redness, and nausea.
  • Mast cell stabilizers: Block the release of mediators from the mast cells, alleviating a variety of MCAS symptoms.
    Antileukotrienes: Inhibit the effect of leukotrienes, a common type of mediator. Antileukotrienes are particularly helpful with respiratory symptoms such as wheezing or difficulty breathing.
  • Corticosteroids: These should be used as a last-resort for treatment of edema (excess fluid trapped in the body's tissues) and difficulty breathing.
  • Omalizumab: Binds to the mast cell receptors and has been reported to reduce mast cell activation, reducing the number of anaphylactic episodes experienced by patients.

Although there is no cure for MCAS, effective treatment can greatly improve your symptoms and quality of life. If you are experiencing symptoms of MCAS or are being treated for MCAS and feel you are not getting the help you need, it may be time to find a different doctor and treatment plan. Locating an effective and knowledgeable MCAS physician can seem daunting and unending, but there is hope!

At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to properly diagnose and treat your MCAS condition, optimize your health, and improve your quality of life. Contact us to see how we can help you!


Holtorf Medical GroupThe Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease. We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.


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