Mast cells serve an important purpose in our immune systems. Located in just about all bodily tissues, they are present in large amounts within connective tissue, reproductive organs, the nervous and cardiovascular systems, skin, and the intestinal lining. Mast cells respond to perceived threats by secreting chemical mediators such as histamine, interleukins, prostaglandins, cytokines, and chemokines. This results in physiological changes including inflammation, increased mucus production, and smooth muscle contraction. While this cascade of events is a protective mechanism that aids in healing, it is also a good example of how “too much of a good thing” can cause harm. When mast cells become chronically activated or overactive, it can affect many organs and body systems, leading to a multitude of frustrating and debilitating symptoms.

When mast cells produce an excess of mediators, it leads to repeated episodes of anaphylaxis (a severe allergic reaction). Symptoms include: hives, swelling, low blood pressure, difficulty breathing, and diarrhea. However, MCAS does not just occur in episodes. People suffering from MCAS frequently deal with it affecting many bodily systems but the most common areas affected include: skin, nervous system, heart, and gut. The functions that MCAS affects vary from person to person, but some common symptoms include:

  • Skin: itching, redness, sweating, and hives
  • Eyes: itching, watering, general irritation
  • Nose: itching, sneezing, congestion, running
  • Mouth and throat: itching, swelling of the tongue and/or lips, swelling of the throat
  • Lungs: wheezing, difficulty breathing
  • Heart: increased heart rate, low blood pressure
  • Gut: vomiting, diarrhea, cramps
  • Nervous system: headaches, migraines, dizziness, brain fog, fatigue

More people than ever before – possibly as high as 17% of the population –are said to have this problem, which is now referred to as mast cell activation syndrome (MCAS). Unfortunately, the cause(s) of MCAS are still uncertain. There is some research that suggests there is a genetic component to the condition. A 2013 study found that 74% of participants with MCAS had at least one first-degree relative who also had it. Some experts hypothesize that the large toxic load we now carry due to environmental exposures is one of the main contributors to the growing number of individuals affected by mast cell disorders.

MCAS often goes hand in hand with postural orthostatic tachycardia syndrome (POTS) in that they have many overlapping symptoms. Additionally, POTS is often thought to lead to the development of MCAS in some individuals. Other disorders and diseases that have been linked with MCAS are autoimmune diseases, allergies/asthma, Fibromyalgia, chronic fatigue syndrome, GERD, irritable bowel syndrome, food intolerances, migraines, and interstitial cystitis, just to name a few.

Treatment of MCAS can include pharmaceuticals such as H1 and H2 blockers, altering diet and lifestyle to avoid triggers, adding in dietary supplements such as ashwagandha, and natural mast cell stabilizers. Since Mast Cell Activation Syndrome can be a component of so many illnesses that are chronic, debilitating, and involve such a wide variety of symptoms, it is encouraging to see it getting more attention in recent years. We now have a greater understanding of how these complex and seemingly unrelated symptoms tie together and point to one common mechanism gone awry.

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