Mast cell activation syndrome

Mast cell activation disorder (MCAD) is a disorder where mast cells are normal in number but over-responsive to dietary and environmental triggers. Cells release excess histamine and other signaling molecules, causing symptoms.

Symptoms
A confounding element in diagnosing MCAD or MCAS (the disease of mast cell activation is known as both a disorder and a syndrome) is that symptoms occur in almost all areas of the body, and tend to wax and wane and disappear and reappear. One patient may have ongoing daily episodes of anaphylaxis, while another patient may simply experience years of insomnia and low appetite. Symptoms do tend to respond to some sort of "trigger," which can range from a food to an environmental trigger to stress. Anaphylaxis does not need to be the typical presentation of swelling throat; anaphylaxis can also present as a sense of "impending doom" and gastrointestinal distress. Mast cell activation syndrome also often appears with skin presentations - chronic urticaria (hives) is the main one, but some patients have otherwise unexplained psoriasis, eczema, sores and swelling.

MCAS often coexists with malabsorption problems, leading to low iron and low Vitamin D and low b12, which can cause extreme fatigue.

An exhaustive list of symptoms would include almost every symptom a person can have, but the main ones seem to be:

dizziness/brain fog fatigue loss of appetite swelling in tongue/face/throat difficulty swallowing difficulty remembering words - different from brain fog, this is a sudden-onset of cognitive decline diarrhea/IBS shaking full anaphylaxis insomnia restless sleep unrefreshing sleep

Comorbidities
It is often found in patients with Ehlers-Danlos syndrome (EDS) and postural orthostatic tachycardia syndrome (POTS), a form of orthostatic intolerance.

It has been implicated in many other immunological diseases including autism, fibromyalgia, and chronic lyme disease.

Treatment
Over the counter antihistamines are a common treatment for MCAD. Some patients also use herbal antihistamines and supplements such as quercetin and diamine oxidase (DAO), an enzyme normally produced by the body that breaks down histamine. Vitamin C, which reduces blood histamine levels, may also be helpful along with magnesium, a cofactor for producing DAO.

Sauna may also be helpful. There is some evidence it may be useful in urticaria, an autoimmune disease that involves the production of excess histamine.

Triggers
Stress, many foods and environmental allergens can trigger mast cell degranulation.

Food triggers
There are many food lists detailing common triggers but individual reactions will vary. Some individuals will react to all foods while others only some.

Some common good triggers include red wine, strawberries, raspberries, cherries, spinach, and leftovers (especially fish and meat).

Environmental triggers
Mold, air pollution, and car exhaust are common environmental triggers.

Learn more

 * Low Histamine Chef (Blog)
 * Mast cell activation syndrome, Wikipedia