What is/are MCAD?
- Umbrella term for the full realm of Mast Cell Activation Disorders
- Mastocytosis (rare disease)
- Allergies, Urticaria, Angioedema, Anaphylaxis
- Inappropriate activation of the Mast cells
Symptoms
- Possible to see any and all systems in the body affected
- General themes include inflammation and allergic reactions
- Can manifest as a wide range of symptoms
- Neurological: fatigue, motor and sensory, irritability, brain fog
- Central nervous system: depression, anxiety
- Dermatological: rash, flushing, hives, runny nose, issue with hair, teeth, nails
- Rheumatological: joint pain
- Cardiovascular: autonomic, tachycardia, variable heart rate, blood pressure, palpitations
- Musculoskeletal: pain, osteopenia, osteoporosis
- GI Tract: reflux, nausea, diarrhea, constipation
- Urinary tract: irritation, pain, inflammatory problems
- Immune system: increased susceptibility to infection, risk for malignancies, autoimmune disease
- And more…
What causes it?
- Many different possibilities
- Mast cells overreacting
- Assorted mutations
- More research is needed
Testing
Questionnaire – a validated questionnaire can be obtained from this study.
- Basic/preliminary screen: Histamine plasma, Chromogranin A, Tryptase (can be done using LabCorp). If two tests are positive = MCAS
- MCAS Questionnaire filled out by patient and by doctor.
- Score between 8-14 = suggestive of MCAS, score above 14 = highly suggestive. Either score indicates you should continue looking for MCAS.
- If score is below 8, consider other similar conditions; Lyme disease, environmental allergen/exposures
Natural and OTC Medication Treatments
Dr. Michael Ruscio is a DC, natural health provider, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.Natural
- Afrin has found identifying dietary and environmental triggers and avoiding them to be very helpful
- Low Histamine diet
- Low FODMAP diet
- Glutamine, shown to lower HI
- Probiotics
- Treatment of dysbiosis, SIBO
- Natural anti-histamines
- Vitamin C, B6
- DAO enzymes
Medication
- Identify an OTC H1 blocker and H2 blocker that works for you
- Non-sedating H1 blockers (preferred)
- Claritin, Zyrtec, Allegra, Xyzal
- Sedating H1 blocker
- Benadryl
- H2 blockers
- Pepcid, Zantac, Tagamet, Axid
- Cromolyn is good for digestive involvement, because it’s not absorbed. Might be most effective for GI
- Comes in various forms: oral, eye drops, nasal, nebulizer, cream
Time and Dose
- A month at most to clearly notice effect; if not, move on to trying a different medication
- Follow the dosing listed on label at first, but often for MCAS patients it’s best to take twice per day. You could experiment with higher dose for 2-3 weeks, but if it doesn’t clearly help, then reduce dose. Do not take anymore than is beneficial
- Best practice, start with less expensive drugs first
Research to support?
- Gut’s impact – one study showed 22% of patients with unexplained GI symptoms had HI
- 8-fold decrease in histamine
Learn More
- Mast Cell Activation Syndrome with Clinician and Researcher Dr. Lawrence Afrin
- Mast Cell Activation, Part 2 with Dr. Lawrence Afrin
- Could Mast Cell Activation Syndrome (MCAS) Be the Cause of Your Non-Responsive Symptoms?
- Visit Pubmed.gov and search Mast Cell Activation Syndrome or MCAS (Dr. Ruscio’s favorite site).