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
- 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
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
- 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
- Treatment of dysbiosis, SIBO
- Natural anti-histamines
- Vitamin C, B6
- DAO enzymes
- Identify an OTC H1 blocker and H2 blocker that works for you
- Non-sedating H1 blockers (preferred)
- Claritin, Zyrtec, Allegra, Xyzal
- Sedating H1 blocker
- 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
- 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).