Mast Cell Activation Syndrome – The New Kid On The Block
Mast cell activation syndrome, or MCAS, is a relatively new clinical disorder marked by regular bouts of symptoms associated with allergy. This includes nasal congestion, hives, headache, throat swelling, hypotension (low blood pressure), coughing, wheezing and various gastrointestinal symptoms. Not fun at all, right!
Mast cells are located in mucus membranes, the skin, and connective tissue of various organs that play a role in the immune system – they are part of our defence network. They contain inflammatory mediators and proteases that are released when a trigger activates them. It turns out people with MCAS have a normal number of mast cells, but that these cells are more sensitive to activation.1
MCAS is diagnosed based on the following 3 criteria1, 2:
- Regular presence of the signs and symptoms of acute systemic allergic reaction involving multiple systems.
- Confirmed elevation of serum mast cell mediators such as histamine, tryptase, prostaglandin D2, or their metabolites in urine.
- Improvement in symptoms with mast cell stabilisers, antihistamines, or medicines that affect mast cell mediators.
There are various environmental triggers for MCAS. At Nordic Clinic we focus on such triggers as foods, temperature extremes, stress, exercise, sunlight, perfumes and dyes, and various environmental chemicals. We have also found that some patients have bacterial infections, SIBO and other GI related imbalances. Patients with MCAS should really work with a healthcare practitioner to identify triggers and limit their exposure as first priority.
Treatment of MCAS
What can you do to battle MCAS – the new kid on the block? Currently, there is no well-defined standardised treatment for MCAS. Management of symptoms includes avoidance of triggers, histamine receptor blockers, mast cell stabilisers, and leukotriene receptor blockers.3 Adrenaline may be required during acute bouts of MCAS, and glucocorticoids can be used during prolonged episodes.4
At Nordic Clinic we have found that elimination diets, like the AutoImmune Protocol (AIP), can help to identify food triggers. Assessing pathogens and bacterial imbalances in the GI tract and treating anything found has, in some cases, helped to significantly improve symptoms in those patients.
Though people with MCAS have a normal life expectancy, their quality of life is greatly diminished as you can imagine with all these symptoms. This is due to both the regular development of symptoms as well as uncertainty due to a history of misdiagnosis. A diagnosis of MCAS combined with a personalised approach to management can improve the situation by providing a level of control and predictability over the symptoms.
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This article was originally published as a guest editor post at foodpharmacy.se
By: Graeme Jones, clinical physiologist and CEO at Nordic Clinic Stockholm.
Published: 28/03/2022
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References
1. https://www.mdpi.com/1648-9144/57/2/124/htm
2. https://www.sciencedirect.com/science/article/abs/pii/S0091674917310254
3. https://link.springer.com/article/10.1007/s12016-015-8487-6#citeas
