Mast Cell Activation Syndrome (MCAS for short) is one of those annoying conditions in which a patient, after having read an article like this one and suffering similar symptoms, asks her doctor and gets one of two disappointing answers: “Never heard of it” (translation: MCAS is fairly new and often overlooked) or “Consulting Dr. Google again?” (Translation: MCAS is probably over diagnosed because there are no good tests for it. This phenomenon has occurred with candida for decades.
First, what are mast cells?
Mast cells are a special type of white blood cell manufactured in your bone marrow that travel just beneath the surfaces of your skin, moist mucosal surfaces like your respiratory tree (nose to lungs), and your digestive tract. Mast cells contain a variety of protective inflammation chemicals, most notably histamine. But like cayenne pepper, you only need a little histamine for its job to be done right. Overly irritate (or ‘activate’) a mast cell, it will burst, release too much histamine, and you’ll feel uncomfortable.
When there are a lot of potential mast cell irritants around (like during allergy season), they’ll trigger release of lots of histamine. You’ll reach for…you guessed it…antihistamines.
Sometimes, when the antihistamines can’t cover everything, doctors will add a ‘mast cell stabilizer’ (like Singulair a/k/a Montelukast) and you can guess what it does. Not neutralizing the histamine but rather preventing the histamine release.
But then, “something” goes wrong with this usually smoothly running system. It’s like the bar gets set too low to trigger this mast cell rupture and histamine release. “Activation” suddenly gets too easy. Patients who never had any allergies, or the mildest of allergy symptoms now have severe allergies, like hives, or food allergies (facial swelling, abdominal pain, diarrhea, wheezing, coughing, chest tightness). When a primary care doctor is told of these symptoms, she recognizes them as “allergies” and prescribes antihistamines and sometimes mast cell stabilizers. But very little else is suggested.
