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Mast Cell Activation Syndrome (MCAS) and Testing Options
MCAS Definition:
Immune system dysfunction through abnormal activation of the mast cells.
Presence of genetically altered mast cells.
Excessive or atypical release of many of these cellular inflammatory mediators.
MCAS Exacerbation:
Poor methylation (genetic MTHFR defects).
Deficiency of intestinal diamine oxidase enzyme (DAO) necessary to degrade histamine in the intestines.
Excess histamine in the intestines promotes intestinal permeability and increases intestinal inflammation.
Deficiency of liver histamine-N-methyltransferase enzyme (degrade histamine in the blood).
MCAS Symptoms due to DAO deficiency:
Small Intestine Bacterial Overgrowth (SIBO), Leaky Gut Syndrome,
Gastrointestinal Inflammatory Condition (Irritable Bowel Disease, Colitis, Crohn's Disease and Celiac Disease). It causes eczema and food and/or chemical sensitivities/intolerance and a whole sequence of immune system dysfunction described further down the list. Many drugs are known to cause DAO deficiency including anti-depressants, immune suppressants, acid blocking medication, NSAIDs, and vaccines.
MCAS Neuro-Symptoms:
Headaches, Brain Fog, Anxiety, Panic Attacks, Depression, Autism, Insomnia or Oversleeping, Decreased Concentration, Confusion, Sense of Uneasiness, Dizziness, Lightheadedness
MCAS Cardiac Symptoms:
POTS, Hypertension, Palpitations, Tachycardia
MCAS Intestinal Symptoms:
Nausea, Vomiting, GERD, Heartburn, Eosinophilic Esophagitis, Celiac Disease, IBS, Bloating, Cramps
MCAS Allergy Symptoms:
Flushing, Urticaria, Angioedema, Food/Chemical/Environmental Sensitivities/Intolerance, Anaphylaxis, Rhinitis, Throat Tightness and Swelling, Asthma, Shortness of Breath, Chest Tightness, Eczema
General Symptoms:
Muscle Pain, Joint Pain, Nerve Pain, Chronic Fatigue, Fibromyalgia, Weight Loss, Weight Gain, Delayed Healing, Interstitial Cystitis, Chemical and/or Food Sensitivities/Intolerance
MCAS Sequalae:
Increased risk of autoimmune diseases
Increased risk of malignancy/cancer
Increased risk of infections
Increased risk of infertility
Increased risk of spontaneous miscarriage
MCAS Triggers:
General Triggers:
Extreme temperatures, food and drinks containing high histamine including fermented food & sulfites, exercise, emotional stress, physical stress (outer or inner physical stress from vaccines, viruses, bacteria, chemicals, fragrances, fungus/mold in your home/car/office, parasites, nutritional deficiencies, heavy metals, gut dysbiosis), medications for pain (NSAIDs and narcotics), strong scents, pressure or vibration on the skin, insect bites, vaccination, food coloring, pigments, make-up, contact dyes, insecticides, fungicides, pesticides
Environmental Triggers:
Mold, sun exposure, ultra-violet light, barometric pressure changes, dust, heavy metals, animal dander, pollen
Foods High in histamine:
Alcohol (particularly beer and wine), milk, eggs, fish (sardines, mahi-mahi, smoked fish, mackerel, and anchovies), shellfish, canned fish, vinegar and vinegar-containing foods (mayo, ketchup, chili sauce, pickled, radishes, olives, pickles, etc), aged cheeses, nuts, soured foods (sour milk, sour cream, soured bread, buttermilk)
Fruits high in histamine:
Over ripe fruits, dried fruits (prunes, dates, apricots, raisins and figs), banana, papyaya, strawberries, pineapple, citrus, stone fruits, grapes
Vegetables high in histamine:
Eggplant, avocado, mushroom, spinach, tomatoes, sweet potatoes, over-ripe vegetables
DAO blockers (exacerbate symptoms/inflammation due to histamine accumulation in intestines): Alcohol, black/Green/Mate tea, energy drinks
MCAS Testing/Diagnosis:
Serum Tryptase (Alpha and Beta) elevated level of 11.5 or more. Alpha and Beta testing together allows for more accuracy. This test alone is typically all you need to determine if you have MCAS. I can order the Serum Tryptase blood test through LabCorp for $69.
Serum tryptase occasionally can be normal, requiring additional testing listed here:
Plasma prostaglandins D2
Plasma hepaprin levels
Histamine
Chromogranin A
Urine: 11 beta prostaglandin F2/leukotriene E4/ n-methylhistamine