WRITTEN BY: Tammy C. Perez, M.A., NCC, LCDC, LPC
REVIEWED BY: Dr. Terry Schroeder on April 18, 2023
Mast Cell Activation Syndrome (MCAS)
What is MCAS?
Mast Cell Activation Syndrome, or MCAS, is a complex medical condition involving the abnormal activation and release of mast cells within the body, leading to symptoms that can affect multiple organ systems.
Mast cells are a type of immune cell that helps regulate the body's response to allergens and pathogens. When activated, they release various substances, such as histamine, cytokines, and proteases, which can cause inflammation and other immune reactions.
With MCAS, mast cells are abnormally activated even without a specific trigger or antigen, leading to a chronic state of inflammation and various symptoms that range in severity. It is a rare condition and often underdiagnosed or misdiagnosed, making treatment challenging.
What causes MCAS?
The exact cause of MCAS is unknown but thought to involve genetic, environmental, and immunological factors.
Research suggests genetic mutations or variations related to mast cell regulation may predispose the development of MCAS. Exposure to allergens, infections, toxins, and physical or emotional stress can also trigger mast cell activation. These conditions may not be the primary cause of MCAS but could contribute to producing or worsening symptoms.
Abnormal immune system responses, such as autoimmunity or immune dysregulation, may influence MCAS. In some cases, the immune system may mistakenly target mast cells or their mediators, leading to excessive activation and release of mast cell-derived substances. Occasionally, MCAS can occur with other disorders, such as Ehlers-Danlos syndrome, postural orthostatic tachycardia syndrome, and chronic inflammatory response syndrome. The relationship between these conditions and MCAS is not fully understood, but common underlying mechanisms or predisposing factors could contribute to the disease.
What are the symptoms of MCAS?
Various factors, such as stress, certain foods, temperature changes, exercise, and medications, can trigger symptoms of MCAS. Common symptoms of the condition are flushing or reddening of the skin, itching, hives, rash, abdominal pain, bloating, diarrhea, vomiting, headaches, migraines, and swelling of the face, lips, tongue, throat, or other parts of the body.
Other disease symptoms include fatigue, brain fog, difficulty concentrating, joint and muscle pain, shortness of breath, wheezing, rapid or irregular heart rate, anxiety, panic attacks, and depression.
How is MCAS treated?
Treatment of MCAS usually involves a combination of medications and lifestyle changes. Medicines used to treat the disease include antihistamines, mast cell stabilizers, corticosteroids, immunosuppressants, and epinephrine.
Antihistamines and mast cell stabilizers block the action of histamine and other agitating chemicals, relieving symptoms such as itching, redness, and swelling. Corticosteroids are powerful anti-inflammatory agents that help decrease acute flare-up severity. Immunosuppressants restrain immune system activity and reduce the number of mast cells in the body. Epinephrine is used in emergencies to treat severe allergic reactions and anaphylaxis.
Lifestyle changes can also help manage the symptoms of MCAS. These modifications include avoiding triggers, such as certain foods, medications, and environmental factors, and reducing stress through meditation and yoga techniques.
How does MCAS affect brain wellness?
The symptoms of MCAS can dramatically impact brain wellness, affecting overall health. Cognitive function and memory decline result from chronic fatigue and brain fog produced by the condition. These symptoms make focusing and reasoning difficult. Inflammation can also lead to neuroinflammation, damaging brain cells and increasing cognitive decline risk.
Also, mast cells and their mediators can disrupt the blood-brain barrier, potentially leading to neuroinflammation and oxidative stress, damaging the brain. These effects may increase the risk of developing neurodegenerative disorders like Alzheimer's and Parkinson's.
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RESOURCES
Substance Abuse & Mental Health Service Administration (SAMHSA): https://www.samhsa.gov/
Health Resources & Services Administration (HRSA): https://www.hrsa.gov/
National Institute of Mental Health (NIMH): https://www.nimh.nih.gov/
Center For Disease Control & Prevention (CDC): https://www.cdc.gov/
American Psychological Association (APA): https://www.apa.org/
National Institutes of Health (NIH): https://www.nih.gov/
National Suicide Prevention Line: https://988lifeline.org/
National Library of Medicine: https://medlineplus.gov/
Mayo Clinic: https://www.mayoclinic.org/
WebMD: https://www.webmd.com/
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