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The Wide Ranging Symptoms of Mast Cell Activation Syndrome and Disorders


Mast cells disorders have been covered in great extent on my podcasts and on my blogs. Its something that we see so often embedded within in other conditions.


Your mast cells being active is simply the immune system that is aggravated by some environmental triggers (ie. smoke, chemicals, hormones, stress, infections, and more). Some people have genetic disorders that make their mast cells more abundant/excessive and/or more reactive.






Here are a list of symptoms that might indicate a mast cell dysregulation.

Eyes: Blepharospasm (twitchy eyes. Gritty, sandy, and/or burning, eyes/

Ears: Itchy ears, otitis externa, alterations in hearing (dysacusis) , chronic sense of fullness/waxing and waning in both ears.


Sinonasal: Congestion (stuffiness), post-nasal drip (into the throat) and coryza (external nasal dripping), and sometimes nasal and sinus irritation and closed and open sores. Occasional unexplained nosebleeds.

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Oral Findings: White findings on side of tounge, sores and ulcers, white patches termed leukoplakia, fibrosis (scarring), lichen planus, throat discomfort (or “irritation” or “tickle”) often leading to intermittent dry cough, proximal dysphagia (difficulty swallowing that is perceived or real sense of obstruction, globus (persistent sensation of material or obstruction in the throat without actual dysphagia , episodes of edema in the throat), and excessive pharyngeal mucus production.


Lymphatic findings: Lymph node enlargement that is waking and waning. They can be in the neck region, under arms, groin. Sometimes painful, sometimes not.


Pulmonary/Lung findings: Lungs being a huge interface with the environment have a large population of mast cells. Symptoms include sinonasal congestion, internal (post-nasal) and external nose drip, hoarseness and laryngitis, cough (much more commonly dry than productive), shortness of breath (medically called dyspnea). Wheezing (often diagnosed as asthma) appears to be less common than dyspnea. Note “short of breath” but rather “I just can’t catch a deep breath,” On X-ray and CT scanning, inflammation appears as “patchy ground-glass infiltrates,”


Cardiovascular Findings: MCAS patients who have chest pain that worries physicians about the possibility of angina or an actual heart attack. But the findings mainly are benign and the symptoms might be from decreased blood flow through the heart rather then obstruction. These symptoms my possibly arise from a flare of inflammation or spasm of the chest wall or esophagus or lung or some other thoracic wall structure. Also common are symptoms of “lightheadedness,” “dizziness,” “weakness,” and “vertigo sometimes leading to the diagnosis of Postural Orthostatic Tachycardia Syndrome (POTS). Non-dependent edema is common in MCAS.


Gastroenterology Findings

Thee GI issues in MCAS include pain, discomfort, and inflammation of any or all components from the mouth to the anus and the solid organs, too (e.g., the liver and pancreas). Including:

  • “Refractory GERD”

  • irritable/inflammatory bowel syndrome” (similarly) are very common.

  • Episodic queasiness, nausea, and vomiting (sometimes “cyclical,” as in “cyclical vomiting syndrome”) are common.

  • Diarrhea and/or constipation , that can alternate are common.

  • Malabsorption

Genitourinary Findings MCAS patients have ongoing chronic cystitis, overactive bladder, interstitial cystitis, and chronic UTI's (that come back negative on Urinalysis)


Musculoskeletal. pain in the bones, sometimes it’s just in the muscles, sometimes it’s just in the joints (though rarely to a degree or of a pattern that a rheumatologist will declare to be a specific arthritic diagnosis), and sometimes it’s in a combination of bones and/or muscles and/or joints. It may becalled fibromyalgia. A subset of MCAS patients will have hypermobility/EDS


Neuropsychiatric Findings Suicidality, homocidality, hypomania, and hallucinations. Mast cell activation disease certainly can cause a sense of anxiety, and panic. Insomnia and sleep disruption.


Endocrine Findings: Ferritin disorders, hypomagnesemia , thyroid disorder, pituitary disorder, reproductive hormone disruption, blood sugar destabilization.


Hematologic Findings . Too many red cells (polycythemia), too few red cells (anemia), too many white blood cells (leukocytosis)., too few white blood cells (leukopenia), Too many platelets (thrombocytosis). Or too few platelets (thrombocytopenia). Or too much clotting (hypercoagulability). Or too little clotting (that is, bleeding)


Now you know why this is on my radar so much with my patients. We have many tools to balance mast cells but it it takes patience and a comprehensive strategy. Source: Afrin M.D., Lawrence B.; Neilsen Myles, Kendra. Never Bet Against Occam: Mast Cell Activation Disease and the Modern Epidemics of Chronic Illness and Medical Complexity . Sisters Media, LLC. Kindle Edition

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