Co-morbidities

People who are impacted by MCAS release mast cell mediators in greater numbers and more often by triggers that for most are not a problem.  In other words, the body overreacts to substances that it deems to be a danger.  This extreme reaction may occur after you ingest food, are exposed to toxic chemicals or when you take normal levels of certain medications. ​ What are the symptoms of MCAS? MCAS can cause a variety of symptoms that may mimic other diseases making it difficult to diagnose.  It can cause symptoms in several body parts at the same time.  Swelling of the skin, tongue, lips, throat, or other parts of the body in relationship to something in the environment or to a food or drug, is a serious symptom of MCAS.  One can experience wheezing or difficulty breathing, gastrointestinal symptoms, headaches, unusual fatigue, which may be kept in check with over the counter antihistamines until an unusually difficult stressor is encountered. Anaphylaxis is a life-threatening emergency. It can occur very rapidly, causing a person’s throat and tongue to swell until the air passage is blocked.  It is critical that a person experiencing shortness of breath or swelling of the tongue or throat get emergency treatment as quickly as possible.  The individual may collapse and become unconscious if medication is not delivered immediately.  To avoid a fatal event, individuals who suffer from anaphylaxis, will be prescribed an EPI Pen to carry with them at all times.   How is it diagnosed? Doctors are recommended to take a four-stage approach to diagnosis. Stage one:  Depends upon have more than one bodily system impacted. This stage may be under control with medications but becomes more severe with a stressful or unusual event like surgery.  Symptoms can randomly wax and wane over time. Stage two: Doctors will try medications to see if the patient’s symptoms are improving. A trail of various drugs will give the doctor another reason to suspect MCAS as a reason for your symptoms. Stage three: Doctors may test for levels of several known mediators.  If they are higher than normal, it is another positive sign of MCAS.  However, not all mediators may be increased at the time of testing, especially if the patient is not experiencing a flare of their symptoms.  Tryptase, methylhistamine and prostaglandins may not be elevated so positive tests can be suggestive of MCAS, but negative tests do not necessarily rule out MCAS.  The doctor may order biopsies of the gut or skin to look for additional evidence of abnormal numbers of mast cells. Stage four: Your doctor may want to rule out other diseases that may be contributing to your symptoms.  More than one disease can be present at a time and depending upon the disease they may require additional treatments. Why is this important for those affected by ME? MCAS has been found to be associated with a number of co-morbid disorders including, EDS, POTS, dysautonomia, type 2 diabetes and ME.  Unusually frequent and/or more severe allergic reactions to food, environmental toxins and medications have been documented by physicians who care for those with ME.   As a result, your doctor may want to prescribe medications to address your MCAS symptoms.