How to Treat Mast Cell Activation Syndrome

Co-authored by wikiHow Staff

Last Updated: August 25, 2021 References

Let’s face it: nobody likes allergies. But if you’ve got mast cell activation syndrome (MCAS), you can experience allergy symptoms for no reason at all. Luckily, there are treatments to help you manage your symptoms.

Question 1

Question 1 of 6:
Background

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Mast cells release mediators that cause allergic symptoms. Mast cells are actually an important part of your immune system. Whenever you’re injured or exposed to foreign bodies (like allergies), your mast cells release chemicals called mediators that help protect and heal your body. Histamine is a classic example of a mediator released by your mast cells that helps protect against allergens.^{[1]
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2
MCAS causes your mast cells to release mediators for no reason. When you have MCAS, your mast cells become defective and the mediators they release can cause allergic symptoms. Sometimes, your mast cells can produce identical mast cells (called clones) that then overproduce or spontaneously release mediators.^{[2]
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Question 2

Question 2 of 6:
Causes

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The exact cause isn’t known, but MCAS could be genetic. MCAS episodes, where you experience the symptoms of an allergic reaction, are called “idiopathic.” That means it isn’t actually caused or triggered by anything and just spontaneously happens.^{[3]
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PubMed Central
Journal archive from the U.S. National Institutes of Health
Go to source} However, studies do indicate that there may be a genetic component to MCAS, and you’re more likely to have it if you have a relative who has it.^{[4]
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PLOS ONE
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2
Lyme disease can potentially lead to MCAS. Lyme disease is caused by bacteria that are transmitted to humans by infected ticks. Symptoms of Lyme disease include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. Many Lyme patients develop severe allergic reactions to foods, medications, and chemicals, which can be a sign of MCAS.^{[5]
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Question 3

Question 3 of 6:
Symptoms

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MCAS causes hives, swelling, breathing issues, and diarrhea. The symptoms of an MCAS episode are pretty much identical to an allergic reaction. The mediators released by your mast cells can affect your skin, digestive system, and your respiratory system.^{[6]
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You can also have a rapid heart rate and low blood pressure. An MCAS episode can also cause a reaction in your cardiovascular system, causing your heart to beat faster. You can also experience a drop in blood pressure, which can make you feel tired, lightheaded, or like you might faint. If your blood pressure drops low enough, you could pass out.^{[7]
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Question 4

Question 4 of 6:
Diagnosis

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A doctor who specializes in MCAS needs to make a diagnosis. Because MCAS is relatively new and isn’t fully understood, there aren’t many lab tests that can confirm a diagnosis. Instead, a doctor who is familiar with the condition can examine and assess your medical history to make a diagnosis. If your doctor isn’t able to diagnose you, they may refer you to a specialist who can.^{[8]
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An allergy test can rule out allergic reactions. If you keep having symptoms of an allergic reaction, your doctor may refer you to an allergist. They’ll be able to test you for a wide range of different allergens. If there isn’t an allergic basis for your symptoms, you may have MCAS.^{[9]
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Question 5

Question 5 of 6:
Treatment

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Allergy medications help relieve your symptoms. Because the immediate symptoms of an MCAS episode are similar to an allergic reaction, allergy meds can help reduce and manage them. Antihistamines can help with itching, abdominal discomfort, and flushing. Epinephrine can help if you have difficulty breathing.^{[10]
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Corticosteroids are used to treat extreme episodes. They can help with serious cases of hives, difficulty breathing, and major swelling, known as edema. But, they’re only used as a last resort, so your doctor will generally only prescribe them if your symptoms are serious.^{[11]
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3
Omalizumab may help manage your MCAS. Omalizumab is a specialized allergy medication used to treat severe allergic asthma. Studies indicate that a low-dose (about 150 mg a month) seems to be effective at managing MCAS and preventing serious episodes.^{[12]
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PubMed Central
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4
Avoid things that trigger your symptoms to help prevent episodes. Triggers are specific chemicals or substances that can cause your mast cells to release mediators. It can be things like a specific food, a smell, or even cold temperature. Keep track of anything that causes you to have allergic symptoms. Try to avoid anything you know will cause an episode as best as you can.^{[13]
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Question 6

Question 6 of 6:
Prognosis

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Managing your symptoms is the best way of dealing with MCAS. While there isn’t a known cure for MCAS, there are medications you can use to help relieve and manage your symptoms. Having MCAS means you’re at a higher risk for anaphylaxis, a potentially life-threatening condition that can happen if your MCAS causes a serious reaction. If you can avoid triggers and manage your symptoms, you can prevent anaphylaxis and minimize MCAS episodes.^{[14]
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Warnings

If you’re having trouble breathing or your allergic symptoms become too severe, seek emergency medical care.

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Don’t take prescription drugs unless they’re prescribed by your doctor.

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