What is Mast Cell Activation Syndrome?

by | May 15, 2025 | Immune Health, Recent Articles

Written by Taylor Woosley, Science Writer. Learn about the symptoms, triggers and management techniques for Mast Cell Activation Syndrome (MCAS).

scratching armMast Cell Activation Syndrome (MCAS) is a condition marked by the inappropriate activation of mast cells, which are a type of white blood cell integral to the immune system1. Mast cells reside in the connective tissue of vascularized organs, in mucosal tissues, and in the skin2. These cells release chemicals, including histamines, to respond to allergens, pathogens, and other stimuli3. However, in individuals with MCAS, mast cells can become overly reactive, leading to a range of symptoms that can affect multiple organ systems.

Mast cells are involved not only in allergic reactions but also in inflammation and tissue repair4. They are first to respond to injury, releasing proinflammatory signals resulting in the production of cytokines, chemokines, and reactive oxygen species through microglia response5. When they malfunction, they can cause symptoms like hives, gastrointestinal distress, and even anaphylaxis. Given the diverse nature of these symptoms, MCAS can often be misdiagnosed or overlooked, making awareness and education vital for both patients and healthcare providers. Mast-cell associated disorders exhibit a female sex bias, however, the specific contribution of mast cells to this sex bias is poorly understood6.

Recognizing the significance of MCAS is crucial for improving the quality of life for those affected. By gaining a better understanding of what is mast cell activation syndrome, individuals can better manage their symptoms, seek appropriate treatments, and make informed decisions about their health. Exploring natural supplements and dietary changes can support individuals in their journey toward managing this challenging condition.

Symptoms and Triggers

MCAS can manifest through various symptoms that may differ significantly from one individual to another. Common symptoms include chronic fatigue, skin rashes, angioedema, gastrointestinal issues, and respiratory problems7. Patients may also experience neurological symptoms such as headaches, brain fog, and mood fluctuations8. These symptoms often arise unpredictably, making daily life challenging for those affected.

Identifying physical and emotional triggers is crucial for managing MCAS effectively. Common physical triggers can include certain foods, medications, environmental factors, and temperature changes. Emotional stressors, such as anxiety or significant life changes, can also provoke mast cell activation.

It is important to note that symptoms of mast cell disorder and triggers can vary widely among individuals with MCAS. While some may experience gastrointestinal symptoms, others may find that their key issues are skin-related or respiratory. This variability can complicate diagnosis and treatment, emphasizing the importance of working closely with healthcare professionals to develop a tailored management plan.

Management and Treatment Options

Managing MCAS involves a combination of lifestyle changes, supplementation or medication, and collaboration with healthcare providers to effectively alleviate symptoms. One of the most impactful lifestyle changes is dietary modification. Individuals with MCAS often benefit from an elimination diet, identifying and avoiding triggers such as certain foods like fermented food, additives, and environmental factors9. Maintaining a food diary can help pinpoint specific reactions and guide dietary choices.

In addition to dietary adjustments, stress management techniques such as mindfulness, yoga, and regular physical activity can significantly improve overall well-being and reduce symptom flare-ups. Staying well-hydrated and ensuring adequate rest are also crucial in managing the condition.

When it comes to medications and supplements, antihistamines are commonly prescribed to control symptoms associated with mast cell activation. Other options may include mast cell stabilizers or corticosteroids, depending on the severity of the symptoms. Supplements such as Vitamin C10, quercetin10, and omega-3 fatty acids10 are also believed to support mast cell health and reduce inflammation. Vitamin C, also known as ascorbic acid, has been shown to reduce the serum concentration of histamine in allergic patients and suppress the release of histamines from mast cells11. Quercetin, a robust polyphenol, is known to inhibit histamine release and degranulation12. Additionally, research on pro-resolving mediators derived from omega-3 fatty acids shows that it effectively reduced mast cell-driven allergic responses and inhibited mast cell degranulation through suppressing inflammatory signal pathways13. Always consult with a healthcare provider before starting any new supplement to ensure it aligns with your specific health needs.

Outlook and Prognosis

The long-term outlook for individuals with MCAS can vary significantly depending on the severity of the condition and the effectiveness of management strategies. Numerous individuals may experience a range of symptoms that can fluctuate over time, making it crucial to develop a personalized treatment plan. With appropriate dietary changes, lifestyle adjustments, and potentially the use of supplements, many people find relief from their symptoms and can lead fulfilling lives.

If left untreated, MCAS can lead to serious complications, including chronic inflammation, organ dysfunction, and anaphylaxis. These complications highlight the importance of early recognition and intervention, as timely management can help mitigate the risk of severe reactions and improve overall health outcomes.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Tzitiridou-Chatzopoulou M, Kazakos E, Orovou E, et al. The Role of Helicobacter pylori and Metabolic Syndrome-Related Mast Cell Activation Pathologies and Their Potential Impact on Pregnancy and Neonatal Outcomes. Journal of clinical medicine. Apr 18 2024;13(8)doi:10.3390/jcm13082360
  2. Giannetti A, Filice E, Caffarelli C, Ricci G, Pession A. Mast Cell Activation Disorders. Medicina (Kaunas). Jan 30 2021;57(2)doi:10.3390/medicina57020124
  3. Sumantri S, Rengganis I. Immunological dysfunction and mast cell activation syndrome in long COVID. Asia Pac Allergy. Mar 2023;13(1):50-53. doi:10.5415/apallergy.0000000000000022
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  9. Singh P, Grabauskas G, Zhou SY, Gao J, Zhang Y, Owyang C. High FODMAP diet causes barrier loss via lipopolysaccharide-mediated mast cell activation. JCI insight. Nov 22 2021;6(22)doi:10.1172/jci.insight.146529
  10. da Silveira Gorman R, Syed IU. Connecting the Dots in Emerging Mast Cell Research: Do Factors Affecting Mast Cell Activation Provide a Missing Link between Adverse COVID-19 Outcomes and the Social Determinants of Health? Medical sciences (Basel, Switzerland). May 28 2022;10(2)doi:10.3390/medsci10020029
  11. Kazama I, Sato Y, Tamada T. Pyridoxine Synergistically Potentiates Mast Cell-Stabilizing Property of Ascorbic Acid. Cellular physiology and biochemistry : international journal of experimental cellular physiology, biochemistry, and pharmacology. Jun 30 2022;56(3):282-292. doi:10.33594/000000534
  12. Shaik Y, Caraffa A, Ronconi G, Lessiani G, Conti P. Impact of polyphenols on mast cells with special emphasis on the effect of quercetin and luteolin. Cent Eur J Immunol. 2018;43(4):476-481. doi:10.5114/ceji.2018.81347
  13. Yoon J, Kim D, Jeong NH, et al. Protectin D1, an omega-3-derived lipid mediator, resolves mast cell-driven allergic inflammation via FcεRⅠ signaling. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. Apr 19 2025;187:118060. doi:10.1016/j.biopha.2025.118060