Welcome everyone to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

Here in East Tennessee, we all know about allergies. Tennessee cities rank high on the list of allergy capitals with Knoxville ranked as number 35 out of the top 100 list by the Asthma and Allergy Foundation of America (AAFA). But what you may not know about is a condition called MCAS (Mass Cell Activation Syndrome) that causes repeated episodes of allergy symptoms that can affect multiple body systems. This can be a nightmare. 

MCAS is complex and usually falls in the hands of a functional medicine doctor. That is why I chose this topic for today’s podcast. In this episode, we will unpack MCAS: what it is, how it happens, and what you can do if the symptoms become chronic. I believe those who learn well, live well! Tune in


  • MCAS stands for Mast Cell Activation Syndrome, a condition where mast cells release excessive mediators like histamine in response to triggers, resulting in repeated allergic reactions affecting multiple body systems. 
  • Symptoms of MCAS can include hives swelling, low blood pressure, shortness of breath, diarrhea, rapid heart rate, headaches, and migraines. Essentially, it can lead to a variety of discomforts commonly mistaken for other issues. 
  • There is a significant relation between MCAS and Long Covid, where symptoms such as fatigue, brain fog, tachycardia, and shortness of breath overlap. MCAS has been observed in a high percentage of Long Covid patients. 
  • Diagnosing MCAS is challenging because there isn’t a simple blood test for it. It often goes unrecognized, causing patients to suffer for years without an accurate diagnosis. 
  • Environmental toxins and factors such as mold exposure and mercury exposure can trigger MCAS, making it more common in today’s toxic environment. 
  • MCAS shares a considerable overlap with other diseases like Lyme Disease and potential conditions like Ehlers-Danlos Syndrome. The symptoms can be interconnected, causing diagnostic challenges. 
  • Treatment often involves dietary changes to remove gluten and dairy, using supplements like L-Glutamine, essential fatty acids like EPA and DHA, Vitamin D, Magnesium, and potentially medications like H1 blockers (Zyrtec, my favorite) and H2 blockers (Pepcid AC), and aspirin (blocks prostaglandins). Hyperbaric O2 (helps stabilize mast cells), and Singulair (blocks leukotrienes). Detoxifying and gut health are foundational steps in the functional medicine approach to treating MCAS. Note: It is also encouraging to know that Methylene Blue and LDN are becoming new treatment options for Lyme Disease and MCAS, as well as many other conditions. 

Living with MCAS can be stressful, and stress can make the symptoms feel worse. I encourage you to prioritize rest and relaxation exercises (i.e., deep breathing, a nice walk, meditation, journaling, listening to music or enjoying a hobby) in your daily routine. Improving your physical and mental health can help you conquer the challenges of MCAS.  

Stay educated. Stay healthy. 

Till next week.