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Diagnosing and Treating Mast Cell Activation Syndrome (MCAS)

Mast cell activation syndrome (MCAS) is a complex and often misunderstood disorder of the immune system that occurs when mast cells — a type of white blood cell — trigger an excessive inflammatory response.

MCAS can cause a range of symptoms, including skin rashes, itching, flushing, bloating, constipation or diarrhea, difficulty breathing, fatigue, headaches, joint and muscle pain, and neurological symptoms. It often makes people hypersensitive to foods they never had a problem eating in the past.

Based on their symptoms, patients with MCAS are often diagnosed as having allergies, asthma, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), postural tachycardia syndrome (POTS), an inflammatory bowel disease (such as Crohn’s or ulcerative colitis), or another medical condition. Meanwhile, their underlying MCAS, which is the root cause of their symptoms, remains undiagnosed and untreated.

Illustration of Mast Cell

If you’re experiencing the symptoms I described or you’ve been diagnosed as having one of the conditions I mentioned, you’ve probably been prescribed medication to alleviate your symptoms. Medication for symptom relief may be effective to some degree for a period of time, but it doesn’t fully address the underlying issue. As a result, you’re likely to continue to suffer.

Through this post, I’m hoping to increase awareness of mast cell activation syndrome, so more patients can get the right diagnosis and effective treatment.

Identifying Your Triggers

When they function properly, your mast cells play an important role in protecting your body against pathogens, such as infectious bacteria and viruses. When these cells perceive a potential threat, they release chemical mediators — including histamine — to launch a rapid immune response intended to destroy and eliminate the pathogen.

However, when these cells become overly sensitive, they release chemical mediators in response to non-threatening triggers. Sometimes, they release too much. Triggers vary among individuals and may include the following: Continue reading…

What is Postural Orthostatic Tachycardia Syndrome – or POTS?

While there’s probably only a handful of Philadelphia Eagles fans living here in Tampa, Fla., the team’s 2018 Super Bowl-winning quarterback Nick Foles has certainly been highlighted in the news lately.

That’s because Foles and his wife, Tori, have brought public attention to a private issue within their family. Tori Foles was recently diagnosed with postural orthostatic tachycardia syndrome — better known as POTS — which is an often undetected and underdiagnosed chronic syndrome that causes an increased heartbeat, fatigue, dizziness, and fainting.

POTS patients like Tori Foles frequently find themselves at battle with gravity, which is why this disorder is often referred to as “the fainting disease.” The human heart normally beats 70 to 80 times per minute when we are at rest. That rate climbs another 10 to 15 beats per minute when standing up, then settles back down. But for people with postural orthostatic tachycardia syndrome, the heart rate often increases 30 to 50 beats per minute — or more — leading to the lightheadedness, dizziness and fainting that Tori Foles experienced.

(Image © Maria Hagsten Michelsen)

While the plight of those suffering POTS became more visible last month when Tori Foles took her case to news outlets and a CNN audience, many of us in healthcare — especially those of us who practice functional and integrative healthcare — are committed to raising awareness about the disorder, and the misconceptions and frequent poor diagnoses surrounding POTS.

Women and the Misdiagnosis of POTS

Between one and three million Americans suffer from postural orthostatic tachycardia syndrome, and 80 percent of them are young women — particularly those in their early teens — with the condition getting worse through the growing years. Because these women are younger and otherwise appear healthy when the disorder strikes, doctors often dismiss the physical prognosis, choosing instead to explore the Continue reading…