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Mast Cell Activation Syndrome (MCAS) Doctor in NYC

Mast Cell Activation Diagnosis and Treatment

Mast cell activation syndrome is thought to be a common, yet under-recognized, chronic multi-system disorder that occurs when mast cells inappropriately activate. Mast cells are present in virtually every tissue of the body and release mediators which can have a range of effects on other cells which can manifest in a variety of symptoms. Therefore it is difficult for many doctors to accurately diagnose and treat mast cell activation syndrome (MCAS).

Dr. Dean Mitchell has over 20 years of experience diagnosing and treating illnesses that are difficult for many doctors to identify. He has the knowledge and experience to help you identify if you suffer from MCAS and effectively control it.

stomach intestinal medical issues

Symptoms Associated with MCAS

The most common symptoms associated with mast cell activation syndrome include:

  • Skin Issues: hives, flushing, itching, rashes
  • Gastrointestinal (GI) Issues: bloating, reflux, nausea, diarrhea
  • Respiratory Issues: sneezing, wheezing, shortness of breath
  • Cardiac Issues: palpitations, chest pain, low blood pressure

If you feel that you have been sick forever; have trouble with allergies and asthma; get facial and chest flushing; suffer from skin rashes that come and go; regularly get brain fog and headaches; have overreactions to insect bites, bee stings and chemcial intolerances; or suffer from poor wound healing and bruise easily you may have MCAS.

Factors that Can Cause MCAS

Mast Cell Podcast with Dr. Mariana Castells

Medicines that can trigger mast cells to activate include
  • Opioids: codeine
  • Anesthesia
  • Antibiotics
Other miscellaneous factors that can activate mast cells include
  • Foods: nuts, shellfish, strawberries
  • Mold
  • Electromagnetic radiation: cell phones
  • Temperature changes

Telehealth Meeting Available

Schedule a virtual telehealth visit with Dr. Mitchell to find out if you suffer from mast cell activation syndrome and the treatment options available.

What is Mast Cell Activation Syndrome (MCAS)?

Mast cell activation syndrome or MCAS is a newly discovered disease that has been known about since the 1980s but only formally diagnosed as a disease in 2008. It has been a controversial classification as it doesn’t have any specific physical or laboratory findings that distinguish it from other related disesases but it’s prevalence is now almost 20% according to recent medical journals.

When someone has mast cell activation syndrome it means their mast cells are overactive and release chemicals in the body that cause a wide range of symptoms that mimic allergies, chronic fatigue syndrome, candida and a host of other diseases. This is way it is very difficult for the majority of doctors to accurately diagnose it.

To keep it simple: mast cell activation syndrome (MCAS) happens when the mast cells in your body release too much of the substances inside them at the wrong times.

What is a Mast Cell?

A mast cell is a white blood cell that is an integral part of our innate immune system. In fact, these cells were the original defense cells in evolutionary times when multi-cellular organisms were first developing different cells to handle all the functions of a multi-cellular body.

These cells are mainly found in tissue such as in the gastrointestinal lining, the nasal and lung tissue and skin. It is rare to be found in the blood. As part of the immune system, mast cells function to help our bodies detect, resist and recover from the huge array of threats that we face in the environment.

Mast cells have granules inside them that contain the chemicals: histamine, prostaglandins, and herparin. They are responible for the symptoms such as itching, sneezing, wheezing and bleeidng when the mast cells are active.

older couple speaking with doctor

Diagnosing MCAS

MCAs is difficult to diagnose with great confidence as most doctors are not familiar with MCAS and it presents with a potential wide range of symptoms. Many people spend decades going around in circles visiting many different specialists and achieving no proper diagnosis. Thankfully, there are doctors now, like Dr. Dean Mitchell, who understand the issues and there are tests that can support a diagnosis.

Diagnostic criteria for MCAS was only recently agreed upon in 2011 and the criteria relies upon a number of factors which include:

  • typical clinical symptoms
  • evidence of mediator release and response to medication
  • thorough discounting of any other potential diseases

The first challenge of suspected MCAS sufferers is to find a doctor who has the time and experience to assimilate a complicated medical history. Dr. Mitchell specializes in diagnosing and treating difficult to diagnose chronic illnesses. He is able to get results for people when many other specialists have failed and his first step in any diagnosis is taking a thorough medical history.

Tests Used to Diagnose MCAS

The following are tests Dr. Mitchell utilizes to diagnose MCAS.

  • Tryptase levels: a 20% rise even if in normal level
  • 24-hour urinary prostaglandin D2
  • Histamine in the blood greater than 8nmol/L
  • MMP-9 greater than 400
  • Simple skin stroke test

How is Mast Cell Activation Syndrome Different Than Another Similar Named Disease – Mastocytosis?

Mastocytosis is a hematologic disease where there is an overabundance of mast cells. There are mutations of genes and abnormal bone marrow in some types. The c-kit 806 codon mutation is a way to make the diagnosis along with an abnormally elevated tryptase level.

dr dean mitchell treating chronic illness patient

Treating Mast Cell Activation Syndrome

Successful treatment of MCAS consists of incorporating a low-histamine diet, modulating immune response and stabilizing mast cells, and simultaneously addressing underlying triggers. All of these are key components to resolving the condition.

Some of the approaches Dr. Mitchell takes to treat mast cell activation syndrome can include:

  • Low histamine diet
  • Antihistamines to decrease histamine load in the body – Allegra and Zyrtec are great over-the-counter (OTC) choices
  • Leukotriene antagonists – Monteleukast 10mg is safe and effective
  • Cromolyn sodium – this is available as Gastrochrome which blocks some of the GI symptoms of the disease
  • Natural remedies such as Quercetin and Vitamin C to lower histamine
  • Sodium bicarbonate or baking soda to raise stomach pH and make the body more alkaline so mast cells don’t activate
Low Histamine Diet

A low histamine diet is pivotal in the successful treatment outcomes for MCAS. While the above treatments are very helpful, they build upon the foundation of dietary strategies. Consider a sinking boat that has a hole in the bottom – mast cell stabilizers and antihistamines are akin to bailing out the water with a tiny cup while the dietary interventions plug the hole.

A few foods that are high in histamine and should be avoided if you have MCAS include:

  • spinach
  • eggplant
  • parmesan cheese
  • tomatoes
  • fermented foods – no leftovers
  • avocado

Once a patient has incorporated a low-histamine diet, mast cell stabilizers and antihistamines are introduced to further calm the immune dysregulation and resulting inflammatory response.

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57 W 57th St, Suite 601
New York, NY 10019


Rockville Centre
165 North Village Avenue, Suite 129
Rockville Centre, NY 11570