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Understanding Mast Cell Activation Syndrome: How COVID-19 and Vaccines Can Be Triggers

 

Mast Cell Activation Syndrome (MCAS) is a condition where certain cells in your body, called mast cells, release too many chemicals, causing various debilitating symptoms. Normally, these cells help protect you from infections and help with healing. However, in MCAS, they become overactive and release chemicals even when they're not supposed to.

How MCAS Affects the Body

Mast cells are found in many parts of your body, like the skin, stomach, lungs, and heart. When they release too many chemicals, it can cause:

  • Skin problems: Flushing, itching, burning skin and eyes, hives, and swelling.

  • Stomach issues: Pain, diarrhea, nausea, and vomiting, loss of appetite, early satiety and constipation

  • Breathing problems: Wheezing, shortness of breath, stuffy nose, 

  • Heart and blood pressure issues: Fast heart rate, low blood pressure, and dizziness, POTS,

  • Brain and nerves problems: Headaches, trouble concentrating, fatigue and neurological issues such as tremors, numbness in limbs and nerve pain.

The Link Between COVID-19, Vaccines, and MCAS

The COVID-19 pandemic has shown that the virus and the vaccines designed to protect against it can sometimes trigger MCAS.

COVID-19 and Long COVID

COVID-19 can worsen or reveal MCAS in some people. The virus causes a lot of inflammation and can make mast cells release too many chemicals. For some people, this continues even after they recover from the initial infection, leading to what’s known as Long COVID. Symptoms of Long COVID that are similar to MCAS include extreme tiredness, trouble concentrating, and stomach problems.

COVID-19 Vaccines

The Covid 19 Vaccine can trigger MCAS in some people. The body sees the vaccine as a threat and the mast cells become angry and switch into defence mode. The vaccines activate the immune system, which can sometimes trigger mast cells to release their chemicals, causing MCAS symptoms to flare up. Instead of settling back down again, the mast cells can remain activated, continuing to release chemical mediators into the bloodstream and causing a cascade of horrible symptoms. This can go on for months and/or years or until the spike protein has been broken down and removed from the body (see how to do this below).

 

Potential Triggers for MCAS

MCAS symptoms can come and go, with good days and bad days. Various things can trigger these symptoms, including:

  • Environmental factors: Heat, cold, and weather changes.

  • Food: Certain foods, especially those high in histamine like aged cheeses, fermented foods, and alcohol.

  • Medications: Some pain relievers, opioids, and certain antibiotics.

  • Stress: Both physical and emotional stress.

  • Infections: Viral, bacterial, or fungal infections.

Managing MCAS: Treatments and Natural Remedies

Managing MCAS involves avoiding triggers, using medications to control symptoms, and incorporating natural remedies for overall health.

Medications

  • Antihistamines: Help by blocking histamine, a chemical released by mast cells. I have found loratadine to be particulary helpful here. As a H2 blocker (H1 is histamine 1 and H2 is histamine in the gut) I have found famotidine at a dose of 20mg twice daily, helpful in controlling my stomach symptoms. I have now weaned off this successfully. 

  • Mast cell stabilizers: Prevent mast cells from releasing too many chemicals. Ketotifen has been my saving grace. and I worked up to 1mg twice daily. I remain on this medication as I feel I still need it keep my mast cells calm). Cromolyn Sodium is another mast cell stabiliser that can be very effective but both ketotifen and cromolyn must be made up at a compounding pharmacy so you will need to see a GP to get a script for these.

Natural Remedies

  • Quercetin: A natural compound found in fruits and vegetables that helps stabilize mast cells.

  • Vitamin C: Reduces histamine levels and supports the immune system.

  • Curcumin from turmeric decreases prostaglandins (one of the mediators released from mast cells)

  • Vitamin D2/K2 helps stabilise mast cells from degranulation

  • DAO enzyme with each meal (helps the body break down excess histamine - one of the big mediators)

  • Low-histamine diet: Avoiding high-histamine foods can reduce symptoms. See more about this in my low histamine diet section. 

  • Stress management: Techniques like mindfulness, yoga, and meditation can help manage stress, a known trigger for MCAS. I have found meditation, breath work and grounding very helpful in calming my nervous system down which in turn has helped to calm my mast cells and reduce my overall symptom load. I recommend a daily practise of meditation, breathwork and bare foot grounding. Getting some sunshine on the whole body each day is also very healing for MCAS. Just be careful not to overheat as this can trigger a flare. 

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For further information and support on MCAS see the below resources:

Mast Cell Stabilizing Foods - Dr Becky Campbell

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Dr. Lawrence Afrin - Hematology/Oncology & Mast Cell Disease Specialist (drtaniadempsey.com)

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