Understanding Mast Cell Activation Syndrome (MCAS): A Functional Medicine Approach to Healing

What is MCAS?

Mast cells are specialized immune cells that play an important role in protecting your body from threats. However, in Mast Cell Activation Syndrome (MCAS), these cells become overly reactive and release chemicals like histamine, prostaglandins, and other inflammatory substances at inappropriate times—even when there's no real danger.

This overreaction can cause symptoms throughout your entire body:

• Skin reactions: flushing, hives, itching

• Digestive issues: bloating, diarrhea, nausea, abdominal pain

• Neurological symptoms: brain fog, headaches, anxiety

• Cardiovascular: rapid heartbeat, blood pressure changes, dizziness

• Respiratory: shortness of breath, wheezing, throat tightness

• Constitutional: fatigue, temperature dysregulation, night sweats

Many patients struggle for years with these seemingly unrelated symptoms before receiving a correct diagnosis.

The Functional Medicine Difference

While traditional medicine typically addresses MCAS with antihistamines and symptom management, functional medicine asks a deeper question: Why are your mast cells overreacting in the first place?

Our approach focuses on:

• Identifying and addressing root causes (gut dysfunction, infections, toxic exposures, chronic stress)

• Stabilizing mast cell activity

• Reducing total inflammatory burden

• Supporting your body's natural healing mechanisms

• Personalizing treatment to your unique triggers and biochemistry

Below are three foundational tools we may use at Clark Wellness to help our MCAS patients reclaim their health.

1. Low Dose Naltrexone (LDN): Rebalancing Your Immune System

Low Dose Naltrexone is a compounded medication that works quite differently from standard naltrexone (used for addiction). At very low doses (0.5mg to 4.5mg), LDN temporarily blocks certain receptors in your body, which triggers a rebound effect—your body responds by producing more of its own natural "feel-good" chemicals called endorphins.

Here's what makes this interesting: these endorphins don't just affect mood and pain—they also help regulate your immune system.

How LDN helps MCAS:

• Calms down excessive immune activation

• Reduces inflammatory signaling throughout your body

• Helps stabilize mast cells indirectly

• Improves your body's resilience to triggers like stress, infections, or environmental exposures

• Many patients notice improvements in energy, mental clarity, and overall inflammatory symptoms

What to expect: LDN isn't a quick fix—it typically takes 2-3 months to see full benefits. We start at very low doses and adjust based on your individual response. Some patients experience vivid dreams initially, which usually resolves within a few weeks.

2. Ketotifen: Direct Mast Cell Support

Ketotifen offers powerful dual benefits for MCAS by working through two different mechanisms simultaneously.

How it works:

• Mast cell stabilization: Prevents your mast cells from releasing histamine and other inflammatory chemicals in the first place

• Antihistamine action: Blocks histamine receptors so any histamine that does get released causes fewer symptoms

This makes ketotifen particularly effective for patients experiencing frequent reactions or multi-system symptoms.

What to expect: We typically start with a low dose (0.5mg) at bedtime since drowsiness is common initially. Most patients find this sedation improves significantly after 2-3 weeks. We gradually increase your dose as your body adjusts.

Ketotifen serves as an important bridge—helping control your symptoms while we work together to address the deeper issues driving your mast cell dysfunction.

3. Anti-Inflammatory Nutrition: Lowering Your Baseline Inflammation

What you eat directly impacts mast cell activity. Food can either fuel healing or trigger more inflammation—which is why nutrition is foundational in MCAS management.

Key dietary strategies:

Remove high-histamine foods:

• Fermented foods (sauerkraut, kombucha, yogurt)

• Aged cheeses and cured meats

• Alcohol and vinegar

• Leftovers (histamine increases as food ages)

• Certain fish like tuna, mackerel, and sardines

Eliminate common triggers:

• Gluten and conventional dairy

• Artificial colors, preservatives, and additives

• Foods you know cause reactions

Focus on fresh, healing foods:

• Freshly prepared vegetables (especially leafy greens, zucchini, carrots, sweet potatoes)

• Low-histamine fruits (blueberries, apples, pears)

• Fresh proteins prepared and eaten immediately (grass-fed meats, pasture-raised poultry)

• Anti-inflammatory fats (olive oil, coconut oil, avocado)

• Bone broth and collagen peptides for gut healing

  
  

Supportive nutrients:

• Quercetin: A natural mast cell stabilizer found in foods and supplements

• Vitamin C: Helps break down histamine

• DAO enzymes: Support your body's ability to process dietary histamine

• Omega-3 fatty acids: Reduce overall inflammation

  
  

Gut healing is critical: Since approximately 70% of your immune system lives in your gut, healing intestinal permeability ("leaky gut") is often essential for calming mast cell over reactivity. We address this through targeted protocols including L-glutamine, specific probiotics (introduced carefully), and gut-soothing nutrients.

Your Path Forward

MCAS doesn't have to control your life. While this condition can feel overwhelming, especially when symptoms affect so many body systems, effective treatment is possible.

At Clark Wellness, we combine:

• Appropriate medications like LDN and Ketotifen for symptom control

• Personalized anti-inflammatory nutrition plans

• Comprehensive testing to identify your specific triggers

• Targeted protocols to address root causes like gut dysfunction, chronic infections, mold exposure, or toxic burden

• Ongoing support and adjustments as you heal

  
  

Every patient's MCAS journey is unique. What triggers one person may not affect another. What helps one patient might need adjustment for you. This is why personalized, functional medicine care is so important.

You deserve to feel heard, understood, and supported as we work together to identify your triggers, calm your overactive mast cells, and address the root causes keeping you stuck in this cycle.

Ready to take the next step?

If you're struggling with unexplained symptoms that seem to involve multiple body systems, or if you've been diagnosed with MCAS and aren't getting better with conventional treatment alone, we're here to help.

Clark Wellness specializes in root-cause approaches to complex conditions like MCAS. Our comprehensive functional medicine evaluations help identify what's driving your symptoms so we can create a personalized healing plan.

Contact us to schedule your initial consultation:

Clark Wellness Functional Medicine in Waco | Personalized Care

Disclaimer: This information is for educational purposes only and should not replace personalized medical advice. MCAS treatment should always be supervised by a qualified healthcare provider familiar with mast cell disorders.