Tryptase? I check it, sure. But I can’t say I care when it’s negative. Tryptase is elevated in only a minority of those with mast cell activation. That’s why the new Consensus-2 guidelines updated the diagnostic framework for MCAS — and finally gave us the flexibility to treat the patient, not just the numbers. Consensus-2 Criteria for MCAS: 1. Typical symptoms of mast cell activation (affecting ≥2 systems — e.g., flushing, GI upset, tachycardia, brain fog) 2. Elevated mast cell mediators (e.g.,

Let’s talk about MCAS — Mast Cell Activation Syndrome. The tests we have? Honestly… not that helpful. Most have low sensitivity — meaning they can miss the diagnosis even when it’s really there. Serum tryptase? Often normal in MCAS. Urine prostaglandins, leukotrienes? Only elevated if you test right after a flare and the sample is handled perfectly. Real-world sensitivity? Likely under 50%. Here’s the key: one of the diagnostic criteria for MCAS is improvement with therapy. So if your symptoms i

Mast cells are immune cells found throughout the body, including the gut, skin, nerves, lungs, and around the blood brain barrier. While they’re best known for allergies, mast cells do far more and growing research links mast cell disorders to autism. When mast cells are triggered, they release inflammatory chemicals like histamine, cytokines, and prostaglandins. They can also release inflammatory signals without histamine, triggered by stress, toxins, infections, or hormones. Mast cell disorder