12 Tips for Living With Mast Cell Activation Syndrome

Living with Mast Cell Activation Syndrome (MCAS) usually results in widespread symptoms that are seemingly unrelated. Unfortunately, most people go many years or even their whole life without a diagnosis.

If you’ve been diagnosed with MCAS or suspect you have this condition, the best course of action is making a series of lifestyle changes and working with your functional medicine doctor. Fortunately, many of the changes are easy to implement and you’ll see the benefits from implementing them fairly quickly.

Try not to get overwhelmed by this list, instead pick one or two items and incorporate them into your routine. Add a few items week by week, and soon enough you’ll have a comprehensive plan that has the potential to significantly improve your symptoms and your quality of life.

1. Adopt a low histamine diet

Avoid leftover foods, alcohol, cured meats, canned fish, pickled and fermented foods, berries, citrus, nuts, chocolate, dairy, yeast, soy sauce, tomatoes, vinegar, and preservatives.

2. Avoid triggers of MCAS (non-food items)

Avoid temperature extremes, mold, emotional stress, insect bites, chemicals in personal products, medications that liberate histamine of block DAO, sodium benzoate (common food preservative), airborne chemicals, smoke, heavy metals and anesthetics.

3. Work on your gut health

Good gut health is a cornerstone of overall wellness and will help you get your MCAS under control. Cut back on food that damages the gut or causes inflammation. Take probiotics and a DAO enzyme (generic name Umbrellux DAO).

4. Stabilize mast cell mediator release

Stabilize mast cell release of histamine with quercetin and vitamin C.

5. Use H1 and H2 blockers every 12 hours

Try using 5 mg of levocetirizine twice daily and 20 mg of famotidine twice daily.

6. Block nighttime histamine release

You can block nighttime histamine release and get a better night’s sleep by taking 0.25 -1 mg of ketotifen or zaditen at night.

7. Treat existing infections

Treat any existing infections to help your body heal and reduce mast cell triggers. Get a thorough examination with your functional medicine doctor and test for any pathogens.

8. Identify and remove toxins and allergens

When you have MCAS, you’ll do your body a world of good by reducing its toxin burden. You can reduce your exposure to toxins in your daily life through cleaning up your personal care products and opting for natural solutions, using natural household cleaners, and removing mercury fillings.

9. Take helpful nutrients

Support your health with important nutrients that assist in treatment. Some of these include vitamin B6, alpha lipoic acid, vitamin C, selenium, omega-3s, N-acetylcysteine, methyl-folate, SAMe, and riboflavin.

10. Add supportive herbs

Take nigella sativa, butterbur, turmeric, ginger, and peppermint to support your MCAS treatment.

11. Get into a routine and stick to it

Try to stick to a routine because your body’s cycles are closely linked to your daily activities. This will also help you get high quality sleep, which is essential to reducing the impact of MCAS on your life.

12. Reduce stress

Stress can activate your mast cells and cause them to release mediators like histamine. Reducing stress is important for anyone living with MCAS.

For a comprehensive guide on Mast Cell Activation Syndrome, you can read my in-depth article, Mast Cell Activation Syndrome and Histamine: When Your Immune System Runs Rampant.

Another great resource for dealing with histamine and MCAS using diet and exercise is through Yasmina Ykelestam at Healing Histamine.

6 thoughts on “12 Tips for Living With Mast Cell Activation Syndrome”

  1. Hello,
    Have had several people tell me to get checked for what they had some kind of mast cell problems.
    Havnt yet as thought then if had it, Dr would prescribe something would react to ,but since oesto might be caused by it and have some slight symptoms even when eat better and carefull of environment.
    Most anithistamine react to but found Ketotifen at market that rid eye pain and helped feel more brain normal. If take more than twice a week, get sick. Rarely get flu or colds in last 20 yrs, so wonder if anithistamine increases immune system or decreases (so get a cold) immune system.
    Have found what helped the most was slowly decreasing oxalaic acid foods,(got worse for a while ).
    (now need to keep fingers toes warm as chillblain, trying quick fast exercises for a minute).

  2. I have had continually flaring MCAS for over one year. I’m on all H1&2 blockers, cromolyn, DAO, but quercetin, ketotifen, and vit. C cause cardio/pulmonary reactions. I’ve gone from 162 to 125 lbs. due to limited foods. Next stop: NG tube. I have a doctorate, have been seriously researching all aspects of the syndrome, but I need a MCAS -aware functional medicine specialist in my area: Brandon/TampaBay, FL 33569. Do you have any recommendations? If so, I’d appreciate it. Thank you, and best wishes.

  3. This seems to be exactly what is going on with me when I notice the hives and feeling I’m going into anaphylactic shock and I frantically take a Benadryl. This will defiantly help me. Thank you so much 🙏🏻


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