MCAS (Mast Cell Activation Syndrome)

MCAS (Mast Cell Activation Syndrome) services offered in Portland, OR

Mast cell activation syndrome (MCAS) is a complex immune condition that causes mast cells to release inflammatory mediators inappropriately and excessively - triggering a wide range of symptoms across multiple body systems. Naturopathic physicians
Rebecca Sand ND and Elizabeth Emrick ND at Open Wellness PDX specialize in identifying and treating MCAS and related conditions, including histamine intolerance, using a thorough root-cause approach. If you have struggled with unexplained
reactions, multiple sensitivities, or symptoms that worsen with stress, food, or environmental triggers and have not gotten clear answers, we can help. Call the Portland office, request a telehealth visit, or book online.

MCAS Q&A

What is mast cell activation syndrome (MCAS)?

Mast cells are immune cells found throughout the body - in the gut, skin, lungs, brain, and connective tissue - that play a critical role in immune defense and inflammation. In MCAS, mast cells become overactivated and release large amounts of chemical mediators including histamine, prostaglandins, leukotrienes, and cytokines in response to triggers that would not typically cause a reaction.

Because mast cells are found in virtually every tissue, MCAS symptoms can affect many systems simultaneously. Common presentations include flushing, hives, rashes, or itching; gastrointestinal symptoms including nausea, bloating, cramping, and diarrhea; nasal congestion, sneezing, or asthma-like symptoms; heart palpitations or rapid heart rate; brain fog, anxiety, or mood instability; fatigue and post-exertional malaise; headaches or migraines; widespread pain or hypermobility; worsening with heat, exercise, stress, alcohol, medications, or certain foods; and overlap with conditions like POTS, hypermobile EDS, and long COVID.

MCAS is frequently underdiagnosed. Many patients with MCAS have seen multiple specialists and received partial answers - or no answers at all.

What causes MCAS?

MCAS can be primary, secondary, or idiopathic. Common contributing and triggering factors include gut dysbiosis and intestinal permeability, chronic infections, hormonal fluctuations particularly estrogen which activates mast cells, mold or environmental toxin exposure, nervous system dysregulation, connective tissue disorders, and post infectious immune shifts including those following COVID-19.

The gut-mast cell connection is particularly important: much of the body's mast cell population resides in the GI tract, and gut dysbiosis or SIBO can be a significant driver of mast cell overactivation.

How does naturopathic medicine treat MCAS?

At Open Wellness PDX, Dr. Sand and Dr. Emrick use advanced lab testing - including inflammatory markers, nutrient levels, hormone panels, and gut assessment - to identify the upstream drivers of mast cell overactivation in each patient. A comprehensive MCAS plan may include low-histamine and low-mast-cell-triggering nutrition guidance; mast cell stabilizing agents including quercetin, vitamin C, luteolin, and DAO enzyme support; gut healing protocols addressing dysbiosis, SIBO, intestinal permeability, and microbiome restoration; nutrient optimization including key cofactors for histamine metabolism; hormone balancing particularly estrogen modulation; nervous system support and stress physiology tools; environmental trigger reduction guidance; and pharmaceutical mast cell stabilizers and antihistamines when appropriate.

MCAS is treatable. With the right investigation and a systematic approach, most patients experience meaningful improvement in symptom burden and quality of life.

To get started, call 503-770-0670, request a telehealth visit, or book online.