When I diagnose Mast Cell Activation Syndrome (MCAS), I use the Consensus 2 criteria. This method moves beyond the traditional tryptase-level criteria of Consensus 1, and focuses instead on symptom charts, response to treatment and specific lab tests. I’ve found this method to work impeccably. Many practitioners are not aware of mast cell activation syndrome and the complexity of how it can present, or either continue to use the outdated Consensus 1 approach or, worse, revert to an understanding
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MCAS is a complex condition influenced by many factors, including hormones. Excess estrogen can contribute to increased mast cell activation, which becomes very significant for women undergoing bioidentical estrogen replacement therapy for perimenopause or menopause. That is why I always ensure a balance between estrogen and progesterone when I provide bioidentical hormone replacement therapy to such patients. In my experience, adequate levels of progesterone can often counter the pro-MCAS effec
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Diagnosing MCAS requires more than just tests. Mast Cell Activation often begins during puberty, which is why a detailed history of symptoms, responses to antihistamines, and triggers like stress or certain medications all help paint the bigger picture. Tests alone can’t reveal the root cause – it's the patient’s story that provides real clues. Module 2 of my New Medical Curriculum is entirely dedicated to MCAS and POTS. Comment LEARN for the free masterclass. Disclaimer: The information shared
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