How to Diagnose Mast Cell Activation SyndromeHow to Diagnose Mast Cell Activation Syndrome
Chronic Inflammation

How to Diagnose Mast Cell Activation Syndrome

With a multitude of symptoms, nailing down a diagnosis for MCAS takes time—using certain guided steps can create a path that heads in the right direction.
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A mast cell releasing histamine during an allergic response. Kateryna Kon/Shutterstock
By Ashley Turner BCDHH
Updated:
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This is part 2 in “Demystifying Mast Cell Activation Syndrome”

Mast cell activation syndrome afflicts many people with a bewildering array of symptoms, making it easy to misdiagnose. In this series, we explore what MCAS is, its many symptoms, and how diagnose and treat it.

If you suspect that mast cell activation syndrome (MCAS) might be the root cause of your many seemingly unexplainable symptoms, hopefully, this article will help shed some light on the steps you can take to obtain a diagnosis.

First, it’s important to know that a diagnosis of MCAS is likely not going to happen in a one-time visit with your provider. Working through the necessary steps to reach an accurate formal diagnosis of MCAS takes time—which can feel frustrating for a patient desperate for answers. However, taking a slow and systemic approach to a diagnosis is the best way to ensure the diagnosis is correct and develop the proper healing protocol.

4 Steps to Diagnosing MCAS

There are four general steps to follow when seeking an MCAS diagnosis. These steps aren’t always necessary (or a feasible option) for all patients, but are the typical process of reaching a formal diagnosis:
  1. Identify and recognize all clinical symptoms.
  2. Observe and investigate any response to treatment.
  3. Obtain mediator tests.
  4. Consider and rule out other diagnoses.
Let’s consider each of these steps and what they entail.

Step 1–Identify Symptoms

The first step to diagnosing MCAS is understanding the presence of clinical symptoms across multiple body systems. Most patients suffering from MCAS experience symptoms that come and go and fluctuate in severity over time due to different triggers. MCAS can affect every system of the body and may include the following symptoms:

Systemic 

  • Fatigue
  • Malaise
  • Inflammation
  • Sensitivities to food, chemicals, medications, or other environmental factors
  • Temperature dysregulation
  • Swollen lymph nodes
  • Swelling

Musculoskeletal 

  • Muscle pain
  • Bone pain
  • Osteoporosis and osteopenia
  • Arthritis
  • Hyperflexible joints

Dermatologic

  • Urticaria
  • Red, flushed, or swollen skin
  • Rashes
  • Bruising
  • Burning sensation
  • Dermatographia (white or red marks that persist after scratching skin)
  • Poor wound healing
  • Rosacea
  • Psoriasis
  • Eczema

Cardiovascular

  • Rapid heart rate
  • Heart palpitations
  • Dizziness
  • Low blood pressure
  • Syncope

Gastrointestinal

  • Diarrhea
  • Constipation
  • Abdominal cramps
  • Bloating
  • Nausea
  • Vomiting
  • Reflux
  • Difficulty swallowing
  • Tightness in the throat
  • Malabsorption
  • Food sensitivities
  • Food allergies
  • Irritable bowel syndrome

Nervous

  • Headaches or migraines
  • Brain fog
  • Memory concerns
  • Anxiety
  • Depression
  • Difficulty paying attention
  • Nerve pain
  • Insomnia
  • Dizziness
  • Tinnitus
  • Numbness and tingling in extremities
  • Temperature changes

Lungs and Respiratory

  • Sinus congestion
  • Swelling of the sinuses
  • Coughing
  • Shortness of breath
  • Wheezing
  • Asthma

Eyes

  • Itchy or watery eyes
  • Red or inflamed eyes
  • Blurred vision

Reproductive System

  • Infertility
  • Endometriosis
  • Menstrual problems
  • Hormone dysregulation

Urinary Tract 

  • Pain or burning with urination
  • Inflammation of the urinary tract