Are nasal corticosteroid sprays safe for individuals with Mast Cell Activation Syndrome (MCAS) taking Quercetin?

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Last updated: May 14, 2025View editorial policy

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From the Guidelines

Nasal steroid sprays can be used safely by individuals with Mast Cell Activation Syndrome (MCAS) who are taking quercetin, as there is high-quality evidence supporting their safety and efficacy in treating chronic rhinosinusitis 1. For most patients, medications like fluticasone (Flonase), mometasone (Nasonex), or budesonide (Rhinocort) can be used as directed on the packaging, typically 1-2 sprays per nostril once or twice daily. However, some MCAS patients may be sensitive to preservatives or propellants in certain nasal spray formulations. If you're concerned about potential reactions, start with a single spray in one nostril as a test dose and monitor for any adverse reactions before continuing regular use. Quercetin, as a mast cell stabilizer, may actually complement the anti-inflammatory effects of nasal steroids by reducing histamine release through different mechanisms. The steroids work primarily by reducing inflammatory pathways, while quercetin helps stabilize mast cells directly. Key benefits of nasal steroid sprays include:

  • Improvement in nasal symptoms
  • Enhancement of quality of life
  • Effective long-term treatment for chronic rhinosinusitis, as supported by the European position paper on rhinosinusitis and nasal polyps 2020 1. If you experience worsening symptoms after using nasal steroids, discontinue use and consult your healthcare provider who specializes in MCAS, as they may recommend a preservative-free formulation or alternative treatment approach.

From the Research

Nasal Steroid Sprays and MCAS

  • There is no direct evidence in the provided studies regarding the safety of nasal steroid sprays for individuals with Mast Cell Activation Syndrome (MCAS) taking Quercetin.
  • However, it is known that patients with MCAS may experience symptoms of mast cell activation, which can be managed by various treatments, including blockade of mediator receptors and inhibition of mediator synthesis 2.
  • Quercetin is often used as a natural antihistamine and anti-inflammatory agent, and some patients with MCAS may use it to help manage their symptoms.
  • The use of nasal steroid sprays in patients with MCAS is not explicitly mentioned in the provided studies, but corticosteroids are sometimes used to address prolonged episodes of mast cell activation 2.
  • It is essential to note that MCAS is a complex condition, and treatment approaches may vary depending on the individual patient's needs and symptoms 3, 4, 5, 6.

Considerations for Treatment

  • Patients with MCAS often require a personalized treatment plan, and healthcare providers should be aware of the potential interactions between different medications and supplements 6.
  • The diagnosis and management of MCAS can be challenging, and healthcare providers should be prepared to work with patients to develop effective symptom-management strategies 3, 4, 5, 2, 6.
  • Further research is needed to fully understand the mechanisms and pathways involved in MCAS and to develop more effective treatment approaches 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Mast Cell Activation Syndrome and Mastocytosis: Initial Treatment Options and Long-Term Management.

The journal of allergy and clinical immunology. In practice, 2019

Research

Clinical Approach to Mast Cell Activation Syndrome: A Practical Overview.

Journal of investigational allergology & clinical immunology, 2021

Research

Mast cell activation syndrome: Current understanding and research needs.

The Journal of allergy and clinical immunology, 2024

Research

Mast cell activation syndrome.

Journal of the American Association of Nurse Practitioners, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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