From the Research
Alpha-glucosidase inhibitors should be used with caution in patients with Mast Cell Activation Syndrome (MCAS), dysautonomia, and Ehlers-Danlos Syndrome (EDS), as they may exacerbate symptoms in these conditions. The most common side effects of alpha-glucosidase inhibitors, such as bloating, flatulence, and diarrhea, could trigger mast cell activation in MCAS patients or worsen autonomic symptoms in those with dysautonomia 1. For patients who must use these medications, starting with the lowest possible dose (e.g., acarbose 25mg once daily with the first bite of a meal) and gradually titrating upward while monitoring symptoms is recommended.
Some key points to consider when using alpha-glucosidase inhibitors in patients with MCAS, dysautonomia, and EDS include:
- The potential for gastrointestinal disturbances to trigger mast cell activation or worsen autonomic symptoms
- The need for close monitoring of symptoms and adjustment of treatment as needed
- The importance of working with a multidisciplinary team of healthcare providers, including specialists in MCAS, dysautonomia, and EDS, to manage these complex conditions 2, 3
- The possibility that some cases of hypermobile EDS may be rooted in mast cell activation syndrome, highlighting the need for careful consideration of the relationship between these conditions 4
Overall, while alpha-glucosidase inhibitors may be beneficial for some patients with MCAS, dysautonomia, and EDS, they should be used with caution and careful monitoring to minimize the risk of adverse effects. Patients with these conditions should work closely with their healthcare providers to weigh the potential benefits and risks of these medications and to develop a treatment plan that takes into account their individual needs and circumstances 5, 1.