From the Guidelines
Experiencing increased Mast Cell Activation Syndrome (MCAS) symptoms during weight loss is common and can be managed with specific strategies, prioritizing a gradual weight loss approach to minimize the release of stored histamine and toxins from fat cells. According to the most recent and highest quality study 1, weight loss can trigger MCAS flares due to the release of stored inflammatory compounds from fat cells. To manage symptoms, it is recommended to lose weight gradually rather than rapidly. Medications such as H1 antihistamines like cetirizine (10mg daily) or fexofenadine (180mg daily) combined with H2 blockers such as famotidine (20mg twice daily) can help manage symptoms 1. Additionally, considering adding a mast cell stabilizer like quercetin (500mg twice daily with meals) or sodium cromolyn (100-200mg before meals) may be beneficial. Maintaining a low-histamine diet during weight loss, avoiding fermented foods, aged proteins, and alcohol, and staying well-hydrated with at least 2-3 liters of water daily can also help flush histamine.
- Key strategies for managing MCAS symptoms during weight loss include:
- Gradual weight loss
- Medications such as H1 antihistamines and H2 blockers
- Mast cell stabilizers like quercetin or sodium cromolyn
- Low-histamine diet
- Adequate hydration
- Moderate exercise
- Stress management through meditation or gentle yoga
- Tracking symptoms and food intake to identify specific triggers It is essential to note that weight loss can ultimately improve MCAS symptoms long-term by reducing inflammation, but the transition period requires careful management as fat cells release stored inflammatory compounds during breakdown 1.
From the Research
Mast Cell Activation Syndrome (MCAS) and Weight Loss
- The provided studies do not directly address the cause of increased MCAS symptoms during weight loss 2, 3, 4, 5, 6.
- However, it can be inferred that changes in the body's physiology during weight loss may trigger mast cell activation, leading to an increase in symptoms.
- Possible factors that may contribute to this include:
- Changes in hormone levels and metabolism
- Increased stress and inflammation
- Alterations in gut microbiota and digestive function
- Studies suggest that mast cell activation can be triggered by various nonspecific stimuli, including stress, inflammation, and certain medications 2, 3, 5.
- Gastrointestinal symptoms, such as irritable bowel syndrome, dyspepsia, and nausea, are common in MCAS patients and may be exacerbated during weight loss 4.
- Measuring urinary mediator metabolites, such as LTE4 and prostaglandin D2, may help diagnose and manage MCAS, particularly during periods of weight loss 6.