Here’s my latest blog post on helpful medications for managing mast cell activation syndrome.
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Who is Betsy Leighton?
I’m a writer, blogger, and healer dedicated to helping individuals reconnect with their innate peace and wholeness by healing nervous system dysregulation. My personal experience with chronic illness called Mast Cell Activation Syndrome (MCAS) shapes my work, and my content offers tools to empower those with chronic illness to improve their well-being and take charge of their health.
I created the Sacred Self-Healing Method and am a trained and certified Safe and Sound Protocol provider, an author, blogger, and A Course in Miracles Teacher. I hold a Master of Divinity in Spiritual Counseling and am a trained spiritual mentor, with certificates in sound healing, aromatherapy, nutrition, and Sacred Deathcare. I offer a self-study certificate program in the Sacred Self-Healing Method, provide spiritual counseling and coaching, courses, and supported subscriptions for the Safe and Sound Protocol.
What is MCAS?
Mast Cell Activation Syndrome (MCAS) is a chronic condition that affects all organ systems. It can cause severe, disabling symptoms every day, including potentially fatal anaphylaxis.
The common triggers for MCAS are infections, toxic exposures including mold exposure and EMFs, trauma, concussions, and stress.
MCAS often occurs with other chronic conditions like Ehlers-Danlos Syndrome (EDS) and Postural Orthostatic Tachycardia Syndrome (POTS). Managing MCAS is challenging because many healthcare providers are unaware of it, and diagnostic tests can be unreliable. Treatments include antihistamines and mast cell stabilizers in the form of medications and supplements, along with avoiding triggers. Check out this post on managing MCAS.
Medications for managing mast cell activation syndrome
Medications for MCAS aim to stabilize mast cells, block the effects of the mediators they release, and reduce inflammation. Most treatment plans use a layered approach, combining antihistamines (both H1 and H2 blockers), mast cell stabilizers, and, when needed, additional agents such as leukotriene modifiers or biologics. The goal is not to suppress the immune system broadly, but to reduce inappropriate mast cell activation and lessen symptoms across systems such as the skin, gut, lungs, cardiovascular system, and nervous system.
H1 antihistamines
H1 blockers (such as cetirizine, loratadine, fexofenadine, or diphenhydramine) reduce symptoms caused by histamine acting on H1 receptors, including itching, flushing, hives, nasal congestion, and brain fog. Second-generation H1 antihistamines are often preferred for daily use because they are less sedating, while first-generation agents may be reserved for acute flares or nighttime use. In MCAS, these medications are often used at divided or higher-than-standard doses under medical supervision.
H2 antihistamines
H2 blockers (such as famotidine or cimetidine) target histamine receptors in the gastrointestinal tract and cardiovascular system. They are particularly helpful for reflux, abdominal pain, nausea, diarrhea, and histamine-related blood pressure changes. When combined with H1 antihistamines, H2 blockers provide broader histamine control than either class alone, which is why dual blockade is a cornerstone of MCAS treatment.
Mast cell stabilizers
Mast cell stabilizers, most notably cromolyn sodium (oral) and ketotifen, help prevent mast cells from releasing mediators in the first place. These medications are especially useful for gastrointestinal symptoms, food reactions, and multisystem flares. They often need to be started at very low doses and increased gradually, as MCAS patients can be sensitive to medication changes. Benefits may take several weeks to become fully apparent.
Leukotriene modifiers
Leukotriene inhibitors such as montelukast or zafirlukast block inflammatory mediators that contribute to bronchospasm, inflammation, and gastrointestinal symptoms. These medications are particularly helpful for patients with asthma-like symptoms, shortness of breath, or inflammation that persists despite antihistamine therapy. They are typically used as add-on agents rather than first-line treatment.
Aspirin (in selected patients)
Low-dose aspirin can reduce prostaglandin production and may help with flushing, bone pain, and headaches in some MCAS patients. However, it can trigger reactions in others, so it must be used cautiously, only when prostaglandin-driven symptoms are suspected, and only after tolerance has been established under medical guidance.
Biologics and advanced therapies
For more severe or refractory MCAS, biologic medications such as omalizumab (an anti-IgE antibody) may be considered. These therapies can reduce mast cell reactivity and frequency of severe reactions, including anaphylaxis. They are typically reserved for patients who do not achieve adequate control with standard therapies and are managed by specialists familiar with complex mast cell disorders.
Other helpful medications
Below are linked blog posts on many other medications I’ve tried:
This post covers mast cell stabilizers
This post covers supplements for managing MCAS.
This post discusses what to keep in your rescue kit for symptom flares.
This post covers Homeopathy.
This post offers pain relief options for people with chronic illnesses.
This post covers the benefits of Methylene Blue.
This post discusses Low Dose Naltrexone.
This post discusses Cromalyn Sodium.
This post covers butyric acid.
This post discusses molybdenum.
The bucket theory
The bucket theory simplifies understanding symptom reactions with MCAS. Imagine your body as an empty bucket you don’t want to overflow. Reactions to various stimuli fill the histamine bucket at different rates, forming the total histamine level (how full your bucket is). More histamine means more symptoms. By managing triggers, reducing exposures, and taking medications and supplements, you can control your bucket’s level.
Know your typical symptom progression
Understanding your symptom progression during a flare is key to developing your rescue plan. This post discusses how to recognize symptom progression so you can be prepared to address them.
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Want a tool to easily track your symptoms?
Check out these circadian health tools!
I’m an affiliate with Bon Charge, a company that makes tools for circadian health, and you can receive 15% off your order with my coupon code BETSYL.
Bon Charge offers tools such as yellow– and red-tone blue-blocking glasses, red light therapy devices, PEMF mats, infrared saunas, and EMF-blocking products.
Sign up for the SSP!
I’ve found the Safe and Sound Protocol (SSP) to be the most helpful bottom-up healing strategy if your nervous system has been overloaded with toxic exposures, including mold or non-native EMFs, chronic infections, concussions, stress, or trauma. The SSP is a passive listening therapy that helps heal nervous system dysregulation. Many people with MCAS and other chronic conditions have nervous system dysregulation stemming from infections, toxic exposures, concussions, and trauma. The SSP is an easy-to-use app that lets you listen to specially filtered music for 30 minutes each day as part of a 5-hour cycle. Studies show the SSP has a profound effect on mental health and chronic conditions. Here’s a short podcast describing the Safe and Sound Protocol.
You can sign up for the SSP here!
Heal your mind!
While the SSP is a bottom-up, somatic therapy for healing the nervous system, the Sacred Self-Healing Method I offer is a top-down nervous system-healing modality that focuses on cognition, attention, perception, and emotion, using the mind’s higher functions. The SSP and the Sacred Self-Healing Method complement each other and together produce lasting results. Here’s a short podcast on my self-healing practice.
I provide one-on-one in-person and remote chronic illness and caregiver coaching, as well as Sacred Self-Healing Sessions based on the Sacred Self-Healing Method, a proven, novel co-creative healing modality detailed in my Books.
Order my books!
Here’s a short podcast highlighting my five books.
My latest book, Living In The Light: Healing with Forgiveness, Sound, and Light, is all about the tools that have been most helpful for me to heal: forgiveness, sound, through nervous system retraining using the Safe and Sound Protocol, and light, through entraining my circadian rhythm with the energy of the sun. Living In The Light is available here!
Rocks and Roots chronicles my solo backpacking journey on the Superior Hiking Trail and my efforts to overcome nervous system dysregulation, gut dysbiosis, and Mast Cell Activation Syndrome symptoms to complete the 328-mile hike successfully.
The Sacred Self-Healing Method ebook is available here and in most ebook retailers!
The Sacred Self-Healing Workbook is available for purchase here!
Betsy’s first book, Sacred Self-Healing: Finding Peace Through Forgiveness, is available here
Companion Recordings
The companion audio recordings of chants, guided meditations, and sound healing demonstrations that accompany the Sacred Self-Healing Method are available for free on my YouTube channel here
What do you think?
I’d love to have your reply below!
Disclaimer
The preceding material does not constitute medical advice. This information is for information purposes only and is not intended to be a substitute for professional medical advice, diagnosis, cure, or treatment.
