@dr.zac.spiritos: When someone is in an MCAS flare, one of the first questions I ask is: what changed? Sometimes the answer is surprisingly small. You refill a medication you’ve taken for months, but the manufacturer changed—and suddenly the fillers, dyes, or inactive ingredients are slightly different. A medication you previously tolerated may now be contributing to symptoms. But this speaks to a bigger point: MCAS flares can give us clues in terms of what to avoid, but also, where to go with potential treatment. Pay attention to the pattern. If food repeatedly triggers symptoms, cromolyn may make sense. If environmental exposures consistently cause flushing, itching, or hives, additional antihistamine therapy—or sometimes something like Xolair—may be a better fit. Food, medications, heat, fragrances, infections, hormones, stress, and other environmental exposures can all provide useful information. Don’t just ask, “How do I stop this flare?” Ask, “What triggered it?” Sometimes the trigger tells you what to avoid—and what treatment to reach for next. #mcas #heds #dysautonomia #mastcellactivationsyndrome #hypermobility

Dr. Zac Spiritos

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Friday 11 September 2026 01:54:08 GMT