@dr.zac.spiritos: One of the stranger phenomena I’ve seen with MCAS is reactive hypoglycemia. Normally, when we think about blood sugar dropping after eating, we think about things like dumping syndrome—where food moves too quickly from the stomach into the small intestine, causing rapid carbohydrate absorption, a large insulin response, and then a blood sugar drop, typically 1–3 hours later. But that’s not always the pattern I see with MCAS. I’ve seen people whose blood sugar starts dropping within minutes of eating, without the typical timeline we would expect from dumping syndrome. The pathophysiology here is still relatively unclear, but these episodes can be scary and cause shakiness, weakness, dizziness, palpitations, brain fog, sweating, or feeling like you might pass out. Fortunately, I’ve also seen this improve significantly with targeted therapy. A lot of people ask, “What should I take for it?” There really isn’t one answer. Treatment is highly individualized and depends on the person, their triggers, their glucose pattern, and what else is driving their symptoms. If you’re experiencing unexplained blood sugar drops alongside other strange, seemingly disconnected symptoms, mast cell activation may be one piece worth considering. #mcas #heds #dysautonomia #mastcellactivationsyndrome #hypermobility

Dr. Zac Spiritos

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Tuesday 15 September 2026 23:14:46 GMT