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Researchers estimate mast cell activation syndrome (MCAS) affects up to 17% of the population. Mast cell diseases contain systemic, cutaneous, and smoldering mastocytosis variants. Some people have the symptoms of mast cell disease but do not meet the criteria for a specific mast cell disease. They fall into the classification of mast cell activation syndromes.

MCAS is linked to multiple infections, including Lyme disease. Some reports state the leading causes of MCAS are Lyme disease, Lyme coinfections, and mold toxicity. They also claim symptoms of the diseases overlap.

MCAS Explained

Mast cells are the body’s white blood cells or immune system cells found in the skin, lymph vessels, nerves, lungs, and other connective tissues. With MCAS, mast cells react inappropriately and cause immune system functions to activate when not necessary. They may also build up or accumulate in your tissues, leading to or worsening diseases.

Diagnosing MCAS

Specific criteria for diagnosing MCAS include the symptoms, proof that mast cells are responsible for the symptoms, and a response to medication that inhibits histamine. Read more on the criteria below.

Symptoms of MCAS

Wherever mast cells cause a reaction, the symptoms will appear. A person must meet at least two of the following symptoms associated with MCAS:

Skin Symptoms

  • Flushing or redness
  • Itching with or without a rash
  • Hives or urticaria
  • Swelling 

Gastrointestinal issues

  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Bloating 
  • Acid reflux

Respiratory Symptoms

  • Hoarseness
  • Sore throat or swelling
  • Shortness of breath
  • Wheezing

Heart-related Symptoms

  • Chest pain
  • Low blood pressure
  • Rapid heart rate
  • Lightheadedness
  • Fainting

Nose and Eye Symptoms

  • Congestion
  • Watering
  • Itching

Neurological Symptoms

  • Headache
  • Brain fog
  • Pain or tingling
  • Anxiety

Bone and Muscle Symptoms

  • Joint and muscle pain
  • Bone loss
  • Brittle bones

Additional Symptoms

  • Genital swelling, pain, itching
  • Loss of bladder control
  • Extreme fatigue
  • Food allergies
  • anaphylaxis


Is There a Relation Between MCAS and Lyme Disease? - Lyme Mexico


Mast Cells Are Causing Symptoms

Your doctor must prove that mast cells are the reason for your symptoms and are not due to something else, like illness, medication, or diet. The preferred evidence is a rise in tryptase serum levels within two hours after a symptom flare-up. If your doctor cannot measure tryptase levels, they may use a 24-hour urinary test to get the necessary documentation.

Medication Inhibits Histamine

The third criterion for diagnosing MCAS relies on your response to medications that inhibit histamine. Common medicines used to test for a response include H1 antihistamines, H2 antihistamines, mast cell stabilizers, anti-leukotrienes, anti-prostaglandins, vitamin C or d, and quercetin. 

MCAS and Lyme Disease

Many people have MCAS and no other conditions. However, some people have both MCAS and Lyme disease. The symptoms of each overlap, and Lyme disease is often the trigger that causes MCAS. People diagnosed with Lyme disease should also be tested for MCAS. A diagnosis of both diseases means different types of treatments must be utilized.

What Is Lyme Disease?

Lyme disease is a bacterial infection transmitted from a deer tick to a human. It causes inflammatory reactions in the body, producing painful symptoms, much like the ones in MCAS. Even those treated for Lyme disease with antibiotics may find some bacteria left in the system, triggering the release of mast cell mediators. 

The Burgdorferi borrelia bacteria causes mast cells to release histamine even without reason. When the histamine is released, it causes significant inflammation in the body. MCAS inflammation further triggers Lyme disease symptoms and vice versa. The cycle can be very painful and debilitating, interfering with how a person functions.

What About Lyme Coinfections?

Lyme disease coinfections trigger the same reaction in mast cells: inflammation and buildup of cells in your tissues. If you weren’t tested and treated for coinfections, you may be confused as to why you are experiencing painful symptoms.

Numerous coinfections are associated with tick-borne illnesses, but the ones most common with Lyme disease include Borrelia, Bartonella, Babesia, Anaplasma, Rickettsia, Ehrlichia, and Mycoplasma. In a study of over 3,000 people with Lyme, 50% had one coinfection, and 30% had more than one coinfection.

Lyme Disease and MCAS Treatments

Getting an accurate diagnosis and treatment plan is the most important step to helping you feel better. Working with a rare and infectious disease specialist, often called a Lyme-literate doctor, is the key to successful treatment.

For Lyme disease, treatments begin with IV antibiotics and, depending on your unique needs, may also include the following:

For MCAS, treatments begin with H1 and H2 antihistamines. Doctors may also administer the following:

  • Aspirin
  • Mast cell stabilizers
  • Antileukotrienes
  • Corticosteroids 

Epinephrine helps people experiencing anaphylactic shock.

Lifestyle Changes for Lyme Disease and MCAS

Lyme disease and MCAS require lifestyle changes that reduce or prevent symptoms. Lifestyle changes include diet, fitness, living environment, and more.

Diet for Lyme and MCAS

Lyme disease and MCAS require anti-inflammatory diets. With both Lyme disease and MCAS, there are specific foods to avoid, foods that trigger inflammatory responses, including the following:

  • Foods that are highly processed
  • Foods with a lot of added sugars
  • Foods with added salt
  • Foods containing gluten

Because each person is different, it may take a trial and error period to know exactly which foods to avoid.

Fitness for Lyme and MCAS

Exercise is crucial for physical and mental health. Even ten minutes a day of exercise can reduce inflammation. Start slow and incorporate fitness into your daily routine by taking the stairs instead of the elevator, parking the furthest away from the grocery store doors, or walking around your block a few times.

Other Changes to Make for Lyme and MCAS

The more stress you have in your life, the more likely you will experience inflammation flare-ups that cause pain. Evaluate your living, work, and social environments to see what you can change to reduce stress. Begin practicing relaxation techniques and make self-care a priority. Talk to your doctor about supplements to support an anti-inflammatory lifestyle.

Consider traveling outside the United States, Canada, and the UK to Mexico to meet with a top clinic, Lyme Mexico. Learn more about coping with Lyme disease or schedule an evaluation. We can discuss your symptoms and the alternative treatment options that work.


Is There a Relation Between MCAS and Lyme Disease? - Lyme Mexico


Check this out!

Listen to Dr. Morales’s interview on the Tick Boot Camp Podcast!

Episode 405: Lyme Mexico – an interview with Doctor Omar Morales

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