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7 WARNING Signs of Mast Cell Activation Syndrome (MCAS) Most Doctors Completely Miss

Kara Wada MD | Allergy, MCAS & Sjogren’s

9,501 views

The test your ER doc ran for MCAS? By the time they drew your blood, it was probably already useless. And if you've been told your allergy tests are negative and your symptoms are anxiety — there's a specific reason your labs keep coming back normal while your body keeps telling you otherwise.

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Dr. Kara Wada walks you through the 7 warning signs of Mast Cell Activation Syndrome — and the testing problem most physicians have never been taught exists.

In this video, we cover:
• The tryptase timing window: why your labs almost always come back normal if the blood isn't drawn within 30 minutes to 4 hours of a flare.
• Urine mast cell testing: the snapshot your blood work keeps missing.
• All 7 warning signs of MCAS — including the multi-system signature that separates it from asthma, chronic hives, or anxiety.
• Why MCAS and Sjögren's so often appear together — and what the science says about why.
• The exact questions to bring to your allergist or primary care doctor at your next appointment.

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CHAPTERS
00:00 Seven Signs of Mast Cell Activation Syndrome
01:56 2:00 Tryptase: The Timing Window
04:11 Sign 1: Dermatographism & Itching
04:43 Sign 2: Sudden Unexplained Flushing
05:21 Sign 3: Unpredictable GI Issues
06:15 Sign 4: Racing Heart & Dizziness
06:39 Sign 5: Wheezing & Shortness of Breath
07:12 Sign 6: Facial or Throat Swelling
07:41 Sign 7: Multi-System Episodes
09:05 What to Do Next
11:21 Resources & Next Steps

20 Comments

@khrisziemke2386 5 months ago

This is great thank you!! I have Sjogrens, Dysautonomia, EDS and I feel I have this 99.9%😅

@tyreerobertson8733 4 months ago (edited)

Im in NZ where medical fraternity are seeming either ignorant of, ir confused byball of this. I love a person whose life has been dramatically altered by this Pots, MCAS . I have a dailyvpractice of making them the best foid possible from a narrow diet range. Clean fresh veges my lovely person can eat around 7 veges and only salmon or chicken ..but it must be the freshest possible. Histamines develop on meats when not fresh. Its a big job to even eat without repercussions. I am so grateful for you and your knowledge. I wish you better health too. A thousand blessings on you.

@monkeybearmax 3 days ago

You are a treasure Dr Wada!

@SG45260 5 months ago

I have Sfn and Mcad with many Sjogren's symptoms but can't stir up doc's desire to consider SS yet...nearly worn out

@kathrynhammes9075 2 months ago

I was diagnosed with MCAS in 2017. I did the Mayo clinic 24 hr urine test and came out with the diagnosis. I did well until I had a major surgery on a kidney tumor. I was reactive to everything and finally I went on half dose of monthly xolair shot. Doing great now!!!

@lawrencebodner6568 1 month ago

Dr. Wada this video presentation is the most accurate description of my current medical status. It details everything that I live with daily. Thank you for a clear over view of my daily living. It is so frustrating that most physicians do not have a clue or understand MCAS.

@runnahpodcast 3 days ago

Thank you for validating us

@ФатМат-с1у 4 months ago

I've spent 6 years seeking because not one could diagnose me. Turned out I have MCAS, but without itching or flushing or other obvious allergy symptoms. But I had many many other symptoms all over the place. And in addition to that bananas and tomatoes were my "safe" foods, so I don't have histamine intolerance. Doctors don't know about MCAS and those who know look for symptoms that I didn't have. 6 years of suffering day and night

@wendystephens4931 2 months ago

This is very interesting, I have talked to my doctor about the things that seem to go along with bouts of explosive, watery bowel emptying and those things are racing heart, BP drop, sweating and flushing of face, neck and upper chest! My PA at the gastroenterology department at least heard me and because I was also having intermittent constipation she said I may have dysautonomia…with gastroparesis. She put me on a regimen of diet change along with daily Milk of magnesia. The first two weeks were crazy as my system “got moving” but generally things are better except for these strange episodes watery diarrhea and it associated troubles.

@EileenBevan 1 month ago

I agree with adequate rest I close my eyes for the best part of an hour when I get home from work and go to bed early it's simple and free. I find the iron supplement good and the antihistamine at night and the bone strengthener my professor told me keep taking the calcium. Still learning about it 😊

@jodyljohnson8515 5 months ago

Thank you for sharing some great information!💞✌️

@KathyKarvonen 5 months ago

I have Sjogren’s , I think I have MCAS as well.

@SuperNovaSag17 5 months ago

Hello Dr. Wada, thank you for your informative video! Could you please advise if this single void urine specimen testing is available in Ontario, Canada? Any information on other testing apart from tryptase serum would be greatly appreciated. Thank you kindly for your time and assistance 🙏

@Hanna-s5j 5 months ago (edited)

I have seronegative Sjogrens, confirmed by lip biopsy and MCAS.,

@KathrynJean05 3 months ago (edited)

Those two you mentioned in random urine, mine were super high but they said because my typtase in my blood was fine they said i had mass cell mediators but not MCAS. I'm confused. My body flares every day. I'm in so much pain. Everything you discussed I have issues with.

@kathybjorn1001 3 months ago

Waterbrashing, refluxing up all kinds of saliva, no food, no bile unless bile is clear. Ill bet over a cup all ready. Started itching all over scalp which is clear and face, back of neck, upper arms and back sores.Treated for Sibo a month ago. Lots of gas and belching and sneezing. I hate when this happens! GASTRO PARESIS, slow motility, constipation, backed up bowels and colon. Taking claritin and pepcid normally helps the flares. Taking protonix now too because endoscopy and stomach biopsy about a month ago showed non bleeding, non H. Pylori ulcers and tiny red lesions speckled heavely around duodenum and lightly around stomach, so those meds and a few others arent helping with motility, constipation and gasteroparesis. SO SO miserable most the time. Malabsorption problems to, cant eat or drink enough. Just cant. Having MRI of abdomen and pelvis as soon as they can get me in. THEN, i have to find a real dermatologist to check non healing sores and then a rhuematologist that can put all this craziness together and hopefully get treated at a root cause level. A few systemic things seem to be going on. Only o dont know what! Some doctors, nurses and others want to treat me with psych meds because they believe others that im crazy. I was crazy because of them! This is very physical!

@Kath-c6c 5 months ago

I have to figure how allergies and histamines factor in! A bit confusing.

@monkeybearmax 3 days ago

I can’t feel worse but I never feel good. I’ve had fatigue every day with no break but I do feel worse with high histamine - shoukd u eat that before a test. I don’t get anaphylactic

@leanng.6110 3 months ago

Tryptase normal, no significant positive allergy, but significant anaphylactic response- gastro, hands stinging, severe vomiting diarrhea dizzy, profuse sweating. Identified tomato. On Pepcid ,
Xolair but still multiple episodes per month. Please help!