10/02/2026
Let’s talk about this. I just got this book today and I’m so excited about it. The title is a direct reflection on the complexity and variability of Mast Cell Activation Syndrome, or MCAS. In the past, medical providers have been trained that if a patient is listing a bunch of seemingly unrelated symptoms, then there is probably a psychiatric reason behind them. What if that’s all wrong? What if the long list of symptoms has another explanation, one that makes more sense and that could explain everything the patient is experiencing, and that explanation is physiologically plausible and even better, treatable?
Occam’s Razor holds that the simplest explanation is probably the correct one. We can apply that here. As I have learned, and continue to learn with the help of experts, conferences, publications, peer discussions, and especially my own patients, mast cell activation can be an underlying cause of a lot of frustrating symptoms.
MCAS is much more prevalent in women, with worsening of symptoms often following times of intense hormone changes, like the 3 P’s of puberty, postpartum, or perimenopause. We see it overlaps a lot with other conditions, like hypermobility, POTS, other dysautonomia, IBS, endometriosis, anxiety, fibromyalgia, and ADHD to name only a few. Estimates are that 17-20% of people experience some form of MCAS. Population trends show this and related syndromes are more common in those of Northern European or Ashkenazi Jewish ancestry, which also the population where we find autoimmune conditions like Hashimoto’s and Celiac disease.
I am seeking out knowledge in MCAS and related complex chronic conditions because I see it a lot in my patient population. Women often come to see me because they don’t feel right, something is wrong, and nobody has been able to help. This probably explains why I see a higher concentration of MCAS than the 20% estimate.
You’ll hear me talking about it a lot these days. I am attending a POTS conference at the end of the month. I am compiling my resources and referral network and tricks of the trade so i can provide better care to complex chronic disease patients than I did last week, last month, and definitely last year. If you are new here or you know someone who needs this comprehensive care, I am accepting new patients in Illinois for consults and complex chronic disease memberships. I also have a network of providers in other states that can help if you’re not in Illinois. Please share the word.
