Why Normal Tryptase Doesn't Rule Out MCAS

Mast Cell Activation Syndrome is one of the most misunderstood, and underrecognized, conditions in modern medicine. In this episode, Dr. Linda Bluestein is joined by Dr. Lawrence Afrin, one of the world’s leading experts on mast cell disease, to unpack why MCAS is so often missed, why tryptase alone is not enough to diagnose it, and how this condition may be driving chronic inflammation, neurologic symptoms, psychiatric symptoms, and even hypermobile Ehlers-Danlos Syndrome (hEDS) in some patients.

They talk about why MCAS can look completely different from one person to the next, how mast cells influence nearly every system in the body, and why so many patients are told “nothing is wrong” despite being profoundly unwell. We also explore emerging treatments, including GLP-1 medications, and what the future of MCAS research may hold.

If you or your patients live with complex, multisystem symptoms that don’t fit neatly into one diagnosis, this conversation may change how you see everything.

Takeaways:

MCAS rarely looks like classic allergy, which is why it’s so often overlooked.

Normal tryptase does not rule out mast cell disease, despite what many clinicians believe.

Chronic multisystem inflammation is the biggest red flag for MCAS.

MCAS may help explain hypermobile EDS in some patients, not as a genetic collagen defect but as an immune-driven process.

New therapies are discussed, offering real hope for improved quality of life.

Find the episode transcript here.

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