The POTScast E122: Mast Cell Matters: Diagnosis and Treatment of MCAS with Dr. Tania Dempsey
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Mar 7, 2023 
Dr. Tania Dempsey, a Johns Hopkins-trained physician specializing in complex chronic disorders, dives deep into the world of Mast Cell Activation Syndrome (MCAS). She discusses key themes for diagnosis, the common mischaracterization of symptoms, and the interplay between MCAS and conditions like POTS. Treatment insights include the use of antihistamines, limbic retraining, and managing environmental triggers. Dr. Dempsey emphasizes a patient-centered approach, advocating for thorough testing and the importance of long-term care strategies.
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Mast Cells Link To POTS And Anxiety
- Mast cells surround nerves and can drive POTS, neurogenic symptoms, and anxiety through inflammatory signaling.
- Treating mast cells can improve autonomic and neuropsychiatric symptoms like anxiety and brain fog.
Do A Full Multisystem Exam
- Take a thorough multisystem history and perform a full physical exam, including dermatographism and orthostatic testing.
- Don’t assume a single symptom; screen from head to toe to uncover multisystem involvement.
Order Mediator Labs And Biopsies
- Use blood and urine mediator tests plus GI biopsy (CD117) when available to support MCAS diagnosis.
- Require at least two positive mediator markers plus consistent clinical history per consensus criteria.