Mast Cell Matters: Deep dives on MCAS with Tania Dempsey, MD - Presented by The POTScast GI Manifestations of MCAS with Dr. Leonard Weinstock
Nov 8, 2023
Dr. Leonard Weinstock, a gastroenterologist and MCAS expert, delves into mast cell dynamics within the GI tract. He explains how high mast cell counts link to conditions like SIBO, IBS, and bloating. Weinstock shares insights on using low-dose naltrexone for treatment, highlighting its benefits and dosing complexities. Dietary strategies for MCAS management are discussed, including gluten-free and low FODMAP options. Furthermore, he explores the challenges of diagnosing IBS versus MCAS, emphasizing the importance of thorough medical education for better patient outcomes.
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Patient Experiences With LDN
- Some MCAS patients report feeling worse when missing LDN for a few days and significant improvement when restarting it.
- Side effects occur but starting with low dose and slow ramp helps manage them.
LDN Dosing and Titration Advice
- Initiate LDN at 1 mg daily and increase every 4-7 days up to 4 mg, adjusting dosage to patient tolerance.
- Consider dividing the dose if severe fatigue is present and monitor for insomnia or dreams with nighttime dosing.
Diet Recommendations for MCAS
- Recommend gluten-free, dairy-free, and yeast-free diet for 3-4 weeks to identify triggers and reduce high-histamine foods.
- For gas issues without SIBO, advise low FODMAP diet and avoid high-fructose corn syrup if SIBO persists.