Having supported a number of people through mast cell activation syndrome (MCAS) symptoms and treatment as a nutritionist, and with my own diagnosis and journey too, I wanted to share some observations that might be helpful.
These are patterns I see again and again in clinic. They say a lot about the link between MCAS, the nervous system and how safe the body feels.
Healthy on paper
Most of the people I've seen with MCAS are, on paper, incredibly healthy. They've often researched and eaten a really healthy diet for years, and many are keen exercisers.
They bring the same commitment and dedication to their work and to caring for others.
They're often the kind ones in the family, prone to perfectionism and people pleasing. Gabor Maté describes this as "goodism": putting everyone else's needs first.
Many volunteer. In friendship groups they're the sounding board, always there for everyone else and careful never to be a burden.
They tend to be hyper-independent, and are often known for being very resilient.
Early experiences and a sensitive nervous system
Another thing many of them have in common is some degree of struggle with attachment, or what are called adverse childhood experiences (ACEs). As a result, their nervous systems tend to be on the more sensitive side.
Many describe things that happened when they were younger, often involving caregivers.
For others, it was a lot of pressure from caregivers, whether around academic or sporting achievements, or simply part of their cultural and family conditioning.
So they're very sensitive to the judgement of others and what people think of them. They try to find a sense of safety by being superhuman.
They often chase safety in external things: their appearance, their achievements, how they come across.
They might describe themselves as an empath, or as overly self-conscious in social situations.
They often don't recognise or acknowledge their many positive traits, and they constantly feel they're never enough. Some of that is linked to their experiences with their caregivers.
I'm sharing this in no way to blame anyone, including parents, who were often doing their best under pressures of their own. These patterns are nobody's fault.
But understanding them can be a really important part of MCAS recovery.
How this might show up in our biology
Quite simply, it can come down to never feeling safe.
Some of this may go back to very early, even pre-verbal, years. Your mum may have had a stressful pregnancy or birth with you. Your parents may have had health issues, addictions or huge work demands.
This could have meant less attunement than you needed as a baby: less eye contact, less skin-to-skin contact, and fewer moments of having your cues and body language read and responded to.
This may have caused your body to become more hypervigilant: scanning, checking, always on alert. And a body in that state tends to be much more sensitive, including the mast cells.
This often shows up in two ways:
Hormones. Many people with MCAS have a history of hormone issues: low hormones such as testosterone, or imbalances between oestrogen and progesterone. Many have had fertility struggles and a lot of hormone interventions. Some of this is linked to the physical pressure they put on their bodies, and some to their stress and emotional load.
The immune system and chronic inflammation. That same load can leave the immune system more sensitive and overreactive, which means more allergies, more histamine reactions and more inflammation. In fact, chronic inflammation has often been there in some shape or form for most of their lives, sometimes from puberty and the early teens.
What helps with MCAS recovery
The heart of it is a journey towards finding safety within, which also means coming back to being your true self and realising you're already good enough.
The following are all helpful:
Psychoeducation, to understand how your experiences, emotions and nervous system connect.
One-to-one therapy, which some people need.
Arts and creative activities, a way to discover more about yourself, connect with your emotions and find safety in that.
Emotional allowing and nervous system support, so you become familiar with your emotions and able to allow them, rather than resisting them and keeping the nervous system on high alert.
Then there are the practical steps that help your system feel safe:
Reducing commitments and the tendency to overwork, over-care, over-exercise and over-optimise everything.
Spending less time with people you feel pressure to please.
Using mind-body practices to cultivate feeling safe in your body, with all your emotions and thoughts.
Meditation and somatic practices to separate from the outdated programs in your mind, and start to rebuild trust in yourself and your sense of agency.
Using nutritional therapy to resource your body and address food intolerances, with a combination of diet changes, supplements and symptom support tools.
Working with an MCAS nutritionist
If any of this resonates, you're not alone.
As a registered nutritional therapist with my own MCAS experience, I support people online across the UK and beyond to support their nervous system, broaden their diet and feel safe in their body again.
If you'd like support, you can book a consultation here.
