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Mast cells are a type of white blood cell that protects our bodies from bacteria and other foreign invaders. Sometimes mast cells can malfunction and react in situations where they should not. This is referred to as mast cell activation syndrome (MCAS) and can cause many symptoms, to include flushing, itching, dizziness, racing heart rate, anxiousness, headache, fatigue, “brain fog”, flu-like symptoms, numbness/tingling, and gastrointestinal problems. In some cases, people with MCAS to be extremely sensitive to scents, lotions, and other chemicals.

MCAS commonly occurs in people with Ehlers-Danlos Syndrome (EDS) and other hypermobility syndromes. MCAS is common in those with autonomic disorders, such as postural orthostatic tachycardia syndrome (POTS). Many of the symptoms of Long COVID syndrome are suspected to be related to MCAS. Most doctors are not aware of MCAS. However, there are many treatments available to help.

Dr. Saperstein has cared for over 2,000 patients with MCAS. He and his team at the Center for Complex Neurology, EDS & POTS can diagnose and manage this puzzling and potentially debilitating condition.

What is MCAS

Diagnosis of MCAS

Management of MCAS


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MCAS can manifest as all those and more. There are blood and urine tests that can be done to look for MCAS.

There are some studies that suggest people who take antihistamines have an increased risk of dementia. This does not mean that antihistamines cause dementia. It may be that people who have conditions that require antihistamines are at a higher risk of dementia.

It is important to have MCAS under good control to get POTS symptoms under optimal control.

There is a lot of research, but no definitive answers. Mast cells, which are dysfunctional in many patients with EDS and POTS, seem to play a role in autism. There may be other inherited factors as well.