Living With MCAS: Where SAAT Fits and What We Do Not Know Yet
SAAT has no published research in mast cell activation syndrome (MCAS). Where it can fit is as an addition to the care your physician leads, aimed at specific triggers you and your physician have already identified. What we do not know yet is whether it helps MCAS at all.
Learn moreHow Dr. Gordon treats mast cell activation syndromeWhat living with MCAS can be like
Mast cells are immune cells that release histamine and other chemicals when they sense a threat. In MCAS, they release those chemicals too easily. The result is repeated episodes that involve two or more parts of the body at once, such as the skin, the gut, breathing or blood pressure.
The episodes are often hard to predict, and that makes ordinary days harder to plan. Many people spend a long time getting a diagnosis. Daily life can mean reading labels, carrying medications and working around known triggers.
How MCAS is diagnosed and treated
A physician, often an allergist or immunologist, makes the diagnosis. A 2019 work group report from the American Academy of Allergy, Asthma and Immunology lays out three parts:
- Symptoms in at least two organ systems at the same time.
- Lab evidence, such as a rise in a blood marker called tryptase during an episode, above your usual level.
- Improvement with medications that block mast cell chemicals or calm the mast cells.
The same report warns that the label is sometimes applied too loosely, and that calling something MCAS can mean missing another condition that is treatable. That is one reason a proper evaluation comes first.
Medical care usually means finding and avoiding triggers, along with medications your physician prescribes, such as antihistamines, mast cell stabilizers, and epinephrine for severe reactions.
Where SAAT fits
SAAT is aimed at specific triggers, so it fits best when you and your physician have identified some, such as certain foods or environmental allergens. I start with the triggers that affect your daily life most. You hold the trigger vial while I find and grade active points on the ear, then tiny implants go in and stay for about three weeks. The SAAT page explains each step, and I am a trained and certified SAAT provider on Dr. Soliman's official practitioner list.
What we do not know yet
SAAT has no published MCAS research.
The only published SAAT study is a 2021 case series of 137 people with alpha-gal syndrome, described on the alpha-gal syndrome page. Remission there was what patients reported, there was no comparison group, and the authors say the mechanism is unknown. Even for alpha-gal syndrome, the evidence is limited and early. Alpha-gal syndrome and MCAS are different conditions, so those results cannot simply be carried over.
That leaves real open questions. We do not know whether SAAT helps MCAS, which patients might respond, how many treatments make sense, or how long any change lasts.
In my practice, MCAS patients treated with SAAT have reported a reduction in inflammatory symptoms. That is my clinical experience, not a study result, and it cannot tell you what will happen for you. Results vary from person to person, and I never call SAAT a cure.
Keeping your safety plan in place
SAAT adds to the care your physician and allergist provide and never replaces it. I never ask anyone to change their medications. Keep taking your medications as prescribed and keep carrying your epinephrine. Any decision about a trigger food or a medication is made with your physician or allergist. Please do not test a trigger on your own.
See a doctor first if you have not been evaluated for MCAS. A physician, often an allergist or immunologist, makes the diagnosis. A severe reaction or anaphylaxis is an emergency. Use your epinephrine as your physician directed and call 911.
Questions people ask
What should I bring to my first SAAT visit?
Bring your diagnosis and lab results, a list of your known triggers, your medication list and your epinephrine. That helps me choose which triggers to treat first.
Can MCAS and alpha-gal syndrome be treated in the same visit?
Yes. When someone has both, I treat them in the same visit. In my experience, mast cell activation left untreated can hold back alpha-gal results, though that has not been studied.
What should I tell my allergist or immunologist about SAAT?
Tell them you are considering it and what it involves. SAAT is meant to sit alongside their care, so your medications and safety plan stay the same, and any change is their decision. I am glad to work with your physicians.
References
- Weiler CR, et al. AAAAI Mast Cell Disorders Committee Work Group Report: Mast cell activation syndrome (MCAS) diagnosis and management. Journal of Allergy and Clinical Immunology. 2019;144(4):883-896.
- Bernal M, et al. Successful Treatment for Alpha Gal Mammal Product Allergy Using Auricular Acupuncture: A Case Series. Medical Acupuncture. 2021;33(5):343-348. https://pmc.ncbi.nlm.nih.gov/articles/PMC8729907/
