MCAS Safety Considerations

Because those with MCAS may have symptoms that seem to be exacerbated by food intake, there are a couple of things to be mindful of to maximize safety and well-being.

1.) Restrictive diets can lead to nutritional deficiencies.

Following a restrictive diet, like the low-histamine diet, for a long period of time without proper assistance from a dietitian, can lead to nutritional deficiencies. For example, someone who follows this diet likely avoids citrus, strawberries, and tomatoes because they are high in histamine. These foods are all great sources of vitamin C, so if they are completely avoided and no other vitamin C rich foods (like broccoli, for example) are added to the diet, they could develop a vitamin C deficiency.

People with MCAS may also react to various foods, leading to many foods being avoided. Sticking with a narrowed diet for a long period of time can also lead to nutritional deficiencies. Working with a dietitian can be helpful in this scenario as well, as they can help with planning a nutritionally balanced plan that includes foods that are better tolerated.

2.) Not getting enough nutrition can lead to malnutrition.

While not getting enough of certain vitamins or minerals can lead to deficiencies, not getting enough nutrition overall can lead to malnutrition. It seems to be a common concern for individuals with MCAS who struggle with frequent reactions to foods that leave them rightly fearful about whether or not their next meal will lead to uncomfortable or frightening symptoms.

Malnutrition leaves someone especially vulnerable to infections, bone density issues, and other health concerns. Getting professional help to resolve malnutrition is crucial before negative health consequences occur.

3.) If MCAS reactions include anaphylaxis, talk to your medical team about the need for Epi-Pens.

To stay safe, it’s essential to get an Epi-Pen if MCAS reactions include anaphylaxis. Anaphylaxis can present differently for individuals with MCAS, and is not limited to throat or lip swelling, so it is important to talk to your medical team about how your symptoms are presenting. Epi-Pens inject a medication that helps stop anaphylaxis (life-threatening allergic reactions), and having one is an important safety measure for people with serious MCAS reactions.

It’s critically important for those with MCAS to work closely with their healthcare teams to stay as healthy and safe as possible.

Written by: Katie Mednick, Registered Dietitian, Nutrition Expert