The Real Reason You’re Exhausted (And It’s Not Laziness)

You’re not lazy. In the video, our doctors unpack a common but overlooked driver of fatigue and “mystery” symptoms: mast cell activation syndrome, or MCAS. They also touch on POTS and Ehlers-Danlos–type hypermobility. Here’s the simple version of what they shared, plus a full FAQ with every question asked in the video.

What MCAS is, in plain English

Mast cells are immune cells that live in your skin, gut, sinuses, brain and more. They react to triggers like pollen by releasing chemicals such as histamine. With MCAS, those cells get stuck “on,” releasing chemicals across multiple body systems. That can look like allergies, gut issues, rashes, brain fog, fast heart rate, dizziness, cysts, and widespread inflammation. It’s multi-system, which is why people bounce between specialists without answers.

Why it’s missed so often

Many folks don’t show the “classic” hives or obvious allergies. When symptoms don’t fit one box, MCAS is easy to dismiss. Old tests and narrow checklists add to the problem, so people go years without a clear plan.

The testing talk (and why the “how” matters)

• Tryptase is the old go-to lab. It’s hard to catch at the right moment and can be high for other genetic reasons, so it’s not very reliable alone.
• Better approach: pair symptoms with blood and urine markers like histamine, N-methylhistamine, prostaglandin D2, and leukotriene E4. Heparin is especially helpful because mast cells make it; an elevated level strongly points to MCAS.
• Handle samples cold. These chemicals are heat-sensitive. If the draw, spin, storage, or shipping isn’t cold, results can look “normal” even when you’re not.

How POTS and hypermobility connect

POTS is a type of dysautonomia, where your autonomic nervous system misfires. Heart rate and blood pressure swing, you get dizzy, and some people can’t get out of bed. Hypermobility can travel with MCAS and POTS, so when you see one, you screen for the others.

Treatment themes from the video

• Foundation first: nutrition, vitamin D and B12 status, and rebuilding what’s low.
• Low-histamine strategies: diet trials, low-histamine probiotics, and short trials of over-the-counter antihistamines to see if symptoms improve. These can also help confirm you’re on the right track.
• Targeted meds when needed: there are mast-cell-targeting prescriptions; in some cases, micro-dosed GLP-1s show anti-inflammatory, mast-cell-calming effects. This is individualized and doctor-directed.
• If mold is part of the picture: you cannot heal while living in a moldy space. Support detox pathways, but step one is getting out or remediating.

Why functional medicine fits this problem

Acute care is great for emergencies. But multi-system, root-cause problems like MCAS need a bigger lens and more time. That’s why we look at patterns across systems and use both advanced testing and clinical trials of care.

FAQ:

1. What are we going to be talking about today?

MCAS, plus quick hits on POTS and Ehlers-Danlos–type hypermobility.

2. What actually is MCAS and how are these things connected

MCAS is an immune-driven, multi-system inflammatory problem. It often clusters with POTS and hypermobility.

3. For all the non-medical people out there, what is [tryptase]? Can you describe what that is and why it’s significant?

Tryptase is a protein released by mast cells; it’s been used to screen for mast-cell issues, but it’s often normal or misleading on its own.

4. Are you using a specific lab that you know is going to keep the specimens frozen?

Yes. Cold handling from draw to lab matters, and not all labs can do it.

5. So to clarify… if you have MCAS, POTS, EDS, and you’re going to conventional medicine, is there really just no good option?

There are options, but you need a clinician experienced with these conditions so things aren’t dismissed.

6. Any tips… things that people can do to manage their symptoms… within reach?

Start with diet, nutrient repletion, simple antihistamine trials, and low-histamine approaches. Individualize from there.

7. How often do you prescribe or suggest a low-histamine diet?

Often as a short trial to see if symptoms calm down.

8. Did she come to you already with an MCAS diagnosis?

In that case story, yes. The visit focused on what else could help.

9. Can you dive more into why so many patients end up in this position… the conventional system and why that is?

Acute-care systems shine in emergencies, but stumble with multi-system chronic issues that don’t fit one specialty.

10. What are some of the things you’ve used in the past on patients? Supplement-wise?

Detox support as appropriate, plus lifestyle tools like sauna, hydration, and bowel regularity when mold is a factor.

11. Want help putting this together for your case?

At Med Matrix, we connect the dots across systems, order the right labs the right way, and build a plan that fits you. If the above sounds like your story, schedule a functional assessment and we’ll map your next steps together.