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Causes of MCAS include: Chronic bacterial infections, such as Lyme disease, Babesia, and Bartonella Chronic viral infections, such as Epstein-Barr Virus and Long COVID Mold illness & fungal infections Heavy metals Environmental toxins, such as herbicides & pesticides SIBO and leaky gut syndrome Allergens food and environmental Genetically predisposed Additionally, certain triggers cause mast cells to degranulate and release mediators in susceptible individuals

In real life, people miss doses, experience insurance denials, face cost barriers, and stop treatment when side effects become inconvenient

Tota S, Goel R, Pachauri SD, Rajasekar N, Najmi AK, Hanif K, et al