Mast cell activation syndrome (MCAS) and mastocytosis are conditions that impact mast cell function, often due to genetic predispositions. While there is no cure, treatments focus on alleviating symptoms affecting the skin, gastrointestinal, respiratory, and other systems. Antihistamines, especially ketotifen, are commonly used due to their mast cell stabilizing properties.

What are MCAS and Mastocytosis?

MCAS (Mast Cell Activation Syndrome): This condition involves an excessive release of chemical mediators by overactive, but not overproduced, mast cells, leading to chronic health issues.

Mastocytosis: Characterized by an abnormal accumulation of mast cells in the skin and internal organs. In children, it usually affects the skin, while in adults it often impacts the bone marrow. Although there is no cure, treatments can effectively manage symptoms.

Both conditions result in an overproduction of chemical mediators, which have vasodilatory, nociceptive, and inflammatory properties. Genetic factors likely play a role in their development.

Symptoms of MCAS and Mastocytosis

Common symptoms include:

• Itching
• Flushed or pale skin
• Nausea, diarrhea
• Congestion
• Wheezing, coughing
• Increased heart rate
• Light-headedness
• Headache
• Fatigue
• Osteoporosis

Triggers for MCAS and Mastocytosis

Symptoms can be triggered by various sources such as heat, cold, chemicals, scents, bacteria, stress, and certain medications. Ingredients in commercial medications like soy and gluten may also trigger symptoms. Compounding pharmacies can create medications with these ingredients removed to prevent flare-ups.

Ketotifen for Treating Mast Cell Conditions

Antihistamines, like ketotifen, help reduce symptoms by inhibiting the inflammatory response. Ketotifen is particularly effective as it also acts as a mast cell stabilizer. It has been shown to inhibit exocytosis in mast cells and is effective at low doses of 1mg. Ketotifen can also treat symptoms that other antihistamines do not, such as bone pain.

How to Get Ketotifen Capsules

While ketotifen is available under various brand names internationally, it is not commercially available in capsule form in the U.S. At Little Acorn Pharmacy, we compound ketotifen in 0.5mg, 1mg, and 2mg capsules. The typical prescription for adults and older children is 1mg taken twice daily, and for younger children, 0.5mg twice daily.

Explore our compounding services at Little Acorn Pharmacy to get personalized treatment for mast cell conditions.