Gordon Medical Associates

Mast Cell Activation Syndrome is not a localized problem. When mast cells are in a state of persistent activation, the resulting inflammation and oxidative stress create a systemic environment in which the immune system loses its ability to regulate itself accurately.⁠
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This is why MCAS patients so often present with symptoms that cross multiple systems simultaneously, and why treating MCAS in isolation rarely resolves the full clinical picture. The immune dysregulation it creates has downstream effects on everything from neurological function to hormonal balance to gut integrity.⁠
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Mast cells release over a thousand different chemicals, and standard lab panels capture only a fraction of them. Histamine, tryptase, and chromogranin A are the most commonly tested markers, but they require the patient to be in active flare at the exact moment of the draw to register meaningfully. In clinical practice, that window is rarely caught.⁠
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This is why a clinical diagnosis is the most reliable tool commonly available. The patient's symptom pattern, their reactivity profile, and their response to MCAS-targeted treatment tell a more complete story than any single lab value ordered from the standard laboratory. ⁠
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The overlap between Long COVID and Mast Cell Activation Syndrome is appearing consistently in our clinical practice, and the pattern is significant enough that MCAS needs to be part of our evaluation for any patient who has significant health issues from 3 months to years after an initial COVID infection.⁠
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What is less clear is why the association is so high. One area being explored is whether there is an underlying genetic component to how certain immune systems respond to viral triggers, making some individuals more predisposed to mast cell dysregulation following infection. The clinical picture of Long COVID, with its unpredictable, multi-system symptom burden, maps closely onto what is seen in MCAS, and addressing mast cell activation may be a critical piece of moving these patients forward.⁠
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Lyme disease is not a single clinical picture, and treating it as one is where most approaches fall short.

In the early stages, the infection itself is often the primary driver. But as the illness progresses, the infection becomes less of the story, and immune dysregulation becomes more of it. What was triggered by Borrelia may now be sustained by a dysregulated immune system that has lost its ability to regulate itself, shaped by individual biology, pre-existing vulnerabilities, and how long the body has been in that state.

This distinction matters for how these patients are evaluated and treated.

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Patients can expect to recover from Lyme, but the timeline and outcome depend on how long they have been sick and what else is contributing to their illness. For chronic and complex patients, we use the term remission because there is not always a guarantee of complete resolution.

Lyme may have initiated the illness, but it is often not the full picture. Other infections, toxins, or immune dysfunction may be layered on top, and treating Lyme alone does not always resolve everything. That said, we can get patients into a well regulated state where they are asymptomatic or have minimal, functional symptoms.

Lyme remission means living without constant symptoms, even if occasional flares occur. Recovery is possible, and for many patients it is achieved.

What questions do you have about Lyme recovery?

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Happy Memorial Day weekend. If you are spending time outside, make tick checks part of your routine. Prevention is easier than treatment, and finding a tick early makes a big difference.

Check your whole body after being outdoors, not just your legs. Ticks can attach anywhere, including your scalp, behind your ears, and in skin folds. The sooner you find and remove it, the better your chances of avoiding infection.

Comment SUMMER and we will send you our guide on what to do if you find a tick.

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