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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

Recognizing this duality highlights the need for a comprehensive approach that balances symptom relief with potential impacts on gut health, ensuring that interventions contribute positively to the multifactorial nature of ME/CFS [7]

When autoimmunity flares, as in other cases of chronic inflammation, antioxidant defenses are weaker

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