16 Dec The Hidden Connection Between Long COVID, Mold, and Mast Cell Activation with Dr. Tania Dempsey
Have you been told your symptoms are “all in your head” when you know something’s seriously wrong with your body? You’re dealing with random hives, crushing fatigue, brain fog that makes simple decisions feel impossible, and your doctor keeps telling you to focus on “one thing at a time” – as if these symptoms aren’t connected. Sound familiar?
I’ve been there. Over two decades ago, when I was diagnosed with celiac disease, I presented my internist with a laundry list of seemingly unrelated symptoms. His response? “Let’s focus on one thing at a time, Natalie. They’re all separate issues.” But here’s what I’ve learned since then: when your body presents multiple mysterious symptoms across different systems, they’re rarely separate at all.
Recently, while dealing with my own frustrating hive situation (if you follow me on social media, you know this journey), I discovered something that’s revolutionizing how we understand chronic illness: MCAS, or Mast Cell Activation Syndrome. And the more I dug into this topic, the more I realized we might be looking at one of the most overlooked health crises affecting midlife women today.
That’s why I was thrilled to sit down with Dr. Tania Dempsey, one of the leading experts in MCAS who left traditional medicine when she realized the system wasn’t serving patients with complex, multi-system symptoms. What she shared completely shifted my understanding of why so many of us – especially those navigating midlife hormonal changes – are struggling with mystery symptoms that no one can explain.
The Evolution from “It’s All in Your Head” to Real Answers
Dr. Dempsey’s journey from traditional internist to MCAS specialist began with a shocking revelation about our healthcare system. “I was told that I wouldn’t get a bonus or salary increase for patients who had cholesterol levels over 200,” she shared. This eye-opening moment made her realize that the traditional medical model wasn’t designed to help patients with complex, interconnected symptoms.
What struck me most about our conversation was her explanation that conditions like fibromyalgia, chronic fatigue syndrome, and even many cases of “IBS” might all be different manifestations of the same underlying issue: mast cell dysfunction. This isn’t about creating a new catch-all diagnosis – it’s about finally understanding the mechanism behind these mysterious ailments.
Understanding MCAS: Your Body’s Overreactive Security System
Think of mast cells as your body’s security guards, stationed at every interface between your internal world and the external environment – your skin, respiratory tract, digestive system, and even surrounding every nerve in your body. In a healthy system, these cells respond to threats, release their chemical mediators (like histamine), then reset and wait for the next threat.
But in MCAS, these security guards are trigger-happy. They’re constantly leaking inflammatory chemicals – over 1,200 different ones – creating both local and systemic inflammation. As Dr. Dempsey explained, “People who have mast cell activation syndrome have leaky mast cells at baseline that are already leaking chemicals causing inflammation.”
Why COVID Changed Everything
The pandemic brought MCAS into sharp focus. Everyone’s mast cells activate when fighting COVID, but for those with underlying mast cell dysfunction, the response doesn’t stop when the infection clears. This explains why some people develop long COVID while others recover completely.
Dr. Dempsey revealed that many long COVID sufferers likely had a predisposition to immune dysfunction before infection. The virus was simply the match that lit an already primed inflammatory response. This same pattern occurs with mold exposure, Lyme disease, and other triggers that leave some people chronically ill while others recover.
The Hormone Connection: Why Midlife Women Are Hit Hardest
Here’s where it gets particularly relevant for our community. Mast cells have receptors for estrogen, progesterone, and testosterone. They literally scan your internal hormonal environment and react to changes. This explains why MCAS symptoms often emerge or worsen during:
- Puberty (ages 8-12)
- Pregnancy and postpartum
- Perimenopause and menopause
Dr. Dempsey noted that her practice has two main demographic groups: adolescents going through puberty and perimenopausal women. The hormonal chaos of perimenopause – with estrogen dominance followed by dramatic drops, and declining progesterone (which actually stabilizes mast cells) – creates the perfect storm for mast cell activation.
Recognizing MCAS: The Multi-System Connection
The challenge with MCAS is that symptoms can appear anywhere because mast cells exist throughout your body. Dr. Dempsey emphasized that if you have symptoms in only one system, it’s unlikely to be MCAS. But if you’re experiencing issues across multiple systems, it’s worth investigating:
Common MCAS Symptoms Include:
- Skin issues (hives, eczema, psoriasis, unexplained rashes)
- Digestive problems (IBS symptoms, food sensitivities, bloating)
- Neurological symptoms (headaches, brain fog, anxiety, depression)
- Cardiovascular issues (rapid heart rate, POTS, blood pressure fluctuations)
- Respiratory problems (congestion, asthma-like symptoms)
- Hormonal disruptions (heavy periods, irregular cycles)
- Musculoskeletal pain (joint pain, fibromyalgia-like symptoms)
- Chronic fatigue that doesn’t improve with rest
The Autoimmune Connection That Changes Everything
One of the most fascinating revelations was the link between MCAS and autoimmune markers. Many people test positive for various antibodies (thyroid, rheumatoid factor, ANA) but don’t have the actual autoimmune diseases. Dr. Dempsey’s research shows that dysfunctional mast cells can trigger B cells to produce “fake antibodies” that don’t actually indicate disease.
This means all those confusing lab results showing various antibodies might actually be pointing to underlying mast cell dysfunction rather than multiple autoimmune conditions. When MCAS is properly treated, these antibody levels often normalize.
Breaking the Inflammation Cycle: Treatment Approaches
The good news? MCAS is manageable. Dr. Dempsey uses a personalized approach that might include:
Medications:
- H1 and H2 antihistamines (and she clarified an important distinction: H2 blockers like Pepcid are much gentler than PPIs and don’t significantly impact stomach acid)
- Mast cell stabilizers like ketotifen and cromolyn
- Natural stabilizers like quercetin (though she warned this can worsen symptoms in people with certain genetic variations like COMT mutations)
Targeted Supplements:
- DAO enzyme for histamine breakdown
- PEA (palmitoylethanolamide) for inflammation
- Vitamin C as a natural antihistamine
Nervous System Regulation: This was perhaps the most crucial point. Dr. Dempsey emphasized that without addressing the nervous system, supplement protocols often fail. She recommends:
- Limbic system retraining programs (Primal Trust, Gupta, DNRS)
- Vagal nerve stimulation
- Grounding and sun exposure
- Stress management techniques
The Hope You’ve Been Looking For
When I asked Dr. Dempsey about success stories, her response was powerful: “Every patient was getting better… they’re functional, they’re doing all these things.” While MCAS might not be “curable” in the traditional sense, it’s absolutely manageable. The goal isn’t to eliminate mast cells – they’re essential for survival. The goal is to quiet them down and restore balance.
Her final message resonated deeply: “Don’t be scared. Fear is real when you’re dealing with the unknown… but there are people out there who can help you.”
Taking Action: Your Next Steps
If you’re recognizing yourself in these symptoms, especially if you’re navigating hormonal transitions, here’s what you can do:
- Document your symptoms across all body systems – look for patterns and multi-system involvement
- Consider your triggers – hormonal changes, infections, mold exposure, stress
- Address your nervous system – this isn’t optional; it’s foundational
- Find a practitioner who understands MCAS – or one willing to learn
- Remember that small improvements matter – you don’t need a complete cure to dramatically improve your quality of life
The Bottom Line
MCAS isn’t just another trendy diagnosis – it’s a real explanation for why so many of us, especially in midlife, are struggling with complex, multi-system symptoms that traditional medicine can’t explain. The intersection of hormonal changes, environmental triggers, and genetic predisposition creates a perfect storm that affects potentially one in five people.
But here’s what gives me hope: we finally have a framework for understanding these symptoms. We have treatments that work. And most importantly, we have practitioners like Dr. Dempsey who are committed to helping us become our own health detectives.
Your symptoms aren’t “all in your head.” They’re not separate, unrelated issues. And you’re not crazy for thinking they’re connected. It might be time to look at the bigger picture – and MCAS might be the missing piece of your health puzzle.
The contents of the Midlife Conversations podcast is for educational and informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider. Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links mentioned on this podcast.
