OpenHealth Q&A

Exploring Potential Causes for a Series of Symptoms in a 38-Year-Old Woman

At 38 years old and navigating a variety of health issues, I’m reaching out to understand if what I’m experiencing could be linked to mast cell activation syndrome (MCAS) or perhaps an autoimmune condition. As a trail runner and strength coach, maintaining fitness is important, but lately, I’ve been facing a puzzling array of symptoms. I’m a mother to a three-year-old, stand at about 178 cm and weigh 67 kg. Although I generally feel fit, I’ve been struggling with various fluctuating ailments that impact multiple areas of my body. Some of these issues have persisted for nearly a decade, while others have only emerged in recent days. They intensified about a month ago, prompting my current concerns. **Eye Issues:** I experience noticeable swelling upon waking, a droopy eyelid, and an often uncomfortable awareness of my eyes. My vision has deteriorated in the past six months; despite an ophthalmologist confirming that my eyes are structurally sound with only minor refractive changes, I find that fatigue and physical activity greatly exacerbate this decline. **Gastrointestinal Concerns:** I carry a diagnosis of IBS and malabsorption dating back 15 years. I deal with colon cramps and abdominal discomfort that seem to correlate with certain foods. Triggers range from poppyseeds to high fiber content and specific spices. My IgG levels are notably elevated for poppyseed, egg white, and wheat. **Skin Problems:** An acne-like rash appears on my face, shoulders, and back, often linked to sun exposure. I experience a burning sensation that occasionally leads to painful skin during showers, along with flushing and itching related to various factors such as food, detergents, and cosmetics. Recently, a persistent itch developed on my left thigh, lasting three continuous days. **Neurological and Musculoskeletal Symptoms:** I notice tingling sensations in my arms and calves that happen during sneezing or exhaling. This phenomenon began around the time my health issues flared up more noticeably. I also feel cold in my feet when I cough and notice my hands sometimes feeling both cold and hot at the same time. My pinkies and ring fingers occasionally seem to clench without my control, adding to the overall odd sensations. I frequently deal with shifting muscle and joint discomfort throughout my body, particularly in the neck and legs. Although I have existing conditions like herniated discs and sciatica, they don’t seem to be directly tied to my current symptoms. Increased fatigue and cognitive fog are now a regular part of my life. In recent months, my coordination has faltered, and I’ve stumbled several times while running, leading to unusual clumsiness. **Other Systemic Manifestations:** Dizziness has become a frequent occurrence when rising from a seated position. I also experience a general sense of malaise and ongoing increases in heart rate variability when my symptoms flare up. Over the past month, my resting heart rate has risen consistently, even during sleep, and I’ve noticed tachycardia following certain meals, particularly those rich in processed ingredients. My history includes steroid treatments with prednisone and pulmicort, and I’ve had recurrent respiratory infections that can quickly escalate. I also dealt with COVID-19 and pneumonia in 2021, only truly recovering from those effects relatively recently. Throughout my postpartum experience, I faced challenges like a rash around my mouth in response to specific antibiotics and painful swallowing at times due to geographic tongue. Interestingly, my dog has become unusually attentive when I feel unwell, a behavior I’ve not observed before. **Medical Tests and Findings:** My ANA test returned positive with a low titer of 1:80, showing homogeneous nuclear and cytoplasmic patterns. Most immunoglobulin levels came back normal, yet the IgG food allergen screen revealed significant reactions, particularly to poppyseeds, wheat, and egg whites. Tests for C3, C4, CRP, and eosinophils were all within normal range, and basic laboratory assessments were satisfactory. An ophthalmic evaluation showed typical findings aside from minor refractive concerns. I’m scheduled for a bronchoprovocation test this coming Monday. After stopping antihistamines five days ago, I’ve noted some throat discomfort, which raises the question of whether I'm dealing with an infection, possibly due to my son’s interactions at kindergarten, or if allergies are re-emerging. I've also experienced consistent nasal drainage. Given the range and variability of my symptoms, along with their apparent connections to food and environmental factors, I’m eager to learn if this could indicate MCAS or another underlying autoimmune condition. **Questions I Have:** 1. Do my symptoms align more closely with MCAS or could they suggest another health issue, such as an autoimmune or neurological disorder? 2. Which specialists should I consult first to begin addressing these issues? 3. Are there any particular lab tests or imaging studies you would recommend that could help clarify my situation? I genuinely appreciate any guidance or insights that could assist me on this journey!

Answers (1)

8/24/2025, 5:51:29 AM

OpenHealth AI

Your symptoms present a complex and multifaceted health picture, and I understand how concerning this must be for you. It's great that you're actively seeking to address these issues. Let’s break down your situation.

Key Points:

1. Your symptoms may suggest a mix of differential diagnoses, including mast cell activation syndrome (MCAS), autoimmune disorders, food allergies, or even neurological conditions.
2. It’s important to take targeted steps to manage your symptoms while engaging the right healthcare professionals for comprehensive evaluation.
3. Maintaining a detailed symptom diary and noting any potential triggers may also provide valuable insights for your healthcare providers.

Symptom Overview:

• Eye Issues: Swelling, droopy eyelid, discomfort, and vision changes may suggest allergic reactions or inflammatory processes.
• Gastrointestinal Concerns: Your history of IBS and malabsorption, along with specific food triggers, may point to food sensitivities or allergies. The elevated IgG levels indicate an immune response to certain allergens.
• Skin Problems: The rash, burning sensations, and itching suggest potential allergic responses or dermatological conditions that could be linked to your systemic symptoms.
• Neurological Symptoms: Tingling, clumsiness, and coordination issues may indicate neurological involvement, which can also be part of autoimmune processes.
• Other Systemic Symptoms: Dizziness, tachycardia, and increased fatigue signal that your body is under stress and may be responding to an underlying condition.

Next Steps:

1. Identify Triggers: Keep a symptom diary for at least two weeks. Note when symptoms occur, their severity, and any potential triggers such as foods, environmental factors, stress, or physical activity.

2. Consult Specialists:

   • Allergist/Immunologist: Given your symptoms and positive IgG responses, they can help assess for MCAS or food allergies.
   • Rheumatologist: If you're contemplating an autoimmune condition, they can perform comprehensive testing related to autoimmune disorders.
   • Neurologist: If neurological symptoms worsen or persist, this specialist would evaluate potential neurological causes or related conditions.

3. Further Testing:

   • Additional blood tests like specific IgE testing (for immediate hypersensitivity reactions) may help clarify food allergies.
   • Skin testing for allergies could also be beneficial.
   • Consider a referral for an MRI or other imaging studies if neurological symptoms persist to rule out underlying conditions.

4. Lifestyle Adjustments:

   • Maintain a well-balanced diet that avoids known allergens and limits processed foods, particularly if you experience increased symptoms after meals.
   • Stay well-hydrated and consider nutritional support to aid in gastrointestinal health, like probiotics (if tolerated).
   • Engage in stress-reducing activities, such as mindfulness or gentle yoga, that you can perform safely, considering your physical activity background.

Taking these steps can help in managing your symptoms and gaining insights for your healthcare team. I encourage you to communicate openly with your specialists about your experiences and concerns as you seek answers. If you notice any worsening of your symptoms or new ones arise, do inform your healthcare provider promptly. You're taking a proactive approach toward your health, which is commendable!