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Heres how it may present: Neurological & Cognitive Brain fog Headaches or migraines Anxiety or panic attacks Insomnia Light or sound sensitivity Dizziness or balance problems Respiratory Shortness of breath Asthma-like symptoms Nasal congestion Frequent throat clearing Chronic cough Gastrointestinal Bloating Nausea or vomiting Diarrhea or constipation Acid reflux Abdominal pain Food intolerances Cardiovascular Heart palpitations Low blood pressure Flushing or facial redness Dizziness on standing (POTS) Musculoskeletal Joint pain Muscle aches Bone pain Dermatological Hives Itching without rash Rashes or eczema Dermatographia (skin writing) Systemic Temperature dysregulation Sensitivity to smells, chemicals, or stress Reactions to medications, supplements, or anesthesia Common Triggers of Mast Cell Degranulation People with MCAS often react to otherwise harmless stimuli