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This protocol is intended for psychiatric providers working within the Holistic ImmunoPsychiatric (HIP) Framework who encounter patients with suspected or confirmed mast cell activation syndrome (MCAS) using or inquiring about non-prescription mast cell–stabilizing supplements. It provides an evidence-based framework for evaluating these products, understanding their mechanisms, assessing drug interactions with psychiatric medications, and counseling patients.

Mast Cell Activation Syndrome (MCAS), Postural Orthostatic Tachycardia Syndrome (POTS), and [Hypermobile Ehlers-Danlos Syndrome](/rare-disease/hypermobile-ehlers-danlos-syndrome) (hEDS) frequently co-occur as a clinical triad. These conditions produce neuropsychiatric symptoms—anxiety, panic, depression, insomnia, cognitive impairment ("brain fog")—that overlap with and are often misdiagnosed as primary psychiatric disorders. Depression-anxiety symptoms occur in 40–60% of pat