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Understanding MCAS with Dr. Zachary Spiritos

Understanding MCAS with Dr. Zachary Spiritos

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 “When was the last time you felt normal?” For many living with mysterious, fluctuating symptoms...that question feels all too familiar. I’m chatting with Dr. Zachary Spiritos about Mast Cell Activation Syndrome (MCAS) - what it is, what his classic patient looks like, and what to do if you suspect it’s behind your symptoms. If you’ve been told everything looks fine but you still don’t feel right, this episode of The Gut Show is for you! Covered in this episode: Introducing Dr. Zachary Spiritos [3:10] What are mast cells [8:41] His classic patient [12:51] When is the last time you felt normal? [16:00] Why do patients get MCAS? [19:24] Evaluation for MCAS [21:27] Treatment [24:09] Medications [29:12] Histamine vs MCAS [32:39] Is a low histamine diet forever? [34:56] ARFID [37:10] How to find the right provider for MCAS [38:20] Thank you to our partners: FODZYME is the world’s first enzyme supplement specialized to target FODMAPs. When sprinkled on or mixed with high-FODMAP meals, FODZYME’s novel patent-pending enzyme blend breaks down fructan, GOS and lactose before they can trigger bloating, gas and other digestive issues. With FODZYME, enjoy garlic, onion, wheat, Brussels sprouts, beans, dairy and more — worry free! Discover the power of FODZYME’s digestive enzyme blend and eat the foods you love and miss. Visit fodzyme.com and save 20% off your first order with code THEGUTSHOW. One use per customer. This episode is made possible with support from Ardelyx. Gemelli Biotech offers trusted, science-backed at-home tests for conditions like SIBO, IMO, ISO, and post-infectious IBS. Their Trio-Smart breath test measures all three key gases: hydrogen, methane, and hydrogen sulfide to detect different forms of microbial overgrowth. And for those with IBS symptoms, IBS-Smart is a simple blood test that can confirm post-infectious IBS with clinical accuracy. You simply order the test, complete it at home, send it back, and get clinically backed results in about a week that you can take to your provider! Find out which tests are right for you at getgutanswers.com and use code ERINJUDGE25 to save $25 on your order! About Dr. Zachary Spiritos: Dr. Zachary Spiritos is a Philadelphian turned North Carolinian, having made his way south for college and ultimately putting down roots after meeting his wife. He graduated cum laude from Davidson College and went on to ultimately complete his gastroenterology fellowship at Duke University. Dr. Spiritos specializes in neurogastroenterology, with a focus on disorders like postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and gastrointestinal issues related to hypermobility syndromes. He also cares for patients with irritable bowel syndrome (IBS), functional GI disorders, and complex motility conditions. Passionate about patient education and whole-person care, he integrates nutrition, stress management, and gut-brain therapies into his treatment approach. Outside of medicine, Dr. Spiritos and his wife stay busy chasing after their two young kids. He enjoys hiking, playing basketball, and fitting in workouts whenever he can. Connect with Dr. Spiritos on his website or on Instagram. Mentioned in this episode: What’s your poop personality? MASTER Method Membership Connect with Erin Judge, RD: IG: https://www.instagram.com/erinjudge.rd TikTok: https://www.tiktok.com/@erinjudge.rd Work with Gutivate: https://gutivate.com/services
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