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Causes of MCAS include: Chronic bacterial infections, such as Lyme disease, Babesia, and Bartonella Chronic viral infections, such as Epstein-Barr Virus and Long COVID Mold illness & fungal infections Heavy metals Environmental toxins, such as herbicides & pesticides SIBO and leaky gut syndrome Allergens food and environmental Genetically predisposed Additionally, certain triggers cause mast cells to degranulate and release mediators in susceptible individuals

One of the key features of bariatric surgery benefits is the recovery in the response to gut-derived peptides 36 , including OXM, the native dualAG, that positively impacts on whole-body metabolism and energy balance 3,37,38