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Here are some of the most common manifestations: Skin Symptoms: Flushing or redness Hives or urticaria Angioedema (swelling) Itching Dermatographism (skin writing) Gastrointestinal Symptoms: Abdominal pain or cramping Diarrhea and/or constipation Nausea and vomiting Acid reflux Food intolerances Cardiovascular Symptoms: Tachycardia (rapid heart rate) Blood pressure fluctuations Lightheadedness or syncope (fainting) Chest pain Respiratory Symptoms: Wheezing Shortness of breath Throat tightness Chronic cough Nasal congestion Neurological Symptoms: Headaches or migraines Brain fog Memory issues Anxiety Insomnia Dizziness What makes MCAS particularly challenging to diagnose is that symptoms can occur in any combination and severity

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Frequency depends on baseline B12 status and clinical goals

in horses is 500 mg every 4 days for 28 days intramuscularly