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In MCAS, these cells become abnormally sensitive and react excessively to various triggers, releasing inflammatory substances such as: Histamine Tryptase Heparin Prostaglandins Cytokines Free radicals This release, known as degranulation , leads to symptoms that can resemble allergic reactions and often intensify when the person is upright or experiencing low blood pressure

However, in a pinch, you can use other materials like a piece of a business card, thin cardboard, or even stiff paper from a magazine