DrA-Says

DrA-Says Doctor Ahmed MBBS MRCGP BSc

Find out first when clinic list opens 👇

https://drasays.beehiiv.com
(29)

11/06/2026

This a condition I am seeing much more and it is very closely associated with hypermobile Ehlers Danlos syndrome and mast cell activation syndrome.

10/06/2026

Ferritin alone is not a reliable marker for iron deficiency.

Ferritin is an acute phase reactant. That means inflammation, infection, liver disease, and chronic illness drive it UP artificially, masking a true deficiency underneath.

In patients with Long Covid, MCAS, or any chronic inflammatory condition, a “normal” ferritin can coexist with functional iron deficiency at the tissue level.

What you actually need:

Serum iron
Transferrin saturation
TIBC
Ferritin in context

Stop treating a number in isolation. Treat the whole picture.

09/06/2026

All you need to know about mast cell stabilisers. They can be in supplement form which you can get over the counter, or prescription stabilisers. All can be useful.

08/06/2026

Most people think antihistamines are just for hay fever.

But for thousands living with widespread, unexplained symptoms they can be genuinely life changing.

MCAS is a condition where your mast cells become overreactive, firing repeatedly in response to everyday triggers. Food. Stress. Temperature changes. Hormones. Even exercise.

The result is symptoms that seem completely unrelated. Fatigue. Brain fog. Flushing. Joint pain. Nausea. Rapid heart rate. Skin reactions. And because no single test shows it clearly, most people spend years being told nothing is wrong.

H1 blockers (cetirizine, loratadine) target the classic reactions — itching, flushing, hives, and that wired but drained feeling so many of you describe.

H2 blockers (famotidine) work on a completely different set of receptors in your gut, heart, and immune cells helping with reflux, nausea, bloating, and heart rate dysregulation. One type alone often is not enough.

But blocking histamine after release only goes so far. This is where stabilisers come in. Medications like sodium cromoglicate and ketotifen aim to reduce how easily mast cells fire in the first place. Many patients find this is the step that finally moves them forward.

Quercetin and luteolin offer natural stabilising support alongside prescription treatment.

If this sounds like your story, save this and take it to your next appointment.

Have questions? Let me know in the comments .

The reason your good days are making you worseWhy pushing through on the days you feel capable is keeping the cycle runn...
07/06/2026

The reason your good days are making you worse
Why pushing through on the days you feel capable is keeping the cycle running — and what to do instead

02/06/2026

Hair loss is like any other symptom. It needs to be taken seriously and can have many causes. this can make treatment more likely to be successful if we can figure out what the underlying cause is.

01/06/2026

Full explanation 👇

Craniocervical instability is something every hEDS patient deserves to know about. The craniocervical junction is where your skull meets the top of your spine, and it relies almost entirely on ligaments to stay stable. In hEDS, those ligaments are made of the same lax collagen as every other joint in your body, which means they can become lax, stretched, and unable to do their job properly.

When the junction becomes unstable, the brainstem and upper cervical spinal cord can be compressed or irritated with movement and changes in position. This is why so many people with hEDS describe symptoms that seem neurological but get dismissed. Head pressure that worsens when upright. Brain fog that lifts when lying flat. Neck pain that never fully resolves. Pulsatile tinnitus. Swallowing difficulties. Fatigue that goes far beyond what you would expect.

The frustrating reality is that standard MRI in a neutral lying position will often miss this entirely. Diagnosis requires specialist assessment, often including upright or dynamic imaging, because the instability only becomes visible under load or in certain positions.

If you have hEDS and you have been told your symptoms are anxiety, deconditioning, or medically unexplained, CCI is worth exploring with a clinician who understands connective tissue disease. The overlap is real, it is documented, and it is chronically underrecognised within mainstream medicine.

Knowledge is the first step toward getting the right assessment.

The one thing nobody tells you before your fibromyalgia appointmentWhat to say, what to ask for, and what to push back o...
31/05/2026

The one thing nobody tells you before your fibromyalgia appointment
What to say, what to ask for, and what to push back on — so you finally leave with something useful

28/05/2026

Why getting a hypermobile Ehlers syndrome diagnosis is so important. Part 1

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