Multiple MCAS treatments have helped significantly but caused severe anxiety/side effects. Anyone else?

After COVID ~5–6 years ago, my IBS-C became significantly worse and I developed asthma, along with numerous new intolerances/sensitivities to foods, medications, supplements, fragrances, and animals.

I’ve tried several interventions commonly used for MCAS with surprisingly noticeable results:

- LDN (0.5 mg nightly, Ageless/Curexa): Within a few days my facial puffiness and abdominal bloating/distention decreased significantly, and I started looking more like my old self again. It also seemed to act as a prokinetic, which was a huge benefit with IBS-C. Unfortunately, I developed significant anxiety/intrusive thoughts.

- Quercetin dihydrate (BulkSupplements, ~1 g before breakfast and lunch): My normally noisy stomach became much quieter after meals, and after the first dose I almost felt “flat” abdominally. It also initially had a significant calming effect on both my gut and mind. Unfortunately, this was followed by severe anxiety/intrusive thoughts.

- PEA: I was taking this alongside quercetin and stopped both when the anxiety developed. I suspect quercetin was responsible, but can’t rule out PEA.

- Ketotifen (1 mg): I only tried this once. I slept about 12 hours and was extremely sedated and out of it the following day, so I’ve tabled it for now and may revisit a lower dose later.

- Low-dose tirzepatide: I initially tolerated 0.25 mg/week, but after increasing to 0.5 mg/week I’ve noticed increasing abdominal distention. I’m concerned it’s slowing GI motility too much given my IBS-C and may need to discontinue it.

*For LDN specifically, LDN Direct is having me try topical LDN, and I’m also experimenting with very small oral doses diluted in water to see if I can gradually build tolerance.

Has anyone else with MCAS experienced this, especially good results from LDN or quercetin followed by significant anxiety/intrusive thoughts? Did you find a dose or formulation you could tolerate, or an alternative that gave you similar benefits without the CNS side effects?