How I finally linked urinary urgency with mast cell flare IRL

I'd overcome chronic UTI symptoms years ago. Created a protocol that helped many other women too. And, then... following an incredibly stressful day (like an eleventy out of ten), I woke the next morning to smelly pee and urinary urgency.

Other symptoms that day were consistent with MCAS something I'd never even considered until this fateful morning. The morning I finally tied together another loose end in just how important cortisol regulation is to life itself.

What even are mast cells?

Just in case you found this page at random and aren't familiar with wth MCAS is, let's define that first (before you get off down a rabbithole and start bingeing Better Health Guy podcast... I promise stay with me here and I'll save you thousands of hours researching and thousands of dollars chasing more needless supplements/protocols).

Mast cells are immune (and neuroimmune) cells. When they sense a threat, they dump histamine, cytokines, and other inflammatory chemicals in a process known as degranulation. This can show up as:

• irritated bladder lining (causing urinary urgency/burning while peeing)

• the most intense headache you've ever had in your whole entire life (every time you have an MCAS flare)

• GI distress of some sort or the other (skinny poo, constipation, diarrhea, not being hungry, cramps, whatever)

• or a feeling that I described as "raw" for years!!!! Actually, histamine-y feeling. Where your body just hurts like you might be coming down with the flu, maybe or something.

What's MCAS?

MCAS = Mast Cell Activation Syndrome.

It's a condition where your mast cells (immune cells that normally protect you from threats) become overly sensitive and trigger-happy. Instead of responding only to real danger, they release a flood of histamine and inflammatory chemicals in response to everyday things like food, stress, smells, or even hormone shifts.

It’s like your body’s internal alarm system is stuck in overdrive.

Stress, Cortisol, and MCAS

Here’s the kicker: stress—and specifically dysregulated cortisol—can make all of this worse. How the heck does cortisol get dysregulated? Um, well. Here's a short list:

• You get locked in chronic fight-or-flight

• You stop (or start) the pill (or other hormonal birth control like the patch, the ring, or the Mirena IUD)

• You have low thyroid (whether due to Hashimoto's thyroiditis or poor nutrition or because you've been living life stressed for years now)

• Too much blue light at night (oh my gosh, I need tor wrap this up it's dark out), too little natural light in the morning when you wake up, not walking after meals, sporadic eating

• Coffee before breakfast

• MF adaptogens (don't get me started on how much I hate adaptogens! These are marketing gimicks (and I fell for it for way too long!!!!)). If you're taking ashwagandha or rhodiola or schissandra I got bad news... these herbs aren't smart enough to "fix" dysregulated cortisol. These 3 in particular? Suppress cortisol. Full stop.

How do cortisol and MCAS intersect

Dysregulated cortisol—whether blunted (too low) or too high—impact mast cells and histamine clearance.

Cortisol receptors on mast cells allow cortisol to act as a switch. Dramatic rises in cortisol (like when you have an intense conversation, a really stressful meeting, etc.) can prompt mast cell degranulation (histamine release).

And, that's not all. Chronically high or chronically low cortisol also messes with mast cells. Let's go deep into this for just a minute so you've got the whole picture.

How Cortisol Actually Regulates Mast Cells—and What Happens When It Doesn’t

Let’s step back and get clear on what cortisol really does in your body—because this is where most conventional explanations fall flat.

Cortisol isn’t just your “stress hormone.” It’s your internal firefighter, inflammation regulator, and I'm going to go ahead and say it... the most important hormone in your whole entire body.

If you find that hard to believe, check out my other blog posts here and my entire YouTube channel (FeelBetterThanFine... yes, I've got so much to say on cortisol and the two other hormones that make you TIC, I had to put them in their own YouTube channel).

Now back to the regularly scheduled post.

Cortisol works by responding to stress (sounding the alarm), doing damage control, and then—if things are working properly—turning the alarm system back off.

That alarm system is called your HPA axis (hypothalamus-pituitary-adrenal axis... TLDR):

• The hypothalamus releases CRH (corticotropin-releasing hormone) which tells your

• pituitary to release ACTH, which tells your

• adrenals to release cortisol

Why so many relays? They don't all speak the language.

When everything’s in rhythm, cortisol does 3 big jobs (for mast cells... it does WAY more than this generally speaking):

1. Cortisol stabilizes mast cells, making them less likely to dump histamine and inflammatory molecules.

2. Cortisol regulates histamine clearance, by supporting the enzymes (like DAO and HNMT) that break histamine down.

3. Cortisol feeds back to the brain (the hypothalamus particularly) to shut down the original alarm—aka, to stop CRH release.

MCAS/Histamine Release When Cortisol Spikes

High cortisol in short bursts, can actually trigger mast cell degranulation. That’s why stress, an argument, or an intense workout can lead to flares.

This happens because:

• CRH (which kicks off cortisol production) directly activates mast cells in your skin, bladder, gut, and brain.

• Cortisol surges can make mast cells dump histamine in the moment, especially if they’re already sensitized by poor sleep, blood sugar crashes, or hormone swings.

You feel this as:

• Bladder urgency

• Flushing or itching

• Anxiety or racing heart

• Brain fog or sudden fatigue

This is the classic “stress = flare” equation. But there’s more to the story.

MCAS/Histamine Release When Cortisol Stays High for Too Long

Chronic stress keeps your cortisol elevated over time—and that changes how your immune system responds.

To avoid overexposure, your body downregulates cortisol receptors. In plain terms: your mast cells (and other immune cells) stop listening. This leads to:

• Loss of cortisol’s stabilizing effect on mast cells

• Continued CRH production from the brain (because the feedback loop is broken)

• Mast cells staying on high alert without checks or balances

• Immune confusion: your body becomes both hyperreactive and unable to shut down inflammation properly

And this pattern eventually leads to cortisol crash—where your levels drop too low, and things get even worse.

MCAS/Histamine Release in Adrenal Fatigue Stage 4 (Chronically Low Cortisol): The Final Breakdown

Once cortisol tanks:

• Mast cells are completely unregulated

• Histamine builds up (because DAO and HNMT enzyme function drops)

• The hypothalamus keeps pumping out CRH

• Flares become constant—even without a clear trigger

This is when women started showing up in my inbox—seven days into UTI Freedom Formula—saying:
“I’m halfway through the program and I’m still struggling with urgency, burning, and that sickeningly sweet cloudy pee.”

That’s when it hit me: the protocol still wasn't working for Stage 4 burnout! This wasn't something nutrition could fix. This required a nervous system intervention.

Once you hit Stage 4 adrenal burnout, it's possible to get out. With major life overhaul (like quitting your day job and moving to a remote tropical island where you sip filtered mint water all day) and a diet that supports adrenal health.

For the rest of us, a hands-on recalibration's required. Not another group call. Not another “how to regulate your nervous system with box breathing” infographic.

I’m talking hands-on intervention, and I only know of a handful of modalities—Spinal Flow and Network Spinal being the most popular of these that do this.

These modalities go upstream of hormones. Upstream of that HPA axis. They call the nervous system itself out of fight-or-flight so that proper hormone signaling is restored.

So where does this leave you?

If you’ve made it this far, maybe you’ve been that woman too.

The one who’s done the protocols to relieve urgency. Avoided every trigger food. And still wakes up with bladder pain, cloudy pee, or urgency no test (even the micro-infection tests) can explain.

You’re not missing more antimicrobials.

Or another bladder instillation.

And, you’re not broken.

You’re dysregulated.

Because when cortisol’s stuck, when your mast cells are unhinged, when your nervous system’s looping in survival mode—it doesn’t matter what you cut out or pile on. Your body stays on red alert.

That’s why I created a program specifically for women with IC or chronic urinary urgency who’ve tried it all—and are still flaring.

It blends my full revised UTI Freedom Formula protocol with 6 months of hands-on Spinal Flow sessions in Encinitas plus private consults to support your entire healing arc—ensuring you finally break free of urinary urgency.

👉 Learn more about the Urinary Urgency Reset program right here

This is for the woman who’s done managing.
It’s time to actually heal.