Christoforou et al. (2026)
- Authors: Maritsa E. Christoforou, Linda C. van Campen, Frans C. Visser, Carlton K. Lee, Samantha L. Lemmon, Peter C. Rowe, Alba M. Azola
- Institutes: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, Stichting CardioZorg, Hoofddorp, Netherlands
- Publisher: Cureus
- Link: DOI
Summary
This paper introduces a novel dosing strategy for managing Mast Cell Activation Syndrome in ME/CFS and Long COVID patients. By demonstrating that higher-than-standard doses of a well-known medication can be safely and effectively administered through a continuous sipping method, it provides a practical therapeutic option for those who have not responded to conventional protocols. The study highlights the significant role mast cell dysfunction plays in the core symptoms of ME/CFS, such as cognitive impairment and severe fatigue.
What was researched?
The study investigated the effectiveness of a continuous oral regimen of high-dose cromolyn sodium 💊 for managing symptoms in ME/CFS patients who also meet the criteria for Mast Cell Activation Syndrome (MCAS).
Why was it researched?
Researchers sought to improve patient compliance and therapeutic outcomes, as standard four-times-daily dosing of cromolyn is often difficult to maintain and may be insufficient for controlling severe MCAS symptoms in this population.
How was it researched?
This was a retrospective case series involving five patients with ME/CFS or Long COVID and comorbid MCAS. Participants were instructed to mix their total daily dose (ranging from 1600 to 2400 mg) into a water bottle and sip the solution continuously throughout the day.
What has been found?
All five patients experienced significant clinical improvements in symptoms, including reduced fatigue, better cognitive function, and improved heart rate control. The high-dose regimen (1600–2400 mg daily) was well-tolerated and proved more effective than conventional 800 mg doses.
Discussion
The continuous sipping method may provide more stable plasma levels of the medication compared to discrete bolus doses. While the doses used were higher than typical clinical practice, they remain within the safety guidelines established in the original FDA application for the drug.
Conclusion & Future Work
High-dose continuous oral cromolyn is a safe and effective treatment strategy for a subset of ME/CFS and Long COVID patients with MCAS. Further prospective trials are needed to validate these findings in larger, controlled cohorts.