Specialized MCAS Care, From Evaluation Through Treatment
MCAS can be complicated—and finding a provider who understands the condition, medication sensitivities, and the trial-and-adjustment process involved in treatment can be challenging.
The LDN Direct MCAS Program provides a structured, 6-month care pathway for patients seeking knowledgeable support and medical treatment for suspected or established Mast Cell Activation Syndrome (MCAS).
Your care begins with a comprehensive consultation with our clinical nutritionist and MCAS specialist Jade Arellano, CNS. This consultation is focused on your health history, symptoms, triggers, previous treatments, nutrition, supplements, and available medical records. This information is then used to prepare for your medical evaluation with Dr. Sajad Zalzala, who will determine appropriate treatment and discuss medication options with you.
Throughout the program, you’ll also receive ongoing support to track your response, identify patterns, and navigate your treatment plan.
The program includes four consultations over six months and is $449.
How the MCAS Program Works
MCAS is complex, and treatment is rarely one-size-fits-all. Our program is structured to give us time to understand your history, gather relevant medical information, and develop an individualized approach to your care.
This program is not a one-time consultation, nor is it an unlimited or open-ended prescribing service.
Initial Program Structure
(First 6 Months- $449)
The initial MCAS Program includes four (4) consultations, which must be completed within the first six (6) months of enrollment:
Initial MCAS Consultation with Jade Arellano, MS, BCNS
Review your symptoms, health history, triggers, diet, supplements, previous treatments, medication responses, and available labs/medical records.
You’ll receive individualized nutrition, supplement, and lifestyle guidance while we prepare for your medical evaluation.
(No prescriptions are issued at this visit.)
Initial Medical Evaluation with Dr. Z
Dr. Zalzala reviews your history, labs, and relevant medical records, evaluates your case, and discusses treatment options.
(Prescriptions initiated at this visit when medically appropriate.)
Follow-Up Consultation with Jade
Ongoing education, symptom tracking, and program support
Follow-Up with Dr. Zalzala
Dr. Zalzala reviews your response to treatment, addresses medication-related concerns, and makes adjustments to your treatment plan or prescriptions when medically appropriate.
Program Fees & Medication Costs
The MCAS Program fee covers consultations, clinical evaluation, education, and care coordination only.
Medication costs are not included and are paid separately to the dispensing pharmacy. Patients are responsible for all medication costs, which may vary based on pharmacy, formulation, and dosage.
Important:
All included visits must be used within the first 6 months of enrollment.
Unused visits do not roll over and are forfeited after the 6-month period.
Scope of Medications Within the Program
During the MCAS Program, licensed providers may evaluate the appropriateness of commonly used MCAS-related medications, including:
Low-Dose Naltrexone (LDN)
Amlexanox
Cromolyn
Ketotifen
Hydroxyzine
Compounded antihistamines
Clemastine
Cimetadine
Pyridostigmine
All medication decisions are made solely by a licensed medical provider based on clinical appropriateness, safety considerations, and patient-specific factors.
Prescriptions are not guaranteed.
Medications Outside Program Scope
Medications outside of the list above may require additional clinical evaluation beyond what is included in the MCAS Program.
If consideration of other medications is clinically indicated, patients may be required to schedule additional follow-up visits to allow for appropriate assessment of safety, interactions, and monitoring needs.
These additional visits are not included in the program.
Ongoing Care
Beyond the Initial 6 Months
Patients who are clinically stable on their MCAS treatment plan may continue care beyond the initial 6-month period through the MCAS Refill process.
MCAS Refill Process
The MCAS Refill option allows established MCAS Program patients to submit an online refill request for provider review for all currently prescribed MCAS medications at one time.
Format: Refill request for provider review ($89) or follow-up consultation with provider ($99-$145)
Eligibility: Clinically stable patients without new concerns or medication changes
This process is intended for maintenance care only.
Submission of an MCAS refill request does not guarantee approval or issuance of prescriptions.
All refill requests are subject to provider review and clinical discretion.
If new symptoms, side effects, medication changes, or safety concerns are identified, patients may be required to schedule an additional follow-up visit instead of—or prior to—medication continuation.
When Additional Visits Are Required
Additional follow-up visits may be required if:
New or worsening symptoms are reported
Medication changes are requested
New medications outside the program scope are being considered
Safety monitoring or reassessment is clinically indicated
Patients Under 18
Patients under the age of 18 will complete their initial consultation with Jade; however, no prescriptions will be issued until the patient has completed a medical evaluation with Dr. Zalzala, which can be scheduled shortly after meeting with Jade.
Additional Consultation Fees
If additional visits are needed beyond the included program visits or after the initial 6-month period, the following fees apply:
Follow-Up Visit with Dr. Z: $145
Follow-Up Visit with Jade: $99
Telehealth & Licensing Notice
All services are provided via telehealth. Providers may only offer care to patients located in states where they are licensed at the time of the visit.
Additional requirements may apply depending on state regulations.
Important Program Notes
The MCAS Program supports both initial evaluation and ongoing maintenance care
Continued participation depends on clinical stability and provider review
Medication recommendations may change over time
Participation does not guarantee specific medications or outcomes
Questions?
📩 Message us through your patient portal (preferred)
📧 Email: info@rootcausesclinic.com
📞 Text (non-urgent): 559-640-7756
MCAS Navigator
If you are looking for more than medication to help manage your MCAS symptoms, consider joining Jade’s MCAS Navigator Support Program. Monthly membership also gives you access to discounts on the MCAS Medication Program, as well as discounted fees for testing and one to one consultations. Learn more by clicking below.
