Brain Body Reset

Unexplained symptoms across multiple body systems, normal labs, and a doctor who says you look fine? Mast cell activation syndrome (MCAS) may be part of the answer, and most clinicians were never taught to look for it.

In this episode I sit down with gastroenterologist and researcher Dr. Leonard Weinstock, co-author of the global Consensus-2 diagnostic criteria for MCAS and the 2026 follow-up paper Progress in Mast Cell Activation Syndrome. We cover why one of the most common immune disorders is still missing from medical textbooks, and why so many patients are dismissed before they’re ever tested.

In this episode:

• Where MCAS came from. How Dr. Molderings’ work nearly 20 years ago separated a non-malignant mast cell disorder from systemic mastocytosis and mast cell leukemia.
• The two sets of diagnostic criteria. Consensus-1 depends on anaphylaxis and a tryptase spike drawn within hours of a flare. Consensus-2 looks at symptoms in two or more body systems, a broader set of mediators, and response to treatment. That difference explains why prevalence estimates run from about 4% to 17%.
• Why testing misses people. A test drawn on a “good day” can be falsely negative 30–40% of the time.
• Mild cases. Some patients have only stubborn reflux and seasonal allergies, which is why “you don’t look sick enough” fails them.
• Triggers. Perfume, smoke, chemical odors, metal implants, and infections like COVID or mono, and how a single event can permanently lower someone’s baseline.
• Long COVID and alpha-gal. Both can look nearly identical to MCAS. Gelatin capsules and magnesium stearate in supplements can quietly keep a reaction going.
• The treatment ladder. H1/H2 blockers, why fillers in a pill can cause a reaction that has nothing to do with the drug itself, vitamin C and D, quercetin or luteolin, and microdosed low-dose naltrexone (LDN).
• Low-dose GLP-1 therapy. Its anti-inflammatory effects, including a patient who had been bedbound for 12 years and recovered.
• The POTS connection. Mast cells live along the sympathetic nervous system, and about 60% of POTS patients improve with mast cell treatment.
• Concussion and puberty. Why head injuries and hormonal changes can switch MCAS on, especially in young female athletes.
• Finding care, and why “practitioners serve human needs first, science second.”

Resources:

• Triad Library: triadlibrary.org
• Understanding Stealth Syndromes, a 59-minute documentary on YouTube that’s worth sharing with family who don’t understand what you’re going through: Watch here 

This episode is for educational purposes and isn’t medical advice. Talk with a qualified provider about your own care.

Mast Cell Activation Syndrome, while still relatively unknown, is likely massively underdiagnosed. 

In this episode, I explore:

• What Mast Cell Activation Syndrome is 
• The diagnostic criteria of Consensus 1 vs 2
• Natural and pharmaceutical treatment options
• What you should consider when the treatment isn't enough. 
  
  

To learn more about our approach to mast cell activation syndrome, visit https://peakbrainandbody.com/conditions/mcas/

What happens when a physician develops long COVID and finds herself struggling to get the medical system to understand what she’s experiencing?

In this episode of Brain Body Reset, I’m joined by internal medicine physician Dr. Kim Robinson Shumate for an honest conversation about how long COVID changed her health, career, and daily life.

She shares her experience with a stroke, POTS, dysautonomia, and mast cell activation, along with the frustration of being told her cognitive testing looked normal when she knew her brain wasn’t functioning the way it had before.

We discuss:

• Why “normal” cognitive testing can miss a meaningful decline from your previous abilities.
• The difference between anxiety about losing your health and anxiety being the explanation for your symptoms.
• The pattern of pushing through symptoms, crashing, and struggling to accept new limits.
• How short appointments and fragmented care can leave both patients and physicians frustrated.
• Her experience with pacing, identifying personal triggers, and making difficult changes to support her health.
• The grief of losing your previous life and finding purpose as you move forward.

Dr. Robinson Shumate also explains what she means by “self-care is health care” and how learning to listen to her own body became an essential part of her progress.

If you’re navigating long COVID, POTS, or overlapping chronic conditions and feel like no one understands how much your life has changed, this conversation will resonate.

Your experience matters. Keep asking questions, advocating for your needs, and looking for care that takes the time to understand you.

To learn more about Dr. Robinson Shumate visit: https://www.energymavenmd.com/

To learn more about how Dr. Zimmerman NP, DC at Peak Brain and Body visit: https://peakbrainandbody.com

If you have POTS, you’ve probably heard conflicting explanations for your symptoms, each presented as the answer. How do you sort through the noise and figure out what actually applies to you?

In this episode of Brain Body Reset, Dr. Spencer Zimmerman is joined by Dr. Howard Snapper, a respected cardiologist, president-elect of the American Autonomic Society, and autonomic specialist practicing in the Atlanta, Georgia, area.

Together, they unpack common POTS myths, misleading claims, and the truths that sometimes get stretched too far.

We explore:

• What POTS is from a diagnostic standpoint, and how it differs from orthostatic hypotension.
• Craniocervical instability, mast cell activation syndrome (MCAS), and compression syndromes.
• Why a condition may matter for some patients without explaining everyone’s symptoms.
• Why finding one contributing problem doesn’t necessarily mean you’ve found the whole answer.

The goal is to help you ask better questions, understand the limits of broad claims, and pursue care that reflects your individual needs.

Connect with Dr. Snapper:

Facebook
X: @howardsnapper

If you have POTS or another form of dysautonomia, you’ve probably been told to increase salt, push fluids, wear compression, and maybe try a medication or two. That advice isn’t wrong, but it’s compensation, not correction. And for most people, it’s a forever strategy.

In this episode, Dr. Spencer Zimmerman, a dual-licensed nurse practitioner and doctor of chiropractic, walks through the research on a system that is almost never evaluated in POTS, Long COVID, ME/CFS, or hypermobile EDS: the vestibular system.

Most people think of the vestibular system as balance and vertigo. But the gravity-sensing otolith organs feed directly into the brainstem’s cardiovascular centers. When you stand up, this vestibulosympathetic reflex fires before your blood pressure has a chance to drop, constricting blood vessels and activating the leg muscles that pump blood back to the heart. It responds roughly twice as fast as the baroreceptor reflex that most POTS models focus on. When that early-warning system isn’t working, blood pools, less returns to the heart and brain, and the heart races to compensate. That racing heart is the downstream effect, not the root problem.

Dr. Zimmerman connects this to a 2026 paper framing POTS, ME/CFS, and Long COVID as neuroimmune disorders, research showing brainstem inflammation in Long COVID near vagal and vestibular centers, a study showing otolith stimulation changes blood flow to the brain independent of blood pressure or breathing, and astronaut research where reduced gravity weakens the otoliths and produces POTS-like orthostatic intolerance on return to Earth.

He then gets practical: what testing should be done (and why video-recorded eye movement testing should be the minimum standard), why generic habituation-based vestibular rehab often makes this population worse, and what a complete plan looks like. That includes visual and vestibular work, cervical spine and proprioception, heart-rate-guided progression, and addressing “sabotagers” like mast cell activation, anemia, thyroid, hormones, and gut issues.

Key takeaways

• What triggers POTS (infection, surgery, injury) is different from what keeps it going
• The vestibular system directly regulates blood vessel tone, heart rate, the skeletal muscle pump, and blood flow to the brain
• Tachycardia in POTS is a compensation for upstream dysfunction, which is why rate-lowering medications rarely make people feel truly well
• Research shows reduced brain blood flow appears about two minutes before nausea sets in, which is why measuring physiology beats waiting for symptoms in sensitive patients
• “Normal” and “no pathology” are not the same thing; you can have intact balance and still have impaired vestibular function
• Standard vestibular rehab is built for conditions like BPPV and relies on pushing through symptoms, which backfires in dysautonomia
• The best outcomes come from treating vision, vestibular, cervical, proprioceptive, and whole-body factors together, not in isolation

Chapters

• 0:00 Why salt, fluids, and compression aren’t the full answer
• 1:23 Triggers vs. what keeps POTS going
• 3:46 The 2026 paper: POTS, ME/CFS, and Long COVID as neuroimmune disorders
• 4:47 How POTS is actually diagnosed
• 7:44 The vestibular system is more than your inner ear
• 9:22 The vestibulosympathetic reflex vs. the baroreceptor reflex
• 13:59 What likely breaks down in POTS
• 16:21 How the inner ear regulates blood flow to the brain
• 19:44 Blood flow drops before symptoms appear (and why we use fNIRS)
• 21:42 What astronauts teach us about POTS
• 24:12 What should be evaluated
• 26:07 The skeletal muscle pump and the vestibular connection
• 30:13 Brainstem inflammation and the self-perpetuating loop
• 33:12 Levels of vestibular testing: VNG, positional, caloric, rotary chair
• 37:27 Why generic vestibular rehab often makes people worse
• 39:58 What a thorough treatment plan looks like
• 44:08 The neck, upper cervical care, hypermobility, and CCI
• 47:03 The visual system and “central” dysfunction
• 48:23 What needs to change in the field
• 51:31 Research citations and where to learn more

Learn more: Peak Brain and Body, near Tampa, FL, serves patients traveling from across the country and around the world. Visit peakbrainandbody.com.

Brain fog. Exhaustion. Dizziness. Food reactions. Symptoms that flare without an obvious reason. If you’re living with long COVID or mast cell activation syndrome (MCAS), you may have collected diagnoses and tried multiple treatments without understanding why you still feel so sick.

In this episode of Brain Body Reset, Dr. Spencer Zimmerman sits down with long COVID researcher and immunology educator Dr. Novack PhD to explore what may be keeping that cycle going, and the research investigating ways to interrupt it.

Dr. Novack shares findings from his clinical trial examining a no-added-sugar diet and fasting in people with long COVID. We discuss autophagy, your cells’ internal cleanup and recycling process, and why researchers are interested in its potential role in persistent symptoms.

We also connect the dots between mast cells, inflammation, mitochondrial dysfunction, and the nervous system to help you better understand symptoms that are too often treated in isolation.

You’ll hear about:

• Why mast cells do much more than release histamine, and why that matters when antihistamines only help so much.
• How mast cell activity and autonomic dysfunction may influence each other in MCAS and POTS.
• The possible role of persistent virus in long COVID, and the limitations of current testing.
• How damaged mitochondria may contribute to fatigue and post-exertional malaise.
• Mast cell stabilizers, including cromolyn and ketotifen, and emerging treatment research.
• Why nutrition, sleep, and individual treatment responses deserve a place in the conversation.

If you’ve been told to manage each symptom separately, this conversation offers a more connected way to understand what may be happening and questions to bring to your healthcare team.

This episode discusses emerging research and proposed mechanisms, not established cures. Fasting is not appropriate for everyone, and changes to fasting or medication should be discussed with your treating clinician.

Have you been diagnosed with hEDS and have a variety of neurological symptoms and findings?

Maybe you struggle with: chronic fatigue, brain fog, headaches/migraines, dizziness, light/noise sensitivity and more.

Your imaging suggest chiari malformation or cranio-cervical instability.

A recent research article is proposing for a new subtype to hEDS, known as Neuro-EDS. This is meant to better capture what is happening.

To learn more about our approach to EDS: https://peakbrainandbody.com/conditions/eds/

Most conversations about Ehlers-Danlos syndrome focus on joint hypermobility, ligament laxity, pain, and the musculoskeletal system. But is that enough to explain the brain fog, fatigue, dizziness, headaches, sensory overload, anxiety, and autonomic symptoms many people with EDS experience?

In this episode, Dr. Spencer Zimmerman NP, DC, DACNB reviews a 2025 research paper exploring the neurological and neuropsychological side of Ehlers-Danlos syndrome.

You’ll learn about:

• The 13 recognized EDS subtypes and why hypermobile EDS receives the most attention
• Brain structural differences associated with EDS
• Chiari malformation and craniocervical instability
• Small fiber neuropathy and autonomic dysfunction
• The overlap between EDS, POTS, and reduced cerebral blood flow
• How impaired proprioception may affect balance, coordination, joint stability, and injury risk
• The roles of interoception, sensory processing, and neurological efficiency
• Why anxiety, panic disorders, depression, ADHD, and autism are discussed in EDS research
• How the amygdala, prefrontal cortex, insula, anterior cingulate cortex, cerebellum, and brainstem may contribute to symptoms
• Why normal structural imaging does not necessarily rule out impaired neurological function

The presence of a structural finding such as Chiari malformation or craniocervical instability does not automatically mean it explains every symptom. At the same time, treating EDS as purely a joint and connective-tissue condition may leave major pieces of the problem unaddressed.

This episode explains why people with EDS may need an integrated approach that considers the musculoskeletal system, nervous system, autonomic regulation, mental health, blood flow, immune function, and the way the brain processes information from the body.

Educational only and not personal medical advice.

https://peakbrainandbody.com/conditions/eds/

POTS is not one condition with one cause and treating the elevated heart rate alone often fails to address why someone remains sick.

In this episode, Dr. Spencer Zimmerman breaks down a major POTS review published in August 2026 and translates the findings into language patients and families can understand. He explains the different processes that may contribute to POTS, including small fiber and autonomic neuropathy, low blood volume, excessive sympathetic activation, and impaired blood flow and oxygen delivery to the brain.

You’ll also learn why normal oxygen saturation and blood pressure readings do not necessarily mean the brain is receiving adequate blood flow, which conditions most commonly overlap with POTS, and why migraines and irritable bowel syndrome may deserve more attention than they currently receive.

The episode also examines standard POTS treatments—including exercise, fluids, salt, compression garments, dietary changes, and medications—along with medications that may worsen symptoms. Finally, Dr. Zimmerman discusses what the current research may be missing, including vestibular and eye-movement dysfunction, cervical integration, overlooked lab findings, hormonal changes, and why neurological rehabilitation may need to come before traditional cardiovascular conditioning for some patients.

To learn more: https://peakbrainandbody.com/conditions/pots-dysautonomia/

If you become dizzy, nauseous, weak, foggy, or feel like you might pass out when you stand, it is easy for everything to get labeled as POTS. But POTS is only one form of orthostatic intolerance.

In this episode, Dr. Spencer Zimmerman breaks down the differences between POTS, orthostatic hypotension, and neurocardiogenic syncope. These conditions can cause very similar symptoms, but the changes in heart rate, blood pressure, and neurological regulation do not follow the same pattern.

You’ll learn:

• What should normally happen to your circulation when you stand
• How POTS, orthostatic hypotension, and neurocardiogenic syncope are diagnosed
• Why the timing of heart-rate and blood-pressure changes matters
• Which of these conditions can occur together—and which cannot
• Why cardiac testing is still important, even when it comes back normal
• How dehydration, anemia, medications, neurological conditions, and other factors can contribute
• Why salt, fluids, compression, exercise, and medications help some people but not everyone
• Why receiving the correct diagnosis is only the beginning of understanding what you need to improve

If you have been diagnosed with dysautonomia but still do not understand why you are struggling or why the standard recommendations have only helped partially; this episode will help you see what may still be missing.

This episode is for educational purposes only and is not medical advice. Speak with your healthcare provider before changing medications or treatment.

To learn more: https://peakbrainandbody.com/conditions/pots-dysautonomia/