Hi
Ive had MCAD most of my adult life without a formal diagnosis until recently as a result of getting Covid and having post Covid issues and lots of labs and testing , we were able to get the elevated Tryptase during one of the labs and get that diagnosis.

For me I do best when I avoid complicated foods and medications I dont absolutely need.
Things with more than a few ingredients for foods depending on the day and how much can set off hours to days of misery.
Also staying on H2 blockers , Sodium Cromlyn can help GI issues and if you have respiratory issues Cromlyn Inhalers help but you have to order them via Canada since the US doesnt carry them anymore. Find what works for you and do your best to stick with it. Avoiding things that trigger symptoms is the key , but that can be tough to do sometimes.

Good Luck!