Dr. Todd Maderis

Dr. Todd Maderis Contact information, map and directions, contact form, opening hours, services, ratings, photos, videos and announcements from Dr. Todd Maderis, Doctor, 700 Larkspur Landing Cir, Suite 205, Greenbrae, CA.

I specialize in treating Lyme disease and tickborne infections, mold-related illness, autoimmune conditions, chronic viral infections, and conditions with complex chronic illnesses - mast cell activation disorder and chronic fatigue syndrome.

June is MCAS Awareness Month, and mast cell activation syndrome remains one of the most underdiagnosed and misunderstood...
06/11/2026

June is MCAS Awareness Month, and mast cell activation syndrome remains one of the most underdiagnosed and misunderstood conditions in complex chronic illness.

Mast cells are part of the innate immune system and are concentrated throughout the body, including the skin, respiratory tract, gastrointestinal tract, and nervous system. In MCAS, they release inflammatory mediators inappropriately and episodically, producing symptoms that can affect virtually every organ system. Because the symptom profile is so broad and so variable, most patients spend years cycling through specialists before anyone connects the picture.

What makes MCAS particularly challenging is that it rarely exists in isolation. In my clinical practice, MCAS frequently presents alongside Lyme disease, mold illness, Long COVID, POTS, and other complex chronic conditions, each one amplifying the other and complicating both diagnosis and treatment.

This month I will be covering MCAS in depth, and I want the content to reflect what matters most to the people following this page.

Drop in the comments what MCAS topic you want more information on.

Follow for clinical insights on mast cell activation syndrome and complex chronic illness.

One of the most disorienting aspects of complex regional pain syndrome is that it does not always follow an event. No fr...
06/10/2026

One of the most disorienting aspects of complex regional pain syndrome is that it does not always follow an event. No fracture, no procedure, no identifiable trigger. Pain simply begins, and then persists.

This is part of why CRPS is so frequently dismissed or misdiagnosed. When there is no clear precipitating cause, the assumption is often that the pain is not real or not explainable. The research tells a different story. Spontaneous CRPS points to an underlying vulnerability in immune regulation and neuroimmune signaling, one that does not require external trauma to activate. For patients with complex chronic illness, that distinction matters significantly in how the condition is evaluated and approached.

Comment MAST and I will send you the research on mast cells as a treatment target in CRPS.

Follow for clinical insights on complex chronic illness and emerging research.

06/09/2026

CRPS is one of the most treatment-resistant pain conditions in medicine, and the cytokine-driven inflammation at its core is rarely addressed directly.

What makes the MCAS connection clinically significant is the specificity of the overlap. The same proinflammatory cytokines driving tissue inflammation in CRPS are the mediators released during mast cell activation. This is not a loose association. It is a shared biological mechanism that points toward a more targeted treatment approach. For patients who have cycled through medications, nerve blocks, and procedures without meaningful improvement, evaluating mast cell activity adds a variable that is almost never considered in standard pain management protocols.

The hypermobility connection adds another layer. Joint hypermobility syndrome is well documented in MCAS patients, and hypermobile joints carry a higher risk of the type of injury or surgical trauma that can trigger CRPS. In these patients, the condition may not simply be an unfortunate complication. It may be the predictable consequence of untreated mast cell dysregulation.

Comment MAST and I will send you the full review article on mast cell-targeted approaches in CRPS.

Follow for clinical insights on MCAS, complex chronic illness, and emerging research.

Chronic pain that persists long after an injury has healed is not a mystery. It is a mechanism, and mast cells appear to...
06/08/2026

Chronic pain that persists long after an injury has healed is not a mystery. It is a mechanism, and mast cells appear to be central to it.

What makes CRPS particularly difficult to treat is the convergence of peripheral inflammation and central sensitization occurring simultaneously. Proinflammatory cytokines drive tissue-level inflammation while mast cells, positioned in direct proximity to neurons in both the central and peripheral nervous systems, create a neuroimmune feedback loop that amplifies pain signaling at the spinal cord level. That combination is what makes CRPS so resistant to standard pain management approaches.

The overlap with MCAS is clinically significant. Patients presenting with complex chronic illness and regional pain syndromes deserve a thorough evaluation of mast cell activity, not as an afterthought, but as a foundational part of the workup.

Comment MAST and I will send you the full research paper on mast cells as a treatment target in CRPS.

Follow for clinical insights on MCAS, complex chronic illness, and emerging research.

06/04/2026

You might be walking through more MCAS triggers on a Saturday afternoon than you realize.

Chemical sensitivity is one of the most underrecognized symptoms of mast cell activation syndrome. For patients with MCAS, navigating public spaces filled with synthetic fragrances, off-gassing products, and exhaust can trigger real physiological reactions including headaches, brain fog, flushing, and fatigue.

Do you know what your biggest MCAS trigger is? Share it in the comments below.

Follow for clinical insights on MCAS and complex chronic illness.

Three decades of symptoms without an explanation is not an outlier in MCAS. It is the norm.The diagnostic delay in mast ...
06/03/2026

Three decades of symptoms without an explanation is not an outlier in MCAS. It is the norm.

The diagnostic delay in mast cell activation syndrome is not simply a matter of rare disease recognition. It is a reflection of how multi-system conditions are evaluated in conventional medicine. When a child presents with abdominal pain, skin reactions, headaches, and fatigue, the symptoms are rarely connected. Each one is addressed in isolation, often by a different specialist, and the underlying immune dysregulation driving all of them remains invisible. By adulthood, many patients have accumulated a long list of diagnoses that partially explain their symptoms without ever identifying the root mechanism.

MCAS does not develop in adulthood. For most patients, it has been present since childhood, quietly driving symptoms that were dismissed, minimized, or attributed to something else entirely. Recognizing it earlier changes the clinical trajectory significantly.

Comment MCAS and I will send you the full article on mast cell activation syndrome, including causes, symptoms, and how to get properly tested.

Follow for clinical insights on MCAS, complex chronic illness, and emerging research.

06/02/2026

MCAS symptoms are so varied and system-wide that patients spend years collecting diagnoses that each explain one piece of the picture without anyone connecting them.

What makes MCAS clinically distinct is not just the breadth of symptoms but their variability. The same patient can react differently to the same trigger on different days depending on inflammatory load, hormonal status, and concurrent stressors. That inconsistency is not psychosomatic. It is the biology of mast cell degranulation.

The more important clinical question is always what is activating the mast cells in the first place. Lyme disease, mold illness, chronic viral infections, and environmental toxins are all documented causes. Treating symptoms without identifying those underlying triggers is why so many MCAS patients improve temporarily and then relapse.

Mast cells do not activate without reason. Something is always poking the beehive.

Comment MCAS and I will send you the full article on causes, associated conditions, and how to get properly tested.

Follow for clinical insights on MCAS and complex chronic illness

June is MCAS Awareness Month, and there is no better time to address one of the most underdiagnosed conditions in comple...
06/01/2026

June is MCAS Awareness Month, and there is no better time to address one of the most underdiagnosed conditions in complex chronic illness.

Mast cell activation syndrome affects every organ system in the body, which is precisely why it takes the average patient 30 years to receive an accurate diagnosis. Symptoms that begin in childhood are dismissed, attributed to anxiety, labeled as functional, or misidentified as histamine intolerance. By the time a correct diagnosis is made, most patients have accumulated years of ineffective treatment and unanswered questions.

What makes MCAS particularly relevant in complex chronic illness is its relationship to underlying triggers. Lyme disease, mold illness, chronic viral infections, and environmental toxins are all documented causes of mast cell dysregulation. In my clinical experience, MCAS is rarely an isolated condition. It is almost always downstream of something that has not yet been identified or addressed. Finding and treating those root triggers is what changes outcomes.

If you have been dealing with multi-system symptoms that no single diagnosis explains, MCAS deserves a place in the conversation.

Comment MCAS and I will send you the full article on mast cell activation syndrome, including causes, symptoms, and how to get properly tested.

Follow for clinical insights on MCAS, complex chronic illness, and emerging research.

This is one of the most clinically significant diagnostic challenges in chronic illness. Both pathogens produce low-leve...
05/28/2026

This is one of the most clinically significant diagnostic challenges in chronic illness. Both pathogens produce low-level, intermittent bacteremia that standard blood panels are not designed to detect. A negative result is not a clean bill of health. It is a reflection of the test's limitations, not the absence of infection.

The study that confirmed active Babesia and Bartonella infection in 46% of ME/CFS patients required enrichment blood culture combined with advanced PCR across multiple blood draws to find what standard testing missed entirely.

For patients who have received negative results and still have no answers, the methodology behind the testing matters as much as the result itself.

Comment ROOT and I will send you the full study on Babesia and Bartonella infection in ME/CFS patients.

Follow for more clinical insights on complex chronic illness and tick-borne disease.

05/27/2026

Chronic fatigue syndrome has a testing problem, and most patients are never told about it.

The standard infectious workup for ME/CFS has historically centered on chronic viral infections, EBV, HHV-6, CMV, and similar pathogens. That work is important, but it leaves a significant gap. Tick-borne infections, including Babesia and Bartonella, are well-documented drivers of chronic fatigue and neurological symptoms, yet they are rarely included in the initial or ongoing evaluation of ME/CFS patients. A study published earlier this year used PCR-based testing to examine just how prevalent these infections are in people with chronic fatigue and neurological involvement. The results were notable.

Incomplete testing leads to incomplete answers. For patients who have pursued diagnosis and treatment without meaningful improvement, the missing variable is often an infection that was never looked for in the first place. Advanced tick-borne testing is not a last resort. It belongs in the foundational workup.

Comment ROOT and I will send you a link to the research.

Follow for clinical insights on ME/CFS, tick-borne disease, and complex chronic illness.

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700 Larkspur Landing Cir, Suite 205
Greenbrae, CA

Opening Hours

Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm

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