As I suspected since I was not having a reaction, my tryptase levels all normal.  Taking into consideration that I'm dealing with a physician that knows nothing about MCAD, what test would you recommend I ask for next?  Is there a specific blood test that will show mast cells even though I'm not having a severe reaction?   I appreciate your help.

Regardless of the variant of SM, the release of various pro-inflammatory and/or vasoactive mediators from MCs can cause diverse clinical problems [21, 25–27, 28•, 29•, 30]. The symptoms recorded vary in severity and frequency, and range from mild pruritus or flushing and headache to severe hypotension or even life-threatening anaphylaxis [21, 25–27, 28•, 29•, 30]. In severe cases, tryptase levels increase substantially and an MC activation syndrome (MCAS) is often diagnosed [

MCAS is a syndrome characterized by severe, episodic, systemic symptoms, with proven involvement of MCs and MC-derived mediators [31, 32••, 51–55]. It is noteworthy that MCAS is not a novel category of mastocytosis, but a clinical syndrome that can develop in any type of mastocytosis and in any kind of patients, and can also disappear even if mastocytosis is still detectable. The diagnosis of MCAS can be established when (a) severe recurrent MC activation, usually in form of anaphylaxis, is found; (b) involvement of MCs can be demonstrated, preferably by a tryptase test (increase in serum tryptase during or shortly after the event); and (c) the symptoms respond to treatment with anti-mediator-type drugs or MC-stabilizing drugs [31, 32••]. The diagnostic elevation of tryptase is defined as at least 20 % of baseline plus absolute 2 ng/mL [32••]. For example, an increase from 10 ng/mL basal to >14 ng/mL at the event is diagnostic

http://path.upmc.edu/cases/case366/dx.html

That link includes the major criteria and the minor criteria for diagnosis.  My tryptase is normal but my urine histamine is off.  My son's tryptase is elevated by my other two children have very elevated prostaglandin.  It is different for each of us yet we all share similar symptoms and different severity levels.  The one with the least symptoms actually has the highest prostaglandin levels.