Cholinergic Urticaria (Chronic Heat Hives)-Cholinergic Urticaria.net I Get Itchy Heat Hives (Cholinergic Urticaria) When I Get Hot or Exercise

Well it has been a while since I have posted, and I have a new theory that I am getting excited about: Hard Water!

I am becoming more and more convinced that there is something in the water that is causing my hives to get worse, and could possibly be the source of my Cholinergic Urticaria altogether. So let me back up for a moment and explain:

In my old house, I had hard water for sure. I had first developed cholinergic urticaria during the winter, when hard water is supposed to be the worst. During the winter, the ground freezes and the water tends to pull in even more minerals and become harder than in other months. Also, the air is more dry and the skin gets tight and itchy.

I used to stand in the shower at my old house for like 20 minutes and turn the water as hot as it would go. That is when I first developed cholinergic urticaria.

My hives then cleared up that summer, which is when the water is supposed to naturally soften a bit. So I think something changed in my water that helped me clear out the hives. I also sweat more regularly that summer, and got more sun exposure which could have helped. My hives then remained in remission for a year or two after that. I even almost forgot about them!

Then fast forward to my moving into a new apartment with a different water source. The water here is a nightmare (in fact, it got a really bad analysis report a few years back, and they were forced to make it better). Suddenly within a week or two of moving out to here, I started to develop these rashes on my body (which was eczema/dermatitis). They got worse and worse over time.

This was incredibly odd for me, because I always had perfect skin and NEVER had eczema before in my life. And BAM, the hives came right back into the picture, and I have had them since.

The water in my apartment is way harder than my water at home. In fact, I would say 2-3 times much harder. Soap scum builds like crazy, and is almost impossible to get off. I have even posted before about the water softener idea.

In my shower, I scrubbed that thing for hours until it was finally clean, and just a month later, I can rub my finger up the side very softly and get a powdery residue on my finger! So now that I am thinking back, I am getting more and more convinced that the hard water is the cause of my hives problem.

What is even more interesting is that many of the people on here are from the UK, which also mostly has very hard water. People on the forums have also mentioned a white residue on their skin, and once again that is a tell-tale sign of hard water.

And like I said, cholinergic urticaria, eczema, and other rashes tend to get much worse during winter, and it just so happens that the water quality tends to be harder during those months as well.

Why I Think  Hard Water Could Cause or Aggravate Cholinergic Urticaria

As I have mentioned in the past, I think cholinergic urticaria is merely a symptom, not a disease itself. There may be different causes of the hives for some of us.

But in my case (and perhaps others), I think it could be caused by the hard water (or other chemicals in the water). I have never really realized how big of a deal this was, until recently when I have researched this topic in more detail. I always thought water was water, but not so. The minerals and chemicals in the water can affect you seriously.

Did you know that water softeners often help skin disorders such as eczema? That surprised me. In fact, a research group in the UK actually did a big study to see if water softeners could help treat eczema. Turns out it does, and many dermatologists are now recommending getting a softener!

One child in the study had such severe eczema, that he had to have his hands bandaged to keep himself from scratching the sores. He was placed on a water softener, and in 2 weeks there was a dramatic improvement. In a few months, he was back to normal again. They re-introduced hard water to make sure that was the cause, and sure enough the eczema returned!

This is huge because while not all eczema may be caused by hard water, it proves that at least some cases are caused (or worsened) by hard water. This makes sense, because obviously if the water is irritating your skin, it will clear once you remove that irritant. However, if the eczema is caused by a food allergy, then the water softener may improve the eczema, but not cure it (unless you remove the food allergen).

In either case, the water softeners seemed to help in many cases, or drastically improve (even cure) eczema in other cases. In fact, on most all websites I seen people recommending water filtration and softeners and that it dramatically helped their skin. Some even had itchy skin, rosacea, and more, and it made it much better.

How Hard Water May Be Behind Cholinergic Urticaria

There are 4 possible ways that I theorize water quality could affect cholinergic urticaria.

Theory 1–The chemicals in the hard water (calcium and magnesium ions) are in excessive quantities. These chemicals get really sticky, and bind to every surface they touch. Therefore when we take showers, they clog our sweat pores with a sticky film of calcium/magnesium which makes sweating very difficult.

Theory 2–The chemicals in the hard water form a coating on the skin, and the magnesium or calcium ions somehow weaken our  mast cells in our upper skin layer. Then, when we get hot, these mast cells quickly break down. This could be due to the weakening of the mast cell membrane by the chemical composition/ions in the water source. One interesting thing I found online is that metals do often change the membrane of the mast cells, and one person with CU had copper sensitivity that was the cause of cholinergic urticaria (from an IUD and fillings).

Theory 3–The chemicals in the water just have something our immune system has identified as an enemy. Therefore, when our bodies get hot and the blood flows to our skin, these cells suddenly identify an invader and the mast cells break down.

Theory 4–The composition of the water (acidity/chemicals) have somehow caused an imbalance in our skin flora. This could allow the “bad bacteria” to grow in greater abundance, and perhaps these bacteria are either clogging our pores, or stimulating our immune system in a way that is causing hives.

I definitely think that if the hard water is to blame, it is doing it in one of those 4 ways above. Even my wife has had much more scaly skin since moving into this apartment. And my hives were okay before I moved here, and suddenly, my body went nuts and I got rashes, hives again, and everything.

So I am now highly convinced that something specifically in the water (either the hardness or other chemical additives) are a directly affecting or even causing my hives.

How To Cure Water Hardness and Chemical Additives?

After researching online, it seems there are definitely things we can do to help our water quality.

1. Get a Water Softener–This is always the most recommended thing. I want one so bad, but I live in this apartment right now and there is no way to hook one up. You must hook them into the pipes before the water heater. A downside is that they are quite expensive for the average person ($400-1000). But I would pay just about anything to cure these hives.
2. Get a Filtration System–They make many different types of filters, such as reverse osmosis, which also removes the harsh chemicals and minerals from the water. Water softeners are generally recommended for the bath and whole house, whereas a reverse osmosis filter is recommended for the kitchen drinking water.
3. Carbon Shower-head Filtration–Unfortunately, this only generally removes chlorine and large sediments, and does not filter out fluoride, magnesium and calcium. So it may make the water slightly better, but the water will still be hard, and contain many other chemicals.

The first 2 require plumbing changes to pipes, which I cannot do at the moment in my apartment, as it would require structural changes and my lease says I can’t do that. The third one I have tried and it did help my skin some, but I still had hives. But again, I think it is mostly the hardness in water, not necessarily the chlorine.

Update on Hives and Other Things

My hives have still been bothering me lately. They are quite reactive, but nothing too severe. It has been a little hotter than usual lately, and that has made me react a little more.

I have tried to avoid showering as much as possible, and I am even considering avoiding showers completely for a few weeks to see if it helps (of course I would wash my hair and body parts as needed). I just think the water could be the cause of all of this torture I have went through the past few years.

Also, my wife and I are finally seriously shopping for houses. This is both exciting, and quite frustrating as there aren’t a lot of great deals right now. We have looked at a few, but nothing great yet, and we haven’t made any offers. I absolutely CANNOT wait to get away from this place.

The first thing I am doing when I get a house is hooking up a water softener, and I will post how I do it on here, and if it helps the hives or not. So hopefully (God willing), I will be in a house within the next 2-3 months and be able to do all of this.

I just can’t imagine if the water was the cause of all of this. That would be both awesome and frustrating. It would be awesome because I can finally cure this frustrating condition and go on with my life. It would be frustrating because I could have done this 7 years ago and avoided all of this torture and negativity it has brought into my life.

Oh well, I will keep my fingers crossed and hope that it works. At least it gives me some hope that I may not have this forever!

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My “stomach issues” always have me wondering if how they are connected with Cholinergic Urticaria. When my stomach feels bloated, achy, or crampy, I usually have a more intense level of hives.

In contrast, when my stomach feels really great and my digestion is great as well, my hives seem to be a lot less intense. This has always puzzled me, and I have often thought that perhaps it was just due to a food allergy, or just a coincidence.

After some research, however, there could be another possible explanation which could count for all of my symptoms (hives included). What is it? Inflammatory Bowel Disease (IBD).

What is Inflammatory Bowel Disease?

Inflammatory bowel disease is any type of bowel disease which leads to inflammation of the intestines (small or large). There are many different diseases that fall into this category such as Crohn’s disease, ulcerative colitis, and more.

Some of the symptoms of IBD include:  abdominal pain, vomiting, diarrhea, hematochezia (bright red blood in stools), weight loss and various associated complaints or diseases like arthritis, pyoderma gangrenosum, skin symptoms (such as hives or rashes), and primary sclerosing cholangitis.

I have many of those symptoms that are listed. The main symptoms I tend to get are frequent gas/bloating, severe stomach cramps, and occasional diarrhea (no blood).

I have now been on a very healthy diet for about 4 days now, and my stomach is still somewhat bloated and uncomfortable at times, and when I press down it sorta hurts (although no diarrhea thank goodness).

I am still unsure what I may have (Crohn’s, food allergies, etc.), but something is definitely inflaming and irritating my bowels, and my digestive system has not been very good for years, and sadly, is getting progressively worse.

Could Crohn’s or Inflammatory Bowel Disease Be Linked to Cholinergic Urticaria?

Here are some interesting things I found that tend to overlap with cholinergic urticaria or my stomach issues in general:

• Inflammatory bowel disease (such as Crohn’s, etc.) tends to flare up and go into remissions. So the disease can come and go over the course of years. Cholinergic urticaria seems to work in a similar way.
• My stomach seems to get better when I remove certain foods from my diet (such as dairy). However, IBD can also be improved by removing foods such as dairy.
• There seems to be a direct correlation with my hives intensity and the severity of my stomach issues.
• IBD can cause cancer sores in the mouth, and I have had my share of those over the years.
• My intestines seem to feel as if they are just bloated, inflamed, or something is up with them.
• These IBD diseases have also been linked to Vitamin D deficiences (due to malapsorption).

Furthermore, I have pulled up a couple of references of cholinergic urticaria being associated with Inflammatory Bowel Disease:

There is a forum thread that discusses Crohn’s and hives. Here is what one of the members “Beave” had to say:

When I first started getting Crohn’s problems about 20 years ago, I would break out in hives every time I got hot — a warm day, a hot shower, exercise, being in the sun, anything that warmed me up.  To this day I still get itchy when I get warm, but I don’t get covered in hives like I used to.  For me the condition is called cholinergic urticaria.

Hives are fairly common, for everybody, not just Crohnies.  It’s often difficult to figure out what’s causing them.  You’re thinking along the right lines by considering new medications, new foods, new soaps, detergents, etc.  You should probably let your general doctor know, and maybe consider seeing an allergy specialist if this continues or gets worse.

One other thing:  Benadryl is an excellent antihistamine and effective for hives.  But it has the drawback of making you pretty drowsy, not to mention it only works 4-6 hours.  Zyrtec is also considered really good for hives and is now over the counter, and it’s available as generic OTC as well (cheaper).  It doesn’t make you quite as drowsy as benadryl and it’s good for a full 24 hours.  My allergy doctor recommended zyrtec for me when I have trouble with hives and it seems to work pretty well.

I found that pretty interesting. And then, the very next comment down by “hspencer” says this:

I started with hives about once every three months…then once a month…then weekly…then three or four times a week….I never related the hives to my crohns….but my gastro prescribed a ten day stint of anti-b’s and that (knock wood) brought it all to an end.

I also found a medical research type article where a man had ulcerative colitis and also cholinergic urticaria together. I thought that was interesting because it almost seemed as if the CU was a direct result of his other issues.

So What to Make of IBD and Cholinergic Urticaria?

So there are definitely some apparent connections or cases of cholinergic urticaria occurring alongside Inflammatory Bowel Disease. The question that remains to be seen is whether this is mere coincidence, or if there is causation involved.

As I pointed out in another post, I feel pretty strongly that cholinergic urticaria is a symptom, and not a disease. So in my mind there is a good chance that IBD can cause cholinergic urticaria type of hives.

Does this mean everyone that has cholinergic urticaria has inflammatory bowel disease? Not at all. In fact, if I am correct in my assumption that cholinergic urticaria is an actual symptom and not a disease itself, then we could all very well have different causes for our hives. In other words, other issues could cause CU symptoms, and perhaps IBD could be one of many.

In my case, I seem to think there is something wrong with my intestines, and that it is connected in some way to the CU. I have tried anti-candida treatments (didn’t work), I have tried elimination diets (helped a lot, but didn’t fully cure CU), and more. So far nothing has worked, but cutting certain foods out does help some.

Conclusion: Cholinergic Urticaria and Inflammatory Bowel Disease

At this point I am getting a little worried that I may actually have some more serious issues with my digestion/intestines than I first thought. I suppose time will tell, and eventually (hopefully within the next year), I may venture out to a gastro doc and have my intestines scoped out.

The only disappointing news is that if I did have IBD, it isn’t exactly curable. And I will basically have to deal with it my whole life (and try to maintain remission by taking drugs). It also puts people at a higher risk for intestinal cancer.

I will never forget when I went to one of the dermatologists for my hives. He looked at my while I was having a reaction right in front of him, and he said, “You don’t have any kind of infection somewhere do you? Something is stressing your body out.” To which I replied, “No, not that I know of anyway.”

But if in fact I have had IBD (and I did have stomach issues at this point, I just didn’t think it was abnormal), then it could potentially be causing the symptoms. So perhaps I did have an “infection,” only, it was in my stomach where I didn’t know about it.

What happens is that the intestines get inflamed, swollen, and also even ulcers. This inflammation starts to eventually affect other parts of the body such as the skin, other organs, and more. Hives is definitely a symptom of IBD, as are rashes and of course the stomach pain & bloating.

But it makes me wonder, do any of you have IBD symptoms? Or are there any more Crohn’s/IBD people out there with cholinergic urticaria as well? If so, please let me know.

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