Further observations and my plan of action

Hi all,

I posted a few weeks ago talking about geographically varying CU. I have become inspired to get rid of cholinergic urticaria once and for all after symptoms recently worsened and therefore spent the last week reading and researching extensively, keen to build up an understanding of what might be going on. Below is a summary of my findings, as well as some further observations I made and my plan of action.

First of all, CU comes in many different shapes and sizes. In some cases, CU is not a condition or allergy, but rather a symptom of another underlying condition or combination of disorders, maybe of autoimmune nature. For instance, I do not suffer from outbreaks when covered by a warm blanked or taking a hot shower. However, any sort of physical exercise, indoors or outdoors, and I instantly flare up in hives. Red spots as well as swollen, larger, red patches and the painful, irritating pins and needles sensation; you know it. This has led me to believe that my CU is not simply triggered by high temperatures, but by another internal process occurring when I exercise.

I looked into candida overgrowth, a fungal growth which may take over the gut. It has the capability to trigger symptoms such as CU. Although I do not suffer from regular fungal infections elsewhere, I have chronic sinus problems for which I took antibiotics 3/4 years ago. It is possible this has permitted candida take over my gut, or caused an imbalance in my gut flora, although I do not usually suffer from digestive issues. To tackle this, I have been taking probiotics for the past week (yogurt, commercial yogurt drinks and supplements). No improvements so far, but I will keep up this habit for a few weeks before drawing any conclusions. Suffering from sinusitis might also suggest mold is the culprit but I am moving house soon, which could help.

In the past 2 weeks, I observed that I was getting a lot of hives on the back of my hands, something which has not occurred before. Incidentally, I also have rough and broken skin on my hands at the moment, due to colder weather/detergents. Perhaps outbreaks are more acute for unhealthy skin? I am using moisturisers to bring my skin back to health, whilst looking out for any changes in CU. Having read that many people complain of stronger symptoms during winter months made me wonder if this is due to dry skin? Low humidity due to colder temperatures and heating may dehydrate the skin.

Next, I have just purchased antihistamines containing acrivastine, an active ingredient I haven’t tried before. I have taken many other antihistamines in the past, including fexofenadine, usually without success. Occasionally the outbreaks are less painful and itchy but still occur as frequently with antihistamines. I will report back on acrivastine. As part of a deal I also purchased multivitamins; whilst it is unlikely they will have any effect on CU, it’s an easy thing to try. I also read some articles stating that vitamin D3 may improve chronic urticaria symptoms.

Finally, a mystery I would like to have your opinion on. As explained in my previous post, I recently spent a year living abroad, where my CU improved and no longer restricted me from regular exercise. I still suffered from outbreaks, but they became more bearable and as a result, I signed up for a 15km nighttime road-running race, my first ever. Due to physical injury, my training plan was badly affected and the maximum distance I had ran before the race was 8km, after which I flared up in hives. I was very anxious how my CU would fare in the race. In the end, I ran a surprisingly fast time – WITHOUT CU! I couldn’t believe it! Although at night, it was still warm and very humid. I remember that I was sweating a lot. Before and during the race I took sugary energy gels, maybe they had some effect? Perhaps the humidity opened up my pores? Anyway, a few days later I played football and suffered a normal outbreak.

So, my plan for the next few months:
– Diet high in probiotics
– Moisturisers
– Acrivastine
– Vitamins
– Test effect of energy gels
– Test effect of humidity, in 1 month I will have access to a wet sauna and steam room.
– Get an appointment with another expert. My previous expert only prescribed antihistamines whilst insisting there is no cure…

For now, I don’t want to try any elimination diets since this would be difficult for me to implement strictly. A few years ago I tried reducing dairy and wheat intake but to no effect, although I wasn’t very thorough.

I will let you know of any results.

-Sam

PS: I also want to wholeheartedly thank Ben for maintaining this website and forum, you’ve done a great job! It is the only genuinely useful CU resource I have come across and it has definitely given me hope again.