Cholinergic Urticaria

Possible Case of Cholinergic Urticaria

by

Hello, everyone.

I think I might have cholinergic urticaria. Here are my stats:

Age: 21
Sex: Male
Height: 69.25 inches
Weight: 155 lbs
Race: Caucasian
Duration: Have had it for about a month, and it happens all over my body, but usually on the upper torso.

So over the past month or so I have developed this mysterious condition and I’m not really sure why. At first as far as I can remember it started as slightly irritating itches on my wrists and arms with no sign of hives. As the days progressed I noticed it started to get worse, and eventually I started having hives and they were also associated with an extremely painful prickling pain that would radiate through my entire body.

These attacks usually happen at least once a day, and after I have a bad attack I usually won’t have another bad attack for the rest of the day. I can always feel when it is about to come on because my body starts to feel really warm, and my wrists or ankles start to itch. The pain from the attack usually lasts 2-5 minutes, and after that the other symptoms: itching and hives/rash, start to go away in the next 10-15 minutes.

Things that I have found to trigger these attacks seem to be situations that either make me anxious or stressful, and activities that require me to physically assert myself. For example sometimes when playing a video game that gets particularly intense I will start to itch a little, and if I don’t take a break an attack might occur. Even getting called out in a competitive game by another player has done it for me. If I’m out in public and get confronted by a stranger, whether it be the register clerk, or another customer in the store I will start to feel itchy on my chest. If I decide to go for a run, or do some sit-ups or push-ups it will also happen.

The weird part about all of this is that nothing ‘really’ has changed in my life. I haven’t introduced anything new into my diet. I don’t consider myself overly stressed. There is a couple of things though that happened that very well might be the reason I suppose. First off, this past Summer and this Fall I have rarely gone outside. I spent most of my time indoors in the dark for whatever reason. This leads me to believe that I might have a vitamin D3 deficiency, which when looking up my symptoms online was one of the many guesses people have of what could be causing it.

Second thing is that about 2 months ago I enlisted in the Navy. And really that is sort of when this all started happening. I can understand how a decision like that could be particularly stressing for someone, but like I said I don’t find myself worrying about this decision as I am quite excited. Or at least I think I am haha.

Anyway, I didn’t have any of these symptoms my entire life until a couple weeks after I went to MEPS and signed my contract. The thing is they did all sorts of medical tests there including blood work, so I would assume that something would have showed up if I was deficient or whatever. (Side note: You don’t suppose I could have contracted whatever this is there at MEPS with a bad needle do you?)

Anyways after suffering with this for a bit I started looking up everything that I could on the internet. All my efforts led me to this condition called Cholinergic Urticaria, which I guess is basically heat hives. After I found this I started realizing that I wasn’t really sweating that much anymore. And that most of the times that symptoms would show was when my body would start its process to sweat. Also when the attacks break out I try to relieve myself by sitting in front of a fan and holding an icepack to my neck. Then I realized that when I do work out, and I try to push through the pain that eventually I sweat and the pain goes away for the most part.

As far as treatments are concerned I’ve tried a few things. I attempted taking some antihistamines: Loratadine and Diphenhydramine, as those seemed to work for some people. Unfortunately for me that didn’t seem to be the case. One person suggested taking an H1 blocker with an H2 blocker, so I did with Diphenhydramine and Ranitidine which also didn’t seem to do anything. Granted I would try these things a few days at a time, so maybe I wasn’t sticking with it long enough.

Now as far as the vitamin D3 is concerned I started taking a daily multivitamin along with an additional D3 supplement, and I’ve still been taking these but I can’t say I feel any better. A lot of people with cholinergic urticaria seem to have benefited from going into to saunas to force the sweating. They say it hurts at first, but if you can knock it out of the way early in the day then you are good saying that your body takes awhile to recharge its histamine.

So I have been going into a steam sauna for a few days now, and yes it does cause me to itch all over after being in there for two minutes, but the strange thing is I notice no hives on my body. I should also mention that I have been going into a steam sauna, so I can’t really tell if I am sweating or not. I’m currently nervous to go into the dry sauna as it is public, and I’m afraid I will have an attack.

From what I have researched so far it seems that this condition happens when the part in your brain that regulates your body temperature sends out a chemical to cause your body to sweat. This chemical gets to where it needs to go, and it has a negative reaction with these things called Mast Cells which then release the histamine and cause all of the symptoms.

I should also mention that I recently emailed my family doctor, and he hasn’t been much help. He simply recommended me taking either Loratadine or Fexofenadine. Today I bought some Fexofenadine, but I am not confident that it will do anything.

So what should I do? This condition is making my life miserable. I also need to tell the Navy sometime soon, as I feel like it could be grounds for disqualification which I am really afraid of as I want to serve so badly. I have held of telling them thus far, as I was sure it was something that I could fix. Should I go see a dermatologist? For whatever reason I feel like this is less of a skin condition and more of an autoimmune condition. I’m thankful for any help anyone can provide, thanks.

Please feel free to ask anymore questions that you might have.

TLDR;
I get extremely painful red hives and itchiness all over my body when getting stressed or working out. The attacks don’t last long, and the hives disappear shortly after. I have a hard time sweating. I recently enlisted in the Navy, and this past Summer and Fall I was indoors primarily.

Thanks,

Rebz

Comments

  1. Your symptoms do sound a lot like cholinergic urticaria. A physician knowledgeable about the condition can confirm for you (allergist or dermatologist is your best bet). A lot of people get help from antihistamines such as Allegra or Zyrtec, though antihistamines might not take away the full sting of the hives. (Always talk to a doctor before self-treating).

    You can read through this site to see how people manage their hives. Sweat therapy, antihistamines, dietary changes are among the most useful for people. Hang in there, and don’t give up hope.

  2. I am confident that mine started after receiving the shingles vaccine. Over time it had greatly diminished. When at the Navy physical did you receive any vaccines????
    From John the accountant.

    • I didn’t receive any vaccines while at MEPS. All vaccines that I’ll receive will be given to me in the first week at boot camp. The only needle exposure I had at MEPS was when they drew my blood.

  3. My son has had the same experience as you. He was two weeks shy of his 20th birthday. We were on vacation and at an amusement park. After a lot of walking, he started to get hot and broke out in red dots all over his neck, chest and arms. It was a burning rash. I took him to the dermatologist who didn’t know what it was and prescribed one Zyrtec (non-drowsy) and Hydroxyzine (makes him sleepy). It helped a little. He had the attacks for a couple months and it was driving him crazy. He just wanted to stay indoors in air-condition. He stopped exercising and always carried a damp cool cloth around his neck to wipe himself down and cool off quickly. Sunshine and heat and anxiety triggers his attacks. He was depressed and just tried to cope and stay cool.

    I took him to an allergist and she said she knew exactly by his symptoms that he had cholinergic urticaria. She had just seen a patient earlier that afternoon who has the same thing, but triggered by COLD. Allergist said that the cold-triggered C.U. is much worse to have. She said he could take 2-3 Zyrtec a day. He is currently on 2 Zyrtec tablets a day and that seems to really help. If he wants to workout, he adds a tablet of Hydroxyzine and he seems to be fine.

    We suspect it was the laundry detergent I was using to wash his martial arts uniform and all his clothes. We were using Oxiclean detergent/whitener in EVERYTHING. I immediately stopped and switched to All Free & Clear detergent, even homemade sensitive-skin detergent. After almost a year, his attacks are a little less severe. He still continues to take 2 Zyrtec every day and adds Hydroxyzine if he is going to workout. For the most part, he has a normal life now, but he tries not to be in the sun too long or overexert himself.

    I hope this helps. I definitely recommend seeing an allergist and maybe bringing a printout of the description for C.U. to show him/her. I will be praying for you and hope you can find some relief soon!

  4. After reading most of these Forum Posts for the past 7-8 months, this is pretty much identical to what my symptom is. I have been experiencing this since October of 2015, and it hasn’t gone away one bit. I turned 20 a couple months ago and I’ve never experienced this ever before. I took blood work multiple times and my Doctor says my results were perfect and apparently I’m allergic to Cats, Dogs, and Dustmites, but that doesn’t seem to have anything to do with my CU. I went to 2 Dermotolgists this year and both were absolutely no help. First one told me to keep taking antihistmine pills which don’t work for me and the second one pretty much told me the same and said there’s no cure for CU and also told me to see an Allergist instead. I literally can’t excerise for long. Could it be the laundry detergent? Or my bad sleeping habits who knows. The only thing I can maybe think of is I pretty much drank 1 energy drink a day for well over a year but I quit drinking it 6 months ago and when I do have caffine it’s the occassional coffee or tea. I’m only 150 lbs and I eat healthy for the most part.

    Another symptom is everytime I go out to eat fast food, if I eat a Burger, Donair, Fries, or anything that’s greasy I would feel the same stinging pain but its on my forehead will turn completely red and my head will itch and when I stop eating it, it goes away in a couple minutes. It’s so weird and I wonder what my problem is.

    Also another thing to note is I took a couple years off since I graduated from High School and hardly had any amounts of excerise and I haven’t sweat much from July 2014 to when my CU occured in October 2015. Now when I try to, I can’t cause of the stinging pain.

  5. Rebz:

    Please go back a page or two and read my October 24th post. I was cured of CU by adopting a whole-food, plant-based diet. Modern science is slowly beginning to understand the mechanism as to why this worked. The secret is the relationship between the amount of fiber in the diet and the bacteria in the gut (the so-called gut microbiome). People who eat a diet high in fiber develop a thick layer of mucous lining their gut. This mucous layer is inhabited by beneficial bacteria which digest the fiber and produce short-chain fatty acids (SCFA). These SCFA pass into the body of the human. They circulate throughout the body and attach to receptors on the regulatory T cells. This keeps the immune system “in balance” and prevents it from overreacting, thus staving off autoimmune disorders like CU. The graphic at the following link illustrates this process: https://www.scientificamerican.com/article/how-microbes-keep-us-healthy-infographic/ .

    So, eliminate highly processed foods from your diet and greatly increase the amounts of fruits, vegetables, whole-grains and legumes.

    Good luck! I hope you find a solution which works for you. I strongly urge you to give this a try.

    • Thank you I will look into trying something like this out. I haven’t gone back to look at your post yet, but how long would you say it took after changing your diet to start noticing the results?