Urticaria - lots of causes - use EPD early

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[UPDATED DECEMBER 2022]

Introduction

Urticaria is otherwise known as hives, or heat lumps. It is characterised by red (or pink, white or skin-coloured) itchy raised bumps on the skin, varying in size which come and go, sometimes within just a few hours. It is typical of type 1 IgE allergy with histamine release - it is the histamine that causes the allergic swelling, inflammation and itching and this explains why the conventional mainstay of treatment is antihistamine drugs and steroids.

Causes

Urticaria can be caused by any inhalant food or chemical including prescription medication. Sometimes it is obvious when the lump comes up as to what has triggered it, but more often the cause is obscure. The first port of call is to do the Paleo-ketogenic [PK] diet - this eliminates the major allergens, namely grains, dairy and yeast. Please see:

and

The second likeliest food cause is urticaria due to salicylates. Aspirin of course is a salicylate but there are natural salicylates present in many fruits, flavourings and colourings. The foods to be aware of are as follows:

Avocado, banana, chestnut, citrus fruit, kiwi, grape, fig, mango, melon, papaya, passion fruit, peach, peanut, pepper, pineapple, plum, potato (raw) and tomato (raw).

If you get rhinitis (runny nose) from inhalants, then you are likely to get urticaria from the foods following.

  • plant allergens and food allergens:
    • Silver Birch Pollen (causes hay fever in April), almond, aniseed, apple (raw) apricot, caraway seed, carrot (raw), celery (raw), cherry, coriander, hazelnut, kiwi, lychee, mango nectarine, onion (raw), orange, parsley, peach, pepper (capsicum), plum, potato (raw), tomato (raw), walnut.
    • Grass pollen (causes hay fever in June and July) kiwi, melon, peanut, tomato (raw), watermelon, wheat.
    • Mugwort pollen (weed - causes hay fever in August)
    • Aniseed, carrot (raw), celery (raw), celery salt, coriander, fennel, parsley, peanut, spices (some)
  • Rubber Latex Allergy (from rubber gloves, surgical appliances, balloons, elastic etc.)
  • Urticaria in the mouth is called oral allergy and the foods which commonly cause this are as follows:
    Almonds, nectarines, apples, orange peels, apricots, peaches, blackberries, plums or prunes, cherries, raspberries, currants, strawberries, gooseberries, cucumbers and pickles, tomatoes, grapes or raisins, green peppers, blueberries.
  • Flavourings and Colourings (in general, artificially coloured and flavoured foods and drinks should be avoided) ice cream, cloves, oleo, margarine, lozenges, oil of wintergreen, cake mixes, mint flavours, licorice, bakery goods, toothpaste and toothpowder, mouthwash, sweets, gum (all chewing gum) jam or jelly, lunch meats (bologna, salami), hot dogs and cold cuts, processed cheese.
  • Beverages - cider and cider vinegars, gin and all distilled drinks, wine and wine vinegars, diet drink supplements, instant soft drink mixes,soft drinks, all tea.
  • Miscellaneous Items - all aspirin containing compounds, including cold remedies, perfumes, toothpaste and toothpowder (a mixture of salt and baking soda can be substituted or unscented Neutrogena Soap)

Chemical sensitivity

It is well recognised that urticaria can be caused by chemicals - in particular prescription medication. See Multiple Chemical Sensitivity (MCS) - Principles of Treatment

RAST tests

This is one situation where RAST tests for food or IgE antibodies for allergy can be helpful in determining the cause of the allergy. This is because urticaria is an IgE mediated response. See Wikipedia Article on Radioallergosorbent (RAST) test

Response to physical factors

Finally one can see urticaria in response to physical factors such as touch, cold and sometimes heat. However it is generally obvious when this happens.

Reducing allergy

There are other interventions that can be made to reduce the allergic tendency - this is not just about avoidance - see Allergy - not just avoidance

Enzyme Potentiated Desensitisation

This works reliably well for urticaria, so if there are problems identifying the cause then I have a low threshold for starting Enzyme Potentiated Desensitisation (EPD)

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