After spicy food and rice, "heat rash" appears next day

Still no hives thank goodness! Even over the joyous yet stressful holiday time.

But last night for dinner, I had some spicy Thai food with a little bit of rice. Later last night, my one cheek near nose started to feel a little itchy. I saw that it was a little pink/red but no hives. This morning, it was the same way and still a bit itchy. But it has almost faded now as I type this in the afternoon. Some slight redness but no more itch.

So either the spicy food or the rice are the cause. I think tomorrow I will eat some plain rice, and see what happens. If nothing then it is probably the spicy food. They (medical websites) do say that spicy foods can aggravate heat rashes. I will be surprised if it is the rice, but I suppose anything is possible.

I am back onto my old antidepressant for anxiety, but taking a slightly smaller dose. I have been feeling pretty good overall. Not having the hives outbreaks for some time now has helped my mood and attitude considerably.

Happy new year all! Hoping that 2013 brings better things to come.

No hives appeared, anxiety med change reason?

In my description on my blog, I admit that I suffer from anxiety. At times in my life, it has required me to go onto antidepressant medications to help keep it at bay. Two weeks ago, my doctor wanted me to switch to a different one, because the one I had been taking elevated my glucose levels (to just slightly above normal ranges). So I have been doing that for the past two weeks, and the change hasn't gone well. I have had horrible side effects from the new drug, including insomnia and increased sweating. Yet amidst all of that, I have not had any hives emerge. But the side effects are too much to take, so I am going back to the old one.

I had long wondered if my antidepressant was contributing to my body's over-reaction with the hives and the red flushing issues. I had hoped that by going off it and onto something else, it would help tell me something if the issues went away. But unfortunately, because I am going to be staying on that one vs. changing, we won't know.

I also have been avoiding rice consumption. I haven't had any hives or the red flushing since my last post.

We'll continue to see how things go!  But the hives seemed to have been fading out, and I am thinking that was probably happening on its own -- regardless of the trial with the thyroid hormone or this short-lived attempt to change anxiety medication.

Here's to a Happy Hives-Free Holidays!! :)

A few here and there, so what next?

Over the past week since stopping the thyroid hormone, I have only seen a small "half hive" here and there -- usually on my hands/wrists (seems to be a favorite spot for mine). I have one on my left hand this morning. But no more pressure hives along elastic or waistband areas in many weeks. My anxiety from the suppressed thyroid (due to all the thyroid hormone) is starting to simmer down a bit, slowly.

From the medical research reports that I read, people who saw the hives disappear once taking the thyroid hormone, after stopping the hormone, the hives returned within 2 weeks time. So I am only 8 days out. We shall see what happens.

So still not taking any antihistamine either. It also does make me wonder if the hives are/were tied to pollen seasonality. I know that my allergists dismissed that notion, saying that hives would not come from inhaling pollens, but to have them subside in the wintertime seems like there might be something to that.

I was decorating our christmas tree yesterday (it's a fresh cut tree) and fearing a bit that the needles would give me hives. They are so prickly and itchy! But I am pleased to report that did not happen. :)

Bad news - must stop the thyroid hormone

My latest thyroid bloodwork came back, after being on the thyroid hormone for 4 weeks. My TSH was significantly low (0.05!), meaning going to "hyper-active" thyroid state. It explains also why I have felt more anxious on the past week and had an unintentional weight loss of 2 lbs. So, my endocrinologist's office told me to discontinue it altogether, and that if the hives return, to call them and maybe we can consider a lower dose at a less frequent  interval. Only time will tell.

I can't totally say for certain if it was the synthroid that cleared up my hives. They seemed to have been fading out slowly before I started it, so it could be timing. If they come back in some noticeable way, then I would probably say the synthroid did help.

The heat rash/cholinergic urticaria continues though, more often it seems lately than before. Or maybe I am just paying more attention to it. I had red rashing on my face, mostly forehead this morning after my shower. Last night a bit on my lower legs when getting ready for bed.

I found an interesting blog about cholinergic urticaria and chronic heat rash:
http://www.registerednursern.com/nurse/cholinergic-urticaria/

One of the things it talks about is a reduced or inability to sweat in many people suffering from that type of rash. I don't know if that is me, because I have been avoiding rigorous exercise for many months due to its tendency to trigger the regular hives outbreaks. But I should probably assess if that is the case for me, maybe will do that this evening.

I miss long hot showers! I miss baths! I miss working out!! :(

Cholinergic rash continues

For the past few days, still hives free -- except for Saturday evening, I took a slightly longer shower than usual and ended up with a very bad case of the Cholinergic hives/rash afterwards. All on my lower legs, from kneecaps to ankles. My face was a bit flushed too, but the legs were the worse. And they itched pretty badly, a burning itch. It went away in about an hour, as usual. I did also end up with a few short-lived hives during that as well, one on my right side of belly and a few wee ones on hands, but they all lasted less than an hour. No different soaps or shampoos -- I think it was simply because I was under the water longer than usual.

I don't even dare to try taking a bath, even though I used to all the time as a way to relax and unwind! Grumble!!

So who can tell -- is the thyroid medication helping reduce the hives outbreaks, and when they do appear, reduce in duration and severity? And why would that not also help with the heat-induced rash?

I got my bloodwork done today to re-check all my thyroid levels now that I've been taking the drug for a month. They want to make sure I'm not getting too much thyroid hormone.

No matter what, I am thankful at least that the hives are greatly reduced!

I call them "half hives"

Day 22 on thyroid medication. Over the long thanksgiving weekend, I only got a few "half hives" - the best way I can describe them. As described before, they are reddish blotches, very small in size, but never fully form as wheals. I am very happy about the progress so far. I am still having underlying, low-level anxiety because based on history, I keep dreading that the hives will fully re-appear and it's only a matter of time. But I keep trying to turn my mind back to being/staying hopeful. Next week I have to get my thyroid function tests to make sure that I'm not going "hyper-thyroid", but I am not having any of those symptoms thus far.

Also in the past week, actually it's been 10 days now, I have had none of the red "flushing" / blotching rash after showering.

I hope all of this continues, and I'll keep the updates coming!

Thyroid medication continues, no hives...

So I am day 15 now on the thyroid hormone. In the past week, I've had a couple more occasions where reddish circles form, maybe one or two small ones per day, but never truly become wheals. But for the past 5 days, I have been completely hive free -- not even those reddish circles. I do still get the rashing/flushing now and then. I am getting heartburn and gas pains really bad too, every other day. I went back to eating my regular diet, except for gluten, the same time that I started the thyroid medication. I contacted my dr. about the heartburn, and she said it is not a reported side effect of this drug -- but that the best way to find out is to go off of the drug for a week, and if the issue resolves, it's the drug and if not, it's something else i.e. diet. I am going to wait until after the Thanksgiving holiday weekend to try going off of the thyroid medication. If I remain hive-free through this stressful weekend, then I know they thyroid medication is helping and the question becomes what to do about this new issue of heartburn and gas. :( argh!! Here I am with that whack-a-mole game again.

I got my hair colored over the past weekend, and not a hive to be found this time. I also asked the hairdresser to use lukewarm vs. hot water on me, thinking maybe that will help, since heat seems to often be a trigger for the rashing and sometimes the hives too. But not even a rash this time either, so that was very nice!

I did find this very useful write-up on Wikipedia about Cholinergic Urticaria -- which creates that rashing/flushing and hives with increased body temperature, the part that jumped out at me is that this often co-exists with people who have CIU:
http://en.wikipedia.org/wiki/Cholinergic_urticaria

We have a long car ride for the Thanksgiving trip. Some other sufferers of chronic urticaria say that long car rides, bike rides, etc. due to the vibrations can cause a hives outbreak. Gosh, I hope that won't happen.

Next time I post, the trip will be over and we'll see how things are going with the hives, heartburn, and medication!

Happy Thanksgiving...

Still a few hives, but too early to tell I think

This weekend, I did get a few small hives both on Saturday and Sunday. They never became "full blown" well defined wheals with the white ring around them, but they were the beginnings of them. They all faded after only a couple of hours too. Interestingly in Friday evening, I did some exercise and worked up a sweat, but did not have any hives as a result. (On Saturday, the hives didn't set in until evening -- after spending most of the day at the park. Sunday, I did some yard/garden clean-up to remove dead plants and our veggie plants that are done from the season. So both of those days, certainly some inhaled and contact pollen exposures, though I imagine very low due to time of year.)

Today I woke up very nauseated and generally not feeling well, so I am working from home today. Not sure if it is due to the new medication, or just a little bug that I am fighting. I have a red circle/spot on my right wrist that just started less than an hour ago. It doesn't look exactly like a hive though, but has the white-ish circle around it, so who knows.

From the studies that I read where patients found resolution from hives through Thyroid medication, a few things were consistent:

• They started off with small doses
• Some had to increase dose to get resolution
• Most found near-complete resolution in less than 4 weeks once they got to the right dose

So I do think it is still early for me. This is only Day #7 on the thyroid medication. And 9 days without antihistamine.

I also need to get my hair colored again this coming weekend. Last time I did that, I ended up with a big hives outbreak. Then later next week, we travel for the Thanksgiving holiday. So lots of triggers coming up. It will be interesting to see what happens!!

Thyroid hormone treatment for hives - Experiment has begun!

Yesterday morning, I started the daily prescription of a low-dose thyroid medication, for a trial period to see how it goes. No side effects noticed, thankfully. The endocrinologist wants me to get all my thyroid panel re-tested in a month and see me in two months, to review how I am doing and feeling and to make sure first and foremost that the med doesn't make me go hyperthyroid. My PCP "signed off" on the decision too (I contacted her first to get her opinion).

I have decided to also stop the antihistamine, so that I can truly monitor the impact on the hives without having that as a variable.

No hives since this past Saturday, and no more of that heat rashing I had a few times on Sunday. But it is early days -- these meds usually take a few weeks before any effect can be registered. And I have gone sometimes a whole week without a single hive. Rare, but it's happened a few times.

I continue to be back to eating my normal diet except as stated prior, I will remain gluten-free for the foreseeable future. I think it's good practice since I have been diagnosed with the autoimmune disease Hashimoto's.

Fingers crossed!!

Maybe I should add dentist visit to list of chronic hives exploration

I was reading this morning about a number of people who had chronic hives clear up after a visit to the dentist cleared up tooth abcesses or other dental issues. I guess the explanation is that there is an infection in the tooth area, root, whatever. I haven't been to see a dentist in 3 years! (shame on me) I don't have any tooth issues that I am aware of. No tooth pain, no headaches, etc. And none of my bloodwork suggests an infection. But perhaps if some of these other options don't work out, I can explore that one.

I think I have decided to go the route of trying the thyroid hormone therapy. Last night, I ended up with another rash on my chest that got very itchy -- not hives, but very much like a heat rash. All I was doing was reading in bed, and not sweating or too hot at all!

I will continue to provide updates on how things go. Going to call the endocrinologist office here soon.

A great resource of medical articles about chronic hives

Last night when doing some more research online, I searched for "chronic urticaria pathology" and came across the Journal of Allergy and Clinical Immunology's website. They have a bunch of medical papers in an online database, and if you search for "chronic urticaria", there are hundreds of things available. I sorted by most recent data, and found a few that were very compelling:

• One on a small test of patients with autoimmune thyroid indicators and urticaria, and treatment results with thyroid hormone: http://www.jacionline.org/article/S0091-6749(12)00855-X/fulltext
• Another from a doctor writing "what the first 10,000 patients with chronic urticaria have taught me" where he goes over different "myths" about causes and treatments. He dispels myths that chronic hives are caused by stress or by food additives, and with skepticism that H. Pylori causes hives. He also goes on to say at the very end that he feels there is not enough sound data yet about treating hives with thyroid hormone for those with thyroid antibodies, but this article was published a few years before many recent ones on that topic. But he does give some nice guidelines for treatment with antihistamines: http://www.jacionline.org/article/S0091-6749(08)01927-1/fulltext

Obviously, anybody reading my blog and any of these articles that I link to should discuss things with their doctor and make decisions based on their doctor's recommendations, not mine. But I do want to share resources that I stumble across and find to be valuable.

I also read the side of my allegra bottle this morning, just out of boredom, and noticed that they say not to take allegra with fruit juice because it can decrease effectiveness by up to 33-39%!!! Yikes!! My allergist and the dermatologists, neither of them told me that! And since I take it in the morning, I often take it with juice. DUH!! So maybe knowing that, it will become more effective for me.

So I think my game plan now is going to be the following:

• Go back to the allegra daily, and on days where needed, I'll do 2x/day.
• If that doesn't help after a few weeks, I will switch to try zyrtec, because some are saying it may be more effective (though it may cause drowsiness, so I may need to switch to taking it at night).
• If that still doesn't help, then I think it's on to try the thyroid hormone therapy as a trial.

One thing that I can't seem to find though are any medical articles about the duration of treatment before the hives go into remission -- other than that first article that I linked to above, sounds like for those thyroid patients, remission is directly tied to maintaining their dosages at a certain level (i.e. no cure in their case).

Diet Shmiet, the Hives Return Anyway

As they did before after two weeks off the antihistamine, the chronic hives remission is over: they came back in more numbers this morning, which was day 13 of no allegra. I had the pressure hives all along my panty line again, where the elastic presses in. Yesterday, I had a hive on my neck in the morning, and later two on my right hand.

So it seems that the diet changes of eliminating those foods listed for me by the naturopath's person was not helping. After popping my antihistamine this morning, I have since enjoyed some rice, potatoes, spicy pulled chicken, and a gluten-free scone. If I'm going to have hives anyway, may as well enjoy my food. I will continue to stay gluten-free for awhile longer though.

At this point, I am nearly out of options to pursue. I still have a few things in my back pocket if I want to push for them or want to try them, but they come with their own risks:

• Try the thyroid synthetic hormone, though with that, comes a host of other possible other issues that might emerge if I don't really need the hormones at this stage, since my Hashimoto's has been sub-clinical.
• Ask the rheumatologist that I saw what this other medication was that he was going to suggest. (He had wanted me to try gluten-free for a few months first.)
• See about getting a gallbladder scan, since I did read about a few cases where poorly functioning gallbladders have been to blame due to release of more toxins into the body. But I don't seem to have any other symptoms that would suggest a gallbladder issue.

I was in a pretty down mood for the first half of the day. But finally the sun has come out this afternoon, so I took my dog for a nice long (chilly) walk to enjoy the feel of the sunshine. That lifted my spirits a bit.

Working on acceptance is going to be hard for me. I am amazed that medical science doesn't not understand the pathology behind chronic idiopathic urticaria; without knowing that, there is really no great way to know how to treat it.

If anyone else out there has any other ideas or pursuits to try, I would love to hear them!

Only Two Tiny Hives in 2.5 Week, Antihistamine Free for 12 Days

I'm not counting my chickens yet, but I like how this has been going. The only problem is that Insomnia has kicked in, I think because of the diet change or the stress/anxiety about the diet change. I am slowly going to work my way back to my normal diet (but I think I will probably stay gluten free for a long time), and continue to monitor how it goes.  If the hives return, then I know it is somehow connected to diet and not connected to seasonal allergies.

Why do I bring up seasonal allergies again?

Looking on weather.com, I see that weed pollen count is now "low" for my region, with tree and grass pollens each at "none." Interestingly, in September and through mid October, weed pollen was "high" and then tapered to "moderate" (now to low). That is when my round 2 of hives outbreak cropped back up again. Coincidence?

However, inhaling pollen doesn't seem to cause hives and that is what my allergists told me too. Only coming in to contact with it. But my perspective is, something is going haywire in my body that is causing hives -- my body is reading something as needing an  allergic response. So in the absence of any other viable explanation, I figure anything might be possible!

Regardless -- I am thrilled that the hives have diminished to one tiny only every couple of days. A far cry from where it was in the middle of summer. Now, if only I could sleep!!

One Week Hive Free - Elimination Diet Helping?

I took the last plunge with a full elimination diet recommended by a naturopath that I saw a few weeks ago. They did this weird testing with some electronic device that supposedly told me about all my food intolerances -- which apparently there were many!! I don't know if I really believe in this device, but I'm willing to take a leap of faith to give it a try.

The list of stuff that I am apparently intolerant to includes:

• Fish - all kinds! (say, what?!)
• Shellfish
• Nuts (which I knew, I have a moderate allergy)
• Melons (which I also knew, moderate allergy)
• Gluten
• Rice -- seriously! this one killed me. I eat rice a lot, and especially rice flour in the gluten-free breads, crackers, cookies, etc.
• Nightshade vegetables -- this is another one that killed me. These include white potatoes (and potato flour counts), tomatoes, peppers of all kinds, chiles of all kinds, paprika, and eggplant. For crying out loud!
• Soy
• Coffee (no big deal here for me, I gave it up 5 years ago)

There are some medical studies underway in this area of Elimination Diets for Chronic Urticaria, but which are so far showing mixed-bag results (see: http://www.ncbi.nlm.nih.gov/pubmed/19137651).

So I did 10 days completely eliminating all of those things, no cheats either!! It wasn't easy, I gotta say. I was basically eating a paleo diet with dairy.

The result, aside from food boredom?! No hives for the last week, and I have been off of the antihistamine (allegra) for five days now. However, my keratosis pilaris has shown zero improvement.

On day 10, which was two days ago, I decided to introduce one ingredient back. That is the recommended way to do an "Elimination diet" -- bring only one thing back for a few days, and closely monitor how your body reacts. For example, you don't bring back "pizza" which contains a lot of ingredients.

I chose rice, white rice specifically. I had a full cup with dinner on Tuesday, and monitored for any reaction for the next 24 hours. Nothing adverse. Not only no hives, but no GI upset or other issues like headache. So I ate rice again last night with dinner, but this time, within hours I had bad gas and all through the night, I was waking up with sharp, stabbing stomach pains from gas. Hmmmm.....

No hives yet today either, though it looks like one possibly may be forming on my arm. Too soon to tell just yet. I also had that red blotchy thing happen with my skin pretty bad today during my shower, which was as always lukewarm and brief.

I plan to eat rice again this evening with dinner, and see if I get the same issues as I did last night. If so, then rice will be off of the menu for at least a few months, then I'll try it again. After the rice experiment, my plan is that this weekend, I'll move on to the next ingredient, which I think I will pick white potatoes.

I have an appointment next week with a Dietitian to see if she has any thoughts on the elimination diet as a way to pinpoint a possible allergic issue that might be causing the hives, blotchy skin, and keratosis pilaris.

In the meantime, I am currently reading a book called "Full Catastrophe Living" on my Kindle, about using mindfulness to weather the difficulties we all face in life. I am only 20% through it so far, but highly recommend it: http://www.amazon.com/Full-Catastrophe-Living-Wisdom-Illness/dp/0385303122

My Visit with the Endocrinologist

Late last week, I finally had an appointment with the Endocrinologist. I left feeling like the whole visit was a total bust. I was in tears as I explained to her my list of woes: Endometriosis; Infertility; Heavy/Irregular Menstrual Bleeding (until I got on the pill); Anxiety; Keratosis Pilaris skin condition; and now, Chronic Hives.

She did confirm that I have Hashimoto's autoimmune disease, but said that my bloodwork results continue to look good and I have not presenting other key "clinical" symptoms to indicate that my thyroid is dysfunctioning yet. (Those symptoms include hair loss, particularly on the outer eyebrows, weight gain, extremely dry skin, low energy, etc.) She said she would be concerned that with medication, it could make me hyper-thyroid and cause new/more issues. She also said that there is no proven link that chronic hives in the presence of Hashimoto's are treated/resolved through the use of thyroid hormone medications.

My response to her? "I have read the exact opposite." (example: http://www.ncbi.nlm.nih.gov/pubmed/11270265)

I left her office with her saying that while she would not agree to thyroid medication treatment yet, she promised that she would take the next week to research it further. Oh, and they did take blood to run additional thyroid function tests. (I felt like she was throwing me a bone, so that I wouldn't feel it was a totally wasted trip.)

I resolved at that point that it is time to stop my quest for answers, and to just accept and live with these hives. Or at least, work on acceptance.

The next day, she called and got my voice mail while I was in a meeting at work -- she said that she did some reading the night before, and found both outcomes from various medical studies, and that given what she read, she was willing to start me on a low dose to see if that would help. VICTORY!!!

I needed to wait for their nurse to call me early this week, so over the weekend, I just continued on -- maintaining my GF diet, elimination of nightshades, soy, and my known allergen items (nuts and some fruits). And still taking the antihistamine each morning.

I have been hives-free since that appointment, so for one whole week. Even more, my bloodwork results came back as excellent; all of my numbers were not only in normal ranges, but they were numbers at which one wants to be!

When I finally connected with the nurse today, I told her that given the lack of hives for the past week and my bloodwork results, plus I generally feel pretty good, that I would like to postpone starting up the thyroid medication -- instead take a wait-and-see approach. She agreed, and said that if the hives return, or other symptoms, to give them a call right away.

Wouldn't you know it -- a single hive appears on my hand this evening. I forgot to take my antihistamine today! I was going to run out for some on my lunch break, but decided to see if I would be hives free without it. NOPE. It was like a little rap on my door saying, "we're still here!" 

I''m still going to give things a few more weeks and see what happens. But I guess it's back to the daily antihistamine tomorrow, for now.

Diet Changes Continue, Hives Reduce

Been awhile since my last post. I have remained gluten free, but for the past week, and I have decided to become even more restrictive. I have cut out Nightshade Vegetables (tomatoes, white potatoes, peppers, chilis, and eggplant). I have also nearly eliminated soy. And fish and shellfish. And I have significantly cut back on grains. (I long ago gave up coffee - 4 years ago.)

It has not been easy, but I'm going to stick with it for a few more weeks.

My hives have been nearly non-existent. Every couple of days, I will get one or two small ones on my usual places (hips, waistline, or hands). But they are fading more quickly lately too.

I unfortunately continue to notice the "red blotches" that temporarily appear after even just a lukewarm-temperature shower; they appear on my face and lower legs, but fade within 30 minutes.

My Keratosis Pilaris (a red goosebump-link skin affliction) has gotten a bit worse too though.

I drank a little bit of red wine tonight, I wonder if that was a trigger?? I also had a little bit of chocolate ice cream, maybe the cocoa?

I am still taking the Allegra every day too. Hmmm....

This is so frustrating!

Hives Flare-Up Linked to Viral Infection?

So this past week, I was really sick for a few days with a bad viral bug -- bad cold and sore throat on Sunday-Wednesday. In the midst of that, I noticed that my hives seemed a bit worse. I didn't take any medicine for the viral bug. Maybe since being sick put additional strain on my immune system, my body responded with some more hives than usual? I had some on my face on Tuesday, and as usual, on my hands and hips. There is an article on About.com on this topic: http://allergies.about.com/od/faq/f/causeofhives.htm

Being gluten free doesn't seem to be helping at all. I'll give it another week or so, until I meet with the Endocrinologist, then decide whether to stay GF or not.

I've started to keep more diligent of a food diary too. I'll do that for a few weeks as well, tracking what I eat, and when and where the hives show up on my body each day. Maybe I will start to see patterns that trigger them.

Despite all of this, my mood has been very good -- and it's not keeping me from work or socializing. I know that having a good attitude is important, and it can be hard sometimes to get there. But staying focused on all the little positives each day and being mindful of those is very helpful.

More Bloodwork Results are In, No Explanation Here

More of my test results are in, but I'm not sure these give an explanation for the hives -- I expected my results would show a worse story, not a better one:


Thyroid Peroxidase Antibodies
253  (my value in December 2011 was = 491)
Reference range: <35
Unit: IU/ML

Thyroglobulin Antibodies
52  (my value in December 2011 was = 280)
Reference range: <20
Unit: IU/ML


So they are both still high, well above normal, but much lower than 9 months ago -- which was long before the chronic hives started up in June of this year. Knowing now that I do indeed have Hashimoto's, maybe my body is reacting differently. Who knows. The odd thing, is that from November 2011 to early January 2012, the timeframe when my values were last taken, I was completely gluten-free -- and my antibodies were higher then!!! However, at that time, I was also under extreme stress due to my infertility, heavy and painful periods (which I later learned was due to endometriosis after I had the surgery in Jan 2012), and my grandmother had just passed away. I was also Vitamin D deficient at that time, too, which I have since corrected.

So what explains the hives? I have two today on my chin, and some on my hips and along my pantyline where the elastic is and one under my right armpit. 

I took an Allegra this morning, as usual.

I made an appointment with an Endocrinologist that I saw earlier this year, who at that time dismissed my other symptoms as not being due to thyroid or autoimmune issues since all my bloodwork was coming back "normal". I go back to see her on October 10 (can't believe I got an appointment that fast!!), and now I can talk to her about the chronic hives and see what she says.

The more I read online, the more I hear that people with Hashimoto's experience a lot of frustration with doctors, and that chronic hives is a common symptom/side effect of the disease. 

I have no idea what I am going to do about this business trip that I am supposed to take tomorrow. I also have come down with a very, very bad cold. Double whammy.

What other tests remain? What is left to be tested? I feel like I have exhausted them all. If anyone is reading this and has any ideas, that would be helpful! :) 

Hive Outbreak Today Following Salon Visit

Ugh, big outbreak today all around my neck with a hives/rash mix following a visit to the salon, where I got my hair colored. My neck is VERY itchy. No idea if it is due to the stress or anxiety of being there, the chemicals in the products, or the fact that I stayed at my parents last night and the empty lot next door (which had chest-tall weeds) was just mowed yesterday. I am still taking my allegra. Still gluten free.

I also have a cluster of hives on my left hip, one below my left armpit, and a few little ones on my hands. I just took a cool shower to try to calm down my skin a bit.

Most of my bloodwork is still not back yet from the lab. Only one test, my TSH, is back, and it has gone from 1.03 in March to 0.94 in April (when I was retested for infertility related things) to 1.50 now. So, essentially a 50% increase. It is still well within the lab's "normal ranges" of 0.5 - 4.0, but that seems to me to be a notable increase in only a few months. And with all of my other symptoms and conditions (endometriosis, infertility, heavy menstrual bleeding, easy bruising, skin keratosis, and anxiety), one would think a doctor would start to put together a picture of Hashimoto's that requires some mild treatment.

I am very nervous about all this, because I am going on a business trip this week for work -- my first one all year, certainly first one since the chronic hives have started. I am worried that the stress of  flying and staying away from home for one night will further aggravate the hives condition, and that I'll have them visible and itching during my business meetings. And that will only add to my stress.

Having this stuff happens on weekends sucks, because I can't get to my PCP to show her and be like, "explain please!!"

Should I get a precautionary Epi Pen? Anxious about medications!

I have also been wondering about this lately: whether or not to ask for an Epi Pen.

I have thus far been extremely lucky that the hives have not affected my airway. But I do read that many sufferers of chronic hives become faced with this unfortunate symptom, requiring a trip to the ER (even after the use of an Epi Pen).

Being an anxious person, I am very gun-shy about medications in general, but clearly in this case, it would be a life or death situation -- you either take it (regardless of side effect concerns) or risk further harm or death.

I should mention that I am on two current prescriptions, which I started in April -- two months before the onset of hives: An anti-depressant called Remeron, and an oral contraceptive called Loestrin-24fe. I also take a daily multivitamin. But none of my doctors or I believe the hives can be attributed to those, due to the long period of time in which I started those drugs and the onset of hives.

I'll have to ask my PCP her thoughts on having an Epi Pen handy "just in case." The makers of Epi Pen don't include "chronic hives" on their list of Risk Factors, interestingly:
http://www.epipen.com/allergicemergencies/at-risk

Skipped Antihistamine Today, Tiny Hives This Evening

I forgot to take my allegra this morning, I realized by early afternoon. By that time, I figured I'd just skip it and see what happens.

By this evening, I noticed a tiny hive on one hand... disappeared in about an hour, but  now I am looking at another little one that's cropped up on my pinky finger: (may be a little hard to see in the photo)

Now, I know these are like "nothing" compared to my big outbreaks, but it's keeping with the theme that every day is a Mystery with these things!!  Still not consuming gluten, and still not using the fabric softener. And it was a non-stress day today. Cool outside, no sweating involved. Didn't exercise today. Didn't wear or use anything new or different today. So we're back to the drawing board, I suppose. SIGH!!

My prescription still has not arrived for my Thyroid Antibodies and Function bloodwork tests, so I sent a note to my PCP this morning and she was surprised -- and assured me that the office will get them in the mail today. I am very interested in what those will show, given that a few hives came back today under these circumstances. I really want to get that done soon!

I was reading in another online forum that someone had relief after having their gallbladder removed. That person had a HIDA scan with CCK of the gallbladder, which found it was no longer functioning -- and I guess the theory is that it builds up lots of toxins that the body is trying to fight against. That person was also experience GI pain, gas-like symptoms for about a week when the Dr. ordered the gallbladder scan. I am not experiencing such symptoms, but thought I would mention it here in case it helps someone else.

Game Day - No Hives from Sweat, But What's the Rash?

Went to my hometown team's NFL game today; home opener. (We won!) It was very hot there for the first hour or so. I was bracing myself for an eruption of hives in those prime sweat areas, where I had been getting them before: back and sides of neck; elbow creases; armpits; waistband area, etc. Nothing though!

However, now many hours later at home while washing up for bed, I notice not hives, but a reddish rash around the back and sides of my neck. Goes back to that ease of "rashing" that I have been getting as well. I have long hair, so it is not sunburn.

The mystery continues...

Hives in Remission, but Why?

Since Monday of this past week, I have been completely hive free. I wonder if it could be any of the following three things, which all happened around the same time:

• Steady dosage of antihistamine -- I've been doing one allegra each morning for 1.5 weeks. Did it just take time for that to 'build up' in my system in order to be more preventive?
• Stopped using fabric softener -- Boy will I feel like an idiot if this turns out to be the culprit. But at the advice of a family member, I stopped using a liquid fabric softener that I purchased several months ago. I hadn't been using it on all of our laundry, only on towels and our sheets/bedding. I don't think this is the cause though, because it doesn't explain the "massive outbreak" days that I have had when the hives go gang-busters when I have worked up a sweat.
• Gluten-Free diet -- After poking around online, a number of people have asserted that going gluten-free has helped dramatically with chronic hives. Gluten free isn't as hard as most people think; I have found breakfast and going out to eat to be the most challenging. I did buy a few boxes of gluten-free breakfast bars, and when dining out, I know what to specifically ask about to make sure it is gluten free (common 'gotchas' are soy sauce and soy products, as well as salad dressings and other sauces where wheat flour is used as a thickening agent). I find that most wait staff are totally ignorant of what gluten-free means. I think being GF is probably a good idea for me in general, so this may be something I just decide to make a commitment to doing.

So now, the challenge is because all those things coincided around the same time frame, it is now difficult for me to know which one has been the reason for no hives in five days. Not that five days is a long stretch, but it's the longest stretch I have had since my last "remission" over a month ago.

Last week, my PCP recommended that I speak to a Rheumatologist to get the auto-immune perspective. I had an appointment on Friday afternoon, and he suggested that I continue to stay gluten-free for next two months, and see him again and we'll go from there. He also wants to re-check my Thyroid Antibody levels and Thyroid Function (TSH, free T3, free T4), so I need to get those done next week. He said that Thyroid Antibody levels fluctuate, and if they are higher now, that would be something they want to identify. (I last had them checked in December.) He does have a medication that he said we could try, if the hives continue to come and go, but I can't remember the name of it; they use it on people with autoimmune issues who get hives.

I keep scanning my hands, arms, neck, waistline, etc. a few times a day wondering when the hives will make their appearance again. Here's hoping they don't...

If I continue to be hives free after two weeks, I am going to first try the fabric softener on my laundry again, and I'll do that on a day where I will skip the Allegra. I figure, that is the easiest one to test.

My skin rashes easily, stemming from same issue as hives?

I have also been noticing since the hives have started that my skin in general is more reactive. As mentioned before, if my husband is snuggling against me with his beard stubble, any skin that he rubs against gets very inflamed and "rashy" -- and takes at least an hour to fade away.

Today, I was in the grocery store carrying a basket of groceries around, with the handles slung across the crook of my elbow. I had a light wool sweater on underneath. Afterwards, I have this bright red rash where the handle rubbed my sweater against my skin, under the weight of the basket. It has been an hour now and the rash is just now starting to fade a little bit.

Even after taking two allegra yesterday and one this morning, I still have a few hives on my hands today, so what good is even doing? Other than giving me a light headache and GI upset...

As I read about others' experiences online, there definitely seems to be a strong connection between Thyroid Antibodies and hives and rashes. In my case, because all of my thyroid tests have come back well in the normal ranges (none even 'borderline'), none of the doctors feel I need to be treated for that.

I feel like I'm banging my head up against the wall!

A few photos of hives

Thought it might be helpful to start taking some photos of the different ranges of hives that I get.

This first picture was taken a few months ago, when my hives outbreak became really bad and before I was considered "chronic." It was a 95 degree day and I was having a high-stress day and sweating as well, so prime sweating spot being back of neck/under hair, this was the result:

This evening, when I changed to bed, I noticed several hives on my waistline due to the pressure of some snug jeans I had on all day; I took a second Allegra for the day an hour before I took this photo too:

Just trying to keep a relaxed attitude about it all. Bah.

Thyroid Antibodies Cause of Hives?

Today, paid a follow up visit to the Allergist...

Despite taking Allegra daily for the past 4 days, I still have been getting some form of hives nearly every day. Not a lot of them, thankfully. This morning I woke up and had a big one front and center on my chin, and by 10 AM at work, I noticed a few little ones on the tops of each hand. I decided maybe it was worth one more visit to the Allergist, especially since ragweed pollen in our area has been high lately. When I called in, expecting it would take at least a month to get an appointment, they told me they had an opening at 2:15 PM today. Yippee!

This time, a different Allergist saw me than who I saw before. We discussed that I've been getting different types of hives, different times of days, different parts of body. Her perspective for me was the following:

• She does not believe these hives are due to stress. Her stance is that hives happen for other reasons, but that stress can just make them worse. 
• She does not believe that pollen allergies are to blame. She said hives usually happen from a "contact allergy" (unless idiopathic or auto-immune in nature), so unless I've been rolling around in the grass or weeds, these are not due to pollens.
• She tested me for Dermatographic Urticaria by scraping my skin, but I did not get a hive for that. (see:  http://en.wikipedia.org/wiki/Dermatographic_urticaria)
• She did notice that in my medical history, I tested positive for having Thyroid Antibodies. The first test that revealed that to me was eight years ago by the way, and I never had hives until a few months ago. She believes that while I do not have an autoimmune disease, the presence of these antibodies alone may now acting on my body in such a way as to cause hives. She said that added stress would just increase this activity.
• She said there is no real treatment for this, other than to treat the symptoms with antihistamines.

I was told to take two Allegra a day (every 12 hours) from now on, that I could do so safely. And if I do get a "big breakout", I could try taking 3 a day -- even up to 4 in extreme cases, but by then, I should call them back. She also recommended Pepcid as needed too, as another histamine blocker.

I asked her what my "prognosis" is, and she said they can't predict. They see patients that have this for decades, some who go into remission for months or even years and then the hives come back. Some patients have them more than others, in terms of coverage and intensity.

I also asked her about the different types of hives I have been experiencing in addition to the standard wheals (i.e. sometimes pressure hives, sometimes rashes like from my husband's beard stubble, and sometimes red blotchy circles). She shrugged and didn't really have an explanation.

So I guess now, I must move on to acceptance that this is just what I am stuck with. And to hope for the best. And finally, to keep a periodic eye on my Thyroid levels to see if an autoimmune issue does start to manifest. But so far, it's only these annoying, frustrating, and unsightly hives!

A Different Variation of Hives: Small, Red Dots

This evening as I was washing up for bed, I noticed small red, perfectly circular "dots" on my left palm -- as though they are "under the skin." I also have a few on the top of my hand and inner wrist. But these aren't like the usual wheals of hives, which tend to be more randomly circular and often have a raised surface with some white or lighter color in the middle.

So, I'm doing the run-down in my head: What could have triggered this? I ate nothing out of the ordinary tonight. I washed some dishes by hand, but wouldn't that affect both hands vs. just one? I went to yoga this evening, and class was more fast-paced and hot than usual, so maybe this is due to the extra exertion? I also had a stressful morning at work today too. But for them to appear 8 hours later?

The physical stress of the yoga class plus the workday stress certainly support the theory that these may be stress triggered. I have read in a few places online that it is the result of stress raising cortisol levels in the body, and the body reacting to that similarly to an allergy.

However, I am puzzled by the different appearance of these marks, which look more like a rash vs. urticaria.

I am thinking that tomorrow morning, I will start back on daily antihistamine (my choice is Allegra) for a few weeks and see what happens.

H. Pylori is not the cause of my hives

Bloodwork test results came back, and I am negative for H. Pylori. So, I guess there will be no easy fix in understanding the cause here.

This past week, my mother had unexpected heart surgery -- she is doing fine, but it was very stressful. The morning after her surgery, I woke with a few hives on my right hand. They faded in about an hour, even before I got to work.

This morning when I jumped in the shower, I noticed a series of hives on my hips where the elastic from my underwear would have been rubbing. I have read that these are called "Pressure Urticaria." These are smaller in radius but a brighter red than other types of hives I get. They are still raised though.

My husband believes that my hives are due to stress. He also thinks they are "trailing"... meaning, they don't appear right away when there is stress, but maybe 1/2 day or a day later. Perhaps something about stress is playing tricks on my body's releasing of histamine???

The most frustrating thing about this is that I never know where and when they are going to show up. Sometimes when I am stressed, there are no hives. Other times, there they are. And I am about to turn 40 years old, and have had a lot of stress in my life (as we all have), and never had hives as a response before!

But at least for now, they are not as widespread as they were a few months ago. I haven't been taking any antihistamines for weeks either. I figure I will reserve them for when/if they start to become more numerous or frequent.

Random Hives... A few here, a few there...

Last Saturday the hives cropped up again, this time from an obvious reason: I was trimming up some flowers I bought to put into a vase. They were more 'mixed wildflowers' in appearance, not roses or anything more standard. My left hand/arm that was brushing against the stems and leaves most ended up with hives, and they lasted for about five hours before finally fading. Oddly, when I work in my vegetable garden, this doesn't happen to me. 

I was hive free all week. Last night, I felt itchy on my stomach, and when I looked, there was a single hive on my tummy - about an inch wide, half inch high. Nowhere else though. I was wearing a synthetic fabric camisole under my shirt all day, if that means anything. So odd.

This morning, I woke up and noticed one on the front of my neck and one above my right temple. 

So random! You see the dilemma when people attempt to find the answers by asking about things I might be "allergic to." Based on the past week, it would be: flowers, synthetic fabrics, and my blankets?! :)

In about an hour, I am going up to get my bloodwork done to check for the H. Pylori, see if that will provide any answers. I suspect I'll have the results back by the middle of next week.

Chronic Idiopathic Urticaria - Targeting the "Idiopathic" part

I've been hive free for the past two days. Took my antihistamine on Sunday and Monday, but for past two days, have been able to do without. I am keeping watch a few times a day, to see if any are cropping up.

Idiopathic means that the cause is unknown, hence CIU (chronic idiopathic urticaria) is used for cases like me.

Interestingly, there seems to be a lot of medical research happening that link the bacteria H. Pylori to CIU, and that treating H. Pylori is leading to a 'cure' rate of around 70% for those suffering from chronic hives of unknown cause.

That is certainly not a test that I've had yet, so I am definitely going to ask my PCP about it! There seem to be three testing options: bloodwork, breath test (after drinking some kind of fluid -- blechh!), or the much more invasive endoscopy where they remove a tissue sample for lab testing.

I found this link to a study done in India a few years ago, with very promising findings and results:
http://www.indianjmedsci.org/article.asp?issn=0019-5359;year=2008;volume=62;issue=4;spage=157;epage=162;aulast=Yadav

The CDC website has more details on H. Pylori and the tests that can be done, including the reliability of those tests to accurately screen for the bacteria:
http://www.cdc.gov/ulcer/keytocure.htm

Not that I want to have to endure a course of antibiotics, but any information can help and then I can make a decision accordingly!

The Hives are Back!

Yesterday, hives returned to me. Damn, I thought I was in the clear! So - let me back up: Several months ago, out of "nowhere", my body erupted in hives. I had been riding bikes on a hot summer day, working up a sweat, and a few hours later, noticed hives all on my upper body. They were concentrated on areas where I would have had sweat: back of neck, armpits, under my breasts, along my waistline. Eek! I popped a benadryl and in a few hours, they were gone. That was on a Saturday.

Two days later, Monday, they emerged again -- but this time much worse. I had been sitting in a meeting, and started to feel very itchy. A colleague said, "you are getting a rash on your neck." I excused myself to the bathroom, and saw my entire neck (all around) and chest had wheals all over, and some starting to appear on my chin.

I have long struggled with anxiety and panic attacks, so the sight of this put me into a panic. What was going on with me??!! I decided to head home, and before I reached my house, noticed that my lip was starting to swell a bit. My panic escalated, and I drove straight to the ER, where they shot my up with a steroid, gave my a Benadryl and Pepcid, and sent me on my way -- with directions to see my doctor within 3 days.

So, my doctor the next day had no idea -- told me to take Claritin daily and referred me to a dermatologist. I managed to get a dermatologist appointment for later in that week (total luck). In the meantime, I continued to have hives daily, despite the Claritin and the Prednisone that the ER told me to take for 4 days following my visit there. The dermatologist basically shrugged and said, "sometimes, we never know what causes hives" after my answers to their standard list of allergy-related questions provided no clues ("no, I didn't change soaps. No, I wasn't hiking through weeds. No, I haven't traveled outside the U.S. recently..."). He said it could be stress related, but said that it technically wasn't CHRONIC URTICARIA (hives) yet since it hadn't been 6 weeks -- usually the cut-off for acute versus chronic distinctions. But the dermatologist also said 50/50 wasn't likely to end up chronic. I didn't like those odds. They told me to see an allergist if I wanted, and prescribed Atarax to take in addition to the Claritin and Prednisone.

By now, the Prednisone was making me very jittery and wired, and frankly, since it wasn't helping at all, I stopped taking it. I tried the Atarax one day, but it made me feel 'strange' so I stopped that as well. But I kept taking daily the Claritin, and also Pepcid (which is an H2 histamine blocker and suggested by my PCP) for good measure. I continued to have hives for the next week as I awaited the appointment with the allergist.

I stopped wearing perfume, using lotions, wearing jewelry... I stopped exercising, for fear of my own sweat. I tried to stay in the AC all the time, to keep cool, which put a damper on summertime outdoor time. I went into work when I didn't look a-fright, other times, I worked from home. But I knew that all of that couldn't continue.

As my appointment with the allergist approached, I started to have fewer hives each day. "They are going away!" I was so hopeful that this wasn't going to be a CHRONIC case, which based on my restrained internet searching, certainly didn't sound pleasant.

When I met with the allergist, they could not do skin testing since I was taking antihistamines, but they ordered a barrage of blood tests. My PCP had also ordered a number of blood tests as well -- I was to take them all at once and get them done, and share the results with both doctors. The tests included a complete CBC, various auto-immune tests, and some specific allergy tests that can be done through bloodwork samples.It was at that time peak pollen season where I lived, and the allergist was wondering if my history of seasonal allergies had this time manifested in hives -- not something they generally see, but not without possibility. And though I had only a few hives at the time of my appointment with her, the allergist told me to switch to Allegra 24 hour, stay on it for a month (hives or no hives) until our follow up appointment, and that we'd take it from there once she'd reviewed the test results.

Oddly enough, in a few more days, I was hive free. Yippee!! But I continued to take the Allegra each day without fail, until I learned more from the doctors.

My PCP was the first to call, about a week after my bloodwork was drawn. Everything came back looking great -- no signs of infection, no indications of autoimmune issues. I had tested positive for ANA (anti-nuclear antibodies), which I knew from previous tests in years past, but they were very low (I was in the 1:40 titer). Other tests ordered included: DNA Antibody Double Stranded (negative); Complement C3 and C4 (both well in normal ranges); Rheumatoid Factor (negative); Sjogren's Antibodies SS-A and SS-B (both negative); Sed Rate (well in normal ranges); and complete CBC with platelets (all in normal range here too). She assured me that there is no reason to believe that it was auto-immune based. I breathed a huge sigh of relief.

One week later, I got the allergist's test results: Above-normal ranges for various tree pollens (birch and maple, slightly high for oak); extremely above range for Timothy Grass; but negative for the IGE Antibody -- a blood test that had to be sent to a special lab, one of only a few in the U.S. that can test for this, which helps to indicate if it's auto-immune based.

At this point, I blamed it on the pollens. The timing lined up, and the fact the the daily antihistamine regime seemed to clear it up further supported my theory, and when I met with the allergist a few weeks after all that, her theory as well. She told me to start to wean off of the Allegra, pollen seasons was pretty much over, and to call back if the hives returned and did not respond to Allegra again.

Almost three weeks went by with no hives after stopping the Allegra. I was so happy, so relieved. Until...

Yesterday, I was enjoying a relaxing Saturday at home, reading quietly in my room -- when a bathroom visit look in the mirror revealed, "what's this?!", a big hive -- a nice, round red wheal with its hallmark white border -- on the front of my neck! "WTF!!!"

I started to panic again, "Oh my god, they are back! The hives are f-ing back!" I was so upset. I had done nothing to trigger them. Ate nothing unusual. My husband said, "Maybe they are from stress?" since I had been a little stressed earlier that day. But stress had never brought hives on before, so why now?

After simmering down, I told myself, "Let's just see what happens. Could be a random thing." The hive actually faded rather quickly, in about 90 minutes. But like the game whack-a-mole, a new one had appeared on my belly and a small one on one of my hands. A few hours later, those were gone, and I went to sleep hive-free.

This morning, a look in the mirror showed me to still be hive free. "Whew!" But by noon, I noticed one on my lip, and it was causing my lip to get slightly puffy. A took a deep sigh.... and reached for the Allegra.

Now, four hours later as I type this, my lip is still a little puffy. And I have a small hive on one of my hands now too. I know it will take a few days for the Allegra to build up in my system.

I am feeling confused and sad and a bit stressed. I don't know what will be in store for me -- I've certainly read a few very difficult personal experiences shared on the Internet from other chronic hive sufferers, and I try to avoid those so as not to overly worry myself. But I am hoping that this blog will serve as a way to cope, learn, share, contribute, and maybe also lead to some answers....eventually.