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.