Chronic Urticaria

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What type of urticaria do you have and do you have some doubts about the allergen that caused it and i will surely help you, i have a website about hives and i am quite knowledgeable about the topic

Heat urticaria

Hi everyone, just thought I'd add to this as it seems a very helpful source of info for cu.
Ill make it as 'brief' as possible:
- had heat urticaria for four years as a possible 'off cut' from EBV/mono/glandular fever
- went to GP and was prescribed fexofenadine (type 1 antihistamine) with ranitidine (type 2 antihistamine)
- symtpoms improved but did not go away, still had large reactions (rash and lip swelling) after sport and brisk walking.
- offered steroids (prednislone) for when its at its worst, however never used them as I am aware of the side effects of long term steroid use.
- continued with fexofenadine as ranitidine didn't make much difference.
- recently put on loratadine (slightly older than fexofenadine but still a non-sedating antihistamine) and symptoms seem to have improved although still not resided.

Im a medical student and have used my access to do some literature reviews to find out study evidence for urticaria treatment, I have also spoken to around 10 GPs, a private consultant dermatologist, a consultant paediatrician and an immunologist (scientific not clinical).
These are my findings:
- apparently between 1-3% suffer with urticaria at any one time, so I'm struggling to understand why there isn't much on it...
- the evidence suggesting fexofenadine and ranitidine combined improves symptoms is inconclusive
- loratadine and fexofenadine have been shown to reduce symptoms to a similar degree, fexofenadine with greater success.
- EBV can cause urticarial rashes, it survives (dormant) in the B cells of your immune system and is activated when you are run down. Taking a dose of immunosupressent wipes enough of the B cells to weaken the virus and so should stop the rashes, however leaves you prone to other infections as you have a temporarily weakened immune system
- taking long term corticosteroids can give side effects such as osteoporosis, so for a young person apparently it is best to put these off until you really need them.

My own personal findings:
- I have tried eliminating certain food and drink from my diet for 6 weeks at a time, none have shown improvement: aspartame (fake sugar in "no added sugar" drinks), milk, oranges & apples and their juices, wheat, excessive sugar (i.e. no sweets, fizzy drinks, juices, limited citrus fruit etc.), strawberrys, fish and spicy food.
- I have excema so my IgE levels for allergy are higher than normal which can also give urticaria
- doing exercise in the morning to bring out the rash means that i won't get the rash again no matter how much sport I do/how hot I get for another 1-2 days, however I couldn't fit this into my week to make it worthwhile.
- I am currently trialing loratadine rather than fexofenadine for six weeks, then I will ask my gp for another non sedating antihistamine to see if the symptoms are any better (I have a reserve stash of fexofenadine and prednislone just in case it doesn't work).

This is the stage I have got to with it so hopefully that helps, apologies for the length and any questions or if you want me to look anything up in medical textbooks/online study evidence then reply on here and ill email you or however this forum thing works
Oh and I'm just a student, so i don't know the same amount about medicine as doctors do so if I'm wrong about something it's because I haven't learnt it yet and I'm not qualified and part of this is based on my opinions from chatting to my family who also aren't doctors (disclaimer).