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Urticaria

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Urticaria is a condition which presents itself as an itchy rash (hives/wheals).  This is caused by tiny amounts of fluid that leak from blood vessels just under the skin surface.

The pathogenesis of uticaria has not been pinpointed to any one particular mechanism. However, it appears that mast cells (which are types of white blood cell) play a prominent role.  Mast cells are found throughout the body including near the small blood vessels in the skin. Inflammatory mediators such as histamine are released from mast cells causing the wheal and flare reactions commonly associated with urticaria.

Causes/Contributing factors

A number of factors that may to contribute towards urticaria:

• Food allergy including food colourants, flavourings, preservatives and stabilisers¹
• Intestinal permeability²
• Secretory IgA deficiency³
• Hypochlorhydria⁴
• Hypothyroidism⁵
• Infections - candida, bacterial, viral such as hepatitis B⁶
• Contact - wheals caused by pressure exerted on the skin. The following conditions may be associated with contact urticaria - pregnancy, thyroid disorders, hormonal changes, diabetes, candida, psychiatric disorders and insect bites⁷
• Autoimmune - some forms of urticaria have an autoimmune component⁸
• Heat -  caused by stress, eating spicy food, alcohol, exercise or overheating⁹
• Cold - this can accompany a number of clinical conditions including viral infections, parasitic infestations, stress, dietary change, insect bites and penicillin injections¹⁰
• Drugs - such as penicillin, aspirin and non-steroidal anti-inflammatory drugs¹¹

Nutritional factors to consider

• Anti-inflammatory diet
• Nutrients with an antihistamine effect eg quercitin, Vitamin C
• Elimination of problem foods
• If necessary, removal of candida , repair of gut wall and re-innoculation of intestinal microflora
• Management of hypothyroidism if necessary

Possible laboratory tests

• Candida Antibody
• Food intolerance including gluten
• Intestinal permeability
• Thyroid
• Secretory IgA