Are you scratching your head over the incessant itchiness and wondering, “Why do I have chronic hives?“
If you’ve been longing for an understanding of chronic hives causes, you’re in good company.

This disease was once called Chronic Idiopathic Urticaria, because the medical community didn’t understand why we get chronic hives. The name of the disease is now Chronic Spontaneous Urticaria, because we know that it is a mast cell mediated disease, but the mystery still surrounds what causes this condition to develop.

In this article, we’ll explore:

• Re-framing Hives – Not Just an Allergy
• The roles of autoimmune and auto-allergy in chronic urticaria
• Assessing chronic hives through the lens of functional medicine
• Frequently asked questions
• My recommendation for a functional medicine practitioner specializing in hives

Re-framing Hives – Not Just an Allergy

Let’s begin by changing the way we look at chronic hives. Quite often, people think of hives and allergies as interchangeable concepts – they’re not. Here’s why:

Allergies are an overreaction of the immune system to environmental substances, like pollen or pet dander. While acute hives tend to be allergy-driven, chronic hives often have deeper root causes that involve the immune system.

Over the years, medical science has discovered that in many cases, chronic hives stem from autoimmunity and auto-allergy. Let’s delve into these next.

Understanding Autoimmunity in Chronic Hives

In autoimmunity, the immune system mistakenly launches an attack on some part of your body, mistaking it for a foreign invader.

The term “autoimmune” likely rings a bell. We hear it in the context of conditions like rheumatoid arthritis or Type 1 diabetes. But how does it connect to chronic hives?

Simply put, autoimmunity is an immune response directed against the body’s tissues. When your immune system mistakenly attacks normal cells in your body, it results in an autoimmune disorder. Your body’s defense mechanism goes overboard and starts treating healthy tissue like an infectious disease.

In the context of chronic hives, autoimmunity can be considered as one of the primary causes. Reportedly, up to 50% of cases, where hives become chronic, it’s due to an autoimmune response. Autoimmune conditions such as Hashimoto’s Thyroiditis and Lupus can contribute to hive symptoms, but oftentimes Chronic Spontaneous Urticaria itself is the autoimmune disease.

For myself, I did end up developing Hashimoto’s, but I had already had CSU for years prior. It is estimated that among chronic urticaria patients, 12% have Hashimoto’s thyroiditis. The prevalence of Hashimoto’s is about 2 % in the general population.

Read more about why women are at increased risk for autoimmune conditions HERE.

While autoimmune disorders can be a bit scary to contemplate, understanding them can offer incredible insight in dealing with chronic hives. Now that we’ve covered autoimmunity, there’s another important cause to consider – auto-allergy, which we’ll delve into in the next section.

Auto-Allergy

The phrase “auto-allergy” is less familiar. Auto-allergy implies your body produces an allergic reaction to itself.

The immune system reacts excessively or inappropriately to substances that are a part of the body’s tissues or cells.

Auto-allergy, as the name suggests, is a self-allergy of sorts. It’s an unusual phenomenon where your immune system reacts to its cells and proteins. It’s like being allergic to your own body. This is distinctly different from an autoimmune reaction – it’s less about the body attacking itself and more about the body responding as if it’s been invaded by a harmful allergen, despite the allergen in question being part of the body itself.

The Differences Between Autoimmune and Autoallergy

While both autoimmunity and auto-allergy involve the immune system’s reaction to the body’s components, they aren’t identical. With autoimmunity, the immune system’s ‘attack’ is directed at normal cells. With auto-allergy, the immune system is responding ‘allergically’ to its cells or proteins. It’s a subtle, but significant distinction.

• Auto-allergy: The immune system reacts to its cells and proteins, essentially treating them as if they were foreign invaders. This is akin to having an allergy, but the target is a part of the body itself.
• Autoimmunity: This is when the immune system mistakenly targets and attacks the body’s tissues, believing them to be foreign invaders.

Chronic hives can be puzzling and frustrating. Autoimmunity and auto-allergy are just two pieces of the puzzle. You’re probably wondering “Why did I develop an autoimmune or auto-allergic disease?”

Next, we’ll explore the wider perspective of functional medicine and how its approach can offer a more comprehensive understanding of chronic hives’ causes, whether autoimmune or auto-allergy in nature.

Unveiling Chronic Hives from a Functional Medicine Perspective

The world of functional medicine offers a different approach that can lend deeper insights into some factors that, though they might seem unrelated, have proven to significantly contribute to hive occurrences.

What is Functional Medicine?

Functional medicine, at its core, takes a systems biology-based approach that focuses on identifying and addressing the root cause of diseases. Unlike traditional healthcare which mostly addresses the symptoms, functional medicine delves deeper to understand why a health problem has occurred in the first place. A good functional medicine practitioner can help you uncover your unique chronic hives causes. I think of it as the Band-Aid approach vs addressing the root cause.

How Functional Medicine Relates to Chronic Hives

From a functional medicine standpoint, chronic hives are not perceived as an isolated issue requiring symptomatic treatment. Rather, it’s scrutinized within the context of the body’s broader health system:

• Integrated approach: Functional medicine considers the human body as an integrated system, not merely a collection of independent organs divided by medical specialties. So for chronic hives, a practitioner would try to look beyond the skin’s reaction and into your lifestyle, environment, mental health, and more.
• Personalized assessment: In functional medicine, it’s understood that every individual is unique — genetically and biochemically. The causes of chronic hives can vary widely, and the treatment approach is tailored to the individual’s unique needs and circumstances.

My Journey through the Functional Medicine Lens

When I first explored functional medicine, it was a revelation. The emphasis on understanding the whys behind my health conditions, including chronic hives, was a life-changer. Instead of patchwork solutions for the outbreaks, I was guided through a comprehensive evaluation of my health and lifestyle.

Uncovering how different factors like diet, stress, sleep, and more could be provoking the hives was enlightening, and it allowed me to take appropriate steps to manage my condition better.

Viewing chronic hives from a functional medicine perspective broadened my understanding and provided a roadmap toward a tailored health solution. This was an empowering experience and my chronic spontaneous urticaria no longer rules my life.
In the coming section, we’ll summarize some functional medicine insights into the causes of chronic hives.

The Role of Gut Dysbiosis and Leaky Gut in Triggering Chronic Hives

• Gut dysbiosis refers to an imbalance or disruption of the gut microbiota. This can potentially lead to chronic hives due to the vital role the gut microbiome plays in maintaining our immune system.
• Chronic inflammation and irritation caused by gut dysbiosis can lead to leaky gut syndrome, a condition where undigested food particles, waste products, and bacteria “leak” through the intestines and into the bloodstream. This can cause food sensitivities and result in an overactive immune response.
• The immune response triggered by these foreign substances entering the blood can initiate chronic hives. There’s a growing body of evidence indicating a close correlation between gut health and autoimmune conditions, including chronic hives.

In my case, I had taken numerous rounds of antibiotics in my childhood, and developed chronic joint pain as a teenager, taking NSAID medications, which are damaging to the gut, on a daily basis for many years. These things contributed to poor gut health, and an overactive immune response.

The Impact of Infection and Parasites on Chronic Hives

Understanding the connection between the gut infections, parasites, and your immune response can provide powerful insights into managing chronic hives.

Have you ever noticed that your symptoms are exacerbated if you have a cold or flu? That’s because your immune system has been activated due to the invading threat. Now, imagine you have an infection that you aren’t even aware of, your immune system is constantly stimulated and on high alert, making you more prone to hives outbreaks.

• Infections, whether bacterial, fungal, or viral can often serve as triggers for chronic hives. This is due to the body’s immune response, instigating inflammation and, potentially, hives. This could be an infected root canal, the common gut infection H.Pylori, SIBO, or any other underlying infection that you may not even be aware of.
• Parasitic infestations can also contribute to the development or exacerbation of chronic hives. Parasites can stimulate a chronic immune response that results in ongoing inflammation, an underlying cause of hives. People like to think that this is not a problem in first-world countries, but that is not the truth. Although we have the luxury of clean water and are less at risk, parasitic infection can happen to anyone, anywhere.

Hormonal Factors and other Culprits behind Chronic Hives

In this section, we’ll delve into how endocrine factors such as adrenal fatigue and hormonal imbalances might contribute to chronic hives. Then, we will explore the role of toxins and molds in this concerning health issue.

Adrenal Fatigue and Hormonal Imbalances

• Adrenal fatigue refers to a condition characterized by the diminished ability of the adrenal glands to respond to stress adequately. Symptoms often include tiredness, trouble falling asleep at night or waking up in the morning, salt and sugar cravings, and the need for stimulants like caffeine to get through the day.
• Adrenal hormones, particularly cortisol, play a role in managing the body’s immune response and preventing inflammation. When these hormones are out of balance due to adrenal fatigue, it may lead to excessive inflammation and subsequent hive outbreaks.
• Hormonal imbalances, such as fluctuations in thyroid hormones, estrogen, and progesterone, have also been associated with chronic hives. Hormonal changes can disrupt the immune system, leading to an overactive immune response manifesting as hives.

My functional medicine testing revealed that my hormones were quite imbalanced. I had low testosterone and cortisol, and my estrogen levels were elevated. You can read about Estrogen Dominance as a potential cause of chronic hives HERE.

Toxin Build-up and Mold as Potential Chronic Hives Causes

• Chronic hives can also be a symptom of the body dealing with an overload of toxins. Toxin exposure can overload the body, hindering its ability to efficiently neutralize toxins, which in turn can trigger inflammation and hives. It’s not that the body isn’t able to detox, rather, it becomes overburdened.
• Exposure to certain molds can trigger an allergic reaction causing hives in some individuals. Mold spores entering the body through inhalation or skin contact can trigger an immune response, leading to chronic hives. Learn more about mold exposure and chronic hives HERE.

I grew up with a lot of mold exposure and this is also a big driver for my hives. Unfortunately, I did not discover this until later in my chronic urticaria journey, as my functional medicine practitioner was not a specialist in hives and didn’t test me for mold levels. I learned about it doing my own research and tested myself. Unfortunately, we had recently purchased a home that turned out to have a lot of mold, so this exposure is triggering my immune system.

Nutritional Deficiencies

In the Western world, we are often well-fed but lacking in nutrition. Soil depletion, heavily processed foods, and a damaged gut that doesn’t absorb nutrients as well can contribute to lower levels of these important nutrients. There are many vitamins and minerals that play a role in mast cells and the immune system, here are just a few.

Vitamin D: Deficiency in vitamin D has been linked to various immune-related conditions. It plays a crucial role in immune regulation. Some studies suggest that low levels of vitamin D may contribute to chronic urticaria or worsen its symptoms. Read more about the importance of Vitamin D for Chronic Hives HERE.

B Vitamins: Deficiency in B vitamins can lead to a range of neurological and immune-related issues. While it’s not a direct cause of hives, it could potentially contribute to an underlying immune system dysfunction.

Ferritin: Iron is crucial for overall health, including immune function. Severe iron deficiency can lead to a weakened immune system, potentially making a person more susceptible to allergic reactions and itching.

It’s important to note that while these nutrients play roles in immune function, they are just one piece of the puzzle.

A functional medicine practitioner can conduct tests to identify any nutrient deficiencies and provide appropriate recommendations for treatment or supplementation, if necessary. I found that my vitamin D and Ferritin levels were both low.

A Summary of Chronic Hives Causes

Understanding the various potential causes of chronic hives can be empowering. It aids in removing the mystery and fear associated with the condition and promotes an action-focused approach. With these insights, you can start seeking individualized treatments that target your hives’ root cause, guided by a functional medicine practitioner’s advice. You will uncover the importance of professional guidance in the next section as we conclude this exploration of what causes chronic hives.

In this exploration of chronic hives causes, from understanding autoimmune and auto-allergy relevance to exploring the functional medicine perspective, we’ve spanned a broad body of knowledge to help those affected by this condition.

Here are the key takeaways:

• Chronic hives can be linked to autoimmune disorders and auto-allergy, where the body’s immune system turns against itself. Hives can be caused by a separate autoimmune condition, but it is usually its own distinct autoimmune disease.
• Gut dysbiosis, leaky gut, infection, and parasites could all play a role in causing chronic hive outbreaks.
• Hormonal imbalances, such as adrenal fatigue or estrogen dominance may influence the occurrence of chronic hives.
• Environmental and internal elements, including toxin build-up and mold exposure, are also potential contributors to persistent hives.
• Nutritional Deficiencies can result in recurring hives. Addressing deficiencies can lessen the frequency and severity of chronic hives.

It’s essential to remember that tackling and managing chronic hives calls for a lot of patience, controlled management, and positivity. Identifying chronic hives causes and triggers can help you better manage your symptoms. Read more about potential triggers HERE.

How do I find a functional medicine practitioner who specializes in Chronic Urticaria?

When looking for a functional medicine practitioner, be sure to ask a lot of questions about their experience with chronic hives. I made the mistake of going to the functional practitioner that was closest to me, and although it was helpful to get my labs, I found that they had a cookie-cutter approach and were not familiar with chronic hives.

I ended up having to do my own research and was still doing a lot of the work myself. It turns out that I have mold toxicity, a test that they never even suggested, which is a big driver for hives. I could have saved myself so much time, money, and frustration if I had worked with someone who was familiar with treating hives.

FAQs on Chronic Hives Causes

What is the connection between autoimmune disorders and chronic hives?

Autoimmune disorders occur when the body’s immune system attacks and destroys healthy body tissue by mistake. In some cases, this reaction is due to an existing autoimmune condition such as Hashimoto’s, but oftentimes, Chronic Spontaneous Urticaria is the autoimmune disease itself.

What role does gut health play in causing chronic hives?

A functional medicine lens highlights the role of gut dysbiosis and leaky gut in causing chronic hives. When the gut microbiome is imbalanced, it can lead to inflammation that manifests in different ways, including chronic hives. One of the body’s enzymes to break down food sources of histamine can also become deficient with a damaged gut microbiome, potentially contributing to histamine intolerance symptoms and hives.

What does adrenal fatigue have to do with chronic hives?

Adrenal fatigue is linked to hormonal imbalances, which, in turn, can cause inflammation in the body. This inflammation may trigger outbreaks of chronic hives. Histamine is also influenced by other hormones and can be elevated due to the disruption of balance.

How can environmental factors like mold contribute to chronic hives?

Exposure to certain toxins or molds can introduce irritants and allergens into the body and lead to an inflammatory response. Chronic hives can be one manifestation of this bodily response.

Does chronic hives mean that I’m allergic to something?

Chronic hives are rarely caused by a true allergy. My immunologist told me that allergy testing was completely unnecessary because chronic hives are not caused by allergy, but rather an overactive immune response to one’s own body. A functional medicine practitioner can test you for food sensitivities, which can contribute to inflammation and hives, but these are different from an allergic response.

How do I get tested for the root cause of chronic hives?

If you have a good relationship with your doctor, some of these tests can be run through their lab. There are some functional medicine lab tests that traditional doctors won’t run, or you may be nervous about asking. Working with a functional medicine practitioner can help guide you on the tests that you need, and help you interpret what the results mean, with a clear roadmap to address the underlying issues uncovered by these tests.

You can order your lab tests through True Health Labs

Here are some of the most common functional medicine tests for Chronic Hives:

Complete Thyroid Panel (Ask your doctor)

Vitamin D (Ask your doctor)

Ferritin (Ask your doctor)

DUTCH test (hormones/adrenals)

Mold Testing

GI-MAP assess gut health and check for parasites and yeast overgrowth