Chronic idiopathic urticaria and diet - Foods to eat and avoid

Article by Master, Doctor Mai Vien Phuong - Department of Examination & Internal Medicine - Vinmec Central Park International General Hospital.

Chronic idiopathic urticaria (CIU) is a term for people who have had hives for 6 weeks or more with no known cause. Symptoms can come and go for months or even years. Here are some diets and foods that can help you manage your chronic idiopathic urticaria symptoms.

While many people think that hives are always an allergic reaction to a particular food, this is not the case with chronic idiopathic urticaria. It can be caused by exercise, stress, hot or cold weather, pressure, or many other factors that can trigger flare-ups. They can also appear spontaneously, triggered by what seems indistinct.
Although chronic idiopathic urticaria is not an allergic reaction, dietary modifications can help relieve a person's symptoms. Currently, there is not much concrete evidence on the impact of specific diets on chronic idiopathic urticaria symptoms. However, some trials suggest that dietary changes can help relieve symptoms in people with the disease.

Dietary Antihistamine
High levels of histamine may play an important role in chronic idiopathic urticaria, as many sufferers respond well to antihistamines. However, for the 40% of people who don't respond to antihistamines, trying an antihistamine diet could be a worthwhile next step.
In a recent study, 22 people with chronic urticaria restricted histamine-rich foods for four weeks. There was a statistically significant reduction in urticaria severity scores in the participants. Blood samples from patients in the same study showed that their blood histamine levels also decreased after four weeks on an antihistamine diet.

Low-histamine foods to eat
The following foods are low in histamine and can help you manage your symptoms:
Most vegetables Raw meat Bread Pasta Rice Dairy products ( except cheese and yogurt) Certain types of fresh fish, including salmon, cod, and trout Histamine-rich foods to avoid
You might consider avoiding the following foods high in histamine.
Cheese Yogurt Preserved meats Fruits like strawberries and cherries Spinach, tomatoes and eggplants Alcoholic beverages Fermented foods Fast foods Canned, frozen and smoked fish, including tuna, anchovies and sardines Spices such as: chili powder, cinnamon, cloves and vinegar This list is not exhaustive and the amount of histamine from food sources may vary.
Certain foods, beverages, additives, and medications are also said to aid in the release of histamine or inhibit the enzymes needed to break it down. Some examples of these include:
Citrus fruits Nuts Alcoholic beverages Tea Egg whites Food additives Certain preservatives Medicines such as aspirin and nonsteroidal anti-inflammatory drugs or isoniazid and doxycycline

Pseudoallergen elimination diet
Even if a person tests negative for a food allergy, it is possible that they are hypersensitive or intolerant to certain foods. Ingesting these pseudo-allergens can lead to reactions that resemble real allergic reactions, including hives.
With this in mind, some doctors may recommend that people with chronic idiopathic urticaria try a pseudo-allergy elimination diet. Some examples of pseudo-allergens include:
Food additive Histamine Natural substances in fruits, spices, and vegetables In one study, approximately 1 in 3 patients with chronic idiopathic urticaria reacted positive response to a pseudoallergic-free diet. However, there have not been any randomized controlled trials to provide conclusive evidence of the effect of the diet on a larger scale.
If you think diet plays a role in your chronic idiopathic urticaria symptoms, talk to your doctor to help you figure out which foods to cut from your diet in a healthy way. safe. Everyone's tolerance to histamine is different; Therefore, it is very important to personalize the diet plan.
You may also find it helpful to keep a diary to keep track of your symptoms after each meal. Take notes including specific foods you ate, when you ate, and how long after your symptoms got worse or better. Share your findings with your doctor so you can make a plan together.
Conclusion
People react to foods differently. One type of diet may work for someone else, but it may not work for you. Before trying a new diet, talk to your doctor. They can help you understand what to do based on your individual circumstances.
There is still not much evidence that adopting certain diets can significantly affect your chronic idiopathic urticaria symptoms. However, the low risk and low cost of doing so may make dietary changes worth trying.

References
Cornillier H et al. (2019). Effects of diet in chronic idiopathic urticaria: A systematic review. DOI: 10,2340 / 00015555-3015 Kohn JB. (2014). Is there a diet for histamine intolerance? DOI: 10.1016 / j.jand.2014.09.009 Magerl M et al. (2009). Effect of a pseuodoallergen-free diet on chronic idiopathic urticaria: A prospective trial. DOI: 10.1111 / j.1398-9995.2009.02130.x