Chronic hives: what is going on inside the body?

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If you’ve had hives before, you will know how annoying they can be. It’s even more annoying when they keep coming back, or get worse instead of going away.

Hives (also known as urticaria) are red, itchy welts or wheals brought about by the immune system releasing histamine and other chemicals that cause inflammation and fluid to accumulate under the skin. They can disappear and reappear within minutes or hours. Typically, hives last a few days (or only when you are in contact with an allergen i.e. something that you are allergic to) and they are not contagious. But if you continue to get hives daily or almost every day for a period exceeding 6 weeks, you have chronic hives, also known as chronic spontaneous hives (CSH), chronic idiopathic hives (CIH) or chronic urticaria (CU). While acute hives are often due to culprits like an allergy to food or medication, insect stings, blood transfusions and infections (viral infections are the most common cause of acute hives in children), chronic hives are rarely caused by allergies and are more tricky to treat. Experts believe the underlying abnormality is “intrinsic”, whether it is autoimmune, or some unknown process. Chronic hives can be frustrating as it significantly impacts the quality of life.

If you suffer from chronic hives, the information below may help you better understand your condition.

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  1. Chronic hives stem from immune abnormalities. According to the Allergy Center of Connecticut, the leading theory is that your immune system attacks healthy cells in your body and in this case, your own allergy cells (mast cells and basophils) are the target. Studies have found a link between chronic hives and autoimmune diseases (e.g. thyroid, rheumatoid arthritis, Celiac disease).
  2. Since chronic hives are a sign of immune dysfunction, Dr. Yik helps her patients correct and resolve the immune response. She uses nutraceuticals, supplements and nutritional therapy to address immune dysfunction and the ongoing state of chronic inflammation. She also spends the time to investigate underlying factors or concurrent conditions such as gut dysbiosis or gut-related disorders (since 70% of our immune cells lie in our gut), nutrient deficiencies (such as vitamin D- read more below) and other inflammatory conditions.
  3. Are you deficient in vitamin D? Vitamin D supports optimal immune function and one of its roles is to increase T regulatory function. T regulatory cells are a component of the immune system that suppresses immune responses of other cells. This is an important “self-check” built into the immune system to prevent excessive reactions. Studies have found that many people with chronic hives have lower vitamin D levels.
  4. Could it be a parasitic infection? There have been cases where patients with chronic hives were found to have a parasitic infection and upon taking anti-parasitic medication, the chronic hives went away. Though not very commonly seen, a parasitological workup may be warranted depending on the patient’s symptoms, dietary habits, country of origin and travel history.
  5. Stress can trigger a bout of hives. On the other hand, the condition itself may be a source of distress and could worsen patients’ quality of life. Care should be taken to reduce and manage stress appropriately. Click here to learn how to cope with stress and anxiety.


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