Hives and Angioedema

Hives (Urticaria) are raised red skin wheals caused by allergy (mast cell degranulation. They usually appear suddenly and disappear rapidly, only to return again. If they last for more than five or six weeks, hives are considered to have become chronic. Any number of antigens can cause hives, including antibiotics, aspirin, curare, and various chemicals or foods etc. These antigens can remain dormant, stored in the tissues, until stimulated by pressure, heat, cold or other stimuli. Angioedema is a more severe condition with diffuse swelling of the lips, skin hands and feet, respiratory tract etc.

TAM doctors call the condition of hives “cold bile disease (sitapitta),” and TCM doctors call it “Wandering Wind Evil.” I actually developed this problem several years ago, and it took me a while to figure out the best way to treat it.  I did not respond to any of the normal herbal therapies for removing inflammation from the liver and blood. The condition persisted for more than a full year.

As it turns out, a stool test revealed that I had a hidden and symptomless intestinal infection.  Once I treated the infection, the problems decreased by about 50%.  Unfortunately, the food allergies I had developed during the time my intestine was secretly infected were still active.  I worked on clearing up intestinal inflammation and eliminating offending foods from my diet, and I got 75% better.  I didn’t return to 100% health until Dr. Mana gave me a formula containing condensed neem leaf powder (which is very cold and stops skin itching), mixed with hot and spicy yavani seeds (Trachyspermum ammi), which have an action similar to thyme.  Both neem and yavani are potent anti-inflammatories and anti-fungals, and they help the liver to remove  heat toxins  The treatment worked.  I used standard intestinal healing herbs for several months, and the hives have never returned.

The first step in treating hives is to resolve digestive problems, hidden intestinal infections (intestinal dysbiosis) and liver problems.  It is also often necessary to identify and remove hidden food allergies.  After that, you can use herbal formulas to treat the prominent signs and symptoms. In addition to neem and yavani combination, try the following:

•  If there are signs of severe heat and itching, use blood cooling herbs such as raw rehmannia root, red peony root, honeysuckle flower, chrysanthemum flower, peppermint leaf, licorice root and boswellia gum.

• If there are signs of deficiency, and the patient has an aversion to wind and perhaps a pale tongue, use salvia root, cinnamon twigs, dandelion root, dang gui root, astragalus root, white peony root and licorice root.

Research Highlights

• One controlled clinical trial tested for hypersensitivity reactions in children with chronic urticaria. According to the results, 75% of the subjects had clear reactions to one or more foods or food additives, especially coloring agents and preservatives (Ehlers et. al., 1998).

• According to a review of Chinese research published in the Archives of Dermatology, Acute urticaria can be treated effectively with acupuncture.  L-111 (Quchi), Sp-10 (Xuehai), Sp-6 (Sanyinjiao), and S-36 (Zusanli) were the 4 most commonly prescribed acupuncture points. Injecting the acupuncture points with vitamin B1 was also reported effective (Chen and Yu, 1998). These clinical trials were not placebo-controlled.

• In a series of rigorous studies, researchers found convincing evidence that certain food ingredients provoke urticaria symptoms and sustain the disease in a majority of patients. In one trial, by following a diet avoiding preservatives, dyes and other natural pseudo-allergens, 73% of patients experienced remission of more than six months duration, as compared to 24% of controls.  Remission started within the first three weeks of following the diet (Henz and Zuberbier, 1998).

• Researchers have also identified a potential link between H. pylori infection and chronic hives, though the data are still conflicting (Wedi and Kapp, 1999). Make sure to have your doctor test for this possibility.

• One very interesting study attempted to determine the most frequent food allergy skin reactions in children, and to find the most frequently involved foods. Researchers reported that certain food allergens are frequently responsible for specific skin manifestations. The foods that most commonly cause allergic skin reactions are fish, egg and milk. About half of the children who developed atopic dermatitis were sensitive to fish, half of the children with angioedema were sensitive to eggs, and half of the children with hives were sensitive to milk (Oehling et al., 1997).

• In a three-year trial, researchers gave 279 infants an allergy-prevention regimen and compared them to a control group of 80 infants. The regimen included prolonged breast milk feeding, hypoantigenic weaning, and protection against adult smoking. Researchers reported that “The incidence of allergic manifestations was much lower in the intervention group than in the non-intervention group at 1 year (11.5 versus 54.4%, respectively) and at 2 years (14.9 versus 65.6%) and 3 years (20.6 versus 74.1%)” (Marini et. al., 1996).

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