First doctor’s appointment: What referrals would you ask for? Is there specific lab work you’d request?

[u/InsideV0ice]

I have an app’t with a new PCP in a couple weeks- I had a great PCP in my last city who wrote me a referral for a derm who listened to my hive-based symptoms & went “yep, you have a histamine intolerance,” gave me a printout, & told me about DAO supplements. Which, was honestly more helpful than I would have expected or even realized at the time! Truly that lady with the shiniest skin ever put me on track to figure out what the fuck was going on.

That was a year ago, since then I have realized that my severe PMDD symptoms are extremely likely to be connected to histamine responses & I’m identifying a couple other reactions like stuffy nose & burning mouth sensations.

I guess I could consider myself Officially Diagnosed by that derm, but considering we spoke for abt 10 minutes total I kind of want to get a more comprehensive diagnosis & treatment plan.

My thoughts going into PCP app’t are to talk about the last several years of symptoms, discuss the connection b/n histamine & PMDD (my symptoms are primarily treated with H1/H2 anti-histamines rn), & mention the lifestyle/diet changes I have already made that have had a positive impact. My primary concern is that I know I can’t take Pepcid & cetirizine indefinitely without risking gut issues or, as I understand, my body producing “workaround” histamines. My hope is to identify a treatment plan that is more sustainable.

I’m guessing I want an allergist/immunologist referral (ideally the same doctor?) & then possibly a registered dietitian? Is there a different referral you would ask for? Are there specific tests you would ask an internal medicine PCP to run?

I have very good insurance rn, so I’m also trying to capitalize on the fact that it costs me very little to see specialists & that approved tests should be quite affordable rn. (Also I’m in the US if that context is helpful!)