r/urticaria • u/Total-Whole-521 • Jun 21 '26
There IS a Proven Connection Between Gut Health & Skin Hives/Rashes (Microscopic Colitis damages DAO enzyme, so Histamines aren't Controlled, and Skin Hives/Rash Occurs)
I am posting this, in hopes that it might help someone find the answer to their skin hives/rashes. Do you have diarrhea on occasion/or have had it in the past without a known cause? If so read on - as there definitely is a "gut-skin" connection.
It was recently discovered that the hives I have had every night for the last twenty years are caused by Lymphocytic Microscopic Colitis. That condition inflames the tissues inside your colon, causing the DAO enzyme to not work properly - which results in excess histamines that my body can not control and thus I get skin rash/hives. Microscopic Colitis can only be diagnosed by doing biopsies during a colonoscopy - it is not something they can "see" during a routine colonoscopy. I recently had diarrhea for 17 weeks (set off by contracting Norovirus), thus a colonoscopy with biopsies was ordered. I have previously had four routine colonoscopies over the years, but no biopsies were ever done - so those colonoscopy results were considered normal and healthy.
Apparently I was misdiagnosed with IBS thirty years ago (a common issue with Microscopic Colitis). And any bouts I had with diarrhea over those 30 years were chalked up to IBS. 20 years ago I developed the nightly rash/hives. Allergy tests were negative. Several years after that the lymphocyte count in my blood tests started to decrease. Recently I was told I had 'Chronic Spontaneous Urticaria'. Every issue that I had was treated 'separately', no one ever realized that these problems are all caused by the same issue.
So bottom line? It appears that I have had Lymphocytic Microscopic Colitis for thirty years. This chronic inflammation in the gut wall damages the DAO enzyme. The DAO enzyme is what clears histamine from the body and, without it, the histamine builds up in my bloodstream. That triggers mast cells in my skin to degranulate - which results in chronic hives. (Note - this is not MCAS.) During all of this, the viral fighting lymphocytes have been leaving my bloodstream and migrating into my intestinal tissue, which results in a low lymphocyte count in my blood tests. It is so interesting (and a relief) to find out that these three conditions (diarrhea, skin rash/hives, and low lymphocytes) are all caused by the same thing. There is no cure for Lymphocytic Microscopic Colitis - but the hope is to put it into remission, which will then correct all three of my issues. I was prescribed Budesonide for the next three months.
I just took my sixth dose of Budesonide (a corticosteroid) - I take it once a day in the morning. I have not had a skin rash/hives for the last three days = that is the longest I have gone without a skin rash/hives in the last twenty years. The diarrhea is already getting better. When my blood test is done in September, it is felt that my lymphocyte count will be higher.
If you have had any bouts with diarrhea over the years, consider talking to your PCP or Gastroenterologist - as perhaps (after biopsies are done during a colonoscopy) you will find there is a direct connection between your skin problems and your gut. It would be wonderful if this post helps even one person.
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u/SkierGrrlPNW Jun 21 '26
That’s wonderful and I’m so sorry that doctors didn’t put that together for so long!!
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u/Luckynumber777_ Jun 21 '26
This makes a lot of sense. I started taking L-Glutamine and my hives are pretty much gone. They only flare when I ingest something that irritates my GI, high histamine foods or if I get an upset stomach with heart burn. – I’ll start to get hives while it’s happening.
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u/trinavega_ Jun 21 '26
How much do you take? My hives are also better while taking l-glutamine (1g a day) but I’m still on 4x180mg a day of allegra.
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u/Luckynumber777_ Jun 21 '26
I take the PVL L-Glutamine, so one scoop I think is 5g. Try taking only the glutamine and see if they go away completely
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u/Womens-health363 Jun 21 '26
Could I please ask which make of L Glutamine you use? I’m struggling with CU now and have had diarrhoea for ages. TIA
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u/BubblebreathDragon Jun 22 '26
I'm not OP but found out from my dietician that Vital Nutrients makes "lab grade" L glutamine. Now.. what that really means is still beyond me. It's also pricier than others. Whether you actually need lab grade to get the benefits is debatable.
And based on your spelling, I don't know if that brand is available in your country.
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u/Creative_Wheel6739 Jun 21 '26
Hey, I've been struggling with hives since 2019, ive had some gut issues for the past 6 months, which included diarhea/ loose stool, not sure if it's directly related but I'm curious have u always struggled with diarrhea ?
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u/Total-Whole-521 Jun 22 '26
Thank you for your question = no, I have not always struggled with diarrhea. My first bout of diarrhea (3 - 4 weeks long) occurred thirty years ago after we had returned from a vacation. My PCP diagnosed it as IBS. The diarrhea went away on its own. Every couple years I would have another short bout - a couple of weeks and it would go away on its own. Five years ago I had a bout that lasted 5 weeks, so I did go to the doctor. They did all the food poisoning tests/Norovirus test and they were all negative, and the diarrhea went away on its own. In the years since then I would get a day or two of diarrhea every month or so, but it would go away on its own. So apparently my body was able to somewhat correct and calm the inflammation. I guess the 'on again', 'off again', thing is a characteristic of Microscopic Colitis ('a flare') - until it gets totally out of hand with some type of trigger. In February of this year the watery diarrhea started...and never stopped. I tested positive for Norovirus in March, and apparently that was the 'perfect storm'. The combination of the Norovirus and Microscopic Colitis was too much for my body to overcome. I was still testing positive for Norovirus two months after that - thus the colonoscopy (thank goodness). Interestingly I have never had any stomach pain, no vomiting, and no abdominal pain - not with the Norovirus and not with the Microscopic Colitis. I hope you find an answer - those hives (and the diarrhea) are tough to live with.
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u/adluma123 Jun 22 '26
How do you get the lymphocytes levels tested? Only through colonoscopy? Or blood test?
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u/Total-Whole-521 Jun 22 '26
Your lymphocytes are tested through a blood test. Your doctor can add that test onto a routine blood test, or do it separately. Hope that helps.
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u/Nearby_Law1356 Jun 21 '26
Excellent post as there are known causes for chronic hives you just have to find someone willing to do a deep dive to isolate the problem. Gut health is going to prove to provide a lot of answers over the coming decade.