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Hives

Hives (urticaria) is an allergic reaction in the skin characterized by white or pink welts or large bumps surrounded by redness.

These welts are known as wheal and flare lesions and are caused primarily by the release of histamine (an allergy mediator) in the skin. About 50% of people with chronic hives develop angioedema—a deeper, more serious form of hives involving the tissue below the surface of the skin.

While the basic cause of hives involves the release of histamine from white blood cells, what actually triggers this release can be a variety of factors, such as physical contact or pressure, heat (prickly heat rash), cold, water, autoimmune reactions, infectious organisms (e.g., hepatitis B virus, Candida albicans, and streptococcal bacteria), and allergies or sensitivities to drugs (especially antibiotics and aspirin), foods, and food additives.

 

Rating Nutritional Supplements Herbs
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Betaine HCl
Vitamin B-complex
Vitamin B12
Vitamin C


Reliable and relatively consistent scientific data showing a substantial health benefit.

Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.


What are the symptoms of hives?

Symptoms include an itchy skin rash with red bumps that can appear on the face, trunk of the body, and, sometimes, on the scalp, hands, or feet. Individual lesions usually last less than 24 hours and can change shape, fade, and then rapidly reappear. People with hives may also have wheezing, or swelling of the eyelids, lips, tongue, or throat.

Dietary changes that may be helpful for hives

Allergy to foods and food additives is a common cause of hives, especially in chronic cases.1 The foods most often reported to trigger hives are dairy products, eggs, chicken, cured meat, alcoholic beverages, chocolate, citrus fruits, shellfish, and nuts.2 3 4 Food additives that have been shown to trigger hives include colorants (azo dyes), flavorings (salicylates), artificial sweeteners (aspartame), preservatives (benzoates, nitrites, sorbic acid), antioxidants (hydroxytoluene, sulfite, gallate), and emulsifiers/stabilizers (polysorbates, vegetable gums).5 6 7 Numerous clinical studies demonstrate that diets that are free of foods or food additives that commonly trigger allergic reactions typically produce significant reductions in symptoms in 50–75% of people with chronic hives.8 9 10 11 People with hives not clearly linked to a known cause should discuss the possibility of food allergies with a doctor.

Nutritional supplements that may be helpful for hives

In theory, high amounts of vitamin C might help people with hives by lowering histamine levels.12 Amounts of at least 2,000 mg daily appear necessary to produce these effects.13 No research trials have yet explored the clinical effects of vitamin C supplementation in people with hives.

Vitamin B12 has been reported to reduce the severity of acute hives as well as to reduce the frequency and severity of outbreaks in chronic cases.14 15 The amount used in these reported case studies was 1,000 mcg by injection per week. Whether taking B12 supplements orally would have these effects remains unknown. On rare occasions, vitamin B12 injections cause hives in susceptible people.16 Whether such reactions are actually triggered by exposure to large amounts of vitamin B12 or to preservatives and other substances found in most vitamin B12 injections remains unclear.

According to preliminary studies from many years ago, lack of hydrochloric acid (HCl) secretion by the stomach was associated with chronic hives, presumably as a result of increasing the likelihood of developing food allergies. In one such study, 31% were diagnosed as having achlorhydria (no gastric acid output), and 53% were shown to be hypochlorhydric (having low gastric acid output).17 In a related study, treatment with an HCl supplement and a vitamin B-complex supplement helped to treat people with hives.18 Betaine HCl is the most common hydrochloric acid-containing supplement; it comes in tablets or capsules measured in grains or milligrams. One or more tablets or capsules, each containing 5–10 grains (325–650 mg) are typically taken with a meal that contains protein. Diagnosis of a deficiency of HCl and supplementation with HCl should be supervised by a doctor.

Are there any side effects or interactions with hives?

Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful for hives

Two components of green tea, the polyphenols epigallocatechin (EGC) and epicatechin gallate (ECG),19 are reported to have an antihistamine effect. Some doctors recommend approximately 3 cups of green tea per day or about 3 grams of soluble components providing roughly 240 to 320 mg of polyphenols, although no human trials have studied the effects of green tea in people with hives.

Are there any side effects or interactions with hives?

Refer to the individual herb for information about any side effects or interactions.

Holistic approaches that may be helpful for hives

Psychological stress is often reported as a triggering factor in people with chronic hives.20 Stress may play an important role by decreasing the effectiveness of immune system mechanisms that would otherwise block allergic reactions. In a small preliminary trial of people with chronic hives, relaxation therapy and hypnosis were shown to provide significant benefit.21 People were given an audio tape and asked to use the relaxation techniques described on the tape at home. At a follow-up examination 5 to 14 months after the initial session, six people were free of hives and an additional seven reported improvement.

 

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