257: Itchiness + Histamine Intolerance - Why Am I Itchy?

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Most people assume that itchiness means there’s too much histamine in their bodies.

This assumption is often very wrong leading people to take anti-histamine medications that they will admit don’t help much.

If this hits home, you’ll be shocked to know that there are many different reasons (or hidden root causes) that can drive itch that often isn’t explored in conventional dermatology.

So if you’re frustrated that nothing seems to help that awful itch, you’re in the right place!

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In this episode:

  • MYTH-BUSTING – itchiness + histamine intolerance
  • Common meds + supplements used to stop itch
  • What happens when these options don’t work?
  • Different itch triggers (that have nothing to do with histamine)
  • What about chronic hives + dermatographia?

Quotes:

If itchiness were solely triggered by histamine, then the medications and even potentially the supplements would help.

Itchiness is associated with higher levels of IL-31 in the body (especially in those with eczema, urticaria, and prurigo nodularis).

 

Woman scratching itchy skin on arm

257: Itchiness + Histamine Intolerance – Why Am I Itchy? (FULL TRANSCRIPT)

Welcome back to episode #257 of the Healthy Skin Show!

In today’s episode, I want to debunk a pervasive myth in the skin rash community – namely that itchiness means that you have high histamine levels (or even a histamine intolerance).

Itchiness (especially when it gets worse at night) can be highly detrimental to your quality of life.

It can also determine how much mechanical damage (via scratching) can get done to your skin potentially resulting in scrapes, scratches, cuts and even wounds that then can be open to infection.

Often, clients and participants of my Skin Rash Rebuild program think that because they’re itchy, they must have a histamine problem.

But after working with so many clients all over the world, I can tell you that being itchy doesn’t mean you’re histamine intolerant.

It also means that anti-histamine medications and even supplements for supporting histamine won’t necessarily help.

For many, this comes as a real surprise, but also makes sense for people who never found much relief from prescribed anti-histamines.

This is because itchiness can be caused by so many different factors that have nothing to do with allergies or histamine.

So let’s talk about why this is and what else could be going on!

 

Woman scratching her itchy arm

Itching-Histamine Intolerance Connection

If you’ve thought all this time that being itchy should be helped (or solved) by taking an anti-histamine medication, you’re not alone.

Itchiness (especially when you’re dealing with chronic skin problems like eczema, psoriasis, dandruff + rosacea) is often treated with over-the-counter or even prescription anti-histamine medications.

The list includes medicines such as Singulair (also known under its generic name, Montelukast), Zyrtec, Benedryl, Claritin, Allegra, and more.(1)

Then there are other meds commonly used in addition to these when itchiness isn’t well-controlled such as Famotidine (also know as Pepcid). This medication is typically prescribed or used over-the-counter to help with GERD or heartburn, but also is considered an anti-histamine as well (H2 blocker).

One very common complaint that I repeatedly hear from private clients is that anti-histamine drugs don’t really help (even taking them more than once a day or taking more than one medication).

And there are times when even more natural options like Quercetin and other supplements for histamine support aren’t helpful either.

So – if itchiness were solely triggered by histamine, then the medications and even potentially the supplements would help.

But what does it mean when they don’t?

This is the question that got me thinking deeper about the assumption that itch is a histamine problem.

As I reviewed more and more cases, I came to see that while it’s certainly important to consider itch and how intense it is, it can’t be used AT ALL as a sign of histamine overload.

 

Woman thinking about what drives her itchiness

What Drives Itch?

So what drives itch then if not histamine?

This is a complicated question that has answers that may not have been explored by your doctor.

And my opinion on this topic was reinforced by the presentation I saw during the Eczema Expo 2022 from Dr. Shawn Kwatra where he not only pointed out what I just shared, but also went deeper into the various science on itching.

And he explicitly noted that the non-histamine pathways for itching were a bigger problem!

I won’t do a deep dive into his presentation because Dr. Kwatra will be coming on the show to talk about this more in-depth in the coming months, but here are a few highlights:

Pain + itch stimuli experienced in the body are extremely similar.

Itchiness is associated with higher levels of IL-31 (a cytokine) in the body (especially in those with eczema, urticaria, and prurigo nodularis).(2,3)

He also mentioned in his presentation that the signal of itch could be transmitted from the gut via the vagus nerve as the result of certain microbes!

In addition to these points, my clinical experience has demonstrated that itchiness can be a sign of other underlying issues such as:

These issues will trigger itchiness that doesn’t respond to anti-histamines very well, if at all.

AND – itchiness can be a sign of a skin infection!

So you can see why the idea that “itchiness inherently means you have histamine intolerance” is a myth.

There are many different reasons why that must be ruled out, especially if the anti-histamine approach (including meds, supplements and even a low histamine diet) isn’t bringing you relief.

If you’re doctor or practitioner isn’t open to looking any further, then it’s time to start digging deeper. One really helpful tool to use is my free Skin Rash Root Cause Finder Guide to help you pinpoint some of these “hidden” root causes!

And of course, my practice works with clients struggling with these issues to identify what’s actually going on under the surface + create custom plans for you to follow. We see clients virtually from all over the world so if you’re looking for more help, you can learn more about working with us here.

 

Woman scratching her arm in bed

Exception To The Itchiness + Histamine Rule

I’ve talked a lot about itchiness and how it might not be a sign of histamine issues, but I want to clarify one thing.

If you’re struggling with chronic urticaria (aka. Hives) or dermatographia, you will experience itchiness as a sign of excess histamine.

This is because these issues are inherently a part of a concept I talk a lot about called Histamine Overload.

The itchiness experienced from hives, welts, weals, or other marks due to pressure, heat exposure, cold exposure, and other sources IS connected to histamine.

So if you’re reading this thinking that what I’m saying doesn’t make sense given your case because of hives or dermatographia – you are the exception.

Your itch is likely driven by histamine, but also could be additionally triggered by those non-histamine pathway avenues I mentioned earlier.

I hope this episode is eye-opening for you and pushes you to think outside of the box about what itchiness might mean for your case.

For too long, assumptions about chronic skin issues (and the awful symptoms that accompany them) leave people like you suffering (or feeling like a more serious medication is your only option for life).

Instead of feeling at war with your body + living in a nightmare of hellish symptoms every day, let’s start asking WHY they’re happening.

It’s okay to use tools (like meds or supplements) to help you cope with or minimize these symptoms.

But if you’re serious about making them stop (or at least way more manageable), you have to ask WHAT the symptom could be pointing towards so you can address it.

If you’ve got any questions or thoughts to share about this, leave a comment below so I can address them.

Thank you so much for tuning in, and I look forward to seeing you in the next episode!

 

Woman looking at reference books in library

REFERENCES

  1. https://www.webmd.com/allergies/antihistamines-for-allergies
  2. https://www.frontiersin.org/articles/10.3389/fmed.2021.638325/full
  3. https://www.frontiersin.org/articles/10.3389/fimmu.2019.01383/full

If itchiness were solely triggered by histamine, then the medications and even potentially the supplements would help.