Chronic urticaria will not be cured for a long time, please keep the list of taboos

First avoid three types of high-risk foods that have been proven by evidence-based medicine to aggravate symptoms, and then adjust personalized taboos based on your own body constitution and attack patterns. There is no need to starve yourself to the point of losing weight and slowing down your recovery.

A while ago, I saw a 25-year-old girl who had suffered from chronic urticaria for 3 years. The elders at home told me to avoid all "fatty foods" and even boiled pork and cabbage with water. She lost 18 pounds in half a year, but the rash still appeared when it happened. Last week, after eating half a piece of mango, it swelled into a "sausage mouth". She came to me crying and asked me if she would never be able to eat normally again in this life. In fact, there is never a "one-size-fits-all" list of taboos for slow nettle, whether it is Western medicine or traditional Chinese medicine. Different schools have different concerns, and a combination of them will produce better results.

Allergists in Western medicine generally believe that less than 10% of chronic spontaneous urticaria is directly related to food allergy, and most attacks are related to factors such as autoimmune disorders, chronic infections (such as Helicobacter pylori, periodontitis), long-term stress, and temperature stimulation. Therefore, the core of taboos is to avoid foods that can induce the release of histamine or have extremely high histamine content. After all, the core mechanism of urticaria outbreaks is the massive release of histamine in the skin and mucous membranes. Of course, if you take antihistamine medicine and eat high histamine foods at the same time, it will certainly not get better. For example, leftovers that have been stored for several days, deep-sea fish that have been frozen for more than a week (tuna, sardines, saury, etc.), fermented foods (cheese, fermented bean curd, natto, pickles), and things like pineapple, kiwi, and unripe bananas. Fruits that promote the release of histamine are recommended to be avoided during an attack, no matter what your physical condition is. I have seen many patients who had already controlled their symptoms well, but after a late-night meal of kimchi hotpot, they relapsed and went to the emergency room. There are also artificial colors, preservatives, and flavorings in processed foods, especially aspartame and sodium benzoate. Many people don’t pay attention and eat bagged snacks and prepared dishes every day, which offsets most of the effects of taking medicine. I once met a young man who had an attack every time he drank fresh lemon water from a milk tea shop. He thought he was allergic to lemons. Later, he tried soaking lemons from his own home and found that he was fine. Only then did he realize that the lemons from the milk tea shop had been soaked with preservatives and had stepped on the trap of additives. You think it was unfair or not.

But if you say that all seafood, beef, mutton, eggs, and milk cannot be eaten, Western medicine will not recognize it. As long as you don’t have more rashes or worsened itching within 24 hours after eating, you can eat normally. On the contrary, blind taboos can lead to malnutrition and reduced immunity, which will make immune disorders more serious and rashes more frequent. If you are really unsure, just keep a food diary for a week. What you ate, how much you ate, and whether you had an attack that day. It’s more effective than anything else.

Traditional Chinese medicine's understanding of the taboos for chronic urticaria is more focused on constitution syndrome differentiation. What we often refer to as "hair-producing foods" actually refers to foods that can stir wind, generate heat, and aggravate evil spirits in the body, such as tropical high-sugar fruits such as lychees, durians, and mangoes, as well as alcohol, spicy and heavy-fat foods. Most people will indeed aggravate itching and redness after eating them, especially those who have a damp-heat constitution, are prone to acne, and have bitter mouth and bad breath. It is best to avoid these things. But if you have a cold constitution that is usually afraid of cold, has cold hands and feet, and has loose stools, eating some beef and mutton appropriately can replenish the body temperature and yang, which is good for recovery, so there is no need to avoid it at all.

I usually give advice to the patients I consult on two types of situations: one is to try not to touch them regardless of their physical condition during the attack, including processed snacks and pre-made dishes that contain a lot of artificial additives, leftovers that have been stored for more than 12 hours, deep-sea fish that have been frozen for more than a week, various fermented foods, as well as alcoholic and spicy things. The probability of being tripped by these is too high, so there is no need to try them. The other type is to avoid all foods without using them, such as seafood, beef, mutton, eggs, milk, mangoes, pineapples, etc. You can try it once by yourself. If it doesn’t get worse within 24 hours, eat it normally. If the itching is severe after eating it, stop temporarily for 3 months, and then try a small amount.

Finally, I would like to remind everyone that taboos are really just a means of auxiliary treatment. Don’t put all your hopes on taboos. I have met many patients who refused to take medicine, so they tried to cure the disease by relying on dietary taboos. However, it took five or six years for the disease to come back again and again, which was completely unnecessary. Nowadays, regular antihistamines are very safe. If you take them according to the doctor's advice, and cooperate with scientific diet adjustments and regular work and rest, most people can control it very well in about half a year, and they don't have to worry about not being able to eat every day.