Hives, Inflammation, L Casei

The following are timelines of 1) the acute hive reaction of late 2018/early 2019, and 2) yogurt consumption since I introduced it in 2011/2012 with additional notes on inflammatory reactions since then. There is a major suspicion that Lactobacillus Casei – and possibly several other strains of bacteria common in probiotics and which are also in my yogurt – might be causing the inflammatory reactions I’ve had during this time. Inflammatory reactions were very low-grade but increasingly stronger over the years, and the major reactions came after introducing probiotics in December 2018. Note: probiotics in food like yogurt will have very little of their live cultures reach the gut because most are killed in the acidic part of the upper digestive system. Probiotics, on the other hand, are designed to reach your lower gut in tact. This could very easily account for the slow build up of inflammatory conditions over many years, and the acute conditions after introduction of probiotics.

Hives and Acute Inflammation
Not discussing facial rashes here because they may or may not have had other issues related to them.

  • Began amoxicillin in mid-December. Started a probiotic at the same time to counter yeast build-up, which I’m prone to with any penicillin products.
  • Had my first hive a few days before the end of December. Each night thereafter, hives grew more plentiful and more severe.
  • Skipped the probiotic one evening to see if the hives were a reaction to it instead of the amoxicillin. Had only one tiny non-severe hive. Since the hives came every night after taking the probiotic, I figured this was what was causing the reaction.
  • Stopped the probiotic but kept taking the amoxicillin. Doc prescribed a longer dose of amoxicillin. I kept getting hives at night but very few and not too severe.
  • Began having a severe reaction to the amoxicillin since I was no longer on a probiotic. Started researching probiotics and histamine reactions, and discovered that certain probiotic strains were thought to cause histamine production in your gut. If your body was weak on the receptors that normally destroy histamine in your body, you could have a reaction like hives that mimics an allergic reaction. This is not well-studied, but I did as much research as I could and found that seven strains are suspected of doing this. Of those seven, the probiotic I was taking had five of them. Notably, my Fage yogurt – which I’ve been eating for breakfast nearly every morning since April 2012 – has three of those seven.
  • I found another good probiotic brand (J and I made sure all brands we got were tested positively for actually having what they say they have, since probiotics aren’t regulated) and got a probiotic that only contained one of the high-histamine strains, Lactobacillus Casei. This is a very common one and is in most yogurts, including mine. I was guessing that L Casei was not the one causing my issues. I picked up this probiotic and began taking it around Jan 3rd.
  • On the new probiotic, I still had minor hives most nights, the same as I’d had when I was on no probiotic at all. I began taking a Zyrtec every morning to counter the histamine reaction, and started taking the probiotic in the morning with the Zyrtec. I moved these to the morning so that I could continue to take a half-dose of Benadryl every night to help with sleep. (Since the facial rashes seemed to be mostly related to the Lunesta, which I stopped taking.) Some night I had no hives, others I had a few, but they were all very low-grade.
  • Around Jan 13th or 14th, I accidentally took one of the old probiotics and had an immediate severe hive reaction.
  • Jan 16th, I saw my ENT, who approved me to get off amoxicillin after a month-long treatment. Because I was still having hives most nights, I also got off all other medications, including the probiotic and the Zyrtec. The only medication I kept was the half-dose of Benadryl at night. Hives persisted most night, usually not too severe, but with the occasional severe night that seemed to come out of nowhere. After two weeks with no improvements, I decided to do some experiments and tracking (of course).
  • On January 28th, I took the old probiotic on purpose – but I did so in the morning instead of the evening. I didn’t take a Zyrtec. I didn’t have an immediate hive reaction like I expected. However, in the early afternoon, hundreds of tiny hives flared up all the way down my forearms, which was not a location where I usually got hives. This was a very unusual reaction and timing for a reaction, and confirmed for me that something about the old probiotic was causing hives.
  • I began taking the new probiotic again since eliminating it hadn’t seen any improvement and I knew my gut biome needed work after a month of antibiotics. I didn’t resume taking the Zyrtec. My hives continued to be sporadic at night and varying in severity.
  • On Feb 7th, I saw my doctor for follow-up. He prescribed a steroid pack because in the past, when I’ve had a hive reaction, the hives don’t stop until I’ve had a steroid pack to calm inflammation. The hives disappeared for the first three days of the treatment, then came back with a severe reaction on the fourth morning (at a time when they’d never appeared, before I’d eaten anything or even had coffee). I had to take a Zyrtec to calm them. After that, I kept taking a Zyrtec every morning per doctor’s orders, and the hives went back to the way they’d been before the steroid treatment. Note: steroid treatment was Feb 7-12
  • Around Feb 16, I added my supplements back in since they seemed unrelated to hives. Two of these were ones I’d been using for a couple years without problems. Two were added in mid-January by my Ob/Gyn, so they were added post-hive era. I have no idea if these contributed to hives or not. I got back off them Feb 24th after the next bullet entry:
  • On Feb 18th, my probiotic ran out and I opened my new one. This was the same brand but included some prebiotics, and recommended two daily instead of one. It had only the same L Casei strain of possibly-histamine-causing probiotics so I figured it was still safe. However, every other night, the hives got worse than normal. On the 23rd, I had a reaction worse than any since my accidental taking of the old probiotic in January, with  hives that were over eight inches long and itch-severe, and which didn’t go away with Zyrtec or sleeping overnight. It was probably the worse hive reaction I’ve had during this whole ordeal.
  • On Feb 24th, I once again removed all medication. The worry is that if I’d removed everything and kept them removed during/after the steroid treatment, the hives and inflammation might have gone away completely. Now I might need another steroid treatment. Additionally, either I’m severely allergic to something and can’t figure out what that is (I’ve been keeping a food/activity/contact diary in relation to hives and nothing seems to coordinate), or I’m reacting to something in my medications/probiotic. I suspect the latter since I’ve seen direct correlation in the past and the hives got worse this time with a change in the probiotic. This may or may not be related to L Casei – again, this is not well-studied. Either way, I’m now a bit over a month since I took the antibiotics, so I’m going off probiotics completely.
  • Now I need to determine if the probiotics in my yogurt are also causing a problem, if perhaps to a much smaller degree (particularly because most probiotics eaten are destroyed in the stomach before they ever get to the gut). This also might be related to histamine intolerance, which would also implicate both yogurt and probiotics.
  • August 2019: I forgot to update this – indeed the probiotics in yogurt cause worsening hives, though it’s likely the hives are due to an underlying autoimmune disorder yet to be determined. In early May, I began taking four Pepcid a day as an alternative antihistamine, and that got rid of the hives, as well as 75% of my anosmia.

Yogurt Timeline
Because my Fage yogurt contains three of the histamine-producing strains of probiotic bacteria, I decided to track this as well. I had an ah-ha moment about this on the night of the massive hive outbreak (Feb 23rd). A lot of this timeline is my best guesses based on old blog posts and photos, plus my memory, which of course can be faulty. I’ve done this my best to piece together faithfully. I’m also including information on insomnia, because that is potentially wrapped up in this.

  • September 2011: Major insomnia flares up and sticks around to present day, with periodic interruptions.
  • December 2011: Discovery of Fage flip packs, beginning to eat these as snacks though frequency of eating is unknown. Prior to Fage flip packs, I had occasional yogurt used in cooking or in place of sour cream, but it had been years since I’d found a yogurt I liked enough to eat regularly.
  • April 2012: Began eating plain Fage yogurt with my own mix-ins during my week of eating all whole foods. Prior to this, I ate Quaker Oatmeal Squares for breakfast. Continued to eat yogurt for breakfast afterwards, probably on a daily basis but it’s possible it took some time before this became a regular thing. It was definitely a regular thing by July 2012.
  • May 2012: First instance of high intensity exercise causing longterm pain and fatigue – however, this may have been related to an injury.
  • Summer 2012: Lots happening in here. I very suddenly dropped from feeling annoyed about slowed weight loss but still pretty good, to extremely depressed and grouchy about everything (early June). My insomnia, which had apparently mostly cleared up in the spring of 2012, started coming back on random nights (late June), and then in early July came back every night, so that I began taking Benadryl nightly for the first time. Strength training of any sort began to cause extreme fatigue and exhaustion that would last for days. (Somewhere in here, so did interval training, but I don’t have the exact when on that recorded.) In early July, I wrote that I was just tired and stagnant all the time (just a few days before the insomnia came back full-time).
  • October 2012: First recorded instance of high intensity exercise (not intervals or strength training) causing fatigue and soreness for an entire week. Note that the same kind of exercise wiped me out a year earlier, but only with normal muscle soreness that recovers after a day or so. There was a definite difference in my body’s reaction from 2011 to 2012.
  • June 2013: A heavy strength training program caused a major inflammatory reaction – bone and organ pain in addition to fatigue for days after any ST workout. At the time I guessed this was a gluten reaction, but the gluten-intolerance turned out to be related to a specific medication that I was not on during my reports of ST problems in June that year. In retrospect, I can see that this was an inflammation issue.
  • July 2013: I took four weeks to go completely dairy free and tracked if I had any changes in skin issues, sleep issues, and/or stomach issues. I can’t find where I have any information about this, but to the best I can recall, I didn’t see changes going off dairy or getting back on. I don’t have any concrete information on this though. However, it’s important to note that while I gave up dairy for the month, I didn’t give up yogurt, and most non-dairy yogurts add in the same live cultures that dairy yogurts add.
  • August 2013 to April 2014: I got on a medication that caused me to start having a gluten reaction, so went gluten free until the end of April 2014, when I got off said medication and discovered about a week into May that I didn’t have gluten-related issues anymore. This particular medicine (birth control) was one I’d been on many times in my life and had never caused these kinds of problems in the past. The last time I’d been on this particular birth control was around 2005/2006.
  • Summer 2014: I discovered that if I drank magnesium citrate daily, I could sleep without Benadryl for the first time in about two years. For three months, I didn’t need sleeping pills and I slept well. However, I also suddenly gained 20-25 lbs in this time. At the time, I attributed this to stress and pain that summer, however the summer/fall of 2013 had been just as painful and stressful for related reasons, and I didn’t gain anything. Wondering now if not having the Benadryl counterbalancing the histamine reaction from my daily yogurt could have allowed inflammation to cause weight gain, since inflammation is one of the major causes of weight problems?
  • August 2014: I began drinking alcohol on a more regular basis. When drinking alcohol, my weight would increase and then stay at the new high regardless of diet, exercise, calorie deficit, etc. In the years since I began drinking alcohol, I’ve discovered that if I abstain completely, my weight starts to drop after a couple weeks, and continues to drop for another couple weeks beyond that. It will then stabilize again. Alcohol is a major inhibitor of your body’s mechanisms to break down histamine, so the use of it might have contributed toward a high histamine environment in my body. This makes more inflammation, making it impossible to lose weight. This would also explain why the good weight loss benefits of removing alcohol from my diet disappear after a couple weeks, once histamine levels are more settled – they won’t continue to go down after a certain time.
  • Whole 30, Sept/Oct 2014: No dairy of any kind. No processed foods. Heavy restriction diet. No live cultures or fermented foods. I lost 12 lbs. I could not say if I felt good or not because there were a LOT of factors involved in Whole 30 that could influence how I felt in good and bad ways. No data from that is conclusive, and when I added foods back afterwards, I didn’t do it very carefully, so I have no idea what, if any, reaction I had to adding back Fage.
  • Since that Whole 30, I’ve never gone more than a week without daily Fage, usually 8-10 oz per day, with occasional days of more when I had it for both breakfast and a snack. I’ve also never been able to get rid of insomnia again. In exercise, I’ve never been able to do any strength training except yoga, never been able to do interval training at all, and struggle with any exercise that gets my heart rate up higher than moderate levels – all induce major inflammation symptoms afterwards.
  • I lost my sense of smell in Jan 2018 and had it return distorted in June 2018. In Feb 2019, discovered that clearing out inflammation via steroids returned my ability to smell properly, but that ability disappeared again with reappearance of inflammation. The distortion also lessens after taking an antihistamine.
  • Feb 25, 2019: First day without any yogurt. No yogurt again until March 10th. During that time, hives disappeared completely, though it took almost a week until that happened. Because this could have been due to either removing the yogurt or removing the probiotic, and because many of the symptoms above (like organ/bone pain) seem to be related to carbohydrate consumption rather than histamine, I decided to add yogurt back in for an experiment.
  • Experiment: Added back yogurt on March 10th. Noted an increase in insomnia, though it could be contributed to other factors. On March 13th, my fourth day of eating yogurt, I noticed a couple small marks on my skin that may have been very minor hives. I also got a stomachache after eating yogurt on the 13th. On the 14th, I had a major hive outbreak, even worse than the one on Feb 23rd. It involved a five-inch round hive on my stomach, with several dozen larger hives across my abdomen and thighs. The larger  hive kept returning, never fading completely, most recently at 3am on the 16th (I write this at 6am the 16th). To be continued. Note that since the 14th, I’ve had no more yogurt. Clearly the probiotics in the yogurt are now causing hives as well.
  • August 2019: In May, I went gluten free because of my suspected autoimmune disorder, and added yogurt back into my diet for two days – hives came back immediately. Yogurt is out at least for a long time.