I’ve tried searching the archives regarding this but can’t find anything so I’m wondering if anyone knows the implications of using antihistamines long term?
I’ve been dealing with incredibly itchy skin (mainly on my chin, cheeks and scalp but occasionally random other places all over my body) and rosacea for awhile now. The only thing that works to relive the itch is an antihistamine (which also seems to reduce the redness in my cheeks). I’ve had allergy testing and can’t find anything that could be responsible.
I saw my GP today and he acknowledges there is a rash on my chin but can’t find anything visible in my scalp. He has also confirmed the rosacea (Does that cause itchiness??)
I’ve read up about rosacea on this forum and the advice seems to be to take an antihistamine. But I’m worried about possible long term usage of antihistamines. Are they safe?? The only other option I have is oral antibiotics (I’ve tried prescription ointments and they did not work) but I want to avoid that as my LC seems to be doing well at the moment (on phase 1 of the recovery diet) and I don’t want to jeopardise that.
Is this constant itchiness and rosacea another indication that I have mast cell issues? I tried asking my allergist about a possible Mast Cell Activation Disorder diagnosis but I was shut down and basically told that it isn’t a “real” condition. I’m so tired of doctors not listening...
Are antihistamines safe to use long term??
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
If mast cell activation disorder/histamine issues is not a real condition, then a surprisingly high percentage of the members here imagine that they itch like mad when they eat high histamine foods. We also imagine that we don't itch, when we're careful to keep our histamine level below our threshold for a reaction. I can assure you that the condition does indeed exist. Mast cell activation disorder (MCAD), or mast cell activation syndrome (MCAS) can be diagnosed by measuring the tryptase level in serum. Tryptase is an enzyme that's released along with histamine and other chemicals, from mast cells when they're activated, either by a normal immune response, or an allergic (hypersensitivity) response. Wikipedia says, "Tryptase is the most abundant secretory granule-derived serine proteinase contained in mast cells and has been used as a marker for mast cell activation."
Diamine oxidase enzyme (DAO) normally purges unused histamines from the body. This may be unique to MC patients, but MC depletes DAO, so that if we eat high-histmine foods, or otherwise provoke a histamine reaction, our histamine level builds up to intolerable levels. We itch as a reaction. If we continue to eat high-histamine foods every day, we will always itch. Some of us also develop hives and whelps instead of, or in addition to, a rash. I've been in remission for over 15 years, but I have to carefully limit high-histamine foods, or the itching will drive me crazy.
I used to take antihistamines, but now I just try to limit my histamine level by watching my diet. Antihistamines are a relatively safe medication for short or medium-term use. But there are several problems with taking antihistamines long-term. After years of use, they tend to lose effectiveness for us. There's also some evidence that long-term antihistamine use may deplete DAO (which may be why they lose effectiveness eventually). Then there's the dementia/Alzheimer's connection. Early antihistamines (generation 1 histamines) have been shown to increase the risk of old-age dementia and Alzeiheimer's disease. First-generation antihistamines include diphenhydramine (Benadryl), carbinoxamine (Clistin), clemastine (Tavist), chlorpheniramine (Chlor-Trimeton), and brompheniramine (Dimetane). Generation 2 and later generation antihistamines don't carry this increased risk.
Anyway, that's my opinion.
Tex
Diamine oxidase enzyme (DAO) normally purges unused histamines from the body. This may be unique to MC patients, but MC depletes DAO, so that if we eat high-histmine foods, or otherwise provoke a histamine reaction, our histamine level builds up to intolerable levels. We itch as a reaction. If we continue to eat high-histamine foods every day, we will always itch. Some of us also develop hives and whelps instead of, or in addition to, a rash. I've been in remission for over 15 years, but I have to carefully limit high-histamine foods, or the itching will drive me crazy.
I used to take antihistamines, but now I just try to limit my histamine level by watching my diet. Antihistamines are a relatively safe medication for short or medium-term use. But there are several problems with taking antihistamines long-term. After years of use, they tend to lose effectiveness for us. There's also some evidence that long-term antihistamine use may deplete DAO (which may be why they lose effectiveness eventually). Then there's the dementia/Alzheimer's connection. Early antihistamines (generation 1 histamines) have been shown to increase the risk of old-age dementia and Alzeiheimer's disease. First-generation antihistamines include diphenhydramine (Benadryl), carbinoxamine (Clistin), clemastine (Tavist), chlorpheniramine (Chlor-Trimeton), and brompheniramine (Dimetane). Generation 2 and later generation antihistamines don't carry this increased risk.
Anyway, that's my opinion.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I agree Tex. I’m convinced I have a histamine issue. I’m itchy all the time, even though I’m only eating a very limited range of food (as per phase 1 of the recovery diet). The only thing that might be considered high histamine though is banana and I follow your recommendations with that (freezing them when they’re just ripe and eating them virtually straight from the freezer). So I can’t see what foods might be contributing in my current diet.
As far as tryptase levels go - I’ve been tested twice and my levels are normal. My understanding though is that baseline tryptase levels really only confirm mastocytosis not MCAD/MCAS (unless you’re in the middle of an acute flare and the test is taken within 2 hours of symptom onset and then compared to a baseline test).
I’ve made an appointment with a naturopath who specialises in treating histamine intolerance. I’ll see if she is able to help me as I really don’t want to be reliant on antihistamines as the only thing that gives me relief from the itching.
Thanks again Tex.
Sarah
PS. I’m guessing I take a generation 2 antihistamine as what I use wasn’t listed in your first generation list - I use Claratyne (I think it’s called Claritin in America).
As far as tryptase levels go - I’ve been tested twice and my levels are normal. My understanding though is that baseline tryptase levels really only confirm mastocytosis not MCAD/MCAS (unless you’re in the middle of an acute flare and the test is taken within 2 hours of symptom onset and then compared to a baseline test).
I’ve made an appointment with a naturopath who specialises in treating histamine intolerance. I’ll see if she is able to help me as I really don’t want to be reliant on antihistamines as the only thing that gives me relief from the itching.
Thanks again Tex.
Sarah
PS. I’m guessing I take a generation 2 antihistamine as what I use wasn’t listed in your first generation list - I use Claratyne (I think it’s called Claritin in America).
Hi Nancy,
The generation 2 antihistamines include fexofenadine (Allegra), loratadine (Claritin), and cetirizine (Zyrtec).
Tex
The generation 2 antihistamines include fexofenadine (Allegra), loratadine (Claritin), and cetirizine (Zyrtec).
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Sarah,
Your understanding of mast cell/histamine issues in general (including tryptase testing) appears to be right on target. You have to remember that we're all different, so we have different sensitivity levels.
I find that I can eat a small banana or 1/2 a large one in the morning (with almond or cashew butter), and an equal amount in the afternoon without any histamine issues. If I eat an additional 1/2 banana during the same day, I'll probably have a rash or a few hives show up before I go to bed, especially if I take a hot shower that night. So my tolerance threshold of bananas is rather low. And once I have a reaction it usually takes several days for it to settle down.
In the U. S., the only allergists (MD's) who are able to understand and successfully treat mast cell/histamine issues in MC patients, are those trained by Dr Maria C. Castells, at the Brigham and Women's hospital in Boston. I know virtually nothing about naturopath qualifications in the U. S., and I have no idea where (or even if) any qualified allergists (MD's) are available in Australia. So you might get better results with the naturopath you have selected. I'd be surprised if she can suggest anything more effective than antihistamines, though.
Are you aware that (in the U.S., at least) allergists often prescribe 3 or 4 antihistamine doses per day, for several months, when trying to treat patients who have severe, chronic itching?
Tex
Your understanding of mast cell/histamine issues in general (including tryptase testing) appears to be right on target. You have to remember that we're all different, so we have different sensitivity levels.
I find that I can eat a small banana or 1/2 a large one in the morning (with almond or cashew butter), and an equal amount in the afternoon without any histamine issues. If I eat an additional 1/2 banana during the same day, I'll probably have a rash or a few hives show up before I go to bed, especially if I take a hot shower that night. So my tolerance threshold of bananas is rather low. And once I have a reaction it usually takes several days for it to settle down.
In the U. S., the only allergists (MD's) who are able to understand and successfully treat mast cell/histamine issues in MC patients, are those trained by Dr Maria C. Castells, at the Brigham and Women's hospital in Boston. I know virtually nothing about naturopath qualifications in the U. S., and I have no idea where (or even if) any qualified allergists (MD's) are available in Australia. So you might get better results with the naturopath you have selected. I'd be surprised if she can suggest anything more effective than antihistamines, though.
Are you aware that (in the U.S., at least) allergists often prescribe 3 or 4 antihistamine doses per day, for several months, when trying to treat patients who have severe, chronic itching?
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Re: Are antihistamines safe to use long term??
Typically in the past, I have taken Zyrtec in the spring and fall months only. I am noticing it is harder to come off of it every year. I always go into a flare for a week or so after I stop Med. Right now I am having a hard time going without it due to the itching. The itching is driving me crazy along with sinus headaches. I am trying to clean up my diet in hopes that will help. I always watch high histamine foods and cannot eat any banana.
Tex, do you take the multi-vitamin in addition to your other supplements specifically copper/zinc?
I really need to supplement more as I am hoping this maybe causing my increased histamine intolerance. I would prefer it in one vitamin if I can tolerate it. I will still continue magnesium and vitamin d3 supplementation too.
So hope you find what works for you!! Please share if your nutritionist can shed any light on the subject as well!!
Thank you,
Martha
Tex, do you take the multi-vitamin in addition to your other supplements specifically copper/zinc?
I really need to supplement more as I am hoping this maybe causing my increased histamine intolerance. I would prefer it in one vitamin if I can tolerate it. I will still continue magnesium and vitamin d3 supplementation too.
So hope you find what works for you!! Please share if your nutritionist can shed any light on the subject as well!!
Thank you,
Martha
Martha E.
Philippians 4:13
Jul 2008 took Clindamycin for a Sinus infection that forever changed my life
Dec 2014 MC Dx
Jul 15, 2015 Elimination Diet
Aug 17, 2015 Enterolab Test
Dec 2015 Reflux
Sept 2016 IC
Philippians 4:13
Jul 2008 took Clindamycin for a Sinus infection that forever changed my life
Dec 2014 MC Dx
Jul 15, 2015 Elimination Diet
Aug 17, 2015 Enterolab Test
Dec 2015 Reflux
Sept 2016 IC
Re: Are antihistamines safe to use long term??
Martha,
Yes, I take Centrum Silver, a zinc/copper capsule, and lotsa other vitamins. But I still have histamine issues if I eat any significant amount of high-histamine foods, especially if there's any other allergy in season. For example, mountain cedar dumps a lot of pollen during December, January, and February, I'm about to do a couple of trials with DAO supplements. Have you ever tried that option?
Tex
Yes, I take Centrum Silver, a zinc/copper capsule, and lotsa other vitamins. But I still have histamine issues if I eat any significant amount of high-histamine foods, especially if there's any other allergy in season. For example, mountain cedar dumps a lot of pollen during December, January, and February, I'm about to do a couple of trials with DAO supplements. Have you ever tried that option?
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Re: Are antihistamines safe to use long term??
Thank you Tex for your response!
I have been reading about those DAO supplements. I definitely need to try them. I still only take d3 and magnesium daily. I take B complex when the kids are back in school. If I don't take it very early in the morning, it keeps me up all night. I took copper for a month when I found out I was low in it and have since then been tested to be within normal levels. I worry about taking too much of it. I guess I should continue it. I do take zinc, but not on a daily basis. I have ordered quercetin because I read where that was recommended for COVID prevention in addition to zinc and d3. I haven't received it yet though. I prefer to take liquid or easy melt supplements because I can put them under my tongue, and they don't seem to bother me as bad.
I have started to go through the change and wonder if that is also contributing to my increased histamine intolerance. I read where lack of estrogen can cause an imbalance of copper/zinc in your body. I was borderline low in vitamin K, B2, and B5. I need to get those levels up.
Let me know how well the DAO supplements work if you try them. I have ordered a multi-vitamin and pray I can take it well! While I was on the antihistamine, I ate a bigger variety of foods and thought I was getting enough vitamins, but probably still not.
Martha
I have been reading about those DAO supplements. I definitely need to try them. I still only take d3 and magnesium daily. I take B complex when the kids are back in school. If I don't take it very early in the morning, it keeps me up all night. I took copper for a month when I found out I was low in it and have since then been tested to be within normal levels. I worry about taking too much of it. I guess I should continue it. I do take zinc, but not on a daily basis. I have ordered quercetin because I read where that was recommended for COVID prevention in addition to zinc and d3. I haven't received it yet though. I prefer to take liquid or easy melt supplements because I can put them under my tongue, and they don't seem to bother me as bad.
I have started to go through the change and wonder if that is also contributing to my increased histamine intolerance. I read where lack of estrogen can cause an imbalance of copper/zinc in your body. I was borderline low in vitamin K, B2, and B5. I need to get those levels up.
Let me know how well the DAO supplements work if you try them. I have ordered a multi-vitamin and pray I can take it well! While I was on the antihistamine, I ate a bigger variety of foods and thought I was getting enough vitamins, but probably still not.
Martha
Martha E.
Philippians 4:13
Jul 2008 took Clindamycin for a Sinus infection that forever changed my life
Dec 2014 MC Dx
Jul 15, 2015 Elimination Diet
Aug 17, 2015 Enterolab Test
Dec 2015 Reflux
Sept 2016 IC
Philippians 4:13
Jul 2008 took Clindamycin for a Sinus infection that forever changed my life
Dec 2014 MC Dx
Jul 15, 2015 Elimination Diet
Aug 17, 2015 Enterolab Test
Dec 2015 Reflux
Sept 2016 IC
Re: Are antihistamines safe to use long term??
It surely might. There's a heck of a lot that we don't know about hormones, and how they affect allergies, intolerances, and the immune system responses to them.Martha wrote:I have started to go through the change and wonder if that is also contributing to my increased histamine intolerance.
I'll post my results about the DAO supplements, good or bad. I intend to try two different kinds, one that also contains a lot of other (supposedly supporting) ingredients (HistaResist), and one that contains only a DAO supplement (derived from porcine kidney protein concentrate — but it also contains ascorbic acid and corn starch). I took my first one (HstaResist) about a half-hour ago, and then ate a bunch of Fritolay Cantina Style Tostitos, which usually cause me to develop a very itchy rash on my lower legs and feet by 8–12 hours later. We'll see how it goes. If the chips work, I may have to add some picante sauce next time — that always causes a mega-rash.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Re: Are antihistamines safe to use long term??
Martha,
These are the two DAO supplements that I'm testing:
https://www.amazon.com/HistaResistTM-Hi ... B07RQ56JQ5
https://www.amazon.com/Hist-Diamine-His ... B01BMWD9QQ
The first one costs $0.50 per capsule, and the dose is two capsules no more than 15 minutes before a meal that contains high-histamine foods for a total cost of $1.00 per meal.
The second one costs $1.22 per capsule and the dose is one to two capsules no more than 15 minutes before a meal that contains high-histamine foods, for a total cost of $1.22 to $2.44 per meal.
I took one capsule of the first one before lunch with big servings of corn chips yesterday and corn chips with picante sauce today. So far, so good.
Tex
These are the two DAO supplements that I'm testing:
https://www.amazon.com/HistaResistTM-Hi ... B07RQ56JQ5
https://www.amazon.com/Hist-Diamine-His ... B01BMWD9QQ
The first one costs $0.50 per capsule, and the dose is two capsules no more than 15 minutes before a meal that contains high-histamine foods for a total cost of $1.00 per meal.
The second one costs $1.22 per capsule and the dose is one to two capsules no more than 15 minutes before a meal that contains high-histamine foods, for a total cost of $1.22 to $2.44 per meal.
I took one capsule of the first one before lunch with big servings of corn chips yesterday and corn chips with picante sauce today. So far, so good.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Re: Are antihistamines safe to use long term??
Tex,
I am keeping my fingers crossed for you!! I will probably be back on zyrtec soon, sadly. The itching is relentless at night. I received the quercetin today, I only took a drop as opposed to the required amount. Below is the one that I bought. I am going to start slowly. I am still waiting on the multi-vitamin melts.
https://www.amazon.com/gp/product/B08C4 ... UTF8&psc=1
Thank you so for letting me know about your progress!! I am so glad you posted the ones you took. I researched all night trying to find out which to try. That price is not too bad at all, especially if it helps!
Martha
I am keeping my fingers crossed for you!! I will probably be back on zyrtec soon, sadly. The itching is relentless at night. I received the quercetin today, I only took a drop as opposed to the required amount. Below is the one that I bought. I am going to start slowly. I am still waiting on the multi-vitamin melts.
https://www.amazon.com/gp/product/B08C4 ... UTF8&psc=1
Thank you so for letting me know about your progress!! I am so glad you posted the ones you took. I researched all night trying to find out which to try. That price is not too bad at all, especially if it helps!
Martha
Martha E.
Philippians 4:13
Jul 2008 took Clindamycin for a Sinus infection that forever changed my life
Dec 2014 MC Dx
Jul 15, 2015 Elimination Diet
Aug 17, 2015 Enterolab Test
Dec 2015 Reflux
Sept 2016 IC
Philippians 4:13
Jul 2008 took Clindamycin for a Sinus infection that forever changed my life
Dec 2014 MC Dx
Jul 15, 2015 Elimination Diet
Aug 17, 2015 Enterolab Test
Dec 2015 Reflux
Sept 2016 IC
Re: Are antihistamines safe to use long term??
I repeated yesterday's test today. Still no symptoms at half the recommended dose. I'm letting some bananas fully ripen, so I can try them in another day or so.
Tex
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.