Following a Healthy Diet with Chronic Hives

Reviewed by: HU Medical Review Board | Last reviewed: November 2022

When you are in the middle of incredibly frustrating itching and swelling, it can be tempting to reach for anything that promises relief from chronic hives. Many well-meaning friends and loved ones may suggest changes to your diet. However, there is not enough evidence of the benefits of diet changes to control chronic hives.

Certain diets may be useful to try as an added treatment for chronic hives. However, diet changes should not replace medicines suggested by your doctor. Diet changes alone will not treat chronic hives. Consider consulting with a registered dietician if your doctor suggests any diet changes.

Can diet changes reduce symptoms of chronic hives?

If you want to try a diet to control your symptoms, talk to your doctor. They may suggest trying a low-histamine diet or a pseudoallergen-free diet. Some people report benefits of these diets, but experts say they are controversial and unproven. Sticking to these diets can be hard and may make it difficult to get enough nutrients to stay healthy.1,2

Overall, a well-balanced diet with enough nutrients is the best way to maintain overall health. If you do want to try one of these diets, work with your doctor. They can help make sure you still get enough nutrients and monitor your symptoms to see if the diet is helping. You will need to try the diet for at least 2 to 3 weeks to see benefits.3

It is very rare for an unknown food allergy to cause your symptoms. Food reactions are not a cause of chronic hives. This is why testing for food allergies is usually not necessary. However, certain foods may trigger chronic hives symptoms without being a true allergy. Eliminating these foods may reduce symptoms.2,3

Pseudoallergen-free diet

Pseudoallergic reactions are not a true allergy. They are hypersensitivity reactions to substances called pseudoallergens. Examples of potential pseudoallergens include:4

  • Some natural compounds in fruits, spices, and vegetables
  • Food additives, such as dyes, preservatives, and flavorings
  • Compounds that affect blood vessels, such as histamine and nitric oxide

A pseudoallergic reaction to these substances may worsen hives for some people. This means avoiding them may help reduce symptoms. A pseudoallergen-free diet consists of only fresh foods and avoids:3,4

  • Most food additives
  • All spices besides salt and chives
  • Eggs and many egg products
  • Smoked meats and seafood
  • Many vegetables, including tomatoes, artichokes, mushrooms, and spinach
  • Fresh and dried fruits
  • Breads with additional grains or herbs
  • Alcohol
  • Herbal teas
  • Candy

If you want to try a pseudoallergen-free diet, your doctor may suggest you first try an elimination diet. This means you will eliminate potential pseudoallergens from your diet one at a time. This can help you identify which ones worsen symptoms and which ones are fine to include in your diet.4

Studies have shown that a pseudoallergen-free diet improves symptoms for some people with chronic hives. However, the benefits vary across studies. None of these studies are conclusive because they lack a placebo control group. Even still, the diet can be an option to try with supervision from your doctor.4,5

Low-histamine diet

Histamine is a chemical released from certain immune cells. It leads to symptoms of allergies and chronic hives. Drugs called anthistamines work by blocking histamine. This is why they are very effective treatments for chronic hives.4

Certain foods contain high levels of histamine. These include:4

  • Seafood, depending on storage conditions
  • Fermented foods, such as aged cheese and dry sausage
  • Some plant foods, such as tomatoes, eggplant, spinach, and avocado

Avoiding these foods as part of a low-histamine diet may improve symptoms of chronic hives. Small studies have shown positive results with a low-histamine diet.4-7

Beneficial nutrients

The diets discussed above mention foods and substances to avoid. But there are also some foods and nutrients that are thought to help people with chronic hives. These include foods that are low in histamine, such as:4

  • Many vegetables
  • Fresh meat
  • Bread and pasta
  • Rice
  • Dairy products other than cheese and yogurt

People with chronic hives seem to have very low levels of vitamin D. Vitamin D is found in a small number of foods, such as oily fish and red meat. Some foods are also fortified with vitamin D, such as cereals. You can also take vitamin D supplements. Small studies have shown that vitamin D supplements can improve symptoms of chronic hives.3,4

Celery juice has reported benefits for chronic hives. It can provide a variety of vitamins and antioxidants while keeping you hydrated. It also may help reduce inflammation, which can help in chronic hives.8

Before making any changes to your diet, talk to your doctor.

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