- Posted by DanTomas
Topics discussed: Psychosomatic hives, migraines, stress response, coping strategies:
In the first part of this guide we discussed how low levels of the histamine degrading enzyme, diamine oxidase, lies at the heart of chronic idiopathic urticaria and migraines. If you have not implemented the protocol for increasing your DAO, I advise starting there first. For how to suppress an outbreak, read the addendum here.
Many of us develop the sudden onset of urticaria and migraines in adulthood without apparent cause. Doctors often send us packing with antihistamines which is akin to treating a broken leg with paracetamol. Frustratingly this class of drugs do nothing to treat the root cause, and inevitably the condition becomes chronic meaning it persists indefinitely. What has happened on a metabolic level is your body’s capacity to produce DAO has eroded leading to bouts of histamine overload which manifests as an outbreak. Once you know this you can take corrective action, and yet that is not the full story. What we are concerned with here is the missing link, the root cause of your plight.
Consider what has caused you to flip from a state of relative health into an auto immune crisis. Your genetics have not suddenly changed (leaving epigenetics to one side for the moment), rather it is your psychophysiological position that has likely changed. In recent decades researchers have discovered multiple links between the nervous, endocrine, and immune system giving rise to the field of psychoneuroimmunology (PIN). These researchers take an interdisciplinary approach combining the hard sciences of genetics, molecular biology, neuroscience, immunology, endocrinology, and rheumatology with sciences of the mind; psychiatry, psychology, and behavioural medicine. We are beginning to understand the exact mechanisms in which physiological functioning of the neuroimmune system leads to disorders such as autoimmune diseases, hypersensitivities, and immune deficiency.
Indeed psychosomatic stress and immune breakdown has been known for centuries. This should not come as a surprise given that we experience this phenomenon daily to some degree. Consider the physical nature of blushing or going weak at the knees in the presence of your crush. Consider how you cry after watching the Titanic (not me), or experience an endorphin rush from watching sport. More pertinent still in clinical terms is the placebo effect. The mind-body connection is phenomenal in its effect, and it can either work positively or pathologically.
The Immune-Brain Loop
The immune system and the brain communicate through the hypothalamic-pituitary-adrenal axis (HPA axis) and the sympathetic nervous system (SNS). The body’s primary stress management system is the HPA axis which responds to physical and mental stress by controlling cortisol levels. Chronic idiopathic urticaria and migraines can be thought of as dysregulation of the HPA axis.
Recent studies show that activity of pro-inflammatory proteins called cytokines are increased by psychosomatic stress originating from depression, mania, bipolar disease, autoimmune hypersensitivity, and chronic infections. This is the key to understanding the root cause of chronic hives and migraines. Cytokines affect brain growth, neuronal function, and mediate immune and inflammatory responses. More specifically cytokines also stimulate adrenocorticotropic hormone (ACTH) and cortisol secretion.
When we are in a state of chronic stress we release stress hormones called glucocorticoids (GCs) and catecholamines (CAs). These in turn reduce the effect of the neurotransmitters serotonin, dopamine, and norepinephrine. Now we have a situation in which our brain attempts to compensate with further neurotransmitter secretion to maintain homeostasis (balance).
Norepinephrine and the immune system
The role norepinephrine is to ready our bodies for action. It is at its lowest levels during sleep, raises in hours of wakefulness, and peaks at perceived threats in what we know at the fight-or-flight response. In the brain it will increase alertness, speed up information retrieval, but also induces the feeling of restlessness, and anxiety. In the body it will raise blood pressure and heart rate, triggers glucose release and directs blood from the gastrointestinal system to skeletal muscle. Norepinephrine also targets immune cell adrenoreceptors (specialized proteins allowing cells to that communicate with neurotransmitters).
The inflammatory and stress responses are perfectly healthy and under normal function it provides us with the ability to deal with imminent danger and recover from disease. However persistently high levels of norepinephrine will affect lymphocyte (white blood cells) proliferation, circulation, and function.
The bottom line is the origin of chronic idiopathic urticaria and migraines is psychosomatic stress
Identifying psychosomatic hives stressors
So called psychosomatic stressors are events or situations that pose a potential threat, actual or perceived. They range from minor ingressions to risk of fatality, and vary in duration and frequency. Acute stressors are considered to last minutes to hours, subacute (less than a month), and chronic (months to years).
Understanding stressors is not necessarily straight forward as we will have multiple stressors of varying intensity that we are not necessarily aware of. For example, my own case of chronic urticaria was triggered by a bereavement in 2009. At the time I made the mistake of burying myself in work in an attempt to take my mind off the situation. There was a background level of stress that accumulated day on day. Within 6 months I had developed chronic idiopathic urticaria and my body appeared to have aged 10 years. Yet it took me approximately 2 years to acknowledge that psychosomatic stress was the root cause of my condition because I was in a state of denial. The good news is that today I am fitter than I ever have been in my life. My take home point here is that we tend to live with our stress allowing it accumulate, rather than making a conscious effort to identify and eliminate it. Do not underestimate the havoc psychosomatic stress can have on your immune system.
Another silent pandemic
I have written elsewhere of pandemics, especially with vitamin D3 where over half of global population is deficient. With respect to stress, estimates are that up to 75% of all visits to a physician’s offices are stress related. It is another statistic that will make you want to sit down and contemplate for a moment.
Suggestions for smashing psychosomatic hives
Now we understand the psychosomatic origin of our condition we can take steps to address the problem. As you can imagine there are various strategies you can take to stress reduction. Explore the options for yourself and look forward to the process of rest and relaxation. With that said I suggest the following steps for the greatest stress reduction impact:
Step 1. Self Assessment
Psychoneuroimmunology researchers have studied long-term naturalistic stressors such as divorce, bereavement, caregiving, and unemployment. Likewise we should start with an honest self-assessment to identify what our unique long-term stressors are. You may be a top flight neurosurgeon on a $500k salary but if you are overworked and under-appreciated then this maybe your root stressor. Relationships with family friends and colleagues are all big risk areas and it is worth an honest review.
Step 2. Bring in help
Psychosomatic stress is unlike other threats we are used to. It cannot be overcome by being mentally strong and powering through it. Analogous to a boa-constrictor, fighting the creature alone is the worst thing you can do. It would be wise to reach out for help, which admittedly is pretty hard for some personality types. Indeed the reason that some of us are prone to developing autoimmune disease could be due to our personality type rather than any genetic predisposition to impaired DAO production. Consider counselling or other professional help. Focus on improving and extending your social circle.
Step 3. Sport/Exercise
The evolutionary purpose of the stress response was to survive physical aggression. Given that protracted psychological stressors now predominate in the modern world, researchers have noted that we are missing the physical exertion that our bodies are expecting. Therefore physical activity puts our body back into homeostasis (balance). There is now abundant evidence that regular exercise does prevent stress-induced metabolic and psychological comorbidities (chronic diseases).
Team sports, martial arts, and yoga (or similar activates) are inherently social so they are great options. For those that prefer solo exercise or are new to exercise, then jogging, running, and hiking is a way of pacing yourself. There is an element of apprehension and self-consciousness that we all experience when we take up a new activity. You might start with slow park jogs this year and be smashing overheads at tennis a few years on. Take it slowly if necessary, work your way up, and enjoy the process.
Step 4. Theanine (L-theanine), Magnesium (Epsom Salts)
Theanine is a remarkable extract of the tea plant discovered in Japan in 1949. If you have ever wondered why coffee gives you jitters but tea does not, theanine is the reason. It provides a subtle calming and soothing effect. It has been researched for its ability to reduce mental and physical stress while improving cognition and mood. It is not like an OTC, it has a very mild effect that works in the background by seeming taking the edge off possible anxious situations. Theanine has a long track record and no risk to overdosing, however there is no benefit in taking more than 200mg at any one time. Some users have noted it potentiates alcohol, so avoid mixing the two. I find this a great little tool to have around the house, something that is mild, clean, and natural.
Hypomagnesia as we have discussed elsewhere is a highly common deficiency. We need to appreciate that only 16% of magnesium remains in refined wheat and is notably absent in modern drinking water. Studies have shown that imbalances in Mg is associated with pathological anxiety. This is due to the critical function Mg plays in modulating the hypothalamic-pituitary adrenal (HPA) axis (part of the stress response). In magnesium deficiency, the metabolic pathways are not fully understood however it is believed that neuronal requirements may not be met causing neuronal damage that results in depression. Researchers are now pointing to hypomagnesia as the cause of most major depression and related pathologies including IQ loss, insomnia, delirium, and susceptibility to addiction. As sufferers of psychosomatic hives and migraines, this is a very big deal.
Magnesium should be taken in the citrate form if possible, and for immediate stress relief in the form of Epsom Salt baths. There is little clinical research specifically on Epsom salts with respect to the absorption of magnesium sulphate in bath water however many people swear by them.
Review part 1, the metabolic protocol
Read part 3, an addendum on emergency relief
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What has your experience been with psychosomatic hives and migraines? Let me know in the comments.