The One Simple Cause and Cure for Cholinergic Urticaria

Medical Disclaimer: This post is written for informational purposes only. A part of this post discusses some medicine used to treat cholinergic urticaria which only your doctor has the authority to prescribe. Please, before you take any medication, talk to your healthcare supervisor.

Cholinergic urticaria is one of the physical types of urticaria brought on by a physical stimulus. It is clinically characterized by pinpoint-sized, highly pruritic wheals. However, the symptoms diminish quickly, usually within one hour.

Cholinergic urticaria affects both men and women alike, and unlike all the other types of hives, cholinergic urticaria seems to be more common in men than in women.

In comparison to other chronic urticaria types, cholinergic is uncommon and constitutes 5.1% of all chronic urticaria diagnoses.


What causes Cholinergic Urticaria?

CU is typically provoked by stimulation such as heat, prolonged exposure to sun, and emotional stress, which elevates the body’s core temperature and promotes sweating. Although warmth, sunlight or exercise can induce cholinergic urticaria, the actual cause is sweating.


Here is a picture explaining scientifically how cholinergic urticaria occurs.

Don’t worry, in the next few moments we’ll demystify the puzzle. By understanding how cholinergic urticaria is caused, you will understand what can be done to easily get rid of it. Sound fair enough?

There are two types of causes of cholinergic urticaria – one can be called “direct” and the second can be called “peripheral”. The direct cause is sweating hypersensitivity. The peripheral cause takes a longer cycle to end up releasing histamine, which Yassin Madwin mentioned in his book.  The fact of the matter is that this “indirect” cause is another type of urticaria. In this post I’m going to focus on the direct cause: sweating hypersensitivity.


You are aware that your sweat, your hormones, whatever is inside you is there to do a certain job, and that job does not include breaking you out in hives. Thus, you must be doing something wrong, right?

What causes cholinergic urticaria is the stimulation of a chemical called acetylcholine. Acetylcholine is proven to induce both sweating and wheals when injected underneath your skin. And you wouldn’t believe why you break out in cholinergic urticaria: it’s simply because you eat too much salt. Yes, that is the actual cause of your mysterious hives.


Table salt or any other food rich in sodium can trigger and aggravate your cholinergic urticaria. Sodium stimulates acetylcholine release. You can see how this mechanism works here.


How to treat Cholinergic Urticaria.

Cholinergic urticaria can be treated permanently by avoiding salt and sodium-rich foods in general.

Canned foods, sauces, French fries, soup packets – all of these contain way more than the amount of sodium your body needs, which is set at 1500 mg/day.

Reducing or avoiding those types of food is for the long term. Quick treatments for cholinergic urticaria include: Nonsedating H1 receptor antagonists, such as Cetirizine, Danazol,  and beta-blockers, such as Propranolol.

Your doctor may prescribe medication:

  • 4 mg of chlorpheniramine maleate (histidine), 3 times daily.
  • 200 mg of cimetidine (tagadine), 3 times daily.


Antihistamines won’t do much because histamine plays a very minor role in cholinergic urticaria.

The most effective treatment for cholinergic urticaria according to Yassin Madwin is through desensitization using partially purified sweat antigen. You can call it diluting your sweat. This technique succeeded in 5 out of 6 patients (83%). Note that and give it to your dermatologist – he will know what to do next.

Urticaria no more is not a complicated scientific book, but rather a simple and to the point blueprint anyone can follow. In this book you’re going to discover the one link between all types of urticaria, how you can easily get rid of chronic idiopathic urticaria, how hives during pregnancy and menstruation can be very serious, and much more….

How To Get Rid of Hereditary Angioedema


HAE sucks!

Hidden promotion for Benadryl (very clever).

Being diagnosed with hereditary angioedema is a nightmare. It’s itchy with successive attacks, painful and disturbingly swollen.

Today, I’m going to share a complete post about hereditary angioedema. You’ll discover the causes, the symptoms and available treatments.


This post is just for educational purposes. We’re not affiliated or endorsing any brands we mention in this post. And as usual, consult your doctor before taking any medication, as some drugs might not be suitable for you because each medicine has its side effects.


HAE is a familial disorder characterized by episodic attacks of severe swelling (angioedema). You can get it on your limbs, face, intestinal tract and airways.

Angioedema is pretty much like hives except that the swelling occurs in the deeper layers of the skin and for different reasons. Sometimes, you can get both the same time.


Quick History:

Milton (1876): First described clinical features.

Quinke (1882): “…Acute circumscribed edema of the skin…” (Sometimes, HAE is referred as to Quinke edema after him.)

Osler (1888): Angioneurotic edema (being related to the nervous system and was commonly called giant urticaria)

Donaldson and Evans (1963): Defined C1 – INH deficiency


Hereditary Angioedema Types:

There are three types of hereditary angioedema. The first type means you have low low C1 esterase inhibitor (C1-INH) levels in your blood. The second type means you have normal or elevated, but ineffective, C1-INH levels.

Type III is a new one; it was thought to be specific to women because a study has shown that 50% of oestrogen-exposed women with Type III HAE had decreased C1-INH inhibitory activity. C1-INH inhibitory activities had normalized when oestrogen exposure stopped.


I hope you’re not lost (yet). We’ll get to explain this C1-inhibitor better and simplify things, so just keep up with me.

It turned out that men can also have Type III hereditary angioedema because it is, in fact, a mutation.

In 2006, two different missense mutations in a non-conservative gene region were identified in German patients with normal C1-INH, located in exon 9 of the F12 gene. The point mutations were found in 5 unrelated families.

Therefore, these patients are classified as having HAE with a functional mutation in the factor 12 gene, abbreviated as HAE-FXII.

This gene (F12) helps in blood clotting (coagulation). F-XII is also an important stimulator of inflammation and is involved in the production of bradykinin and kallikrein (the villains). Remember these two, as from now on, things will make sense.


Now, let’s shed some light on our hero, C1-INH.

C1-inhibitor or C1 esterase inhibitor is an acute phase protein in your blood that helps in preventing inflammation.

C1-INH plays an essential role in regulating both the activation of the complement cascade and many of the serine proteases involved in the clotting and kinin formation processes.


So, what happens when you have low or malfunctioning C1-INH?

During acute attacks in patients with HAE, deficiency of C1-INH leads to the activation of serine proteases, which, in turn, increases the release of BK.



So, what are the possible treatments?

Ps: Anabolism=building, Catabolism=destruction, Metabolism=destructing to build


According to what we have, possible treatments include:

  • Prophylaxis (prevention) by supplementing blood with C1-INH.
  • Blockade of bradykinin receptors (the scientific fuss: KK inhibitor and a B2 receptor antagonist).
  • Lowering kinin formation or helping kinin catabolism to prevent BK accumulation. This is very helpful for people with laryngeal (throat) attacks.
  • Another way is helping enzymes to metabolize bradykenin.


There are plenty of solutions for hereditary angioedema, starting from the simple androgens (Danazol®).

Supplements of C1-INH include: CINRYZE® and Berinert®

Blockade of bradykinin receptors via icatibant injections, brand name: FIRAZYR®

The last two theories require drug companies to think of blockading both BK1R and BK2R, or of gC1q/p33, which I guess is not available for the moment.


I hope I didn’t cause you dizziness. Usually, I make my posts very simple.

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Categorized as angioedema

How did i get rid of hives (my story)


Hello, I’m David Summers and I would like to share my story.

You: Hi, David… LOL


OK. There I go..


“When I was a little boy, whenever I broke out in hives my mother would send me over to her mother’s house, my grandmother. And she would tell me stories about why do we get hives. I’ve never heard these stories, except from her, so I don’t know if she made them up or if they’re just part of the folklore. She told me that when she was a little girl her cousin would tease her to go to the “The Witch’s House” and talk to the lady they called “The Witch.” The thing was that the witch didn’t mind being called that,  and my grandmother always approached the house scared, and every time The Witch would befriend her, take her in, tell her a story and she’d leave, always feeling better. Her friends told her that The Witch put a spell on her, which scared her every time, yet she would still go back for more.


Well, one day The Witch told her a story about when she was a little girl and how she was always concerned about getting too close to the Black Lake. The Black Lake, they told her, was haunted and would pull young girls in from the shore and drown them, if they didn’t take a certain path to the shore…. “. The Legend says the demons shall ask one question. If you get it right. You’ll be given the secret to knowledge and be pulled back from the lake. If you get it wrong, you become one of them.


The witch did it. She didn’t reveal the secret question to my grandma and my granny believed her.

So whenever I asked my grandmother about something like: how did I come to life? She would reply: well, the witch says…


Of course, a lot of things that I learned from the witch unlimited knowledge was wrong. Yet the witch got one perfectly right!


The witch knew how can I get rid of hives fast. Castor Oil. Whenever I got hives I massage the affected area and in a few hours my life continues like nothing happened at all.

[sorry] No picture, I can’t show you my butt.

Well 6 months ago, I broke out in hives but this time my magical cure didn’t work. It made my rash tolerable but it couldn’t get me rid of it.


I consulted a dermatologist to see if there is something serious this time.

The doctor reassured me saying it’s not a big deal. It would go away on its own and there you can take neoclarityn (antihistamine) 5mg every morning for faster results. Bummer.


3 months so far. Don’t panic. No worries…


The next visit he gave me epinephrine shots in his office. It worked at least for a week or so, then I’ve broke into urticaria again plus angioedema this time.


The last thing he did is he gave me Sulfasalazine tablets. Thank God, finally. Since that day I’ve never gotten hives anymore and I’m surely not looking forward to it.


My only regret is that I paid a pretty sum of 213$ to find a solution. If only I had the chance to read “Urticaria No More”. I would be paying way less than that.

The most important thing is to NOT scratch! You’re going to make it worse.


Hives are really common and there is no one size fits all treatment. What worked for me indeed, might not work for you But You can try different solutions. What the heck? You’ve got nothing to lose.