Immune Dysregulation: Chronic Urticaria and Its Challenges - Internal Medicine

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Chronic urticaria, or chronic hives, is a condition that can be quite perplexing for both patients and healthcare providers. It is characterized by the recurrent appearance of itchy welts or hives on the skin, which can be triggered by various factors, including stress, allergens, and even changes in temperature. Your experience of having chronic urticaria for about four years, along with recurrent respiratory symptoms and sleep disturbances, raises important questions about the underlying mechanisms of your condition and the state of your immune system.

1. Understanding Immune Dysregulation: Chronic urticaria is often associated with immune dysregulation, which can manifest as either an overactive immune response (immune hyperactivity) or a weakened immune system (immune deficiency). In your case, the recurrent colds and symptoms such as ear fullness and throat phlegm suggest that there may be some level of immune dysfunction. It is possible for both immune hyperactivity and immune deficiency to coexist; this phenomenon is sometimes referred to as "immune dysregulation." For instance, an individual may have an overactive immune response leading to chronic urticaria while simultaneously experiencing frequent infections due to an inadequate immune response.

2. Immune Modulation and Treatment: Regarding your question about taking supplements like fucoidan (褐藻醣膠) to enhance immunity, caution is warranted. While some supplements claim to boost immune function, they can sometimes exacerbate conditions like chronic urticaria, especially if the underlying issue is related to immune hyperactivity. It is essential to consult with a healthcare provider before starting any new supplements, particularly if you have a history of allergic reactions or immune-related conditions. A tailored approach to treatment, which may include antihistamines, corticosteroids, or other immunomodulatory therapies, is often more effective than self-medicating with supplements.

3. Seeking Appropriate Medical Care: Given the complexity of your symptoms, it would be advisable to consult with a specialist in allergy and immunology. An allergist can perform specific tests to identify potential triggers for your urticaria and assess your immune function. Additionally, if you are experiencing significant sleep disturbances and anxiety related to your condition, a referral to a mental health professional may also be beneficial. Chronic conditions can take a toll on mental well-being, and addressing these aspects can improve your overall quality of life.

In summary, chronic urticaria can be a manifestation of immune dysregulation, and understanding whether your immune system is overactive or underactive is crucial for effective management. It is important to work closely with healthcare professionals who can guide you through appropriate testing and treatment options. Lifestyle modifications, stress management, and a comprehensive treatment plan tailored to your specific needs can significantly improve your symptoms and overall health.