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Writer's pictureJohn Kim

How can functional medicine help with achieve remission from hives?

Updated: Sep 14

I recently saw a patient with hives whose condition is in remission. In this person, two factors played crucial role for success: Elimination diet and ketosis. At first we used multiple approaches including anti-inflammatory diet in the form of ketosis (fat burning state), low dose naltrexone to normalize immune function (addressing autoimmunity), eliminating foods that were responsible for allergic/food sensitivity reactions, and anti-inflammatory supplements.


When condition improved with ketosis and elimination diet, additional measures were discontinued - such as LDN and supplements. Success continued. Additional experiments of adding allergic foods were done resulting in hives.


Functional medicine approaches the treatment of hives (also known as urticaria) by identifying and addressing the root causes rather than just managing symptoms. Here’s how functional medicine may help treat hives:


  • Identifying Underlying Triggers:

    • Functional medicine practitioners look for potential triggers contributing to hives, such as:

    • Food sensitivities/allergies: Common culprits include dairy, gluten, corn, soy, nuts, and shellfish, but often requires testing

    • Environmental triggers: Pollens, dust mites, mold, or chemical exposure can add to the immune inflammation burden.

    • Stress and emotional health: Chronic stress or acute stress can trigger or worsen hives.

    • Infections and gut imbalances: Hidden bacterial, viral, or parasitic infections, as well as conditions like small intestinal bacterial overgrowth (SIBO), leaky gut, or dysbiosis can make it easier to trigger hives.


  • Functional Medicine Testing:

    • Food sensitivity testing: Identify specific foods that might be causing or exacerbating hives.

    • Gut health assessment: Evaluate for imbalances in the microbiome, leaky gut, or infections.

    • Hormone and stress level testing: Measuring cortisol and other stress-related markers.


3. Personalized Nutrition and Dietary Changes:

  • There are many types of diets including anti-inflammatory diet

  • What I have seen most effective is the state of ketosis (fat burning state)


4. Gut Health Restoration:

  • If gut issues are identified, treatments might involve:

    • pre-biotics, probiotics, fiber etc.

    • probiotic foods, prebiotics foods, and fiber


5. Detoxification and Reducing Environmental Exposures:

  • Reducing exposure to toxins, pollutants, and heavy metals also may help in reducing hives.

6. Addressing Autoimmunity:

If autoimmune issues are suspected (e.g., chronic urticaria), functional medicine focuses on calming the immune system.


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