White woman laying in bed and scratching a red rash on her arm

What Is Idiopathic Urticaria? How to Move Beyond Your Diagnosis to Reverse Your Symptoms

Have you been told by your doctor that you have something called idiopathic urticaria? 

In the medical community, the term ‘idiopathic’ is another way of saying ‘we don’t know what’s wrong with you.’ And it’s one of the most frustrating things a person suffering from hives can hear.

I struggled with chronic hives for over 15 years without satisfactory answers from my doctors, dermatologists, and allergists. I believed my condition was genetic, and the only way to manage it was with medication.

But after I lost my good friend to breast cancer in 2015, I realized I didn’t want to be on medication forever. I started questioning the conventional treatment model and was taken down the road of functional medicine. 

Despite what you’ve been told by the medical community, you don’t have to learn to live with this disease. There is a clinical cause, and today we’ll explore what the conventional model gets wrong, and what you can do instead. 

But first…

How Do You Diagnose Idiopathic Urticaria? 

If you’ve been experiencing itchy, uncontrollable hives for weeks, months, or even years, with no clue as to why, you aren’t alone. 

75% of urticaria cases are diagnosed as idiopathic

On first glance, you may believe your hives are the result of an allergy or something in your environment. Your doctor will probably ask if you’ve eaten anything different, or started a new medication. 

If the answer is no, then the conventional approach for diagnosing hives starts with an allergy test. You may also be given a urine test to look for any bacterial infections. 

If no allergies or infections are detected, you may be asked to run a blood test to look for elevated levels of antibodies, which signify high histamine production. 

Understanding your histamine is KEY for diagnosing chronic hives

When your immune system is stressed, it releases high levels of histamine, triggering an inflammatory response. Normal histamine levels protect against viruses and bacteria, but excessive levels can lead to allergies, asthma, eczema, and chronic hives.

This is why idiopathic urticaria is often categorized as an immune system issue, and you may be referred to an immunologist once an allergy is ruled out.

How Does Conventional Medicine Treat Idiopathic Urticaria?

If you’ve been diagnosed idiopathic, one of the specialists you’re working with will put together a treatment plan to try and manage your condition.

It’s important to note that everyone’s experience is unique and each doctor’s approach to treatment may differ. 

If you’ve had a positive experience working with your doctor, and they’ve been able to provide helpful feedback and suggestions, that’s fantastic. But there are others (especially inside my Chronic Urticaria Solution Seekers Facebook group), who feel invalidated by their doctor, and frustrated that their concerns are going unheard. 

I want to recognize that both experiences can be true, and healing exists on a spectrum. 

The most common method of treating idiopathic urticaria is typically a combination of these medications: 


Over-the-counter antihistamines (Zyrtec, Allegra, Claritin,) are used to reduce the impact of histamine in your body. Your doctor may also prescribe Benadryl if those don’t work, but they’ll suggest you take it at night since it can cause drowsiness.

If OTC antihistamines are ineffective, you may be prescribed H2 blockers (Pepcid) – drugs that block the production of histamine by narrowing blood vessels. Read this Facebook post for my views on Pepcid.


After taking the antihistamine route, the next port of call is to try corticosteroids like Prednisone

Steroids decrease inflammation by reducing activity in the immune system.

They can be helpful for managing your redness and swelling, but only as a short-term solution. Long term steroid use is linked to unwanted side effects like increased risk of infection, mood changes, high blood pressure, high blood sugar and gastrointestinal inflammation. 

Immunosuppressants and Injectables

The final medications doctors prescribe if antihistamines and steroids aren’t working are immunosuppressants like methotrexate or injectables like Xolair. These medications are typically saved as a last resort to manage worsening symptoms. 

Although many people find relief with Xolair, it also comes with potential health risks. According to the Xolair website, it has been known to cause cancer, heart problems, and respiratory tract infections.

Aside from medications, doctors may also recommend things like:

  • A low histamine diet (here’s why I don’t recommend that)
  • Avoiding potential triggers like pollen and pet dander
  • Wearing loose, soft clothing
  • Applying cold compresses or taking cold showers

*An important note if you’re worried about coming off medications: Prior to working with me, many of my clients experienced severe rebound in symptoms when they stopped Xolair, steroids or antihistamines, resulting in severe anxiety at the thought of coming off medications again. But once we addressed WHY their bodies were not stable enough to titrate off meds, they were able to safely stop without the hives returning.

What’s the problem with the conventional treatment model?

The biggest thing I tell people is that your body doesn’t have a medication deficiency. And while medications like Xolair or Prednisone can provide temporary relief, they fail to address the real reason you have chronic hives.

The goal of symptom management is to suppress your symptoms, but your symptoms are a response to an underlying imbalance. By treating the symptom and not the area of dysfunction, you’re trying to band-aid a much larger issue.

Over time, that issue will express itself in other areas, leading to more chronic health conditions (meaning more specialists and more medications). 

Conventional medicine also fails to treat the body as a whole.

Specialists like allergists and immunologists are experts in one area of the body. And if you’re struggling with hives, you may have other health issues as well. 

Many of my clients work with multiple specialists on seemingly unrelated issues such as thyroid problems. These specialists almost never communicate with one another to identify the underlying dysfunction that could be driving symptoms in the skin AND the thyroid. 

The specialist approach does not address how the various body systems work together to create and prevent disease.

This means they’re missing vital pieces of the puzzle when it comes to understanding the cause of your hives and addressing the the dysfunction that drives this condition..

The Functional Medicine Approach to Idiopathic Urticaria

If you’re unfamiliar with the term functional medicine, the goal is to address the underlying causes of disease. 

Your body is very wise and always striving for balance. In functional medicine, we aim to understand where and why there is dysfunction in the body and address these imbalances at the cellular level

Your cells make up the tissues in your body, which make up your organs, which are the basis for your organ systems. When we optimize how your cells function, we can restart regenerating tissue and impact the body’s systems as a whole. 

In my functional medicine practice, I do this in three ways:


At a very basic level, your cells need nutrients to function. This is why diet is the foundation to cellular health.

By addressing things like nutrient deficiencies, food sensitivities, and toxins impacting your food, we can optimize important functions like digestion, detoxification, immune regulation, and more. 

The best place to start is with my free 7 Day Clean Eating Challenge where you’ll learn how to eliminate common food sensitivities like gluten, sugar and dairy, and uncover the role they’re playing in your symptoms.

Gut Health

Once you’ve worked on your nutrition, the next area of focus should be how well your body is digesting and assimilating nutrients. 

Many doctors recognize urticaria as an immune system issue, and 70% of your immune system lives in your gut. By optimizing your gut health, you can begin to heal the gut lining, calm your immune response, and finally reverse your hives for good. 

I talk more about the importance of gut health inside my free masterclass GLOW

Nervous System Regulation 

Emotional health is one of the last pieces to healing your chronic hives. If you’re holding onto chronic stress and trauma, the nervous system tends to operate in survival mode. 

This releases a cocktail of stress chemicals that shut down important functions like digestion, detoxification, and immune regulation. 

By regulating your nervous system and addressing the underlying causes of emotional stress, you can restore balance to the body, so these systems can function optimally. 

Idiopathic Urticaria: The Bottom Line

There’s no denying that urticaria is an uncomfortable and debilitating condition to live with. It interferes with important daily tasks like sleeping, getting dressed, socializing, and moving through life feeling confident and comfortable in your own skin. 

While medications can provide temporary relief, they aren’t a long-term solution. 

The good news is, by understanding the underlying imbalances causing your chronic hives, you can reverse your symptoms for good. 

If you’re sick of relying on medications, and want real answers as to why you’re struggling, my Hive-Free coaching program can help. 

You’ll receive 1-1 guidance and support for reversing your chronic hives naturally with the use of nutrition, gut health, and nervous system work. 

Get started by booking a free Reverse Hives Breakthrough session with me here. 

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