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Suggest treatment for recurrent urticaria and high GGT levels

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Posted on Mon, 20 Jun 2016
Question: High GGT and urticaria
Hello, please excuse the long message but I figure more info is better than less…
I have been suffering from physical urticarial (dermatographia) for about five months now, mostly on my torso. It started at a time when I was under significant stress and persisted, with nearly daily welting and itching, burning hot skin. Even light pressure from a scratch would cause weals. Last week, I exfoliated my lower legs with a shower mitt and was a bit heavy handed and about 24 hours later, I started periodically coming up in more traditional hives (lumpy, red and swollen – burning) in the areas I had exfoliated – this carried on for about 3-4 days and so I decided to finally see my doctor because I suddenly had another form of hives and things have been getting worse. I have recently started to wonder if gluten might be another trigger and decided to raise this with her as well.

She examined my skin and said there was nothing of concern – smooth and no rashes. She did a full blood work up including thyroid and advised excluding gluten for a week and then eating a lot of wheat to see what would happen. She was adamant that nothing serious was wrong with me and offered me a referral to a dermatologist if I wanted one but said I wouldn’t need one. (I am 48 hours into excluding gluten and I believe my skin might be slightly less reactive, so I’m in a wait-and-see with this.)

I got my results back with a very high GGT score.

All results were in the normal range except:
Blood lipids:
Cholesterol 5.6 mmol/l
LDL 3.8 mmol/l
(my HDL was normal at 25% 1.4 mmol/l and triglycerides normal at 0.9)
Transferrin saturation low at 16%
Liver function:
GGT – 181
(Bilirubin -4, ALP- 92, AST 31, ALT 24, LDH 214, albumin 42)

About me:
I’m female, 43 years old, 5 foot 1, 140lb (so 10lb overweight). I’m more apple shaped.
I barely drink – perhaps 1-2 units of wine a month. (I had a glass of wine 36 hours before the test, can't remember when last I had alcohol.)
I am a pack a day smoker.
I walk 3-4 miles a day but could use more cardiovascular exercise.
I do not tend to get enough sleep – have never needed much so am tired, but I have no fatigue when I have a decent night’s sleep.
I am on no medication, although I took two Claritin antihistamines in the preceding week, the last 48 hours before the test.
I take a multivitamin daily and various supplements when I remember – including turmeric and tulsi to reduce inflammation for the urticaria, garlic and coQ10.
My diet is reasonable but could improve – no junk food and little processed food. I’d say I get 4 out of 5 of my fruit/vegetable servings most days and could cut down on the red meat.
I have joint hypermobility syndrome and correspondingly suffer occasional panic attacks which I manage. I am prone to anxiety and stress for no good reason but am able to continue with my life unaffected.
I have had a few coughs and colds this winter and am recovering from a chesty cough at the moment.

Does my high GGT score warrant further investigations and if so what would you recommend if I were your patient? What might be wrong with me, looking at my urticarial (which may or may not be linked); my bloods and my general history?

With many thanks,
XXXX

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Answered by Dr. Samir Patil (43 hours later)
Brief Answer:
Lay off alcohol. and repeat GGT after a month

Detailed Answer:
Hello,
I have read the details about the problems you have provided.

For the dermatographia and recurrent urticaria I would suggest that you get a dermatology consult.

The raised GGT could be because of the wine. as alcohol is the most common cause of rise in GGT and can sometimes occur at a lower alcohol consumption Drugs like barbiturates can also cause these( in case you are using them ).

I would suggest to lay off alcohol for a month and then repeat the GGT.

hope this helps
Do get back in case you have further queries
regards
Dr Samir Patil
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Samir Patil

Gastroenterologist

Practicing since :1997

Answered : 551 Questions

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Suggest treatment for recurrent urticaria and high GGT levels

Brief Answer: Lay off alcohol. and repeat GGT after a month Detailed Answer: Hello, I have read the details about the problems you have provided. For the dermatographia and recurrent urticaria I would suggest that you get a dermatology consult. The raised GGT could be because of the wine. as alcohol is the most common cause of rise in GGT and can sometimes occur at a lower alcohol consumption Drugs like barbiturates can also cause these( in case you are using them ). I would suggest to lay off alcohol for a month and then repeat the GGT. hope this helps Do get back in case you have further queries regards Dr Samir Patil