Migraines and Urticaria

[magicfingers]

I'm look for advice.  I am a 24 yr old female with a history of Atypical migraines that started off with aura and classic symptoms of light and sound sensitivity, nausea, irritability and has progressed over the last 3 years to mood changes - euphoria, depression and about 6 episodes of seizures.  Since the seizures I've been left with muscle twitches in my eyelid, but mostly in my legs, gluteals included, sometimes actual muscle jerks than can move the limb.  I am also in my 3rd bout of chronic urticaria. First episode at 10, then 16 then 23. I've been breaking out in hives almost everyday since June 2010 and my Drs dont seem to know how to manage it outside of petty meds that barely suppress it (Allegra, Zyrtec, Claritin, Prednisone). It's been progressing as well...where as i only had hives to legs its spread to arms, torso and last few months my lips, face, tongue. Recently episodes with bouts of weird coughing but no respiratory distress. Otherwise i'm chronically fatigued,  always have weird ticklish sensation in my legs that are increasing as well with a feeling of weakness but i'm not really weak!.  Feeling that as I type this now actually with some lower back pain which i also find a bit weird. Is there any relation to migraines and urticaria ( i have never found the cause and i'm thinking its probably an autoimmune problem now - lupus and RA have been ruled out.)  I do have vitiligo but it never spread past 2 fingers.  I'm suffering! I'm young, I just finished my internship and I'm a registered Physical therapist with alot in me to give but this is debilitating and no one seems to understand how much I'm hurting because I go around smiling and treating patients and trying to be strong but I'm not sure how much else I can take.  Do I do an EEG, EMG, NCV...Can anyone at all offer some advice...I need to know the root of my problem and what kind of Dr I should see....neurologist? internist? immunologist?

Help....please!

[achilles2]

In addition to getting your thyroid checked (this is very important) you might want to see if you are reacting to any food-- especially anything that contains gluten (wheat, barely, rye). Doctors are finding that gluten intolerance can also show up as neurological issues (not just digestive). Gluten intolerance can also cause hives.

[Red_Star]

After all that, i forgot to mention migranes are a listed symptom of autoimmune thyroid disease. :)

[Red_Star]

Vitiligo is highly associated with a number of other autoimmune diseases, mostly thyroid disease, but also autoimmune pernicious anaemia, rheumatoid arthritis, psoriasis, lupus, Addison's disease, and adult-onset autoimmune diabetes.

"Elevated thyroid antibodies are often associated with chronic urticaria, also called hives. Studies report that as many as 57.4% of patients with hives have the presence of anti-thyroid antibodies. An August 2010 paper suggests that treatment with T4 improves the itching associated with urticaria, but did not advise treatment with T4 unless the patient was hypothyroid." - excerpt from Life Extention - Thyroid Regulation

One of the many human trials on selenium lowering TPOAb:

Turkey -  2006 Journal of Endocrinology.  This study showed a 30% decrease in anti-thyroid antibodies after 3 months of 200mcg per day of L-selenomethionine supplementation for in women with Hashimotos Thyroiditis. The starting average TPOAb was 803 and after 3 months the average was 572.    

Ancedotal evidence - Gluten free diet lowers TgAb antibodies.

http://www.medhelp.org/posts/Thyroid-Disorders/Gluten-Free-Diet-Lowers-TgAb-but-not-TPOab/show/1003484

Deficiency states commonly found to be low in thyroid patients include vitamin D, vitamin B12, and magnesium.

The University of Nebraska Medical Center research study has determined that patients with chronic hives may benefit by supplementing with vitamin D.  The researchers found patients with chronic hives had significantly reduced levels of vitamin D, with nearly half of them considered to be vitamin D deficient.  Try 1,000 to 2,000 international units (IUs) daily.  The vitamin D council state optimal vitamin D levels - 80ng/mL or 200nmol/L.

"Migraine often occurs as a result of low brain levels of magnesium - most migraine patients are found to have low brain magnesium levels during migraine attacks.  One clinical trial found that supplemental magnesium caused the complete elimination of migraine pain within 15 minutes in 80% of migraine sufferers and more than half of these migraine sufferers were still free of symptoms 24 hours later." Magnesium symptoms are numerous but includes eye twitching, muscle cramps, restless leg syndrome, and  seizures. RBC magnesium may pick up a deficiency state although no blood test is accurate as only 1% of magnesium is in the blood

Vitamin B12 deficiency - chronic fatigue is the number one symptom. Can cause myclonic jerks or myclonic seizures if levels are low enough.  In a recently study, 25 of the 40 patients with chronic unexplained cough had a deficiency of vitamin B12 (serum levels 300 pg/ml). Optimal B12 serum is over 800pg/mL or 600pmol/L