Mast Cell Disorders Forum - Mast Cell Attack: Chocolate + Zyrtec????

jbean

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Mast Cell Attack: Chocolate + Zyrtec????
04/02/11 at 02:21:35

Just writing to let you know that I had the weirdest mast cell attack last night, and I am not quite sure what set it off. I suspect it was some kind of food/drug allergy? I am wondering if I might need to re-visit some of my food allergy testing.

I was not feeling all that well this past week, just felt very tired and I had been taking Tylenol that week as I had a sprain from an aerobics class. I noticed that I wasn't feeling quite right, but thought maybe it was because of the Tyelnol.

Last night, I felt like I was getting some stomach acid problem, and I took some famotidine for it. It seemed to be o.k., so later that night I had a cup of dark chocolate cocoa. After taking it, I took a teaspon of generic Zyrtec from before going to sleep. Well, about 15 minutes later, I started to get that "warm flushing" sort of feeling all over that I get from mast cell attacks. I waited a bit to see if it would go away. It did for a few minutes, and then it started up all over again, and was somewhat intense. I started to feel kind of weird and dizzy, maybe like I was going to pass out, and then started to tremor a bit. That's when I knew it was a mast cell attack, as this is my usual "cluster."

I didn't want to shock out home alone like I did last year. I called 911, and the paramedics came and got me, took me to the ER. Luckily, the intake doc I had said he had a mastocytosis patient before, which was really fortunate. He asked me straight out what I needed, so I told him the story. He gave me 25 mg of Benedryl to start initially (he was going to give me 50 I'm a lightweight on meds).

Both the doc and I were puzzled by this one. I wouldn't think one could react to Zyrtec, however, when I take it some times, it does seem to knock me out in an abnormaly fast way. I suspect a chocolate allergy, as I have noticed several times before that my stomach feels a little bit of burning after I drink cocoa. But, given that I really like chocolate, I didn't want to think that would be an allergan! But SADLY, I have to admit, I am wondering if that was it, and maybe with the Zyrtec thrown in for fun, it made for a bad mix.

I am going to talk with my allergist. I think I might need to get some food allergy testing again? Seems like things are shifting around a bit. I had also cut down my Gastrcrom a bit, but wondering if I just shouldn't go back to my higher dose of Gastrocrom and Loratadine, as maybe this was a "break-through" event? I did that for seven years and didn't have these types of problems. Also, I've been under WAYYYYYYYYYY to much stress lately at work, and it all is gathering for a "perfect storm">

Just wondering if anybody else ever had any sort of reaction after either chocolate or Zyrtec? This one is a weirdo! Undecided

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Josie

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #1 - 04/02/11 at 02:51:31

Hi J bean ,

Chocolate is on the naughty list on the low histamine diet . So it may be a trigger for you .

You described exercise , stress and a trigger on lower meds . It may be you got away with chocolate on extra meds or without the extra triggers .

The inflammation in your twisted ankle may be adding to matters as any inflammation means more compliment activity and compliment action ( cascade of chemicals ) leads to mast cells being degranulated for the contents have useful role in healing , With out misbehaving mast cells more can be activated than are needed .

Any med can potentially cause problems , but with lower meds , you may have tolerated this preparation before , but not now . In my understanding benadryl is the same drug as Zyrtec - ceterizine . It may be you tolerate the brand better than the generic . I am the other way around . I do better on the generic .

I hope you are feeling better and have no more problems like this .
Hugs
Jose

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DeborahW, Founder

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #2 - 04/02/11 at 02:59:30

Hey Jill,

I love chocolate, and I can eat it just fine anytime. HOWEVER, if I have a hot chocolate (or a decaf coffee even), I know I might start flushing, get itchy, or my stomach might hurt. If I have it at night, then my symptoms are way more severe!

Did you make the hot chocolate from scratch with all true ingredients (milk, sugar, cocoa), or did you use a mixed, prepared version? Definitely any mixed version can do you in. I cannot order a hot chocolate out anywhere, because they always trigger me majorly. I can make it at home with the natural ingredients, and I will be fine if I only drink maybe 6 oz at the most. Even then my stomach might hurt a bit. I can, however, eat as much chocolate candy as I want at any time of the day or night! LOL

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Joan

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #3 - 04/02/11 at 07:31:44

Sorry you had that happen, Jill! Good thinking to call for help!

I've had worse problems with pre-mixed hot chocolate packets (too many additives), but I've also triggered from regular chocolate if there were other factors going on. Right now, my digestion is pretty normal, so I'm eating chocolate often and not having any trouble at all.

You could have a battery of RAST tests for food allergens if you think you might be allergic to foods, but, even if they all turn up negative, that doesn't mean foods aren't triggering you. Either way, avoidance is usually the recommendation. If I'm not feeling right, I try not to take chances, so get really strict with the low histamine diet. Good idea to check with your allergist, though.

If you're having breakthrough reacting, and you didn't before, it might be good to consider returning to your previous meds. It sounds suspicious that you cut back on gastrocrom, had a worsening stomach situation, and then reacted.

Loratadine is one of the mildest antihistamines. Have you already tried Allegra? When you're feeling better, you could ask your allergist about doing a challenge with Zyrtec if you think that might be the culprit, but I wouldn't suggest using it again when you're home alone if you have an alternative. It's hard to know if it's the antihistamine or if your dose was too small to stop the attack.

I'm not a pharmacist, but I don't believe Benadryl and Zyrtec are the same. Benadryl is diphenhydramine and Zyrtec is cetirizine. My understanding is that hydroxyzine (Vistaril, Atarax) is an earlier and more sedating antihistamine and that Zyrtec was developed from it. Xyzal is the newest generation from Zyrtec and is said to have fewer side effects.

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nevermiss

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #4 - 04/02/11 at 08:28:34

Chocolate is one of my triggers. I get diarreha from it, esp. from chocolate ice cream. It is funny because I can tolerate a glass of wine, but not chocolate(Dr. Castells' said if I can tolerate wine it is good for you). My symptoms since I was diagnosed with ISM over 2 years ago have mainly been UP all over my torso and diarreha. I also have colitis which does not help. I also take zyrtec but have not had a reaction.
I have never had an IA as well. With all I have been reading about the reactions and symptoms on this site, do you progress with ISM and get more symptoms?

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Josie Ex Member	Re: Mast Cell Attack: Chocolate + Zyrtec???? Reply #5 - 04/02/11 at 08:46:50 Hi Joan and Jill , Benadryl is ceterizine , in the UK . As I have a bottle here It may well be different in the US . Zyrtec is as well as I have bought it OTC when i have run out of generic ceterizine . Many hugs Josie
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DeborahW, Founder

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #6 - 04/02/11 at 14:23:19

Benedryl is diphenhydramine. Zyrtec is cetirizine. According to google search, Benedryl is a first generation drug and Zyrtec is a second generation drug. Those are definitely different. I reac to many meds, including Benedryl. However, upon Dr. Akin's suggestion, I have tried 2nd, 3rd, and 4th generation meds and found then to be just fine. So, we don't want to say that these are the same drug. They are of the same CATEGORY, but are different meds.

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DeborahW, Founder

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #7 - 04/02/11 at 14:31:53

Nevermiss: I believe that there is no reason to assume that you would progress with Indolent Systemic Masto. If you are maintaining just fine and you know your triggers so that you can be aware and avoid them, AND you are on the right meds, you shouldn't worry. Plus, you have one of the best doctors -- Dr. Castells. If she didn't tell you to worry about it, then you shouldn't. Just stay aware!

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Joan

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Clarification: Benadryl and Cetirizine
Reply #8 - 04/02/11 at 17:51:59

This was puzzling, so I Googled, and according to Wikipedia:

"In the United States and Canada, Benadryl products contain the first-generation antihistamine diphenhydramine....In the United Kingdom, Benadryl products contain either the second-generation non-sedating antihistamine acrivastine (marketed as Benadryl Allergy Relief....) or the non-sedating antihistamine cetirizine (marketed as Benadryl One a Day Relief).

So, for people going to the U.K. for a visit, this will be good to know, especially for people with antihistamine intolerances. Who knew?

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Josie

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #9 - 04/03/11 at 01:36:27

Hi Joan and Deb's

Thanks Wink

I definetley have the ceterizine version here Wink

I will bear this in mind with any brand stuff that I discuss only the drug nor brand name to avoid any confusion .

Does this mean I don't have to worry about build up ?
Someone contacted Dr Castells and she said that daily benadryl was not a problem . Was she in this case referring to the first generation drug not ceterizine ? Ceterizine is prescribed up to 6 times a day here for very intractable conditions .

Diphenhydramine is in the same class of action as piriton and ketiofen . It seems to be the emergency drug of choice .

In the UK Oral and IV piriton - cholerpheneramine mealate , is on the anaphylaxis protocol here in the UK . Alongside hydrocoritsone ( solumedrol ) 200mg IV and salbutamol ( albuterol ) nebulisers .

I had wandered why no one was on Piriton routinely , you are , its just called benadryl .

many hugs
Josie

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Josie

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #10 - 04/03/11 at 01:42:18

Regards bendryl daily , this is the thread i read before :- from bendryl confussion .

Benadryl confusion (just spoke to Dr. Castells)
02/03/11 at 15:03:23 Quote
Hi gang,

I just spoke to Dr. Castells by phone as i've been having some bad lip / tongue / mouth swelling and she told me I could use Benadryl up to 200 mg / day if it helped and that there was no issue with that.

I know I read on this board lots of folks mentioning rebound issues and the fact that it can cause further degradation of mast cells, etc. but she said this wasn't the case. I'm so confused...where did folks who have been told to be wary of too much Benadryl hear it was something to be careful of? I'd love any feedback......

Thx so much!
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Lisa
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Re: Benadryl confusion (just spoke to Dr. Castells)
Reply #1 - 02/03/11 at 15:13:24 Quote
Hmmmm Well this is news to me Brita!!

If I remember correctly this information was given by Nancy Gould to one of our members here. Nancy is a very well respected masto patient and lay researcher. Nancy is a nurse who is now retired and she has SM, but Nancy's been studying and researching masto and MCAD and Dr. Castells knows her well. I never questioned this information about benedryl due to the fact of who Nancy is and her reputation amongst the masto world.

So, this is very interesting information you've got there and if this is what Dr. Castells herself has to say, then as far as I'm concerned, I'll no longer question it either. Dr. Castells is not only the doctor here, but an international authority with a PhD to match it and I'll take her word over that of any patient and the majority of other doctors out there every time!

Lisa

Jose

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Joan FORUM ADVISOR Offline Posts: 1502 Colorado	Re: Mast Cell Attack: Chocolate + Zyrtec???? Reply #11 - 04/03/11 at 05:27:10 I'm presuming Dr. Castells is referring to diphenhydramine when she says Benadryl. Also, surely that means 50 mg. of it, 4 times per day. If anyone knows differently, please correct this.
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Riverwn

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #12 - 04/03/11 at 11:09:39

Hi Jillibean

Im so sorry that happened to you but you know, given the stress youve been under lately Im not surprised. If I had to venture a guess, I would say it happened because you lowered your dose of gastrocrom added to your stress level. think it may have happened anyway with the situation at work. The stress is just too high.

I agree with Debbie about looking at the chocolate IF it is in a mix--and changing it. Think about going back on the Gastrocrom dosage from before.. and remember how much we love you

I am ready to headbutt anyone you choose! Until then, how about a bit of xanax?? Keeping you in my prayers Hon.. and sending much love!
Ramona

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caormiston

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Re: Mast Cell Attack: Chocolate + Zyrtec????
Reply #13 - 05/10/11 at 09:56:32

I had been taking Zyrtec for about 3 days because of my coughing/vomiting due to stress. 1st day, I felt feverish, achy, flu-like symptoms, shakes etc. Thought it was just me being weird. 2nd day was worse as was the 3rd day. Finally googled Zyrtec and found these symptoms were some of the rare side effects of Zyrtec. I googled Allegra and some others and found the same problem. I took some Benedryl this morning and find I feel a bit better (skipped the Zyrtec, or course) this afternoon. Still coughing and I gues I'll take more Ben. for that. I would suppose it might take some time for all the Zyrtec to leave the body, so I'm going to drink alot of water to help it along. Anyone else have this problem?
Candace

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