Hi:

I think you are on a good medicine regimen now.  It may take a while for all these to fully work, so you may have to supplement for awhile.  Hydroxyzine is on my list of antihist that I have used before.  25 mg at night wouldn't hurt you.  I was actually taking 75 mg per day for awhile (1 with each meal), but just could not sustain the "zzzzz" factor during the day cause I work.  One thing you should know is my dr. told me hydrox is a really good antihist, but it makes many sleepy (good one to take at bedtime), and it is short-acting (say 4 hrs or so I think he said).  So, should you add it or not?  Might be a good one to add at bedtime to help you sleep and feel better while you sleep.  It is also a good rescue med if you can sit down and relax zzzzzz.  The only reason I was taking it 3 x a day was everything I was eating was making me flare so urologist tried it on a short-term basis just to get things settled down, but I couldn't sustain it.  Then my allergist said, hey take zyrtec instead, it is the second generation of hydrox, and it didn't make me zzzz all day.  I can take zyrtec multiple times a day and it helps, but some swear by hydrox for emergencies and at night.

One more note...finding food triggers is really tough if you are getting non-anaph.  leaking symptoms.  Best just to go on the diet "whole-hog" the first year and then add foods back in...that is what I did w/IC diet, which is basically low histamine diet + about 20 other items, which include almost all fruits (yep it sucked!...man, I wanted my ketchup, tomato sauce, and fruit - - the only one you can eat is pears on that diet...so wore myself out on pears).  BUT, once you get your symptoms calmed down with meds and diet, you can figure what is causing ups and downs more readily.  I actually found I am not very food sensitive, except for very spicy foods, alcohol, MSG(real killer for me and hidden in many processed foods), fish, spinach and a few other things like anti-inflammatories)...funny  I have a hard time with, you guessed it, FISH!   But, although I am DEATHLY allergic to pecan trees, I can tolerate pecans, weird!  I can eat strawberries in small amounts, but blueberries are not my friends.  So the food puzzle is tough to solve unless you start from scratch...for awhile I kept a food diary in a pocket calendar, so you might try that too.  I am very heat and environmental allergen sensitive more so than foods.  Once your general level of wellness is better, you can introduce things, and just see.  

Sorry loooong post!  Good luck and hang in there.  The diet thing stinks, but if you can do it for awhile, it can really open your eyes to what you can and can't tolerate.

It can't hurt to stay completely on the low histamine diet for a week or two and see if it helps.  Still, you're not on a maximum dosage of gastrocrom.  That would be 2 vials, 4 times/day, but ask your doctor about that before you increase.  I don't know about that amount of Allegra, but your doctor should know if it's okay.  Also, you might want to ask about increasing the Zyrtec at night first.

Do you know on what evidence the GI MCAD was diagnosed?  Is that the same as Mastocytic Enterocolitis?  There is a specific protocol for ME.

In your situation, the main question to ask myself would be, "Are the antihistamines helping?"  If they're helping, but not enough, then okay.  If they're not really helping, and the diet is perfect, then I would keep looking for other answers or comorbid conditions.

Don't have time to look it up, but have you been tested for parasites?  They can cause mast cell instability in the gi tract.

Unfortunately, Allegra causes me to have GERD...I get a bit with Singulair too, but an using it anyway because it is helping with neuropathic pain..which is a beast for me.  For me, zyrtec is the least side effect of all, but we are all different as you know.  For some Allegra is the key, I just couldn't tolerate it, but you may very well be able to.  It will be hard at first to figure out triggers because your symptoms probably are not under as a control as they eventually will be.  As they get better, it is easier to figure out that something has triggered you. I stayed strictly on the diet for a year (keep in mind mine was IC which closely mirrors hist, but also basically no fruit) and then started introducing, but for some people, they may only need a few months, everyone is different.   Oh and yes Allegra kind of amps me up too!  That is probably a benefit so I am not dragging my tail behind me!

Ramona

Thanks for the tip...I may try that later on.  Right now the tip you guys gave me to go back and try singulair is working great for the pain, knock wood, so I may not need to add the Allegra,but if I do, I will add it that way to see if I can do it without the dreaded GERD.

Kim

Hey how is the hydroxide going? My husband used that along with 25 Mg of doxepin but he would get crazy vivid scary dreams from the hydroxine so we just used the doxepin for a long time and he did really good on that. Some people react to the doxepin but I just found out that doxepin is an H1 and H2 histamine blocker. These are both sedating and first gen antihistamines...in larger doses the doxepin is used as an anti depressant so it's supposed to be a bit of a mood elevator and the hydroxine in higher doses is supposed to be more anti anxiety so it can help calm you. When my husband was at his worst both of those were good additions for the strong antihistamine properties as well as who wouldn't need to have their mood elevated and a little anti anxiety help (especially when you don't know what the heck is going on)!

We have found allegra to be a game changer and a huge help. When he first tried it for 3 days it was like he swallowed a bag of cocaine...it freaked me out because he was up for 18 hours but nice to see him with some energy. After 3 days his body adjusted and we eventually replaced his afternoon Zyrtec with the allegra (he was taking claratin in the am and we switched to allegra)...now if he has a GI disturbance or something is breaking through we give him 10or20mg of Zyrtec or 25mg of benadryl and 150mg of Zantac.  My pharmacist also said that taking allegra at night can cause insomnia. So maybe try allegra in the am and see how it goes, Dr Castells told us we should have started with a lower dose and that's why he was so speedy.

I would highly recommend adding quercitin through the day as it's a natural antihistamine, antiinflamitory and repairs cell damage. We use 500 Mg 3x day and we also use neuroprotek by algonot and is the only natural supplement developed to help stabilize mast cells.  The neuroprotek is in olive oil that helps the body absurd it better because you only keep maybe 10% so that's why we take it throughout the day.

I hope you're feeling better and that you had good results with he hydroxine. Oh I also got a really good text book by vickerstaff and there's a whole section on histamine diet ect I could email it to you if you send me your private email...I'm trying to figure out how to post it on here and will ask deborah if there's a way to do it.