General symptoms caused by food intolerance?
Dear doctor,
I am in need of advice from a medical professional, preferably an allergist. For many years, I have been suffering from nonspecific but diverse symptoms that I have never been able to connect. My symptom diary spans almost 200 pages without any previous findings – until recently. I am a 37-year-old male, non-smoker, with an unhealthy to average diet, some exercise, and no alcohol.
My complaints include: a tendency towards nervousness, often high pulse, as well as high resting pulse. Especially frequent palpitations after fatty, rich, or unhealthy meals. Sometimes even ectopic heartbeats after alcohol consumption (which I rarely do), as well as after Chinese food (glutamate? histamine?). Often experiencing diarrhea, soft stools, occasionally stomach noises/digestive problems, no nausea, no vomiting. In addition, for the past few months, I have had discomfort in the throat area: tickling cough due to inflammation in the vicinity of the vocal cords and frequent mucus formation in the throat region. According to the ENT doctor, the mucus is located in the transition area of the larynx to the esophagus, can also be swallowed, and is a white to clear secretion. This mucus appears very strongly after certain foods or drinks, especially after sweet things, such as chocolate. It can last for hours.
My voice has also been affected by this. Although my symptoms may sound severe now, they are not always pronounced, so I could manage to live with them to some extent, but of course with a reduced quality of life. I have been through a series of doctors, suspecting gastric acid to be the trigger of the symptoms (reflux or silent reflux). Therefore, I even took proton pump inhibitors in high doses (up to 80mg of esomeprazole per day) and alginates as well as antacids – but it only got worse. I was on the reflux trip for a long time, until recently accidentally taking cetirizine due to a rash. Suddenly, I felt a significant improvement in symptoms, I became calmer, and digestion normalized.
Now it is becoming clear that it might be a histamine intolerance or another allergy. Allergy had never crossed my mind, nor the doctors', because I never reacted allergic to nuts or insect bites, for example. I have an extensive allergological examination coming up soon, but I wanted to seek advice in the meantime and would appreciate it if you could address the following questions in your response:
1. In your opinion, could my symptoms indicate an allergy/intolerance?
2. If it is not an allergy but an intolerance, can cetirizine still help?
3. Could my tendency towards heartburn be due to this allergy/intolerance?
4. I have always wanted to ask an allergist: Is levocetirizine advantageous over cetirizine? (Note: I took loratadine once years ago, but did not tolerate it well, no issues with cetirizine).
5. Is cetirizine suitable for food allergies or are there better medications?
Of course, I am also considering a change in diet, but I have already experimented a lot with it (back then because of suspected reflux) and have hardly achieved any success. By the way, my blood test results are normal.
Thank you in advance!
