Reddit mentions of Never Bet Against Occam: Mast Cell Activation Disease and the Modern Epidemics of Chronic Illness and Medical Complexity

Definitely worth looking into mast cell and histamine issues if Zyrtec helps you. Have a read of this https://www.amazon.com/Never-Bet-Against-Occam-Activation/dp/0997319615 and check out his YT video if you want to learn about MC disorders.

Hey u/excogito_ergo_sum, you should definitely look into mast cell activation syndrome based on symptoms and what meds have helped you. I highly, HIGHLY recommend reading this book about MCAS. Yes, it's $20 and not available in most libraries, but it is SERIOUSLY life changing. Best book I have read since I've been sick because it explains so. many. things. about mysterious symptoms and why the medications you're on are helping. Quite specifically, H1/H2 receptors are what Dr. Afrin (the author of the book and leading expert on mast cell activation syndrome) uses first in treatment - you are already on Zyrtec which is one of them. Next step is hydroxyzine, which you are already also on.

I was diagnosed and treated by Dr. Afrin after some of my other doctors learned of and began to suspect MCAS.

Regarding where to start, Afrin would be an excellent choice, but I hear he has a waiting list over a year long for new patients. I have some physicians in my family, and most of the diagnosis-searching was done by them, I was not very involved with the process. My primary symptoms are depression and severe fatigue (though the two can become difficult to separate), and during this time (~1-2 years ago) I was mostly too exhausted to do anything other than lay in bed 24 hours a day listening to audiobooks and sometimes watching netflix when I had the energy. I can try to find out about other doctors that might be able to diagnose it.

The price I see on amazon is $14.99 for the kindle version, so either I'm out of touch with the reality of book prices or it's being sold expensively elsewhere.
If you can't afford it, I'd advise trying to find somewhere to pirate it from, the purpose of the book is to spread awareness of MCAS, profit is probably a secondary objective.

Anywayway I hope what I've written makes sense, I took a bunch of supposedly non-psycoactive industrial hemp extract a while ago from what has just turned out to be one of those less-than-reputable online vendors I talked about in another comment because I ran out of CBD from my usual source today and needed these until I could get some more and they came on while i was writing this and I am now high as fuck. I'll edit my top level comment tomorrow with some additional information and try to get back to everyone over the next few days (my fatigue is better but far from gone, can't say how long this will take), I didn't expect this much of a response!

Hang in there.

I'm not a doctor, just a random stranger on the internet, but I am familiar with some of the symptoms you describe, and I do feel obligated to share a piece of information that may or may not be useful to you.

There is an illness called "Mast Cell Activation Syndrome", which has not been recognized until very recently, though it has probably existed for at least a century, if not longer. Symptoms can be extremely diverse, but are commonly of inflammatory nature. The underlyiing cause is inappropriate activation of mast cells (a type of immune cell present in virtually every organ). Common symptoms include rash, gastrointestinal problems, but also "weird" reactions to medications, supplements or foods. It can also produce neuropsychatric symptoms like generalized anxiety or emotional liability ([source][3]). Treatment is not easy, but usually includes medication that inhibits mast cell mediators, like H1 antagonists (often used for "hay fever") or H2 antagonists (often used for reflux). Low dose benzodiazepines have also been reported to work. Also worth noting is that some classes of medication are knowns to interfere with the body's process for disposing of mast cell mediatiors, in particular [MAO-inhibitors][4], which includes some antidepressants.

For more information on this disease, I highly recommend an [overview article by LB Afrin and GJ Molderings][1], and even more highly recommend [Dr. Afrin's book][2], which collects many case reports.

[1]: http://www.wjgnet.com/2218-6204/full/v3/i1/1.htm
[2]: http://www.amazon.com/Never-Bet-Against-Occam-Activation/dp/0997319615
[3]: http://www.ncbi.nlm.nih.gov/pubmed/26162709
[4]: https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor

Sadly, recognition among currently existing doctors is, ... uh, ... not up to par yet.

Anyway, I just wanted to throw this out here, to make sure that all information is on the table.

Check out Mast Cell Activation Disorder and a book by Dr. Lawrence Afrin:

https://www.amazon.com/Never-Bet-Against-Occam-Activation/dp/0997319615

I don't know if that is what you have, but it might be worth a look into this.