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Is There A Connection Between Hives And The Thyroid?
Scientific studies are always on the lookout for more effective measures to treat the thousands of diseases that can affect the human body.
With Thyroid function being an especially important aspect to overall human health and metabolism of every single cell in the body, many studies are aiming to provide more insight into what causes the Thyroid gland to become impaired, and also look for solutions to more appropriately treating these problems.
An underactive Thyroid gland, a condition referred to as Hypothyroidism, is a common type of Thyroid disorder that affects about 2% of the global population, with women being affected most1. The primary cause of Hypothyroidism in the United States is an autoimmune condition known as Hashimoto’s Disease.
New studies have now confirmed that a connection may exist between Hives, a condition also known as chronic urticarial, and this particular autoimmune disease that causes the Thyroid gland to become a victim of the immune system.
While there are still a lot of research to be conducted on the connection that is shared between Thyroid function, Hashimoto’s Disease and chronic urticarial, current study data related to this topic do provide some insight into how treating one condition may assist with relieving the symptoms of the other.
In this post, we will explore the connection between these conditions, consider the appropriate treatment methods that should be implemented to assist with alleviating symptoms, and also consider the current level of evidence available to better understand how Hashimoto’s disease can lead to the worsening of symptoms related to chronic urticarial.
Chronic urticarial is a condition that is diagnosed when a person experiences symptoms of hives on a daily basis over the course of more than six weeks. Hives is a relatively common condition that affects approximately 20% of the worldwide adult population2.
While a particular cause can be identified in some patients who suffer from chronic urticarial, the majority of patients experiences the condition with no obvious cause behind the daily hives symptoms they experience. When no particular cause can be pointed out to the condition, the patient is diagnosed with a condition called chronic idiopathic urticarial.
The symptoms of chronic urticarial can be triggered by a variety of factors. In some patients, consuming certain types of food can cause a trigger of the symptoms associated with hives. Common foods that causes such a trigger include peanuts, wheat, dairy products, nuts, eggs and fish.
There are also environmental allergens that can act as a trigger, such as pollen.
Unfortunately, in many cases, a trigger and particular cause of these episodes cannot be identified. This makes the treatment of chronic urticarial more challenging, as one of the primary treatment measures that are advised to a patient diagnosed with the condition is to avoid the particular triggers that are causing them to experience a flare up of the symptoms.
How Autoimmune Disease Are Linked To Chronic Urticaria
Autoimmune diseases are a series of disorders where the immune system goes awry and, in turn, starts to attack healthy tissue within the human body. It has already been established that a connection exists between several autoimmune diseases and an increased risk of developing chronic urticaria.
One review paper3 describes that autoantibodies that act against immunoglobulin E receptors are found in the majority of patients who are diagnosed with chronic idiopathic urticarial, which is considered an autoimmune reaction by the particular patient’s immune system.
Scientific studies have linked a number of autoimmune diseases to chronic urticarial up until now, including:
- Rheumatoid arthritis
- Sjogren’s syndrome
- Type 1 diabetes
- Systemic lupus erythematosus
- Celiac disease
Another autoimmune disorder that has been linked to the development of both chronic urticarial and Thyroid-related issues is Hashimoto’s disease. In fact, Hashimoto’s disease is considered to be the most common cause of Thyroid impairment, or an underactive Thyroid, among the female population in the United States. This autoimmune disease causes the immune system to start attacking healthy Thyroid tissue.
When Thyroid tissue is mistakenly attacked by the immune system, it causes the Thyroid gland to become impaired and, in turn, leads to a reduction in the synthesis and secretion of important Thyroid hormones into the bloodstream4.
Scientists and medical experts have not yet been able to identify the exact way that Hashimoto’s disease causes a higher risk of developing chronic idiopathic urticarial.
Still, a connection has been identified, which has allowed medical experts to provide a more effective treatment approach to patients who might be experiencing the symptoms of chronic idiopathic urticarial. Medical experts have provided some explanations as to why this particular connection may exist.
The most commonly described connection lies within the effects of these autoimmune diseases in the body. It is known that individuals who suffer from an autoimmune disease are at a significantly higher risk of developing inflammation, when compared to those individuals who do not have any autoimmune disease.
At the moment, it is believed that the higher rate of inflammation in the bodies of individuals who are suffering from autoimmune Thyroiditis, or Hashimoto’s disease, is where the connection lies. When the autoimmune disease causes the patient’s body to become more prone to developing inflammation, it may also aggravate their symptoms of hives, and, in turn, lead to the development of chronic idiopathic urticarial5.
Administering Appropriate Treatment Options
A study6 that was conducted by the Donnguk University Ilsan Hospital found that, among a group of patients who were suffering from both Hypothyroidism and chronic urticarial, providing the right treatment protocols for the treatment of Hypothyroidism caused some participants to experience a remission of their chronic urticarial.
The individuals who were involved in the study all suffered from Hypothyroidism due to the presence of an autoimmune condition that caused impairment of their Thyroid function.
This did not only provide a further confirmation that a relationship does exist between the two conditions, but also provided a means of addressing both conditions through a single treatment approach – which is considered beneficial, since taking a lot of different prescription drugs put a patient at a higher risk of experience adverse reactions to the medication, and also causes an increased risk of interactions occurring between the different medications.
Due to the verified connection between Hypothyroidism caused by an autoimmune reaction, and chronic urticarial, patients who frequently experienced the symptoms that are associated with chronic urticarial are advised to learn about the potential symptoms of Hypothyroidism.
When these symptoms also become present in a particular patient, they are advised to request a blood test to determine the levels of Thyroid Stimulating Hormone, as well as T3 and T4 hormones in their body. This will assist a physician in determining whether the patient may be suffering from Hypothyroidism as well, and might provide a more effective approach to treating the condition.
As described previously, Hypothyroidism is a condition where the Thyroid gland is unable to produce an adequate supply of Thyroid hormones. Since the Thyroid gland’s hormones are primarily involved in metabolic functions in the body, symptoms associated with the condition is caused by a slowdown in overall metabolism.
Not all patients who develop Hypothyroidism will experience the same symptoms, but there are some general symptoms that are associated with the condition – patients should learn about all of these symptoms and look for the presence of one or more symptoms.
Fatigue is usually one of the most commonly associated symptoms. Another very common symptom that is associated with an underactive Thyroid gland is weight gain. The weight gain is usually brought on by the reduced rate of gastrointestinal metabolism. In addition to weight gain and fatigue, patients with Hypothyroidism may also experience some of the following symptoms7:
- The skin may become dry. Hair may also become thin.
- Patients may find that they become more sensitive to cold temperatures.
- The face may become puffy.
- Muscle weakness is another relatively common symptom.
- Memory function may become impaired and concentration difficulties may also develop.
- Patients with Hypothyroidism are also more likely to experience symptoms associated with depression.
- Heart rate may become slow.
- Among female patients, menstrual periods may become heavier than normal or irregular.
- Joints may become stiff and swollen. Joint pain is also not uncommon.
- Blood cholesterol levels may become elevated.
- Muscles may ache and feel stiff. Muscle tenderness may also develop.
When symptoms of both Hypothyroidism and chronic urticarial are present in a patient, tests can assist with diagnosing the specific conditions.
In such a case, a patient may be administered a daily dose of Levothyroxine8. Studies have confirmed that when Levothyroxine is used as a treatment protocol to address Hypothyroidism, there is a possibility that chronic urticarial may ease and the symptoms associated with this particular skin condition might reside.
Should the patient continue to experience hives, even with appropriate treatment protocols being provided to address Hypothyroidism, a number of additional drugs and treatment protocols may be utilized in order to alleviate these symptoms.
Antihistamines are the most common type of drug provided to a patient who continues to experience breakouts of hives. This usually includes H1 second-generation antihistamines. Patients may be provided a nonsedating option to ensure they can take the medication during the day without becoming tired or experiencing mental impairment.
There are other types of medication that can also be utilized in order to address the symptoms caused by chronic urticarial. This may include:
- Leukotriene antagonists
- Systemic corticosteroids
In most cases, antihistamine medication is the first option utilized to assist in alleviating these symptoms.
When the combination of Levothyroxine and antihistamines do not provide the patient with an adequate relieve of the symptoms they experience, then a doctor will continue to prescribe other types of medication used to treat hives in order to find a particular combination of prescription drugs that can help the patient experience a remission of their hives symptoms.
Methotrexate and cyclosporine are two types of medication that are only provided to patients when it has been verified that their chronic urticarial symptoms are caused by an autoimmune reaction within their body.
Systemic corticosteroids are also only rarely prescribed to patients with chronic urticarial, and would usually only be provided when additional worrisome symptoms have become present in the patient, such as angioedema9.
Thyroid disorders are relatively common among the general population, with the majority of patients suffering from these condition being female.
Recent studies have provided evidence that, just like how chronic idiopathic urticarial has been linked to a number of autoimmune diseases, a connection between the condition and Hypothyroidism also exists.
Studies have also provided evidence that administering appropriate treatment for addressing Hypothyroidism might assist in alleviating the symptoms a patient is suffering from due to chronic idiopathic urticarial.
In this article, we discussed the possible connection between these conditions, as well as how treatment can assist in addressing symptoms caused by both.
1 Mario Skugor. Hypothyroidism and Hyperthyroidism. Cleveland Clinic: Center for Continuing Education. August 2014. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/hypothyroidism-and-hyperthyroidism/
2 What Is Chronic Idiopathic Urticaria (Hives). WebMD. https://www.webmd.com/skin-problems-and-treatments/chronic-skin-rash
3 Kathleen Fraser and Lynne Robertson. Chronic Urticaria and Autoimmunity. Skin Therapy Letter. 1 December 2014. http://www.skintherapyletter.com/urticaria/autoimmunity/
4 Hashimoto’s Disease. PubMed Health. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025658/
5 Mary Shomon. Is There a Link Between Your Thyroid Disease and Chronic Hives? Verywell Health. 12 March 2018. https://www.verywell.com/thyroid-linked-to-chronic-hives-autoimmune-urticaria-3232750
6 Do Hun Kim, Nam Hee Sung and Ai Young Lee. Effect of Levothyroxine Treatment on Clinical Symptoms in Hypothyroid Patients with Chronic Urticaria and Thyroid Autoimmunity. Annals of Dermatology. 31 March 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828383/
7 Hypothyroidism (underactive thyroid). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284
8 Ali J. Chakera, Simon H.S. Pearce and Bijay Vaidya. Treatment for primary hypothyroidism: current approaches and future possibilities. Dovepress. 22 December 2011. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267517/
9 Marla N. Diakow. Chronic Urticaria. Medscape. 15 May 2017. https://emedicine.medscape.com/article/1050052-overview