When To See A Doctor
Talk to your primary healthcare provider if you are experiencing one or more of the above symptoms. While these symptoms may not necessarily mean that you have thyroid disease, your doctor can make a proper diagnosis by conducting a blood test and other assessments.
How to diagnose hypothyroidism
The correct diagnosis of Hashimoto’s hypothyroidism depends on these factors:
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Symptoms: Your doctor will ask you about your symptoms, their intensity, and when they started.
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Medical and family history: Tell your doctor about your medical history, including previous surgeries and medications that you take now or in the past. Your doctor will also ask about your family history and whether anyone has been diagnosed with autoimmune or endocrine issues.
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Physical exam: Your healthcare provider will look for changes in your skin, like swelling, dry skin, or slower reflexes, and theyll check your thyroid gland.
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Blood tests: TSH and T4 tests are the two most commonly used blood tests in diagnosing hypothyroidism. The pituitary gland secretes TSH to stimulate the secretion of the thyroid hormones, and therefore, when thyroid hormones are low, TSH is secreted in higher amounts. When this is detected in addition to low T4, this indicates hypothyroidism.
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Antibody tests: Considering that hypothyroidism can be caused by diseases other than Hashimoto’s thyroiditis, an antibody test is often required to confirm the diagnosis.
Treatment of Hashimotos disease-associated hives
When To See A Healthcare Provider
Hives are often short-lasting and non-severe. Even so, there may be times when hives are an indication of a severe, whole-body allergy known as anaphylaxis.Anaphylaxis is a medical emergency that can lead to shock, coma, heart, or respiratory failure, and death if left untreated.
- A sudden outbreak of hives or rash
- Difficulty breathing, including shortness of breath and wheezing
- Abnormally rapid heartbeat
Is A Skin Rash A Symptom Of Hashimotos Disease
Hashimotos disease can have a wide range of symptoms. Although this condition originates in the thyroid gland, it can affect the skin, nails, and hair. For that reason, it can be a dermatologist who first notices the signs of Hashimotos disease.
Keep reading to learn more about the connection between Hashimoto’s disease and chronic skin rash/hives and the treatment plans available.
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What Are The Most Common Thyroid Problems
The thyroid gland is a very important body organ. Through the production and secretion of the two thyroid hormones thyroxine and triiodothyronine , it is responsible for multiple body functions.
Unfortunately, the thyroid gland is often affected by hypothyroidism or hyperthyroidism the two most common thyroid problems.
As a result of the low production of the thyroid hormones, a condition known as hypothyroidism develops. It characterizes itself with symptoms such as cold intolerance, fatigue, weight gain, depression, constipation, muscle, and joint aches, etc.
On the other hand, as a result of too much thyroid hormones being produced, a condition known as hyperthyroidism develops. Some of the most characteristic hyperthyroidism symptoms include an enlarged thyroid gland, hyperactivity, diarrhea, mood changes, sensitivity to heat, etc.
Chronic Hives Its Origin And Clinical Names
The medical term for hives is Urticaria. Hives is a skin condition evidenced by pink or red raised swellings, which are also called wheals. These welts are smooth to touch and circular in shape. They are often itchy or have a burning sensation.
Hives appear on any part of the human body, and they can join and form clustered areas called plaques. Hives disappear on their own after a few hours. However, new ones may appear again, and the cycle continues.
There are cases wherein the urticaria is chronic, which means the person has hives on a daily basis for more than six weeks. This could be attributed to food allergy usually to nuts and seafood. It could also be caused by stress, or environmental allergens, such as pollen grains, dust, and dirt.
When the source is unidentifiable, it is called Chronic Idiopathic Urticaria.
Chronic hives happen when histamines are always present in the bloodstream. Histamines are released by the body when it feels that there is a threat, such as allergens, causing inflammation or swelling in some areas of the body.
It is a response of the body to protect itself. Some hives are accompanied by angioedema or the swelling of the throat and tongue.
Urticaria is pretty common, with around 20% of the population having this condition. Around 25% of the cases have chronic urticaria, while 75% of them have considered their condition as idiopathic in nature.
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Efficacy Of Treatment With Thyroid Drugs On Csu Symptoms
A total of 22 studies assessed the effects of thyroid medication including levothyroxine , methimazole , propylthiouracil , and triiodothyronine on CSU . For seven studies, the drug that was used for the treatment was not specified in the publication.
Of 285 patients treated with thyroid medication, CSU was improved in 120 patients. Fourteen studies reported complete remission of CSU in 68 patients and partial improvement in 28 patients ., , , , , – Beneficial effects were not specified in 24 of 285 patients in two studies and were not seen in six studies in all patients. In total, 182, 85, and 18 patients were hypothyroid, euthyroid, and hyperthyroid, respectively. Treatment of hypothyroidism , euthyroid CSU patients , and hyperthyroidism led to improvement or remission of CSU in 28% , 67% , and 67% of patients, respectively. In five of 17, two of 10, and two of six studies, treatment of hypothyroidism, euthyroid CSU patients, and hyperthyroidism, respectively, had no effect on CSU in any of 64, 4, and 6 patients.
Patients with CSU in four studies were treated for HT or GD. Urticaria improved in 24 of 34 CSU patients with HT and in five of 10 CSU patients with GD., , ,
First effects of levothyroxine treatment on CSU were seen after 3-12 weeks., , According to one study, CSU symptoms decreased within 2 months after the start of treatment of hyperthyroidism with thiourea drugs.
Assessment Of Quality Of Evidence And Strength Of Associations
The links between CSU and AITD were assessed using a rating system as previously described. Based on the outcome and number of studies, we categorized the levels of scientific evidence for association as follows:
- strong: three studies available that find an association in the same direction or 4 studies available, of which more than two-thirds find an association in the same direction and no more than 25% find an opposite association
- weak: two studies available that find an association in the same direction or three studies available, of which two find an association in the same direction and the third study finds no association
- no/too little evidence: 1 study available
- inconsistent: remaining cases.
- strong: > 4 studies are available, of which > 85% find no association
- weak: > 4 studies are available, of which > 75% find no association.
Because of the heterogeneity of data reported by the publications analyzed, that is, the identified studies are variable in design, patient population, disease definition, and laboratory methods, we did not perform a formal meta-analysis and, instead, used a descriptive approach.
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Whats The Difference Between Hives And Chronic Hives
Chronic hives are different than acute hives:
- Acute hives start to fade within 24 hours . They are gone within six weeks. A recent viral infection often causes acute hives.
- Chronic hives are visible at least twice per week for more than six weeks. Some chronic hives last for months or years. The cause is often unknown.
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 patients immune system.
Scientific studies have linked a number of autoimmune diseases to chronic urticarial up until now, including:
- Rheumatoid arthritis
- Systemic lupus erythematosus
- Celiac disease
Another autoimmune disorder that has been linked to the development of both chronic urticarial and Thyroid-related issues is Hashimotos disease. In fact, Hashimotos 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.
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The Hashimotos Hives Ibs And Blastocystis Connection
Did you know that people with Hashimotos are more likely to develop the skin condition chronic spontaneous urticaria , which is manifested by widespread, itchy and swollen skin rashes? These hives can be very distressing, and they can seem to come up randomly. However, they are quite common in fact, forty-two scientific studies have linked Hashimotos with chronic hives!
People with Hashimotos are also more likely to develop irritable bowel syndrome , a chronic condition that affects the large intestine and often shows up before ones Hashimotos diagnosis. This condition can manifest as either diarrhea or constipation, or both, and may also cause excess gas, bloating, abdominal pain, and cramping that is often relieved after passing a bowel movement.
As mentioned previously, a Blasto infection can manifest as symptoms related to the skin and gut, but much controversy is out about this protozoan. Some studies, namely from Thailand and Mexico, suggest that this is a commensal organism . Thus, doctors may be told that there is no need to treat it.
However, studies from Europe, Australia, and the Middle East, have connected this pathogen to not just chronic hives, but also irritable bowel syndrome, both of which are very common manifestations in the early stages of Hashimotos.
This begs the question are hives, IBS and Blasto all connected? Lets take a look at the current research.
Medical Conditions That Cause Hives
Hives are hard to ignore. These patches of itchy, swollen skin can range in size from a tiny pinpoint to a large, uncomfortable rash the size of a dinner plate.
When you have acute hives, they usually last for less than 24 hours. But they can also come in waves, coming and going over days or several weeks. However, its also possible to get chronic hives that last for six weeks or even longer.
Unfortunately, you can develop hives for several reasons, which can make their cause challenging to diagnose. Our team at Advanced Allergy & Asthma shared these insights into the most common medical causes behind hives.
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Are Chronic Hives Related To Autoimmune Thyroid Disease
If you have ever suffered from chronic hives, you know how miserable they can be. Hives are raised, red areas on the skin that can be very itchy, making a person miserable and negatively affecting sleep and overall quality of life. Up to 20% of people experience hives sometime during their lifetime. When hives last for less than 6 weeks, the condition is called acute urticaria. When longer than 6 weeks, it is called chronic urticaria. Individual hives generally show up in groups anywhere on the body and usually resolve within 24 hours but often are replaced by new ones. Hives are caused when mast cells, a type of immune cell, that are in the skin become activated and release histamine. The histamine causes the swelling, redness, and itchiness. The first line of treatment for CSU is second-generation H1 antihistamines1, but for many people this only gives partial relief, and some people might not experience any change in symptoms. Furthermore, this treatment is mainly addressing the symptoms and does not address why these mast cells are getting activated in the first place.
Lifestyle And Home Remedies
- Try to identify and avoid substances that irritate your skin or that cause an allergic reaction. These can include foods, medications, pollen, pet dander, latex and insect stings.
- Use an over-the-counter antihistamine. A nonprescription oral antihistamine, such as loratadine , cetirizine or diphenhydramine may help relieve itching.
- Apply cool, wet compresses. Covering the affected area with bandages and dressings can help soothe the skin and prevent scratching.
- Take a comfortably cool bath. To relieve itching, sprinkle the bath water with baking soda, uncooked oatmeal or colloidal oatmeal a finely ground oatmeal that is made for the bathtub .
- Wear loose, smooth-textured cotton clothing. Avoid clothing that’s rough, tight, scratchy or made from wool. This will help you avoid irritation.
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What Tests Will I Have
To diagnose Hashimoto’s disease, your doctor will order a hormone test and an antibody test. If your thyroid is underactive, the level of thyroid hormone will be low and your TSH will be elevated. The antibody test will confirm the presence of antibodies against thyroid peroxidase , an enzyme normally found in the thyroid gland that plays an important role in the production of thyroid hormones. A low TSH would suggest more of an overactive thyroid state.
When To See A Gp
See a GP if you have symptoms or signs of an overactive thyroid. It might be useful to make a list of all your symptoms and show it to a GP.
These symptoms and signs can have a number of causes. But a blood test can often help to determine whether they’re caused by a thyroid problem.
Page last reviewed: 24 September 2019 Next review due: 24 September 2022
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Who Is Affected By Chronic Spontaneous Urticaria
CSU occurs in about 1% of the adult population2, and it is more common in adults than children3 and in women than men4. However, since the early 1900s, there has been a link between chronic hives and autoimmune disease. In the 1980s, Leznoff et al. identified that autoimmune thyroid disease in particular was more common in people suffering from chronic urticaria5 than people without CSU, but the importance of this association has not been understood. Researchers have asked whether thyroid autoimmunity causes CSU in some people, or is it simply something unrelated that just happens to occur alongside chronic hives?
What Is The Treatment
Treatment for Hashimoto’s disease depends on your situation. If your thyroid is functioning normally and your hormone levels are not deficient, your doctor will likely want to keep a close eye on your symptoms and lab tests. If you do have thyroid hormone deficiency, you will need a synthetic hormone and will require close monitoring to make sure you’re taking the right dosage to fix the problem. An overactive thyroid would be treated with medications and/or radioactive iodine.
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Thyroid Glands Functions And Common Dysfunctions
How about the thyroid then? The thyroid gland is located at the base of the neck of an individual. It is a two-inch, butterfly-shaped organ near the throat. It is a vital part of the bodys endocrine system because it regulates the release of hormones for metabolism control of the body.
Despite this organs small size, it is vital because it controls basic bodily functions, including breathing, heart rate, cholesterol levels, body temperatures, and more!
The most common issue with this organ involves the imbalance in the release of Triiodothyronine and Thyroxine . Imbalance of these two may usually result to either hyperthyroidism or hypothyroidism. However, there are other problems encountered by the thyroid gland, one of which is the Hashimotos disease.
It happens when the bodys immune system attacks the thyroid gland, leading to hypothyroidism. On the other hand, the thyroid can enlarge and cause hyperthyroidism, which is caused by Graves disease.
Blastocystis Hashimotos And Hives
Blasto may be present in up to 50 percent of people in developing countries.
A study of 54 people in Egypt with chronic urticaria revealed that Blastocystis hominis was found in 61 percent of them, while only eight percent of the healthy controls had the parasite. Researchers have suggested that the amoeboid form of Blastocystis hominis is more infectious than the protozoa form, and that it can adhere better to gut cells. Interestingly, the Egyptian study found this form in 60.6 percent of the Blastocystis infected people with hives, while none of the Blastocystis infected controls had this form.
In a letter to the editors of the British Journal of Dermatology, Dr. Tilo Biedermann from the Ludwig Maximilian University of Munich, reported that urticaria and reactions to NSAIDs subsided after treating 10 subjects infected with Blastocystis, with paromomycin , for 10 days.
Another drug, called Alinia , is an FDA-approved antiprotozoal for treating other parasites, and has been helpful in eradicating Blastocystis hominis. One study showed that it eliminated symptoms in 36 of 42 of patients who were put on a four-day treatment of nitazoxanide. This was exciting news, as the parasite had been shown in other studies to be highly resistant to Flagyl , the usual drug of choice.
A 2014 study found that almost 25 percent of people with chronic urticaria also had Hashimotos, and addressing an underactive thyroid with levothyroxine could result in a clinical remission of hives.
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