One of the first noticeable symptoms of hypothyroidism is dry skin, hair and nails. As it turns out, there is good reason for this. All three are considered ‘low priority’ on your body’s survival scale. What this means is that when the body is stressed, nutrients and other things needed for survival are directed to those organs required for survival, like the brain, heart, lungs and so on. Your skin, hair and nails, at the bottom of the pecking order, are amongst the first to lose out. Therefore they’re also the first things to show symptoms that indicate something is amiss on the inside. One of those symptoms is hypothyroidism rash along with dry, flaky skin, and brittle nails and hair.
Thyroid hormones affect every cell in the body. They’re involved in every metabolic pathway in your body; from how the body utilises the food you eat to how your gut functions to cellular metabolism and respiration. When these hormones are low or your cells are resistant to using them efficiently, as is the case with hypothyroidism, your whole body is disrupted.
Hypothyroidism, Gut Health, Nutrition And Your Skin
Low thyroid hormone levels directly impact gut health with flow on effects to other parts of the body. Gut related health problems like leaky gut, immature intestinal mucosa, impaired production of gastric acid, food sensitivities, fungal and bacterial overgrowth, pathogens, sluggish gut motility and various gut disorders like bloating, gas, constipation etc, are all associated with low levels of thyroid hormones. This impacts nutrient absorption as well as facilitates the build up of toxins, resulting in inflammatory conditions that increase the chances of developing autoimmune diseases.
Furthermore, when your uptake of nutrients is impaired because your gut isn’t working properly, your skin (and nails and hair) is the first to feel the pinch. Blood flow to the skin is reduced in order to conserve nutrients for more important processes and this is hugely significant for skin health on 2 counts.
First of all, as the supply of nutrients and oxygen to your skin cells drops off it directly affects cellular metabolism. Cellular metabolism is the process by which cells take in nutrients like glucose, which is converted to cellular energy by the mitochondria, and then expels the toxins that are by-products of this process (like your lungs take in oxygen and expel carbon dioxide). As a result the skin’s ability to perform basic functions like regeneration and repair of skin cells is impaired.
Interesting Questions about Thyroid:
The leading cause of hyperthyroidism is an autoimmune disease called Graves’ Disease.
The leading cause of hypothyroidism is an autoimmune disease called Hashimoto’s thyroiditis.
Autoimmune diseases in general
Autoimmune diseases tend to run in families. In other words, there is a strong genetic predisposition to develop one or more autoimmune diseases. Females are affected five times more than men by autoimmune disease. Patients with other autoimmune diseases are more likely to develop autoimmune thyroid diseases.
Researchers are trying to unlock the mysteries of autoimmune diseases, but there are still many unanswered questions. Basically an autoimmune disease occurs when the immune system produces antibodies that attack healthy tissues. In Graves’ disease, the immune system produces anti-thyroid antibodies that cause the thyroid gland to make too much thyroid hormone. In Hashimoto’s thyroiditis, antithyroid antibodies damage the thyroid gland and prevent it from producing enough thyroid hormone.
Autoimmune diseases associated with a higher than normal rate of thyroid autoimmune diseases
- vitiligo (patchy loss of skin coloration)
- alopecia areata (sudden, circular hair loss)
- premature gray hair
- pernicious anemia (inability to absorb B12)
- rheumatoid arthritis
- myasthenia gravis (episodic muscle weakness that can affect vision, speech, swallowing, and breathing )
- Lupus erythematosus ( connective tissue disorder)
- insulin-dependent diabetes
- Addison’s disease (adrenal insufficiency)
- premature ovarian failure
Tests for antibodies present in autoimmune thyroid disease
- TPOab (thyroperoxidase antibodies)
- TGab (thyroglobulin antibodies)
One of these two types of antibodies is found in nearly all patients with Hashimoto’s thyroiditis and in approximately 50% of patients with Graves’ disease.
- TRab (thyrotropin receptor antibodies; also called thyroid stimulating immunoglobulins or thyroid stimulating antibodies.)
The eye changes associated with Graves’ disease can be called either Graves’ ophthalmopathy, Graves’ orbitopathy, or Graves’ eye disease. Approximately 50% of the patients with Graves’ disease develop some eye disease, but the eye changes may be so subtle that patients are unaware of them. For most patients with Graves’ disease, eye involvement is minimal. Severe orbitopathy occurs in less than 5% of patients with Graves’ disease.
Graves’ eye disease is not caused by thyroid dysfunction. Graves’ disease is an autoimmune disease that affects the eyes and the thyroid gland independently of each other. Thus, the hyperthyroidism may improve with therapy, while the eye disease stays the same or gets worse. Even though the thyroid disease and the eye disease run independent courses, it is important to treat the hyperthyroidism associated with Graves’ disease.
An ophthalmologist is usually involved in the treatment of Graves’ eye disease. Most thyroidologists and endocrinologists should be able to recommend an ophthalmologist experienced in the treatment of Graves’ eye disease. In addition, The Thyroid Society maintains a list of such ophthalmologists throughout the country.
Symptoms of Graves’ eye disease may include a feeling of irritation or sand in the eyes, double vision (diplopia), and excessive tearing. Inflammation and swelling behind the eye may cause actual protrusion of the eyeball from the orbit. When this protrusion occurs, it is called exophthalmos or proptosis.
When the eye changes are severe, there may be marked swelling of the eye, inability to move an eye, corneal ulceration, and in extreme cases, loss of vision. Fortunately, these severe changes occur infrequently, but when they do occur, consultation with an ophthalmologist is essential. Graves’ eye disease usually affects both eyes, although each eye may be affected to a different degree. In some cases, only one eye is affected.
The course of Graves’ eye disease is unpredictable. The initial, or active, phase of Graves’ eye disease may last for eighteen to twenty-four months. During this time period, the eye signs and symptoms may change considerably. For this reason, physicians are reluctant to use certain treatments, such as surgery, during this phase, fearing that ongoing inflammation will cause the eyes to change again after surgery. Thus, most physicians advise patients to defer treatments such as surgery until the eye disease goes into an inactive phase. Of course, if a patient’s symptoms are severe or if loss of vision is threatened, then all available treatments will be used at any time, even during the active phase.
Most patients will receive only symptomatic treatment during the active phase of Graves’ eye disease (see list below). Most importantly, it should be stressed that smoking aggravates Graves’ eye disease.
Physicians may advise the following to relieve symptoms associated with Graves’ eye disease:
- discontinue smoking
- avoid smoke-filled rooms
- use lubricating eye drops
- cover eyes while sleeping
- wear wrap-around dark glasses outdoors during the day
- elevate the head of the bed to reduce overnight eye swelling
- wear prism glasses, or cover one eye with a patch, to relieve double vision
- turn ceiling fans off before going to bed
- avoid exposure to strong sunlight
- avoid or limit wearing contact lenses
- take diuretics temporarily to relieve swelling around the eyes
When symptoms of inflammation are severe, either steroids in large doses or radiation therapy may be advised. Surgery (orbital decompression) is sometimes recommended when the inflammation is so severe that loss of vision is threatened. The choice of therapy among steroids, radiation, and surgery (used individually or in combination) and the timing of therapy require a great deal of thought on the part of the team caring for the patient with Graves’ eye disease.
Once the inflammation in the eyes has stabilized, or entered the inactive phase, patients may then have surgery to relieve signs and symptoms, such as lid retraction, swelling around the eyes, or double vision. Ophthalmologists specializing in plastic surgery of the eye perform the surgery to relieve lid retraction and swelling around the eyes. Sometimes other ophthalmologists who specialize in diseases of the muscles of the eye perform the operation(s) to relieve double vision.
Medical and Surgical Treatment Options for Graves’ Eye Disease
- radiation therapy
- surgical adjustment of eyelid placement
- plastic surgery for swelling around the eye(s)
- eye muscle surgery for realignment of the eye(s)
- orbital decompression
The thyroid is a small, butterfly-shaped gland just below the Adam’s apple. This gland plays a very important role in controlling the body’s metabolism, that is, how the body functions. It does this by producing thyroid hormones (T4 and T3), chemicals that travel through the blood to every part of the body. Thyroid hormones tell the body how fast to work and use energy.
The thyroid gland works like an air conditioner. If there are enough thyroid hormones in the blood, the gland stops making the hormones (just as an air conditioner cycles off when there is enough cool air in a house). When the body needs more thyroid hormones, the gland starts producing again.
About 20 million Americans have some form of thyroid disease. Many are undiagnosed or misdiagnosed. No age, economic group, race, or sex is immune to thyroid disease.
The thyroid gland might produce too much hormone (hyperthyroidism), making the body use energy faster than it should, or too little hormone (hypothyroidism), making the body use energy slower than it should. The gland may also become inflamed (thyroiditis) or enlarged (goiter), or develop one or more lumps (nodules).
|Fact:||Two of the most common thyroid diseases, Hashimoto’s thyroiditis and Graves’ disease, are autoimmune diseases and may run in families.|
|Fact:||Hypothyroidism is 10 times more common in women than in men.|
|Fact:||One out of five women over the age of 75 has Hashimoto’s thyroiditis, the most common cause of hypothyroidism.|
|Fact:||Thyroid dysfunction complicates 5%-9% of all pregnancies.|
|Fact:||About 15,000 new cases of thyroid cancer are reported each year.|
|Fact:||One out of every 4,000 infants is born without a working thyroid gland.|
Have more questions? Need more answers? Check our Full Thyroid FAQ
Second, reduced blood flow also reduces the removal of toxins, which subsequently build up in the skin. These factors combine to create skin problems like hypothyroidism rash, eczema and psoriasis.
Apart from the above mentioned gut disorders, reduced thyroid hormone levels also directly impact cellular metabolism, which reduces energy production within the cells as well as expiration of toxins. When combined with gut issues, the result can be disastrous for the health of your skin!
Treating Hypothyroidism Rash
As with most things to do with hypothyroidism, treatment begins with a diagnosis of hypothyroidism followed by appropriate thyroid hormone treatment. Once this treatment has begun to work, you can then look at treating whatever hasn’t been rectified by replacing your thyroid hormones.