I did post about this symptom among other things a couple of months ago and Clutter kindly replied and was very helpful. However she had no experience of this particular symptom being down to hypothyroidism. I was just wondering if anyone else has any thoughts about this. I did find something similar online and it said it could be associated with thyroid dysfunction among other things. There are slight swellings beneath each nostril too. Had anyone else has anything like this?
Any help or advice would be much appreciated.
With thanks in advance
Best wishes to all
Caroline
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Oh how interesting, I have this too. I first noticed it about 4 years ago and haven't been able to find any reason for it searching online other than it just being a muscular swelling. I do hope someone else here knows what and why!
Thank you so much, Framboise, for your quick response. Do you have a thyroid issue too? Maybe it is something to do with that. I was hoping that the optimal dose of Levo would make it go away but not so far. Still, I was only started on medication last September and my blood tests are not good yet. I've only had this symptom since last summer. Has yours changed at all over the four years? Mine seemed to appear overnight last August and has never changed at all. As you say, it would be great if someone could tell us what it is and hopefully how to get rid of it.
Bantam12 has put forward a possibility. I have heard of angioedema in connection with thyroid dysfunction but have never been sure how this manifests itself. Time for a bit more research i think! Thanks again for your reply. If I find out anything useful, I will post again!
Hi Caroline, I've been treated for hypothyroidism for 16 years but only noticed this swelling in the last few years, and my results and dose of NDT have been stable for most of that time. I did reduce for a while when one endo decided I didn't have a thyroid problem, but that didn't coincide with noticing this and since then I've increased my dose anyway. I'd thought mine was muscular rather than fluid but I'm seeing my GP about two other things next Friday so will ask about this. I hadn't bothered before because I just thought it was me and nothing to do with anything else.
Actually I've just looked up images of angeoedema of the area under the bottom lip and all it shows is angeoedema of the bottom lip. Mine is the area underneath not the lip itself, as in your photo, so this gets more interesting...
I have seen this swelling referred to as a "ledge" below the lip. Like you, I've seen photos of very swollen bottom lips being attributed to thyroid problems but not the kind of swelling you and I have. Oh well, I'll carry on looking and will let you know if I find out anything useful.
Thanks Caroline, I hadn't realised it was called a ledge until I re-read the link I put below. I think the only other place I read about it was a plastic surgery website where they discussed removing them, but that's a bit too drastic for me!
This is not the one I saw with photos of "ledges" but seems to cover the same symptom.
The fact you've had hypo for so long and been stable for ages does sort of throw a spanner in the works tho. I would have expected yours to have gone or at least improved if low thyroid hormones had been the cause.I
Thanks for the link, I don't think it's that in my case mainly because I was diagnosed by Dr Skinner who was very thorough in checking skin etc and if I'd had it then he'd definitely have noticed and mentioned it. He did say my tongue was swollen at the time and he used to examine the backs of my hands with a magnifying glass. All I can think is that I took low dose hydrocortisone for some years for my adrenals, which caused me to gain a lot of weight whereas I'd always been very thin before, and when I finally stopped the hc I lost all the weight plus more. My face in particular had filled out, but not puffy, just not as thin as before, and is now thin, so I wonder if it's left over from the hc side effects. I'd assumed it was muscular but perhaps not!
You were undermedicated to have TSH 3.0. If dose was increased to 50mcg after that test you should have a followup throid test 6-8 weeks later to check the increase was sufficient. Arrange the blood draw early in the morning when TSH is highest and fast (water only) as TSH drops after eating and drinking.
You will be adequately dosed when TSH is 0.5 - 1.0. If you are still symptomatic then it would be a good idea to order your own thyroid tests to check TSH, FT4 and FT3.
Thanks Clutter. My dose was increased by 12.5 mcg after that result and that was the best i could get from him. I'm just hoping it will be enough because I don't fancy my chances of getting another increase unless I see another gp. And maybe not even then!
On a positive note, some of my symptoms have already improved a little and am not due for another test until mid March so perhaps 50 mcg might be enough. Well, here's hoping anyway.
I do intend to do private testing when I reach stalemate with the doctor, just so that I can post a proper set of results here and get good informed advice.
This is a link I had found, my lower lip area is just like the one shown here as Betsy's. The cause sounds slightly mad to me however I do have digestive problems. Also looking back my under lip swelling became apparent after I lost a lot of weight which had been gained originally due to taking steroids: rebeccawood.com/health/swol...
I think I've seen that! Didn't they suggest it was diverticulitis in that instance? I don't have that. My mother had it so I know the symptoms. All I saw was that it could be indicative of an underlying disease. The only diseases i saw specified were diverticulitis (and that is not something fatal as suggested on that site! - i think they are trying to scare us into buying something!) and thyroid disease. Leaky gut is also mentioned which I think is sometimes referred to with regard to thyroid problems.
When I find the link connecting it to hypothyroidism I'll post it.
That's right they did say it was diverticulitis. Sounds too weird to me and I can't think the connection between the two would be. I'll be very interested to see the link with being hypo and also to se if my GP has seen it before.
My doctor had no idea, first prescribing an antihistamine and then a hydrocortisone cream, neither of which did any good at all. Dentist had no idea either. Another gp who I’m seeing for my thyroid problem doesn’t even admit there’s anything amiss! He thinks it’s normal despite my telling him it’s not normal for me! Sometimes I despair!
Yes I agree but, as I understand it, these are 'before' and 'after' pictures of people suffering from undiagnosed hypothyroidism and then treated successfully. The term 'myxedema' in this case refers to a 'dermatological manifestation' of undiagnosed hypothyroidism. At least that's what I understand from the text. At least two of these people have pronounced 'ledges' which improved with treatment.
I think it's interesting and I would be inclined to think it relevant to us except for the fact that you have been cared for properly by Dr. Skinner and your 'ledge' has persisted.
All this aside, I am glad you are stable now! I too am starting to feel the benefits of levothyroxine. I still have a way to go but there's now light at the end of the tunnel.
Thank you so much, bantam12, for taking the time to reply. I will look further into angeoedema. I do know that the face can be affected by thyroid issues but thought it was a general puffiness. Mine is more localized to lip and nose! Thank you again for your suggestion.
Thank you so much, SlowDragon, for your reply and for the link which looks really interesting. I will be looking at that in detail later and hoping it will convince my gp that a TSH of 3 is not ideal when on Levothyroxine!
As with most of the others posting on this site, I seem to have to fight my doctor all the way but at least he has agreed at last to testing for antibodies!!
Thanks again for your help and support, I am very grateful.
Glad to hear that. I fully intend to go gluten free if my test shows antibodies. I already have one autoimmune disease so gluten free might help that too!
Thank you, Caroline for posting your photo. I had searched & searched online but the photos I found didn't look like what I have until yours. Mostly people were talking about swollen pouches on either side, more between the chin & lower lip, rather than just underneath the lip. I also had never heard it referred to as a "ledge" which really describes it well. I just noticed it one day & felt sure it hadn't been there before. I also have a self-diagnosed Thyroid condition & after medical misdiagnosis, decided to treat myself. It runs in my family but again doctors were little help for my mother & grandmother. I've had some success in feeling better but this is one of the many symptoms I've still not been about to fix & shouldn't be surprised that it's yet another possible Thyroid issue. I know Gluten is a problem but certainly not the only one. Wish there was a magic cure!
I am so pleased to hear from you! As you say there are very few photos showing this kind of "ledge". Mine seemed to appear overnight just over a year ago and has stayed the same ever since. I am grateful it hasn't got any worse! GP prescribed an antihistamine but that didn't help at all. She had no idea what it was, nor had my dentist. I am always hoping it might go away as suddenly as it came, especially now I'm taking levothyroxine as I do feel convinced it has something to do with my being hypo.
If I ever find out anything useful or positive i will get in touch with you.
I’m sorry to hear that you have this problem. Hopefully it’s temporary and will resolve in time. In view of the fact that you have had dental treatment, it may well be some sort of reaction to that and it’s still very early days.
In my case, I have an underactive thyroid and am convinced that is the cause of the swelling below my bottom lip. It doesn’t seem to be a common symptom though and I would guess yours is more likely caused by your recent treatment, in which case hopefully it should quickly improve.
Hopefully it will reduce in time. It would seem likely that the cause is your dental treatment. Otherwise it’s a big coincidence. Has it reduced at all?
I came across this thread because I too have a lip ledge and strange swellings below the nostrils. My Doctor denies there is a problem but I am very aware of it and it has caused a loss of confidence when i speak with people. My lips are also deeply cracked, though not by the weather - in fact the cracks appear to go into the ledge. If you are still on this thread, I would be interested in hearing about your own condition.
Sorry to hear you have this too. In my case, it has not changed at all since my first post a year or so ago. Fortunately it has not got any worse either but I had hoped that optimal treatment with levothyroxine would cause it to go away. Not so far😟.
Do you have thyroid issues? I have always believed it is something to do with my being hypo. When I saw the GP about it, she thought it was an allergic reaction to something but did test my thyroid at my request and the blood tests came back positive for an underactive thyroid.
My “ledge” is still the same as in the photo.
How long have you had yours? Did it appear virtually overnight?
I know what you mean about it affecting your confidence. All I can say in that respect is that I truly believe other people don’t notice it as much as you think.
As with your experience, one GP I showed it to denied seeing anything out of the ordinary but you and I both know this is not normal for us.
I suppose we’ll just have to keep hoping it will go as quickly as it came.
I know this is an old thread but very relevant . I posted I too have this ledge but I also get sore and cracked lips on and off constantly (I had low zinc discovered by the hospital when I was first sent there by the dentist as she had dropped some sort of acid on my lip and it wouldn't heal). The edges of my lips are fuzzy but every now and then they edges get a red line right round as if it is sore. This does seem common it seems. Try telling doctors though.
Thanks for your reply Caroline. I've had it about a year; the first thing I noticed were the swellings under my nose and because my Doctor wasn't helpful, I paid to see a skin specialist - who was also not helpful. These swellings come and go. I then noticed a white line under my lips and the vermilion border on the bottom lip was quite red. Within a day or two it swelled and has remained the same. As stated earlier, my lips are also deeply chapped. I have had blood tests and my thyroid is fine. I believe that this is caused by an autoimmune problem and may be related to the digestive tract. Isn't it odd that there is so little information about this symptom? I am strongly considering going to see an allergist - there aren't many options left.
Odd that you should mention the swellings beneath the nostrils! That was the first facial symptom I had too. Mine too came and went, though they have never been as bad again as they were when they first appeared.
The swelling below my lower lip has never changed at all. I do not have the chapped lips so I can't make any suggestions there.
You have said you think it might be a gastrointestinal problem and I have read somewhere that "leaky gut" might be a cause of a "ledge" under the lip. I will try to find some links about this tomorrow. If successful I will post. Leaky gut can also be associated with thyroid disease which is an autoimmune disease.
The GP who suggested an allergy as being a possible cause put me on a course of powerful antihistamines; these had no effect at all.
I really don't think, in my case anyway, that it is the result of an allergy. Like you, I have had this for a long time and it has never varied.
Hopefully one day we will find the true cause so we can tackle it head on. I'm the meantime, I will keep looking for the answer.
Best wishes
Caroline
P.S. As promised, a link suggesting our problem might be down to leaky gut.
Thanks for the link. I didn't want to believe the leaky gut stuff because it seemed to be a little cranky but have since learnt that it is accepted by medical practitioners. I was thinking back when I first noticed my symptoms and remembered that the vermilion border on my lower lip was quite red. It has remained so and is accompanied with deeply chapped lips. I assume that this is caused by the so called leaky gut. I didn't know that thyroid problems were a result of autoimmune issues.
I have read that the immune system can be kick started by fasting - but the fasting should be at least two days long. Quite difficult to achieve but it's tempting to try.
Certainly Hashimoto’s thyroiditis is an autoimmune disease.
I used to have stomachache after meals before going gluten-free about 8 months ago. These have stopped completely now. However, although my stomach appears to be healthier and pain free now, so far the facial swelling remains.
I am looking into probiotics and digestive enzymes and might try these in the future. I do feel quite well now though so am in no hurry to change things too much.
If my swelling alters in time I will certainly post again.
Hi Matt, I’m not sure you meant this post for me but, anyway, the ledge beneath my lower lip is precisely the same now as it was when it first appeared over two years ago. I think it’s here to stay!
Hope it’s not getting you down too much. I’ve kind of got used to mine!
I have just seen this as I was searching for swelling below lip. I have searched before but never found this thread. I have exactly the same - below the lip with the swelling even more pronounced on the right hand side (my right). I might have had it 6 months, not sure, but it is getting worse and spreading downwards. I am undiagnosed for hypothyroidism and been trying to get treated and am about to start self-treatment. I think this swelling could be the result of untreated hypothyroidism . I have quickly read through these replies - perhaps it is to do with gut. I have gut problems. Iwonder if I could take a pic and upload. I'll try tomorrow.
I can’t really say much that hasn’t already been said in this thread but I am sorry to hear you have this problem.
Mine is still just the same as in the photo, neither better nor worse. I am convinced, in my case, it was caused by my having an underactive thyroid. I am now on levothyroxine.
Although mine has stayed the same along with little puffy pads under my nostrils, I have seen photos online where these swellings have reduced greatly when hypothyroidism has been optimally treated.
I consulted GPs and my dentist. None of them had any idea what it was so it must be an uncommon symptom. Hopefully you will get diagnosed soon - if indeed, in your case too, hypothyroidism is the cause - and your swellings will gradually reduce and go away.
Hello - I could uploads a photo but I think I will have to start a new post as I can't see a way to do it in the current thread, which is a shame, as it would be relevant. It is funny, I don't really know when it came as I just noticed one day that I didn't have the lines under my lip any more, they were replaced by swelling - looks like I have had bad Botox ! I will start a new post.
Hi Caroline: I am replying to your first post. Your photo looks exactly like my condition. I discovered it just like you overnight about four months ago. It has not increased nor has it decreased. In October I have an appointment with my dermatologist. I am hoping to find some answer for this condition. I am on Levothyroxine. It seems to have stabilized according to my physician. I am going to look online at my last test results to see if it is in the 0.2 to 2.0 range as somebody on this site had stated. I am going to have blood allergy testing this coming week as I have become allergic to several foods. I will post my results later on this site. Thank you for bringing this topic online for discussion.
The ledge below my bottom lip did appear very suddenly but now, looking back, I remember my daughter pointing out a small puffy area below each of my nostrils a month or so before the ledge appeared. This was in the summer of 2017 and neither the ledge nor the puffy areas have changed in any way since then. I feel that, in my case, they’re here to stay! I am on Levothyroxine but this doesn’t appear to have made any kind of difference. At least they have not got any worse😊
I did see Rebecca Wood’s article online but have not gone down that particular avenue.
I eat a healthy vegetarian diet and my current dose of Levo and my vitamin levels all appear to be optimal so, who knows, perhaps in time the ledge will go as quickly as it came. One can but hope!
I hope your appointment with the dermatologist is helpful.
Hi Caroline: So nice of you to reply so promptly. Yes, I will let you know what the dermatologist states; I don't see her until October. Also, I am going to my regular MD next week to address the issue. I have been getting very lethargic in late afternoon and probably need to get my thyroid tested again. I appreciate your concern and your welcomed reply.
I did use hydrocortisone and in a much higher dose than was specified on the PIL. I was not really happy about that as there were warnings on the PIL about using an excessive amount with instructions to go to A & E if too much was used accidentally! I spoke to a pharmacist in Boots about my concern. Doctors do occasionally make mistakes after all. The pharmacist said off-label dosing was ok in the short term but recommended that, if there was no improvement at all after a week, I should stop it and go back to the GP. The GP had prescribed it for a period of three weeks. There was no sign of any improvement and I didn’t really believe it was an allergic reaction anyway. The hydrocortisone had no effect whatsoever☹️.
Hope the above is helpful and that your appointment goes well.
Hi again Caroline: I just found a link about cool sculpting that might help our condition. The link is healthline.com/health/cools.... Just an idea. It talks about the chin; however, it can be applied to any area.
Thanks Sharon for sharing! The article was very interesting although I am not sure that our swellings are caused by the deposition of fat. From the research I have done in the past I believe the ledge below my lip is made up of something called mucin and is an uncommon dermal manifestation of hypothyroidism.
This link makes reference to mucin and hypothyroidism:
You would think that treating hypothyroidism with thyroid hormones would get rid of the mucin - and I have actually seen before and after photos online which indicate this could happen. Unfortunately this has not been the case for me so far☹️. Oh well, I am grateful that nearly all of my other symptoms have resolved.
I hope your situation improves and the doctors/consultants you see have a better idea of what’s going on than do my GPs.
All the best
Caroline
I have the same swelling just below my lower lip. My Doctor gave me a steroid to put on it. It is not helping. I'm wondering if it is auto-immune.
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however I do have digestive problems. Also looking back my under lip swelling became apparent after I lost a lot of weight which had been gained originally due to taking steroids: 
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