Skin and thyroid

[Gillybabe48]

Before I had thyroid trouble I could sit in the sun and get tanned as I have a dark skin. But now I get an itchy rash even with lotion. Strange. Has anybody else experienced this.

[Sveistre]

Hi, I have Hashi’s but haven’t experienced this so far, though is a different story with my mom, she has Hashi’s too and as I remember for years she’s having this problem, so even with the lotion she has to cover herself or stay under umbrella or so😏

[SlowDragon Administrator]

Your previous post showed low FT4 which suggests under medicated

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine. (Guidelines are approx 1.6mcg per kilo of weight )

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

[Gillybabe48 in reply to SlowDragon]

My last TSH was 0.18 and because they changed lab ranges my T4 was 12. They changed ranges from Medway to Darenth for some reason. The doctor was worried about TSH and was going to drop so I said no I was quite happy on 75mgs. I am having a recheck tomorrow. So will not take my morning dose until blood test. That is what I did last time. They do not do T3 now. Which is disgusting. I am on pension credit so cannot afford private.

[SlowDragon Administrator in reply to Gillybabe48]

75mcg is a very low dose, only one step up from starter dose

What's the range on FT4, that looks very low. FT4 should be in top third of range

Request GP tests vitamin D, folate, B12 and ferritin. These are frequently too low when hypothyroid.

Also high cholesterol linked to being under medicated and still hypo

If TSH is still low and Doctor wants to reduce dose, refuse to do so unless they test FT3 and result is over range (it won't be, it's highly likely FT3 will be too low)

Hives and autoimmune thyroid disease

thyroidpharmacist.com/artic...

verywellhealth.com/thyroid-...

holtorfmed.com/is-there-a-c...

Do you have any gut symptoms?

Are you on strictly gluten free diet?

[Gillybabe48 in reply to SlowDragon]

Yes I do have gut problems all the time. The ranges for Darenth are TSH 0.3 - 5. T4 7.5 - 20 whereas Medway used to be TSH 0.3 - 3 T4 10 - 24. I was on 100 mgs for a while but my TSH went to 0.03 and T4 21 and then I got an irregular heartbeat and they dropped me down. I may ask to go back to endo who I saw when first diagnosed. She always said I could return any time.

[SlowDragon Administrator in reply to Gillybabe48]

You may need addition of small dose of T3 (frequently steadies heart)

But first you need to try strictly gluten free diet and make sure all four vitamins are optimal

Request GP tests them

New NHS England Liothyronine guidelines

Note that it says test should be in morning BEFORE taking Levo thyroxine

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

[Gillybabe48 in reply to SlowDragon]

Thank you. You do wonder why if my TSH in their opinion was out of range they did not then measure T3. Really wonder why they are so unwilling to help. Oh well. Will take advice and go for blood test tomorrow.

[SlowDragon Administrator in reply to Gillybabe48]

Most people with Hashimoto's struggle to get vitamins regularly tested despite it being well known low levels are connected to autoimmune thyroid disease

ncbi.nlm.nih.gov/pubmed/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

endocrine-abstracts.org/ea/...

Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.

ncbi.nlm.nih.gov/pmc/articl...

Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.

Same applies to low B12 - extremely common in hypothyroid patients

All patients who are hypothyroid should have B12 tested

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status.

ncbi.nlm.nih.gov/pubmed/169...

Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.

Folate supplements can help lower homocysteine

ncbi.nlm.nih.gov/pmc/articl...

Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.

Low ferritin frequent in hypothyroidism

endocrineweb.com/profession...

[SlowDragon Administrator in reply to Gillybabe48]

Can see from previous posts you presumably have Hashimoto's

So strictly gluten free diet helps thousands

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

healthcentral.com/article/t...

Other gut issues due to being hypothyroid

healthunlocked.com/thyroidu...

Strongly suggest, looking at posts re your son that he gets full Thyroid and vitamin testing....symptoms suggest Hashimoto's too

[Gillybabe48 in reply to SlowDragon]

Thank you for that help. I will go gluten free. My son's thyroid was just on normal TSH 2.

[SlowDragon Administrator in reply to Gillybabe48]

But essential for your son to test thyroid antibodies and vitamins....just testing TSH is completely inadequate

[Gillybabe48 in reply to SlowDragon]

I noticed on my blood test form that doctor ticked TFT. Surely this should include T3. What should she have ticked for full tests. Should she have written specific requests for the rest of the tests? We have a practice with one qualified doctor overseeing a stream of locums.

[SlowDragon Administrator in reply to Gillybabe48]

NHS lab refuses to test FT3, & often FT4 as well, unless TSH is out of range

GP would need to put on lab request form to definitely test FT3

Central hypothyroidism suspected - please test FT3

Or patient on T3 - please test FT3

Recent FOI request revealed FT3 test costs NHS 92p

Offer on today to do TSH, FT3 and FT4 cheap - £29

medichecks.com/thyroid-func...

[BadHare]

Before taking thyroid medication (NDT, not T3), I burned in 20 minutes, & couldn't tolerate most sun lotions as my skin was too sensitive. I'm very pale & have slightly less sensitive skin than pre THs, but it now takes an hour before I burn, & have managed to get a bit of colour for the past few years, for the first time since 1978.

NDT seems to work marvels for my skin conditions, which T3 doesn't do. I made the mistake of taking only T3 whilst shopping for it in Greece in March, & burned. I'm currently taking Metavive, rather than Nature Throid, which seems to help my wimpy skin too.

[Zelda123]

Sorry to hear your having this.. the only thing I can say that it might be is what happened to me ..

I ended up with hives and having all kinds of allergies after my thyroid started playing up. I have to take antihistamines everyday.

What does your skin look like after being in the sun ?

You can get solar urticaria which is common if you have a autoimmune issue such as thyroiditis or graves.

Try using a good sun cream all year round on your face, try asking for a dermatologist via a referral to see if you need a special type of cream or antihistamines. I’m sorry that’s all I can think of.. as since my thyroid started playing up I had urticaria for a year non stop and thence when I tried excersize it when I got too hot or wore tight clothing.

[Gillybabe48 in reply to Zelda123]

The strange thing is when I was underactive thyroid I did not have the problem. Only since I have had it back to within normal that I have itchy skin in the sun. When my TSH was 30 sun did not affect my skin. Now my TSH is 0.18 after being on meds my skin is affected by sun. Could it be an age thing also.

[Zelda123 in reply to Gillybabe48]

All I know is despite it being either over or under for me.. I’m not saying it’s 100% what’s happening to you .. but you can get other autoimmune issues when you have one already.. and your antibodies can be high and levels look normal for a time until it goes under or over.. it’s like a bomb that goes over after a certain amount of time.. then what CAN not Always happens is your antibodies start attacking other things while there’s a lot of them.. which is why people get autoimmune lupus, diabetes, all these little things that we didn’t have before.. there are specific antibodies that be woken up in our system or triggered which are really there to attack invaders but accidentally attack us.. my dr said your little soldiers are working too well.. so well they are attacking you at the same time.. and what can happen is your antibodies attack under the skin releasing histamine causing allergies or hives.

Hives can appear for a variety of reasons they don’t always have to be autoimmune but is highly likely with thyroid problems and one type of hive is the solar urticaria which is triggers by the sun. It’s a weird thing. You will have to look it up. I don’t have any pics to go off but it was just one idea why your skin had a flare up in the sunlight.

Obviously there could be other reasons. Some medication can cause skin sensitivity, hormones, age.. I just wanted to share what happened to me in case it was that.. so you could rule it out or look into it further xx

[Gillybabe48 in reply to Zelda123]

Wow. Thank you for that explanation. It really helped

[Zelda123 in reply to Gillybabe48]

Awww 🥰 thanks

[Gillybabe48]

I now have thyroid results. TSH 0.07 T4 14 and T3 4.80. They did test T4 and T3. They wrote on print out TSH 0.07 not significant and no action required as other in range.

[NWA6]

Prickly heat? I suffer badly with this. I can’t remember what lotion I had to change to and also scrubbing with mitts and antibacterial soap can really help.

[humanbean]

It is possible to be allergic or intolerant of heat and sunshine. Getting vitamins optimised, particularly vitamin D will help, but may not be a cure, you'll have to try it and see.

I first got prickly heat when I was 15 (which was a million years ago) and I've had episodes of it fairly often. I used to holiday in hot countries a lot when I was younger and several holidays were spoiled by prickly heat. One thing I've discovered in recent years is that some people can reduce their reactions to sun and heat if they try a low histamine diet along with optimising nutrients. I've never done it myself but it might be worth investigating.