I wonder if anyone else has peeling skin on their hands? Or if it is anything to do with my thyroid issues at all?
I am still on a block and replace regime. Currently 40mg Carbimazole daily and 100mcg Levothyroxine. I have been on block and replace for 20 months now and they tweak the Levo up or down 25mcg depending on the TSH and T4 result.
Some of the time I feel ok (ish!) and other times I can feel either hypo or hyper - I haven’t quite worked out any one reason for the changes! But I’m working on that.
I am also on Vit D and calcium. Prescribed by Endocrinologist.
From my latest Blue Horizon results (attached) it looks to me like I need folate?
I have NHS blood tests every 6 weeks, but they only test TSH and T4 - the last was at the same time as the attached.
The letter came from Endo to say results were in the normal range so continue with block and replace at present dose.
I would really appreciate your comments on my peeling hands and anything else you consider I should be doing.
Thank you.
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Milkmaid123
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It's not a symptom I've ever had myself, but it would appear that lots of hypos have peeling hands, yes. If you do a search on this page, you'll probably come up with a lot of other posts complaining about the same thing.
And, you are hypo, despite your good TSH. Your FT3 is very low. Did you ever find out if you really do have Grave's? If they ever tested your TSI or TRAB? Or if you really have Hashi's, and they're treating you for the wrong disease?
B vitamins best taken in the morning after breakfast
Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).
Or Jarrow B-right is popular choice, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
I am no expert only an " informed " patient with Graves who likes to follow other patients with this disease and a couple of things confuse me about your treatment. Why is your TSH so high mine was always suppressed or low ? Why are your fT4/FT3 not higher in range ? Could it be you are on too high a dose of Carbimazole and would benefit from a reduction . Perhaps someone could answer ??
I asked whether I had been tested for Graves, and apparently I was, but Endo didn’t have the results to give me.
I haven’t been officially diagnosed with Hashimoto’s yet.
Unfortunately I have only seen a succession of locum Endos, who all seem to have differing opinions about what should be done.....apparently a permanent consultant is due to start soon, so hopefully a future way forward can be planned for me.
I will go through your suggestions SlowDragon.
Asiatic, I am on block and replace regime at the moment. So the carbimazole is at a dose to ‘block’ my thyroid and then, technically, the Levo should be at a dose to keep me well. But, tweaking the Levo up and down doesn’t seem to stabilise me.
Thank you all again for your replies, I really appreciate them.
the problem with getting TSI/TRAb tested at this stage is that it won't tell Milkmaid123 what they were when she was first diagnosed. Her antibodies may have been positive initaiily but after so many months of carbimazole they may now be sigificantly lower, or even return a negative result.
Milkmaid123 - do you know what your initial FT3/FT3 and TSH were ? How long have your results been within range ?
I'm not sure that it's possible to tell what your natural thyroid levels would be while you are taking such a high dose of carbimazole, combined with levo. For me, that has always seemed to be one of the downsides of the block and replace approach: once your results are within range, you can't really tell whether you are likely to achieve remission or not until you stop the medication, so it's a step into the unknown.
Assuming you did have Graves', it's a positive sign that your TSH has recovered. It can remain suppressed for many months. During active Graves', the antibodies effectively take over the role of TSH, signalling the thyroid to create more hormone, while TSH remains suppressed. Unlike TSH, the antibodies don't switch off when sufficient thyroid hormone has been produced.
I too am on block and replace but to get my sweet spot it was not only necessary to adjust levo but also Carbimazole. I must have had a dozen adjustments and am now on 10mg Carb / 50mcg Levo. I suspect your Carbimazole is too high and as it can have nasty side effects you want to be on the lowest effective dose. Most endos arent prepared to closely monitor a patient as it is time consuming
I am hypo, and have taken levothyroxine for years. I am also allergic to lactose. The consequence of eating something containing lactose depends on the quantity. The very slightest trace causes my skin (particularly on the face and scalp), eyes, nasal passages etc to dry out to the extent that the next morning my face in particular is like a snake shedding its skin, I will be seriously bunged up, and I cannot focus my eyes until I have put in drops. However, that drying has not previously been a problem with my hands. This year, I started taking NDT (NP Thyroid, which is lactose-free). Since then, my hands have been peeling, on the inside of the hand just below the gap between fingers. I've only ever had anything similar in the depths of winter, when being outside in winter air multiple times per day (walking dog) resulted in cracking (rather than peeling) between the fingers (not just below the gap). It may be coincidence of timing that the peeling has started since taking NDT, but my suspicion is that there is a connection. I have had a few lactose reactions in the same time period too (I blame cross contamination in crisps - one of those "made in a factory that also handles milk" cop outs that may actually be true this time), but the peeling hands has been a regular thing since taking NDT, not just when I have had a lactose reaction. Do I have an explanation as to why NDT might trigger this? Nope, afraid not.
(and yes I do dry my hands properly after washing, and yes I do moisturise).
I suffer badly with peeling hands, I don’t know whether it’s my thyroid or vitamin deficiencies but they were very bad and I tried everything going. In the end it was a pharmacist in Boots that recommended a product to me, it is expensive at £10.99 but you can get it on prescription, it’s the only thing that’s worked so I now get it on prescription. It’s called Dermol 500 lotion, it is an antimicrobial emollient and moisturiser and can be used as a soap substitute too. I find it excellent!
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Taken matters into my hands - T3
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