I have been on Levo now since middle of 2016. My diagnosis came about whilst investigating chronic urticaria angidema and the immunologist checked my thyroid and TPO. My TpO when it was last checked was 676 (normal range under 30)
Recently I was having the tell tail tiredness and general loss of get up and go so my gp checked my thyroid and again my TSH has gone over 5 so they increased my Levi to 125mcg.
I have started to feel better and my tsh at the 12 week check had dropped back to 2 (the lowest it had ever been)
I have noticed over the last 4-6 months white patches appearing on the backs of my hands and on the tops of my thighs. Is it possible this is vitiligo and connected to the autoimmune hypothyroidism?
As a side note my vit D was also low despite being supplemented. The gp won’t do anything about low vit D as she says the summer will sort that out..
Any thoughts on the disappearing pigmentation?
Thanks
Amdrea
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Andrea1521
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Do you always get same brand levothyroxine at each prescription
The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is ALWAYS under 2
When adequately treated, TSH will often be around or below one.
Most important results are ALWAYS Ft3 followed by Ft4.
When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)
Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
How much vitamin D are you currently taking
Aiming for vitamin D at least around 80nmol and around 100nmol maybe better
When were folate, ferritin and B12 last tested
For full Thyroid evaluation you need TSH, FT4 and FT3 tested.
EXTREMELY important to test vitamin D, folate, ferritin and B12 at least annually
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
If not get coeliac blood test done before trialing cutting gluten out
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function with Hashimoto’s 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
Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out
If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)
If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
The “fun” thing about having one autoimmune disorder is that you’re more likely to have a second autoimmune disorder. And a third…. They hunt in packs, these pesky autoimmune disorders, dammit.
This looks like vitiligo. It’s the most common comorbidity with thyroid disease. I have it too! It’s important to learn what your triggers are. For me it’s stress, lack of sleep and certain chemicals in strong cleaning products. I’ve only ever had two active phases and I believe both were caused by exposure to strong Sulficants in cleaning products. Your low vitamin d could defiantly be a contributing factor, Vit D is so important for your immune system to work properly. Your Dr doesn’t know what they are talking about, you will need to supplement vit D even in summer and may even need a fairly high dose to keep your levels up, I do all year round and so do many people. It’s not the worst comorbidity to have as other than the cosmetic issue it’s doesn’t make you feel ill.
As yours in quite visible on your hands you may want to look into micropihemtation to cover it, basically a cosmetic tattoo. I’ve learned nothing else really works. But you need to make sure your vitiligo is stable and not spreading actively before doing this.
HiI had vitiligo before I was diagnosed with an under active thyroid 15 years ago and prescribed levithyroxine. I still have white patches on my skin and personally don’t think it’s got anything to do with the levothyroxine medication: my understanding is that it is another auto immune condition.
I too have vitiligo mostly on my arms. I don’t have Hashimotos but do have other autoimmune conditions. I was diagnosed with hypothyroidism sixty years ago but vitiligo only in the last ten years. Certainly when vitiligo was mentioned by the GP she did not link it to my hypothyroidism. Just said it’s another autoimmune to add to your collection. 🙂
I had vitiligo well before my thyroid went south. I look like a reverse panda as it around my eyes, but I am as pale as a pale thing, so a dob of false tan helps. I am now about 50% white/whiter!
Cue to burst into a verse or two of "whiter shade of pale"....
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