thyroid rash on neck and chest, help please

[Runner95]

Hello, I have Hashimotos hypothyroid and have been taking NPthyroid twice a day (60mg each) per my doctor due to my labs showing that I was still very hypo. I believe this helps but recently I have seen a thyroid rash on my neck, chest and stomach. This is very uncomfortable. My skin feels very itchy, especially at night and I have jittery heart palpitations. The heart palpitations do not last long and I can sleep. But the rash is uncomfortable and I feel unwell do to it. Do you have any suggestions, antihistamines, increase my water intake, try lowering my meds(maybe turning hyper?), food suggestions, etc? I still have the standard hypo symptoms, fatigue, constipation, dry skin, puffiness, etc. Could the rash and heart palpitations be a sign that my thyroid meds are too much? Feeling unwell. Thanks for any and all suggestions.

[pennyannie]

Hello Runner :

It's impossible to offer you a sensible opinion without sharing with us some blood tests results and ranges for at least a TSH, Free T3 and Free T4.

Hashimoto's is an auto immune thyroid disease and you are liable to your immune system attacking your thyroid which can cause a myriad of symptoms as well as temporary over range T3 and T4 with your thyroid becoming increasingly damaged and disabled.

You might like to read around on the research and recommendations of Dr Izabella Wentz who has this disease - thyroidpharmacist.com

Do you have a knowledgeable thyroid specialist supporting you or are you basically going it alone ?

 NIKEGIRL

[Runner95 in reply to pennyannie]

Hi PennyAnnie, Thanks for your reply. I plan on getting updated labwork this coming week so I will know more then. I am very diligent with my own healthcare but I also have a good endo. The rash is new but I currently believe it was the result of low immunity for hypothyroidism, primary adrenal insufficiency and chronic allergies due to stress. Once I get my labwork back next week, I will know more. I plan on checking my ferritin, b12, vitamin d levels too. I have had problems keeping these levels are their optimum ranges. Thanks for your reply. Wishing you a great week.

Thanks for recommending reading/ research from Dr. Isabella Wentz. I looked forward to learn more from an expert on thyroid disease.

[NIKEGIRL]

hi. I am in nz. South Island. I am on 105mgs of NDT so 1 and 3/4 grains.

I have recently had a thyroidectomy. Interestingly I have started to get eczema on my legs mainly so I have tried to make sense of this by thinking that the immune system is not settled and inflamed. Given that the thyroid was removed but the true reason for having graves never truly looked in to but now not important or so I thought until I got the eczema.

I am thinking what are your vitamin levels like especially the vitamin d?

I think one member put it into context. That the NDT will never fully replace the thyroid so we try to get to 90% of us before our diagnosis.

Another thought was does asthma or hay fever affect you? As this is the triangle asthma, eczema and bay fever and you can grow into any of these at any stage of life?

Just a thought that maybe the thyroid meds are not the cause of the rash but rather another seperate issue.

Regarding heart palps. Is your NDT dose new to you or have u been on this dose for a long time?

[Runner95 in reply to NIKEGIRL]

Hello, NikeGirl, Thanks for your reply. I plan on getting new labwork to check on this but your questions make a lot of sense to me. Yes, I have chronic allergies so the rash could be due to this and not my thyroid meds. The dose is not new. Although, It was increased by 1/2 grain in Nov 2022 due to my labwork then. The rash just happened this week so your probably right that allergies could have caused it and not my thyroid meds. In addition to having Hashimotos hypothyroidism, I also have primary adrenal inssuffiency (Addison’s disease). This past week was rather stressful and I could have had a low cortisol episode (even though I am on hydrocortisone) which lowered my immunity also. I plan on testing vit d, b12, and ferritin with my thyroid and other labwork early next week. Thanks for your suggestions and guidance. I truly appreciate it. Wishing you a great week! Thanks again.

[radd in reply to Runner95]

Runner95,

If you have chronic allergies, have you looked into mast cell activation and histamine intolerance?

These issues can interfere with the good workings of our thyroid meds leaving us hypo symptomatic, but because we need adequate working thyroid hormones to help control histamine release, it becomes a vicious circle.

[Runner95 in reply to radd]

Hello Radd, I have never looked into mast cell activation or histamine intolerance. I have chronic allergies and have had this problem all of my life. When I see my endocrinologist next I will inquire about these. I looked them up online and either of these could be what is causing more issues with my hypothyroidism. Do you follow a strict auto immune diet? Any suggestions? I plan on getting lab work done this coming week. Thanks for your reply.

[radd in reply to Runner95]

Runner95,

I don’t have these conditions, but MCAS was suggested after four years on Levothyroxine that didn’t agree with me and gave me many of the symptoms. 

I, like many members have unfavourable genetics associated with thyroid physiology. I was also boarder line for histamine intolerance when enzyme DAO was tested but have managed to quell an overactive immune system mainly by optimising hormones and nutrients, and eating clean food without high histamine content. Now the only issue that remains is white wine that makes me sneeze so I simply never drink it. 

Hashi’s influence in dys-regulating the immune system can tip us over in ‘allergy-world’. When mast cells keep releasing excess histamine and the immune on-switch gets stuck releasing harmful chemicals it ends up damaging cells and inducing other unwanted conditions including deactivating thyroid hormones/meds. Any chronic inflammation is bad news for us hypos. The NHS website call it mastocytosis and claim it is rare but it is not and functional medicine thinks some CFS and long-covid is associated with MCAS. 

There are some forum members who suffer MCAS so if you want further info just put a new post up entitled 'Mast Cell Activation' or something similar.