I have terrible urticaria at the moment. Had it for weeks and weeks. No known cause. Have seen specialist and was told to take cetirizine up to 4 times day. Now montelukast been added.
I do have under active thyroid… on 75 mcg levo.
Anyone else suffering with hives and been on this medication?
(I’m off to sit in cold bath!!!)
A year ago you posted thyroid results that showed you are/were not on high enough dose levothyroxine when on only 75mcg levothyroxine
75mcg is only one step up from starter dose
Which brand of levothyroxine are you taking
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Some people need a bit less than guidelines, some a bit more
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Also here
cks.nice.org.uk/topics/hypo...
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Thank you for all your advice. I will try and get another blood test along with vitamins ( I don’t take any at mo)
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease and especially when on inadequate dose Levo
What vitamin supplements are you taking
What are your most recent vitamin results
Hashimoto’s and hives
I empathise - whilst I’ve never taken anything for my hives they’ve been one of my many enduring symptoms. When I first started taking Levothyroxine they became infrequent for a time, but sadly that didn’t last. I do though find I can get control back again by following AIP diet - but suspect I’d need to stay on it forever to keep the hives at bay. The theory seems to be adequate thyroid hormone replacement often resolves the problem, not uncommon in hypothyroidism.
yes there’s a link. You’ll need to get to the root causes which in hypothyroidism usually always results in the gut. Heal your gut and you’ll resolve many symptoms along with adequate medication.
Low histamine diet if you’re not already
I’m sure I read that hives are caused by low stomach acid - very common in hypo patients
I was diagnosed with Hashimotos in 2010 at 47yrs of age tho still not medicated. I have had hives for many years and never found the cause…. They feel like dozens of mosquitos biting me and would start out as pimples tho grow to huge all over. Then they began to go purple. In 2020 I had a serious anaphylactic episode while overseas. The rash covered me and I fell unconscious. Lucky there were 3 doctors there and the ambulance to get me to hospital (this time no hives, my lips, tongue and throat began to swell). Back in Oz an allergy doc told me I had a wheat allergy triggered by exercise or heat. So no wheat for me since. I had another after my 2nd Pfizer vac 🤷♀️
I get the hives seriously now if exercise, dance or am hot. So I have been advised to exercise on an empty stomach.
So maybe see an allergy specialist. I was told since I have an autoimmune disease that the body is more sensitive. I carry 2 epipens with me everywhere now.
I wish you well as they are very you comfortable. Also I was told I can have up to 4 Zyrtec a day without harm. In the past I took polaramine at night to help with the hives as the daily non sleepy antihistamines were not giving me another cover in the day. They helped me to sleep as well.
Daisy: ouch and itchy skin is awful. I had that not when I was taking certified or levothyroxine but when I was eating canned beans or vegetables, tomato sauce, fruit anything canned.. my dermatologist told me to eat fresh or frozen and to take stop drinking tap water. There is fluoride in tap water. That is one thing your thyroid gland does not need. When I get hives, now from something I ate that I shouldn't have, I take Hydroxizine RX (allergy)and use Sarna lotion as much as you need on the hives. I take 30 mg armour thyroid 3 times a week and am tested every 4 months. Take selenium every day and b complex, anod hang in there. It’s miserable but it will pass when you get thos bad mast cells out of your body 😊
My husband, who doesn't have a thyroid problem, developed hives for several weeks. When he stopped eating easy peelers, which I think are either clementines or mandarins, the hives disappeared and he hasn't had a problem since.
Hives are low thyroid hormone problem you aren’t on enough !
I totally agree with you. When I was having thyroid issues before I was even diagnosed I was having terrible itching. Once I was put on T4 meds I was very relieved. But I still have to watch what I eat.
Yes I think I need to insist on a retest.
I think you’re right!
You could try adding T3 to your hormone treatment or taking NDT instead of levothyroxine. It might stop your itching rash misery. I use NDT, and I do not have rash problems any more.
hi
I have hypothyroidism and get angioedema and urticaria. My consultant says that it is quite common to be associated with hypothyroidism.
Had it for years, gets a lot worse with stress. Have used cetirizine, with chlorphenamine if flares up, and epipen for emergencies. Just changed cetirizinne and chlorphenamine for fexofenadine.
Fexofenadine seems better.
Stay well
Paul
thank you…I didn’t get on with fexofenadine but glad it’s working for you.
I have had to go back to steroids to clear this flare although I know it’s only masking the problem. I will get in touch now with the allergy clinic (although I know it’s not an allergy as such)
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