Bruising on knees

[Ganggywaller]

Just noticed quite bad bruising on my knees, dont remember kneeling or banging them. Could this be a symptom of low t4 maybe. Or am i being paranoid.

[Hidden]

Lack of thyroid hormones can lead to porous vein walls and blood leakage. Taking small amounts of T3 every 3/4 hours and T3/T4 at bedtime, with food, will solve the problem in a few months.

[helvella Administrator]

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[RockyPath]

A clinical article discusses this rare effect of severe untreated hypothyroidism. The patient had a TSH of 711.

“A 26yr old man presented to haematology with a short history of easy bruising. There was no spontaneous bleeding. Past medical history was unremarkable. Family history of clotting disorders was negative. On examination there was significant lower limb bruising.

Initial investigations revealed platelets of 238 (150–450), prothrombin time (PT) of 12.0 (12.0–17.0 s) and elevated activated partial thromboplastin time (APTT) of 41.0 (24.0–38.0 s). The elevation in APTT alluded to an intrinsic pathway abnormality which was investigated through further clotting factor analysis. This revealed reduced levels of chromogenic factor VIII 0.46 (0.6–1.3 U/dl), factor VIII clotting assay 0.4 (0.6–1.3 IU/ml), von Willebrand Factor antigen 0.31 (0.7–2.0 IU/ml) and von Willebrand Factor activity 0.39 (0.7–2.0 IU/ml). Factor IX assay was normal at 0.63 (0.6–1.3 U/ml). This confirmed the diagnosis of von Willebrand disease.

On further questioning he complained of cold intolerance, dry skin and lethargy and there was a positive family history of hypothyroidism in an aunt. Clinical examination was unremarkable. Thyroid function was significantly deranged with unmeasurable free T4 <5.5 (9.0–19.0 pml/l) and grossly elevated TSH of 711.1 (0.4–4.5 mU/l). Anti-thyroid peroxidase antibodies were elevated at 3000 (0–135 U/ml) confirming the diagnosis of Hashimoto’s thyroiditis. He was commenced on levothyroxine and the coagulopathy reversed (APTT 36.3 s, Factor VIII clotting assay 0.71 IU/ml, von Willebrand Factor Activity 0.78 IU/ml) as his thyroid function normalised.”

[FallingInReverse]

Hi Ganggywaller

One of the most common causes of bruising like that is low iron.

My daughter had the same thing, woke up one day and had probably half dozen little bruises all over her legs. She’d been to the beach the day before so we thought she’d just played a little rough.

The day after there were more, so looked into it.

I got her an iron panel, did careful diet and supplementation to address and it went away once her iron profile improved.

Let us know how you get on.

[Happysmile]

My daughter’s had this about 4 times on her knees, in diamond shapes. We never knew why, nor did the consultants we raised it with, although she and I both bruise easily too. She has since developed Graves disease and B12 deficiency and has the relevant treatments and she hasn’t had any signs of the knee bruising for a couple of years. I too have these issues, but we both still bruise easily. I have no idea of the cause, but she does have other medical issues and I do wonder if they could be connected. I’d be interested to know if it is iron related for her, but then why would we both still bruise easily elsewhere? Her iron levels are checked fairly regularly.

I hope you find the cause, and it sounds like iron tests may be a good place to start.