Primary Thyroid Dysfunction Is Prevalent in Hidradenitis Suppurativa and Marked by a Signature of Hypothyroid Graves’ Disease

[helvella]

Over the years we have had several members report having Hidradenitis Suppurativa. Yet little has been known or understood about this disorder.

Just now, I noticed this paper, and thought it worth mentioning previous posters. Not something I'd usually do but the number is modest, and I suspect that most of them have rather given up on thyroid to HS connections. Hence might not now be regular readers.

(Apologies if I have missed any others. A combination of poor search here on HU and the possibility of typos, etc., means I cannot be sure. Please feel free to mention/call out to others you know of in replies.)

Primary Thyroid Dysfunction Is Prevalent in Hidradenitis Suppurativa and Marked by a Signature of Hypothyroid Graves’ Disease: A Case–Control Study

Nessr Abu Rached

Johannes W. Dietrich

Lennart Ocker

Daniel R. Quast

Christina Scheel

Thilo Gambichler

Falk G. Bechara

Abstract

Hidradenitis suppurativa (HS) is a chronic skin disease that can have an association with endocrine disorders. There is conflicting information in the literature regarding the role of the thyroid gland in HS. This study aimed to close this knowledge gap and investigate how thyroid disease is involved in patients with HS. We carried out a case–control study with a total of 160 patients, of whom 108 were patients with HS and 52 were controls matched for age and sex. Parametric and non-parametric methods were used to analyze the results. We calculated structural parameters of thyroid homeostasis to detect subclinical thyroid disease, non-thyroid disease syndrome and other forms. The severity of HS was not associated with thyroid hormone levels and antibodies (p > 0.05). HS patients with or without hypothyroidism had decreased FT4 levels and a decreased thyroid secretory capacity (SPINA-GT). Titers of TSH receptor autoantibodies (TRAb) were significantly higher in smoking HS patients compared to non-smokers (median: 1.18 vs. 1.08; p = 0.042). The rate of subclinical hypothyroidism was significantly higher in HS patients; thus, subclinical hypothyroidism is an important comorbidity of HS (p < 0.05). Further studies are needed to investigate whether the chronic inflammation of HS is a cause of increased rates of (subclinical) hypothyroidism.

Keywords:

hidradenitis suppurativa; HS; acne inversa; hormones; obesity; thyroid function; autoimmunity; thyroxine; triiodothyronine; SPINA-GT; SPINA-GD

Open Access:

mdpi.com/2077-0383/12/23/7490

 Demitria  Cillate  writersblock  mandy72  kydyl  Helenback  davidhumphrey  culejules  doglover100

[Tinks101]

Thank you for posting. I've been a sufferer of HS since my early 20's . It started a few years after I had my son, but it's interesting that it's an autoimmune issue and now my body is attacking my thyriod, but this issue showed up right after I had an accident and suffered two bleeds on the brain.I'm really interested in LDN but I'm not even at the point of any offers of treatment, even though my antibodies are elevated.

I'm due to have my Thyroid bloods done next Wed morning and I've requested they check my T3 because I'm suffering overt symptoms of hypothyroidism and have been for quite a few years now. I hope I'm finally on the right path, but when I read all the brick walls (including ones I've experienced upto now) it feels quite hopeless.

Tinks 🐈‍⬛ x

[helvella in reply to Tinks101]

I am happy if even one person with HS gets something out of this.

Wholeheartedly agree with the need for T3 to be tested.

If you are in a position to do so, it might be worth doing a private test if you are let down again.

[sparkly]

I'd forgotten all about this till reading your post.

I likely suffered this for many years. I just put up with it not seeking any help from gp as it was embarrassing in my teens and twenties In 1995 I had one hell of a abscess under my armpit that had to be sorted under general anesthetic ( being packed and unpacked was worse pain than giving birth 😭

It was never mentioned to me from any gp that this could have been hidradenitis even after further infections. Wasn't until my diagnosis with endocrinologist who having took my history now has down possible hidradentitis on my records.

Yes, since being on medication I no longer suffer with boils but I remember when I had stopped meds a few years back I start with it again and once back on meds it disappeared.

[Eccleston]

Thanks for the post. I do not think that I have this condition but, having said that, I have, since early teens suffered with yellow heads and occasional boils. Initially this was across my shoulders and upper back. More recently my nose has been affected with the odd boil now and again.

Whether this has a connection with Hypothyroidism is an unknown to myself. When it comes to monitoring Thyroid function my Surgery are not encouraged, perhaps more correctly, actively discouraged, from monitoring T3 and therefore base their recommendations on TSH &T4. In my case TSH has persistently been below the minimum level and pressure is now being placed upon me to reduce T4 intake. This may be OK if one feels well! Independently I arranged for private tests specifically to obtain T3 levels. It would appear that I may suffer from poor conversion of T4 to T3. Since I have always had a slow metabolism the next step has been to arrange DNA testing specifically for Thyroid functions. Results are awaited.

Having already refused to reduce T4 intake and presenting Thyroid test results to my GP I have been referred on to an NHS Endocrinologist. Still awaiting appointment.

Sorry to have written so much but it seemed necessary to enable you to understand a but mor about the situation I am in.

Yes, I would certainly recommend private testing to establish T3 levels as it could provide that lever for NHS to take more notice.

Eccles