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Is Botox Safe To Use With Hashimoto’s?

What to consider about using this neurotoxin with Hashimoto's.
Is Botox Safe To Use With Hashimoto’s?
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In this article:

  • What is Botox?
  • How is Botox used?
  • Is Botox safe?
  • Side effects of Botox
  • Considerations for Botox and Hashimoto's
  • Who should not use Botox
  • Where to find a reputable provider

Many men and women look to Botox to turn back the clock on aging skin. This helpful agent has a unique way of relaxing facial wrinkles to create a more youthful appearance. While we are usually impressed with the results on the skin's surface, it is essential to be aware of the effects of Botox underneath the skin. 

What is Botox?

Botox, or botulinum toxin type A, is commonly used in cosmetic services and some medical procedures. This toxin is from the bacterium Clostridium botulinum, which causes life-threatening food poisoning called botulism. In small doses, Botox can be used to treat cosmetic and medical problems. 

Botox acts as a neurotoxin when injected. That is, the toxin blocks signals between your nerves and muscles to reduce muscle contraction and spasm. Essentially, Botox works by weakening or paralyzing certain muscle groups or nerves. The effects of Botox last between three and twelve months.

How is Botox used?

When injected correctly, Botox can temporarily relieve muscle contractions and spasms. The most common use for Botox is in cosmetic services, where Botox can temporarily smooth facial wrinkles. Common facial areas for Botox injections include the outer corners of the eyes (crow's feet), forehead wrinkles, and frown lines between the eyebrows. This service is appealing for people with wrinkling due to age, sun exposure, and smoking. 

Botox use is also for a variety of medical conditions, including:

  • Chronic migraines
  • Cervical dystonia (neck spasms commonly associated with Parkinson's disease or neck injury)
  • Neurological conditions (cerebral palsy, etc.)
  • Overactive bladder

Is Botox Safe?

The FDA approved Botox in 2002 as a temporary aesthetic treatment for wrinkles. Botox has since been approved for medicinal uses as well. There have been few cases of adverse effects of Botox use, and most of those cases link to underlying conditions unrelated to the drug itself.

However, some studies find that more adverse reactions occur in people who receive Botox for therapeutic purposes as opposed to cosmetic uses. Likely, cosmetic reactions are far fewer in number because the doses are much smaller compared to therapeutic doses. People receiving Botox for therapeutic needs may also have a higher risk of complications due to other underlying diseases. 

Botox is considered safe and is FDA-approved. Still, this product is a toxin and can be harmful if your body is compromised. 

Side effects of Botox

Of course, like every drug, Botox may present side effects. These side effects are rare (in just one to five percent of cases). They may include mild droopiness, inflammation, or bruising at the injection site. 

If you have signs of an allergic reaction - including hives, itching, wheezing, difficulty breathing, feeling like you might pass out, or extreme swelling - seek emergency medical help. 

Considerations for Botox and Hashimoto's 

Hashimoto's thyroiditis is one of the most common autoimmune disorders in the United States. Indeed, Hashimoto's is the most common cause of hypothyroidism. Like other autoimmune conditions, there is an active genetic component to Hashimoto's disease, and it predominately affects women in midlife. However, it can also occur in men and children.

With an autoimmune condition, your immune system identifies your tissues as foreign and consequently fights healthy tissue. With Hashimoto's, specifically, your immune system attacks your thyroid gland, which leads to chronic inflammation. Because your immune system is hypersensitive in Hashimoto's disease, foreign substances and toxins can be aggravating to an already inflamed system. 

One case study of a woman with Hashimoto's thyroiditis found that cosmetic Botox injections may have a link to the cause of autoimmune thyroiditis. Indeed, the researchers found that her TSH (thyroid-stimulating hormone) levels would elevate following eyelid injections. The conclusion of this study suggests that thyroid complications may go undetected after Botox treatment because many people receiving the injections may only have subclinical (or early) Hashimoto's.

Toxins and bacteria can cause your thyroid symptoms to flare. Because Botox is a neurotoxin derived from a harmful bacterium, your thyroid may be affected by the use of this product. When your body is triggered, your thyroid symptoms can worsen, often called a flare-up.

Some symptoms of a Hashimoto's flare-up may be: 

  • Increased fatigue
  • Increased cold intolerance
  • Significant dry skin
  • Increased brain fog
  • Increased depression and anxiety
  • Excessive hair loss
  • Increased bloating and constipation
  • Increased heartburn
  • Menstrual irregularities

Who should not use Botox

Women who are pregnant or breastfeeding should not use Botox. Those with neuromuscular conditions should also not use Botox. 

Neuromuscular conditions like peripheral motor neuropathic diseases, amyotrophic lateral sclerosis (ALS), or neuromuscular junctional disorders (like myasthenia gravis) affect your muscles and nervous system. Botox weakens muscles, and people with neuromuscular conditions may be at increased risk of having difficulty swallowing or breathing even from a low dose of Botox.

While there is no warning against using Botox with autoimmune thyroiditis, we still recommend consulting with your doctor. 

Where to find a reputable provider

Many manufacturer's websites offer a tool to search by zip code for every licensed physician who's obtained their product legally. This function helps to reduce the risk of getting an expired, contaminated, or potentially dangerous product. You want to make sure that your doctor is an official vendor for any substance you have injected. 

When you visit your doctor for Botox, they typically take an extensive medical history. This assessment is to help your doctor keep you safe by knowing about any preexisting conditions or which medications you take. 

A note from Paloma Health

While the overall risk for an adverse reaction is minimal, Botox is a toxin. It can lead to severe or life-threatening complications if misused. If you have Hashimoto's, or any other autoimmune disorder, it is worth a consult with your doctor before receiving Botox.  

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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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