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If you have ever dealt with skin irritation such as hives or a rash, you know how debilitating and uncomfortable it can be. Unfortunately, chronic hives, or urticaria, can develop for those with Hashimoto’s. Our skin is a reflection of our internal body, so if you’re seeing something new and unfamiliar develop on your skin’s surface, it’s likely that something off-balanced internally needs attention and care.
Affecting around 1 in 5 people, including women in their 30s-60s, urticaria is a developed rash that appears on the skin and can often be very itchy and painful. Most of the time, these rashes go away within several days. However, they can reoccur for weeks if the reason is not tended to or looked after. The development of urticaria, while not common, can result from an allergic reaction, an infection, or a side effect of a certain medication.
It can be classified according to the timeline of symptoms and the severity of the symptoms. The World Allergy Organization states that when the rashes last less than six weeks, it is classified as acute urticaria (or AU). If the rashes, or chronic hives last more than six weeks, they are classified as chronic urticaria (or CU). CU is associated with autoimmunity in 30-45% of cases because it shares some immunological similarities with other autoimmune diseases. It can show up several years before an autoimmune diagnosis, begging the thought of how closely connected the two are.
The connection between urticaria and autoimmunity has been a curiosity since the early 1900s. Specific to autoimmune disease, chronic urticaria is associated with various autoimmune diseases such as diabetes, rheumatoid arthritis, Celiac disease, and autoimmune thyroid disease, Graves and Hashimoto’s. A late 1980s study of over 600 patients reported that 12.1% of the patients who reported having chronic urticaria also had evidence of Hashimoto's.
One of the potential reasons that explain this interconnectedness is an allergic reaction. When someone is in active autoimmune (meaning they’re exhibiting active symptoms) or is in an autoimmune flare, this can trigger the release of an antibody called immunoglobulin E (or IgE). IgE is the antibody that manifests allergic reactions, such as hives or rashes. This chain of reactions, if not addressed nor treated by a medical professional, can occur as a more chronic condition in tandem with the onset of Hashimotos Thyroiditis.
There is also the likelihood of cause and effect - one autoimmunity causing another. Autoimmune thyroid disease and chronic urticaria share some immunological mechanisms. Dysregulation of the immune system occurs amongst both, commonly an imbalance of T cells. Several studies have shown that autoimmune thyroid antibodies could be positive in 10-42% of patients with chronic urticaria.
Assuming that one of the reasons for developing urticaria is an allergic reaction, starting to address the cause of this would be a good place to start. Assessing if there might be a food allergy, environmental allergy, or perhaps the presence of disease could help provide insight as to the cause of skin rashes, and it could also provide insight into other symptoms exhibited. Another promising treatment option is the use of levothyroxine that has been shown to be an even more promising treatment of urticaria than antihistamines. And works for a longer period.
Our bodies are intelligent and alert us when something internally is imbalanced. While conditions such as urticaria are common, it does not deem it normal. If you feel that your body is showing signs of distress, prioritize working with a healthcare professional who can provide insight and accessible solutions and treatments.
Schedule a visit with a Paloma doctor to monitor your thyroid levels regularly and find out if you have any nutritional deficiencies that need to be addressed.