From the Research
Yes, thyroid dysfunction can be an underlying cause for spontaneous urticaria (hives). Autoimmune thyroid diseases, particularly Hashimoto's thyroiditis and Graves' disease, have been associated with chronic spontaneous urticaria in some patients, as seen in a study published in 2020 1. The connection likely involves shared autoimmune mechanisms, as thyroid autoantibodies have been found in higher prevalence among patients with chronic urticaria.
Key Points to Consider
- If you're experiencing unexplained hives, especially if they persist for more than six weeks, it would be reasonable to have your thyroid function checked through blood tests measuring TSH (thyroid-stimulating hormone), free T4, and possibly thyroid antibodies, as suggested by a study in 2018 2.
- Treatment depends on the specific thyroid condition identified - hypothyroidism typically requires levothyroxine replacement therapy (starting at 25-50 mcg daily, adjusted based on lab results), while hyperthyroidism may require anti-thyroid medications like methimazole.
- Importantly, treating the underlying thyroid disorder often helps resolve the urticaria symptoms, though this may take weeks to months, as noted in a systematic review published in 2017 3.
- The connection works through immune system dysregulation, where autoimmune processes targeting the thyroid can trigger inflammatory responses in the skin, causing mast cell activation and histamine release that produces hives.
Recommendations for Clinical Practice
- Screening for thyroid autoimmunity is recommended in patients with chronic spontaneous urticaria, as it may help identify an underlying cause of the condition, as suggested by a study in 2011 4.
- Patients with chronic spontaneous urticaria and autoimmune thyroid disease may benefit from treatment with levothyroxine or other thyroid medications, as seen in a study published in 2007 5.
- Further research is needed to fully understand the relationship between thyroid dysfunction and spontaneous urticaria, but current evidence suggests a strong link between the two conditions, as noted in a study published in 2020 1.