Listen to the podcast on iTunes (also available on major podcast platforms).
You might not realize how much an underactive thyroid can affect your physical appearance.
Inflammation associated with hypothyroidism impact the skin, hair, nails, and joints. To effectively deal with this inflammation, it’s important to understand why your thyroid isn’t functioning as it should.
The most common cause is an autoimmune condition called Hashimoto’s in which the immune system attacks and destroys the thyroid gland.
An estimated 95–98% of hypothyroid cases are caused by Hashimoto’s, which is important because Hashimoto’s is associated with additional inflammatory mechanisms. For those with Hashimoto’s, thyroid hormones alone won’t relieve their symptoms—the underlying autoimmune condition must be managed as well.
Hypothyroidism and hair loss
Hair loss is one of the more distressing symptoms of hypothyroidism. Thyroid hormones impact the metabolic rate of hair follicles, and a deficiency means hair follicles lack the cellular energy to sustain hair growth.
Luckily, managing hypothyroidism with replacement medication often resolves this issue for most patients. However, other factors can contribute to unexplained hair loss:
- Chronic inflammation
Failing to manage the underlying autoimmunity puts the body in a state of chronic inflammation, which not only impacts hair follicles but also makes thyroid receptor sites less sensitive. This causes thyroid hormone deficiency symptoms despite sufficient circulating thyroid hormone.Diet, environmental chemicals, pathogens, lifestyle, stress, and lack of sleep are all factors that can increase or decrease inflammation, which I cover in greater detail in my course Hashimoto’s: Solving the Puzzle.
- Poor blood flow
Another reason people with hypothyroidism continue to lose hair is poor circulation, as healthy blood flow delivers the oxygen, nutrients, and peptides your hair follicles need to produce thick, healthy hair.
One of the nitric oxide pathways impacted by autoimmunity, called endothelial nitric oxide (eNOS), specifically supports blood flow and circulation. Symptoms of poor eNOS include a cold nose, white nail beds (instead of a healthy pink), cold hands and feet, and slow return of blood when you press on your skin.One of the best ways to support eNOS, besides following an anti-inflammatory diet and lifestyle, is through regular exercise.
- Phospholipid autoimmunity
Some people with Hashimoto’s develop phospholipid autoimmunity as a secondary autoimmune disease. While hypothyroidism leads to thinning hair over the entire scalp, phospholipid autoimmunity causes random patches of hair loss that extend to the eyebrows and other body hair.Phospholipid antibodies can lead to clotting disorders, strokes, embolisms, and infertility, so it’s important to properly identify and manage the condition.
Hypothyroidism and nails
An adequate amount of thyroid hormones are necessary for collagen production and healthy blood flow, which brings oxygen, nutrients, peptides, immune cells, and other necessary compounds to the nails.
Because of this, many people with hypothyroidism have soft and weak nails, white nail beds, and are prone to fungal nail infections.
Hypothyroidism and Weight Gain
Weight gain is one of the most well-known symptoms of hypothyroidism. Many thyroid patients find that, despite exercising regularly and eating a healthy diet, they still struggle to maintain a healthy weight.
Thyroid hormones control the metabolic rate, impact insulin signaling, and activate hormone-sensitive lipase, which is necessary to burn fat.
Many hypothyroid patients also have underlying blood sugar and insulin resistance issues, which cause ongoing sugar cravings and fatigue after eating.
Keep in mind that while thyroid hormones and controlling inflammation are necessary to manage weight-related symptoms of hypothyroidism, regular physical activity and minimizing consumption of sugars and carbohydrates are just as important.
Hypothyroidism and Weight Loss
So how can someone with hypothyroidism be chronically underweight when the disease is commonly associated with unexplained weight gain? It may seem contradictory, but difficulty gaining weight and building muscle are also symptoms of hypothyroidism.
Thyroid hormones are intimately connected to a person’s gut health. Patients with autoimmunity conditions and chronic inflammation can develop malabsorption syndrome, meaning they are unable to absorb enough nutrients due to gut inflammation.
This dysfunction impacts the health of their gut microbiome, perpetuating gut inflammation and intestinal permeability. They find they are unable to tolerate fats, proteins, and fibers, with most foods causing bloating and distention. The inflammatory response from hypothyroidism also affects protein metabolism and the ability to develop muscle mass.
Hypothyroidism and skin conditions
For the most part, you can achieve vibrant and healthy skin by consuming enough healthy fats – but thyroid hormones also play a role in skin health and cellular regeneration.
It’s common to see a variety of skin problems in hypothyroid patients:
- Peaches-and-cream skin
Patients with this condition have some skin pores that are very large and some that are small. This is due to the underlying inflammatory response from Hashimoto’s.
- Rosacea or eczema
These conditions are related to systemic inflammation from Hashimoto’s. Phospholipid autoimmunity can also cause skin lesions.
Psoriasis is another autoimmune disease that often occurs alongside Hashimoto’s.
Hypothyroidism and joint pain
An underactive thyroid can also cause joint pain and swelling, due not only to the lack of hormones from the thyroid but to the systemic inflammation that comes along with it. This is compounded by the fact that many Hashimoto’s patients also suffer from rheumatoid arthritis.
This can cause you to appear bent over, crooked, or limping due to joint pain.
Specific foods have been shown to aggravate joint symptoms in those with autoimmune disorders, namely nightshades, gluten, and dairy. Examples of nightshades you want to avoid are eggplant, tomato, peppers, and white potatoes.
Hypothyroidism and puffiness and bloating
The systemic inflammation associated with hypothyroidism also causes the general puffiness many patients experience, specifically swelling of the face and eyes referred to as “myxoedema.” There isn’t a single mechanism that is responsible for this puffiness – it’s a combination of water retention, facial edema, and weight gain.
Bloating is also a common symptom related to the impact low hormone production can have on the intestinal system. The slowed movement of food to the small intestine, constipation, water retention, and salt sensitivity all contribute to bloating.
Hypothyroidism and chronic inflammation
Almost all of the above symptoms are related to the chronic inflammation that accompanies Hashimoto’s and hypothyroidism. Even if you take medication for your thyroid problems, you may still experience symptoms because of an unmanaged autoimmunity causing inflammation in the body.
If you’re looking for more strategies to help manage your autoimmune condition, I suggest looking into Hashimoto’s: Solving the Puzzle. This evidence-based course takes you through different choices regarding nutrition, lifestyle choices, and nutraceuticals that can help dampen inflammation and keep your autoimmune condition in check.
Do you have any research or answers regarding hypothyroid dx but negative thyroid antibodies but with positive ANA and with all the sx of hypothyrodisim? Could this picture be a version of Hashimotos? Thank you!