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Does Thyroid Problem Increase The Risk Of Vitiligo?

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Posted on Fri, 7 Aug 2015
Question: Hi Dr.
I have a vitiligo (white patches) but none in my family history has this. My Family Doctor doesn't give me any answer to my problem. Every year I check my blood work as follows:
08/15/12 Thyroid Peroxidase 164.8 (H)
09/08/12 T3 1.06 Free T4 1.15 TSH 2.51
11/01/12 FT3 6.10 Free T4 1.24 TSH 2.88
12/12/13 TSH 2.87 25-OH Vitamin D 26.5 (L)
07/28/14 TSH 3.36
11/22/14 TSH 1.73 25-OH Vitamin D 25.6 (L) lower from the previous year
11/22/14 Thyroglobulin, Tumor Marker 1.0 (H) and Thyroglobulin Antibody, S 35 (H)
05/26/15 TSH 2.20
I'm 52 years old woman and healthy I don't take any medicines at all but why my vitiligo progressive every year and it's really bother me . Why my TSH like a roller coaster thru my blood work from year to year and my Vitamin D too. I had Hysterectomy when I was 45 years old then my vitiligo started do you think it's hormone problem? but I still have my ovaries.
Please help me ! I'm just giving up to my family Doctor so I see him only once a year for routine blood work check up and he doesn't give me any prescriptions at all about my Vitiligo.
I went to Dermatologist he said I'm sorry I can't help you because you are have Vitiligo. That's it.
doctor
Answered by Dr. Shehzad Topiwala (4 hours later)
Brief Answer:
Thyroid

Detailed Answer:
Very sorry to note your medical problems.

Your thyroid auto antibody levels are high. This means you likely have Hashimoto's thyroiditis. This further means that it is likely your thyroid may become underactive in due course of time. Now it may never happen or happen at any time in your lifetime. There is no definite test to predict this.
The only thing you can do is to have the TSH checked periodically, say once a year.
I see you are already doing this.
So if the TSH rises to above 4.2, especially with a low Free T4 then a case for treatment with thyroid medication called levo thyroxine can be made. Many times even if your TSH is persistently above 3 or 3.5, then too consideration towards treatment with this medicine can be undertaken. However it is best you seek care from an endocrinologists as this can be a complex decision.

There is no need to ever check the thyroid auto antibody levels again.

Regarding the vitamin D levels, I see they have been on the lower side ie Insufficient range. When I see someone like you in my practice with these type of levels I advise them to take a daily pill of cholecalciferol 1000 OU with food. Then I check their levels in 3 months and if they are in the 30 to 50 range I check it only once a year or even less often after that.

Finally with regards to the vitiligo, unfortunately I will have to tell you that it can be hard to treat. People with thyroid problems are at a higher risk of getting vitiligo. But otherwise there is no direct link between the two. So it is not as if treating the thyroid will improve the vitiligo. I understand you have already seen a dermatologist for this and there was not much that could be done about it. Perhaps some cosmetic treatment to minimize or mask it might be an option.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (24 hours later)
Do you think is it ok if I take Actalin with Hashimoto's Thyroiditis ? there's no medication that my PCP can Prescribes me or he can do nothing?
I'm very pleased with your answer because neither of my PCP nor Endocrinologist
explained me very clearly and None of them ever mention that I have Hashimoto's Thyroiditis.
Do you have any idea what kind of supplements can help my vitiligo or medication? Is Hashimoto's Thyroiditis be cured ? Thank you so much.
doctor
Answered by Dr. Shehzad Topiwala (10 hours later)
Brief Answer:
Follow up

Detailed Answer:
To the best of my knowledge, there is no published medical study that indicates an adverse reaction when people with Hashimoto's took Actalin. However, there is no evidence that Actalin is beneficial to specifically improve the Hashimoto's disease.
There is a also a small chance you have 'false positive' thyroid auto antibodies meaning you dont have Hashimoto's but your blood incorrectly tests positive for these auto antibodies due to limitations of the blood test method.
There is no known cure for Hashimotos' and there is nothing you can do to reverse it.
Regarding vitiligo, you will need to seek care from a dermatologist
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Does Thyroid Problem Increase The Risk Of Vitiligo?

Brief Answer: Thyroid Detailed Answer: Very sorry to note your medical problems. Your thyroid auto antibody levels are high. This means you likely have Hashimoto's thyroiditis. This further means that it is likely your thyroid may become underactive in due course of time. Now it may never happen or happen at any time in your lifetime. There is no definite test to predict this. The only thing you can do is to have the TSH checked periodically, say once a year. I see you are already doing this. So if the TSH rises to above 4.2, especially with a low Free T4 then a case for treatment with thyroid medication called levo thyroxine can be made. Many times even if your TSH is persistently above 3 or 3.5, then too consideration towards treatment with this medicine can be undertaken. However it is best you seek care from an endocrinologists as this can be a complex decision. There is no need to ever check the thyroid auto antibody levels again. Regarding the vitamin D levels, I see they have been on the lower side ie Insufficient range. When I see someone like you in my practice with these type of levels I advise them to take a daily pill of cholecalciferol 1000 OU with food. Then I check their levels in 3 months and if they are in the 30 to 50 range I check it only once a year or even less often after that. Finally with regards to the vitiligo, unfortunately I will have to tell you that it can be hard to treat. People with thyroid problems are at a higher risk of getting vitiligo. But otherwise there is no direct link between the two. So it is not as if treating the thyroid will improve the vitiligo. I understand you have already seen a dermatologist for this and there was not much that could be done about it. Perhaps some cosmetic treatment to minimize or mask it might be an option.