Is there a connection between psoriasis (and even psoriatic arthritis) and thyroid problems?
YES.
I started to notice a trend amongst my psoriasis clients in my private clinical nutrition practice — thyroid levels tend to be really off.
No one ever bothered to look at them previously, but I do because a thyroid panel can reveal a lot about the status of certain nutrients. Plus it can explain certain symptoms like fatigue, hair loss, and weight gain… and even autoimmunity.
As I looked deeper into the research, I found some really interesting correlations between these conditions. AND repeated urgings from researchers for doctors to include thyroid screenings in those with psoriasis and psoriatic arthritis.
And yet… I have yet to meet a psoriasis client who has ever had their thyroid evaluated (unless they already had a known thyroid issue).
That's why I want to share this information with you! Let's dive in.
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In this episode:
- Can poor thyroid function make your psoriasis worse?
- How rebalancing thyroid function can improve psoriasis symptoms
- Retrospective study results looking at thyroid function in 162,842 psoriasis patients
- Year-long case-control study results comparing thyroid measurements in psoriasis patients to healthy controls
- Increased incidence of thyroid issues in those with psoriatic arthritis
- What thyroid tests does the research suggest you get? (It's more than TSH)
- Nutrients involved in healthy thyroid function
Quotes:
“This study illustrates that patients suffering from psoriasis have an increased risk of developing autoimmune thyroid disease. The risk increases if the patients are also suffering from psoriatic arthritis.”
“25% of those with psoriasis had TPO antibodies compared to only 9.3% in the control group. Looking at thyroglobulin antibodies, 30.4% in the psoriatic group had them versus 11.1% of the control group.”
101: Psoriasis-Thyroid Connection [FULL TRANSCRIPT]
Welcome back to episode #101 of the Healthy Skin Show!
In today's episode, I want to talk about the connection between psoriasis and thyroid problems!
I've got some interesting research to highlight today, but first I want to start with a story.
My client named Tina (whose name has been changed to protect her identity) is an amazing woman, but she's been struggling with psoriasis for quite a long time. Eventually her psoriasis and symptoms became so unbearable that she sought out my help as her diet became increasingly smaller.
In addition to her psoriatic rashes, she was struggling with extreme fatigue and constantly feeling like she was “on edge”. She was very depressed and her mood was all over the place. Because of how incredibly itchy she was almost all of the time, she really couldn't sleep which was also making her feel worse.
As I mentioned, her diet had became quite small and she really struggled to try new foods because she felt like they would ultimately make her symptoms worse.
So one of the first questions that I pose to all of my clients is, “have you had your thyroid levels checked?”
Most clients coming into my clinical practice really fixate on what's going on with their skin while ignoring other symptoms. But as you listen to the Healthy Skin Show and read articles here at www.Skinterrupt.com, you come to realize that there are so many other pieces of the puzzle that need to be addressed.
AND that sometimes your skin issue may not really truly be a skin issue. It could be rooted in some other imbalance or underlying problem.
In this particular instance, getting Tina's thyroid levels checked was a game-changer!
Her thyroid-stimulating hormone (TSH) level came back in the 30's!
That might not mean anything to you, but according to the American Thyroid Association, the normal range for TSH is between 0.4 and 4.0.(1) And according to functional medicine, a tighter range for optimal TSH is between 1.0 and 2.0.
So you can see from this that her TSH was incredibly high.
Upon reviewing her thyroid panel, I urged her to see her doctor immediately to get the test results reviewed. I felt that she needed to talk to her doctor about the possibility of medication to help support her thyroid levels.
When your TSH is elevated, it oftentimes can indicate a state of hypothyroidism. If antibodies are present, it can indicate a state of autoimmunity. Ultimately any diagnosis has to be made by your doctor.
Tina had just assumed that her symptoms were the result of her psoriasis and the symptoms that she was experiencing. She had also suspected that she was reacting to food. No one had checked her thyroid levels though.
Tina's doctor agreed with me that something needed to be done and prescribed thyroid hormone replacement medication.
It was started immediately and within a month, Tina was feeling significantly better… not 100% but a real significant improvement.
Her energy had greatly returned and she was able to finally start sleeping through the night. She felt calmer and less on edge.
I've had a number of similar experiences with other psoriasis clients which really got me thinking about a potential connection between psoriasis and thyroid issues.
Research Connecting Dots Between Psoriasis And Thyroid Problems
I began digging into the research about psoriasis and thyroid problems. What I found was incredibly interesting!
I'd like to share with you two pieces of research that help illuminate this psoriasis-thyroid connection. AND the importance of getting a full thyroid workup (including an ultrasound), if you've got psoriasis or even psoriatic arthritis.
The first piece of research that I think is worth sharing is from a retrospective study done by a doctor and his colleagues who looked at the Taiwanese National Health Insurance Research Database and came up with 162,842 psoriatic patients between the years of 2000 and 2011. All of these patients were then matched with non-psoriasis controls.(2)
One of the papers that discusses this study drew a really interesting conclusion that I felt was worth noting — “This study illustrates that patients suffering from psoriasis have an increased risk of developing autoimmune thyroid disease. The risk increases if the patients are also suffering from psoriatic arthritis. This study results reaffirm the complexity of systemic inflammation and psoriasis and remind clinicians of the association between psoriatic patients and thyroid morbidity.“(2)
I also found a study published in the Journal of Rheumatology comparing the rate of thyroid issues in patients with psoriatic arthritis. A similar warning was echoed herein — “Anti-thyroid peroxidase antibodies, a hypoechoic thyroid, and subclinical hypothyroidism were significantly more frequent in women with Psoriatic Arthritis than in control women.“(3)
Another piece of research worth mentioning is a year-long case-control study with 56 psoriasis patients that were matched to 54 controls. Researchers evaluated every patient's thyroid function including thyroid-stimulating hormone known as TSH, free thyroxin or free T4, anti-Thyroid Peroxidase (TPO) antibodies, and anti-thyroglobulin (TG) antibodies.(4)
They also performed thyroid ultrasounds on every single person in order to compare them to the control group.(4)
The results were pretty eyeopening!
The study stated that “significantly higher prevalence of TPO antibodies, thyroglobulin antibodies, hypo-echogenicity, pseudo-nodularity, and increased vascularity was found in patients with psoriasis“.(4)
Digging into the data was also quite interesting!
For example, researchers compared the difference between the incidence of TPO antibodies between those with psoriasis and control groups. 25% of psoriasis patients had TPO antibodies compared to only 9.3% in the control group.(4)
Thyroglobulin (TG) antibodies were found in 30.4% of the psoriatic group versus only 11.1% of the control group.(4)
Ultimately, the researchers concluded that “this study demonstrates a clear association between psoriasis and Hashimoto's thyroiditis in the form of a significantly higher prevalence of TPO antibodies, thyroglobulin antibodies, hypoechogenicity pseudo-nodularity, and increased vascularity. Hence thyroid evaluation by antithyroid antibodies, particularly TPO antibodies and ultrasound should be included in the care of psoriasis patients.”(4)
Have You Gotten Your Thyroid Checked Because You Have Psoriasis?
Are you thinking to yourself, “Gee, I never had my thyroid checked. No doctor ever told me this.”
Well, now is a perfect opportunity to do so!
You can get your thyroid checked by asking your doctor to run a full thyroid panel. Or you can go online HERE and purchase your own full thyroid panel.
Once the results are back, you can share them with your doctor or trusted practitioner to get help understanding what they mean and your best next steps.
In case you're not aware of what's included in a full thyroid panel, here's a list:
- Thyroid-Stimulating Hormone (TSH)
- Free T4 (also called Free Thyroxine)
- Free T3 (also called Free Triiodothyronine)
- Reverse T3
- Thyroid Peroxidase antibodies (also known as TPO antibodies)
- Thyroglobulin antibodies
It's critical to note that Total T4 or Total T3 is not helpful when looking at a thyroid panel because it doesn't help us understand the T4-to-T3 conversion that ultimately impacts the Thyroid feedback loop. Make sure that the word “FREE” is included in those two values in order to get the correct marker checked otherwise you're likely getting the total value instead.
Some studies discussed a connection between hyperthyroidism and psoriasis. In that case, it may be wise to ask your doctor to also run a test called TSI. TSI stands for the thyroid-stimulating immunoglobulins that oftentimes are connected with Graves' or hyperthyroidism.
And last but not least, these papers also recommend requesting an ultrasound of your thyroid.
I feel it's worth mentioning that as a clinical nutritionist, I look at the entire thyroid feedback loop because proper thyroid function is heavily based upon nutrient status.
For example, thyroid hormone (both T4 and T3) is predominantly built on the amino acid tyrosine and iodine.
Additionally, you also need selenium, magnesium, vitamin A and zinc to help support this entire process.
So the big takeaways here are that if you have psoriasis or psoriatic arthritis, your thyroid levels should be checked by your doctor or your practitioner at least annually or every other year. Thyroid function absolutely impacts the health of your skin!
If you'd like to also share the studies that I've discussed, you'll find the links to the research below in the REFERENCES SECTION that you can print out and bring it to your doctor's attention.
Got any questions or comments about your thyroid, leave them below!!!
And if you know anyone who's struggling with their psoriasis, share this episode with them.
It's highly likely that they've never been told to get their thyroid checked and probably never even thought about it.
If your thyroid is out of whack, it can absolutely impact not just your skin, but your mood, your body in general, and so many different processes that help you feel well. That's why this is so critical.
As always, I appreciate you tuning in. Have a great rest of your day, and I look forward to seeing you in the next episode!
REFERENCES
1. https://www.medicalnewstoday.com/articles/324096.php
2. https://www.dermatologytimes.com/article/thyroid-endocrinopathy-associated-psoriasis
3. https://www.ncbi.nlm.nih.gov/pubmed/17014017
THANK YOU, JEN! You are such a blessing. Your podcasts are helping me stay sane and hopeful while giving invaluable knowledge and insights for solving my skin puzzles and living with less misery.
You are so very welcome, Jean! I’m glad that this was eye-opening for you!
Wow, thanks so much for this information. I had radioactive iodine (twice) at age 15 so my thyroid levels are checked annually. I sensed that my thyroid levels were off this summer, but until my psoriasis went out of control, I didn’t even think to search for a connection between the two. I will be sharing this article with my doctor.