Thyroid disorders and how they can affect your skin

First and foremost, the thyroid is the butterfly-shaped gland on the front of the windpipe. This gland is responsible for releasing thyroid hormone that controls the growth and metabolism of essentially every part of your body. The pituitary gland, in the middle of your brain, monitors your physiology and releases the thyroid-stimulating hormone (TSH) throughout the body. 

High TSH levels can mean your thyroid is not making enough thyroid hormones, a condition called hypothyroidism. Low TSH levels can mean your thyroid is making too much of the hormones, a condition called hyperthyroidism. However, a TSH test result does not explain why TSH levels are too high or too low – you will need a physical exam, other blood tests and possibly an ultrasound scan of your thyroid gland to determine the underlying cause. The commonest cause of  hypothyroidism is an autoimmune disorder known as Hashimoto's thyroiditis which results in thyroid inflammation. Autoimmune disorders occur when your immune system produces antibodies that attack your own tissues.

The two most significant thyroid hormones, triiodothyronine (T3) and thyroxine (T4), which are released throughout the body, are made purely from iodine in foods. T4 is the main thyroid hormone that travels via the bloodstream to parts of the body, which include the brain, heart, liver, kidney, bones and skin. These hormones activate genes that regulate the energy in your body and, in simple terms, how the body function as a whole. So, it is easy to understand how the body can encounter a multitude of issue when the thyroid isn’t functioning to its optimal level. 

Around 1 in 5 women have a thyroid disorder, but it is often misdiagnosed as the symptoms can be vague and relate to other health conditions. In general, though, thyroid disease is mainly diagnosed in pre-menopausal women, ages 40-50, and women post pregnancy, but it can also affect women in their 20s, too. While it can be frustrating for patients to be diagnosed incorrectly, there are signs and symptoms to be aware of, such as: persistent fatigue, weight gain, feeling cold and unable to regulate temperature, aches and pains in muscles and joints, excessive hair loss, heavy or irregular periods, depression and dry, itchy, flaky skin. 

There is so much to contend with when it comes to thyroid disease, so my focus in this article is on skin and its link to the thyroid. Just like our hair follicles, our skin cells are characterised by rapid turnover. This makes our cells ultra-sensitive to losing the growth signal from the thyroid gland. If the normal cycle of skin renewal is broken, the skin will take much longer to regrow. When the outer layer of dead skin cells is around for too long, they accumulate more damage. Because these dead skin cells take longer to shed, you can be left with flaky, itchy and dry skin. These issues can also be linked to allergies, which makes thyroid issues, once again, harder to diagnose. 

The most important and notable skin problem, directly linked to hyperthyroidism, is Myxoedema. Myxoedema is initially caused by autoimmune skin disease associated with thyroid disfunction of the autoimmune aetiology. Myxoedema increases the glycosaminoglycan disposition in the skin, leaving you with swelling and redness. It can be easily identified due the fact the skin does not pit with pressure, whereas a normal rash/swelling will pit. 

If you have any of the skin conditions discussed above, you should ask your doctor to test your blood levels of thyroid-stimulating hormone TSH. This is the single best screening test for thyroid disease as well as thyroid hormone thyroxine (T4) and T3. 

There are natural ways to help improve thyroid function, particularly if you have an underactive thyroid, first being diet. A combination of exercise, removal of processed foods, and a balanced diet are always a good place to start. Eating two tablespoons of coconut oil daily can help because some studies have shown coconut oil stimulates metabolism and boosts energy, but more studies are needed to determine long term effects, and you should have your thyroid function and cholesterol monitored regularly.

Sea veggies are also a super choice for a concentrated source of iodine, although be careful not to have too much. Nori, for example, is a good option as it has a relatively low iodine content, which won’t overload and cause further disruption. Also check your vitamin D levels are correct. Low vitamin D has been linked to thyroid disfunction. If you are pale, you need at least 30 minutes of sun exposure per day - and that’s without sunscreen. If you have a darker skin tone, you will need up to two hours per day to get the right amount of vitamin D (remember to keep your face out of direct sun, leaving only the body exposed). In my opinion, most people can benefit from some vitamin D supplementation, particularly in the winter months.

Now on to the things to try to avoid. Acid fluoride and chlorine can actually cause iodine deficiency. So, swap out fluoride toothpaste and avoid tap water, which has a high chlorine content in many areas. Avoid raw cruciferous vegetables- these are your leafy greens – as excessive amounts may interfere with how your thyroid products iodine. It is ok to eat them if they are cooked correctly, 2-3 times per week is fine. As with all things, moderation is key with all aspects of diet. Finally, manage your stress levels. Stress impacts on your adrenals and therefore your thyroid. If you are struggling with stress, try meditation to help you switch off - just 5 minutes a day will go a long way and there are so many apps that can help you with this as well.  

In terms of managing skin issues that may be associated with thyroid dysfunction, the key is obviously to correct the underlying thyroid issue. I would suggest seeing your doctor and a nutritionist who can help you work on this.

In the short term, I find an omega 3 supplement can help with persistent dry, itchy skin and using a few drops of a facial oil (such as jojoba oil) added to your moisturiser can help skin feel hydrated more comfortable.