Is there a link between thyroid disease and Vitiligo? There is a direct link between Vitiligo and thyroid disease, and understanding it is easy – autoimmunity. An autoimmune disease is when your innate immune system mistakes certain cells in your body to be foreign invaders. It then tries to identify, kill, and eliminate these assailants. In this article, we discuss the connection between Vitiligo and Thyroid Health.
Vitiligo and Thyroid Health:
Research has found that thyroid disease is a common comorbidity in Vitiligo sufferers. Comorbidity is the simultaneous presence of two or more medical conditions in a patient, e.g., physical illnesses such as diabetes and high blood pressure are often comorbid. Morbidity is the state of being sick or having a disease, whereas comorbidity refers to the overlap of differing conditions.
Vitiligo represents the most common cause of acquired skin, hair, and oral depigmentation, affecting approximately 1% of the population worldwide. It is clinically characterized by the appearance of disfiguring skin macules following melanocyte destruction. Vitiligo can be classified as progressing or stable, based on the activity of the disease. Also, the extent of involvement can be limited or extensive (Localised or Generalised Vitiligo).
Vitiligo is a skin condition associated with autoimmune thyroid diseases such as Hashimoto’s thyroiditis and Graves’ disease. Vitiligo is also more frequently encountered in family members of patients affected by autoimmune diseases, such as inflammatory bowel disease, psoriasis, rheumatoid arthritis, type 1 diabetes, systemic lupus erythematosus, pernicious anaemia, and autoimmune thyroid diseases (AITD).
Several predisposition genes have been identified in both Vitiligo and AITD patients that, along with the identification of shared antigens between melanocytes and the major cell type in the thyroid gland, called thyrocytes, may contribute to the observed association between AITD and Vitiligo
The Thyroid Gland:
The thyroid gland is a key part of the endocrine system, which produces and regulates hormones in the body. Inflammation of the thyroid gland leads to thyroid dysfunction and hormonal dysfunction. The thyroid gland is located at the front of the neck, below the Adam’s apple, and covers the trachea (windpipe). Its main hormone, thyroxine (T4), breaks down into triiodothyronine (T3), which controls the body’s rate of metabolism, growth, and body temperature. The thyroid relies on iodine to make its hormones, and those without seafood in the diet require other sources of iodine, such as iodized salt, cranberries, strawberries, cheese, or potatoes.
The thyroid gland produces triiodothyronine and thyroxine, in response to a stimulus from the pituitary gland. Thyroxine goes on to generate triiodothyronine, and this, in turn, affects the metabolism and has an impact on what happens in all the cells in the body. When the thyroid gland is damaged or over-stimulated for any reason, thyroid disease ensues. There are two types of thyroid disease: –
- Hypothyroidism: this is the most common type of thyroid disease and occurs when your thyroid gland is under-active and cannot produce enough T3 for your body’s needs. People with this condition must take replacement thyroxine for life.
- Hyperthyroidism: this occurs when your thyroid gland is over-active and produces too many thyroid hormones. People with this condition can be treated in a variety of ways, but the most common is to take an anti-thyroid medication, usually for life.
If you have Vitiligo, you have a 2.5 times higher risk of developing autoimmune thyroid disease than the general population, because of the autoimmune nature of both Vitiligo and thyroid disease. Research has shown that people with Vitiligo were found to have specific Vitiligo factors associated with an increased chance of developing autoimmune thyroid disorders.
These factors include: –
- Vitiligo that covers a large body surface area.
- Vitiligo that has been present for a long time.
- A family history of autoimmune thyroid conditions.
- Stress, which is a factor of Vitiligo development.
Autoimmune diseases tend to run in families, so if you have one of these autoimmune conditions, you are likely to have inherited the risk genes from your parents. These genes are generally only triggered under circumstances that affect the immune system. Research suggests that Vitiligo and thyroid disease may have some shared genes because there is a higher prevalence of these diseases happening together.
In studying the link, researchers have identified nine genes that may underlie the development of both Vitiligo and autoimmune thyroid disorders. Having one or several of these shared genes may explain why someone would be more susceptible to both disorders.
There are links to other autoimmune conditions:
Both Vitiligo and autoimmune thyroid disease have links with other autoimmune diseases. Vitiligo is associated with: –
- alopecia areata.
- type 1 diabetes.
- rheumatoid arthritis.
- pernicious anaemia.
There is ongoing research to find out why having one autoimmune disease increases the risk of developing another.
What is the effect of dry skin on Vitiligo?
Vitiligo worsens in individuals with dry skin because the body’s immune system must strive to keep the skin healthy and not mistakenly destroy the healthy cells that cause pigmentation. Dry skin can also result from exposure to the sun. When you’re exposed to UV light, your body protects itself by producing melanin faster. Melanin serves as a natural defense against UV rays.
Exposing Vitiligo lesions to the sun results in the white patches turning bright red and sun-damaged. The key to preventing Vitiligo from worsening is to ensure that skin is kept clean, dry, and moisturized.
Dry skin also tends to become itchy, and if scratched vigorously, could cause skin abrasions. Physical trauma to the skin can result in pigment loss. Minor cuts, scrapes, tattoos and even friction from tight clothing can cause Vitiligo lesions. This is called an isomorphic response, or the Koebner effect. External injuries to the skin are not the source of Vitiligo, but they are a common trigger.
Can diet deficiencies cause Vitiligo?
Preliminary observations suggest that the presence of gluten in the diet may play a role in Vitiligo development in some patients. Research suggests foods that contain certain antioxidants, including hydroquinone (citrus fruits) should be avoided. You should also avoid processed foods that cause oxidative stress in the body, which causes cell destruction more quickly than normal.
Avoid eating the following: –
- Fruit: oranges, lemons, lime, gooseberries, nectarines, peaches, melons, grapes, guava, papaya, pears, tamarind, and watermelon as well as any other fruit rich in vitamin C.
- Vegetables: eggplant, green chili, tomato, garlic, and onion.
- Protein: pork, beef, and most fish.
- Dairy: milk, buttermilk, and curd.
- Beverages: carbonated or sweetened drinks, pre-packaged fruit juices and fresh fruit juice rich in vitamin C. Avoid alcoholic beverages and coffee.
Vitamin B12 deficiency and its link to Vitiligo:
Low vitamin B12 levels can cause hyperpigmentation (excess melanin), nail discoloration, and Vitiligo. Vitamin B12, an essential hormone, regulates the production of pigment in the skin and can potentially prevent the death of melanocytes. It has been found that Vitamin B12 and Folic acid levels are decreased in people who have Vitiligo.
These are important cofactors required for the metabolism of homocysteine; therefore, it is possible that increased homocysteine plays a role in the destruction of melanocytes. People with active Vitiligo had significantly higher homocysteine levels than those with stable Vitiligo, which would also indicate a B12, B6, and folate deficiency.
Does poor gut health affect Vitiligo?
Systemic autoimmune diseases can cause a variety of gastrointestinal manifestations. Adequate stomach acid is required to completely break down and assimilate the nutrients contained in the foods we eat, especially proteins and starches. But when stomach acid is low, the food we eat doesn’t get digested properly. When this undigested food passes into the small intestine, it becomes a breeding ground for pathogenic bacteria and candida, which causes the friendly gut flora to become depleted and overrun by bad bacteria. Once this happens, the lining of the gut becomes inflamed and weakened, ultimately resulting in what is called a leaky gut. Once your gut is permeable, microscopic food particles can enter the blood stream.
This is when things get ugly!
Several things can contribute to low stomach acid: aging, thyroid dysfunction, adrenal fatigue, medications, stress, and poor diet. You can assume your digestive tract is in trouble if you have multiple food sensitivities or allergies, chronic diarrhea or constipation, hives or skin eruptions, discomfort in your abdomen during or after you eat, excessive fatigue, brain fog, and nutritional deficiencies.
Manage the risk:
If you have Vitiligo, be aware that you are at an increased risk for conditions like autoimmune thyroid diseases. You can take several steps to manage your risk of these diseases:
- Get yearly blood tests to examine your thyroid hormone levels.
- Know the signs of autoimmune thyroid diseases. Although many of the indicators are general, keep track of your symptoms and let your doctor know about any changes.
- Find out whether you have a family history of autoimmune thyroid disease. Because there is a genetic factor, a family history of these diseases further increases your risk.
The treatment of Vitiligo therefore depends on the clinical classification or characteristics of the disease and involves arresting the progression of active Vitiligo, to provide stability. Then comes the repigmentation of the affected area. It is important to identify and Treat the Vitiligo symptoms early.
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Published by Vitiligo Treatment