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Hives in Hypothyroidism

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Thyroid conditions can sometimes result in itchy skin rashes, known as hives.

Written by

Dr. Dheeksha. R

Medically reviewed by

Dr. Harshita Sharma

Published At December 13, 2023
Reviewed AtDecember 13, 2023


Thyroid conditions sometimes can result in bouts of itchy skin called hives. Chronic hives is also known as chronic urticaria. Chronic urticaria and thyroid diseases both are autoimmune conditions. Many factors trigger hives, such as food, medication, allergy, sunlight, heat, etc. These hives usually recur without any warning. The causative factor in about 90 percent of hive cases is unknown.

What Are Known as Hives?

Hives are itchy skin rashes where the causative factor of the hive, in many cases, is unknown. Chronic hive is medically known as chronic urticaria. In some cases of hives, the overactive immune system, which attacks the skin, must be blamed. Studies show that about 30 percent of chronic hives are associated with underlying autoimmune disease, which can affect the thyroid gland situated in the neck.

Usually, chronic hives are common in people affected by Hashimoto’s thyroiditis, which is an autoimmune condition that results in hypothyroidism. Hypothyroidism is a condition where the thyroid gland becomes underactive.

What Is Meant by Hypothyroidism?

Hypothyroidism is also known as underactive thyroid, where the thyroid gland does not produce the hormones required for the body's normal functioning. This condition can affect the heart rate, metabolism, and body temperature.

What Are the Symptoms of Hives in Thyroid Conditions?

The most common symptom of chronic hives is round, swollen, pink welts in any region of the skin. These hives are very itchy. Usually, hives subside within 24 hours, but a new hive occurs as the old one disappears. Chronic hives are those that have been present for more than six weeks. Hives are considered one of the symptoms of the occurrence of thyroid disease.

Other symptoms of chronic hives include -

  • Raised patches of red or skin-colored wheals or welts.

  • These welts can alter their shape and size. They sometimes tend to disappear and then reappear.

  • Sometimes, there can be severe itching, burning, and stinging sensation.

  • Most hives related to thyroid conditions are chronic.

  • These hives can occur in the neck, face, back, or chest.

Why Is There the Occurrence of Rashes in Thyroid Conditions?

Thyroid conditions and hives both tend to be autoimmune conditions, where the immune system attacks the body's cells. This also occurs with an immune protein called autoantibodies, which results in chronic and recurrent attacks called flares. The thyroid gland is the target of autoimmune thyroid disease, which can result in hypothyroidism or hyperthyroidism. These autoantibodies, which attack the receptors in the tissue under the skin, will cause the flare. This turns on the trigger receptors called the immunoglobulin E (IgE), the antibody responsible for allergic conditions like hives and rashes.

What Are the Thyroid Conditions Associated With Hives?

  • Hashimoto’s Disease:

This is one of the most common underactive thyroid conditions. It is an autoimmune condition. Chronic hives occur when the disease is active but shows no symptoms. During these episodes, a reduced level of autoantibodies can trigger IgE response. Not all people affected by this condition will get hives, but this condition enhances the risk of chronic hives. Along with this, other environmental and genetic factors can increase the risk.

  • Grave’s Disease:

This is a condition where the immune system attacks the thyroid gland, producing increased thyroid hormone. This condition causes the body's functioning to speed up. Hives are related to some rare conditions. Due to a lack of study, the link between chronic hives and hyperthyroidism could not be clear.

Other thyroid conditions with which hives are associated are

  • Painless Thyroiditis: This condition is a variant of Hashimoto’s thyroid condition.

  • Subacute Thyroiditis: It is usually caused by viral infections and is characterized by frontal neck pain, fever, and signs and symptoms of an overactive thyroid gland.

  • Postpartum Thyroiditis: There are chances of the thyroid becoming inflamed after pregnancy, causing hyperthyroidism followed by hypothyroidism.

What Are the Other Reasons for the Occurrence of Hives?

Chronic hives are caused by autoimmunity, but there are reasons other than thyroid why hives occur; some are:

  • Allergic to food and food intolerance.

  • Cold exposure.

  • Stress.

  • Sunlight.

  • Exercise.

  • Scratching.

  • Pressure over the skin.

There are conditions where the cause is unknown but causes recurrent outbreaks. These are called chronic idiopathic urticaria.

How Can Hives Caused Due to Thyroid Condition Be Diagnosed?

The hives can be diagnosed by visual examination, but finding the underlying cause is a different story. The cause can be identified through blood tests and skin biopsies to rule out the presence of any infectious or inflammatory problems. Skin-prick tests and food challenges can rule out the presence of allergies and food intolerance.

If the doctor suspects an autoimmune thyroid condition, then the doctor recommends

  • Autologous Skin Serum Test: In this procedure, autoimmune reactivity is injected beneath the skin.

  • Thyroid Hormone Test: This is a blood test used to measure thyroid hormone levels.

  • Autoimmune Thyroid Test: This is a blood test used to detect autoantibodies.

How Are Chronic Hives Treated?

There are many ways to manage a hive, but some common methods are

  • Recommendation of medications such as antihistamines.

  • Application of cold compress.

  • Corticosteroids or immune-changing medications.

  • Topical anti-itch creams.

By avoiding the trigger factors, the hive can be prevented from occurring. Some are

  • Food allergy.

  • Intense exercise.

  • Stress.

  • Medication.

  • Change of temperature.

When to See the Doctor?

Hives are usually self-treated. They do not require any treatment and subside on their own. If the hive persists for long and the underlying condition is due to thyroid, then the person should consult the doctor. At any cost, if there is any sudden and rapid outbreak or hive, immediate attention should be given.


Chronic hives are usually related to thyroid conditions. These are occurrences of itchy rashes on the skin. These hives do not require any specific treatment and subside on their own. But when they persist for weeks, it is called a chronic hive and requires treatment. Avoiding certain trigger factors can also help to prevent the occurrence of hives.

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Dr. Harshita Sharma
Dr. Harshita Sharma



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