Autoimmunity is when the immune system mistakenly attacks healthy tissues. It is one of the potential causes of thyroid disease. Scientists believe autoimmunity may also cause vitiligo.
People with a specific type of vitiligo are more likely to have autoimmune thyroid disease (AITD) than the rest of the population. This may be because they have similar underlying mechanisms.
The thyroid is a small gland at the front of the neck. It produces hormones to regulate how the body uses energy. In AITD, the immune system attacks the thyroid, meaning that it either cannot make enough hormones or that it becomes overactive, as in Graves’ disease.
Vitiligo is a skin condition that occurs when the skin cells that make melanin die. This removes pigment from the skin and hair, leaving lighter patches.
In this article, we will explore vitiligo and thyroid disease, their potential link, connections to other autoimmune conditions, and some frequently asked questions.
Yes – but only certain types.
There are two main types of vitiligo. Segmental vitiligo only appears in one area of the body. This type of vitiligo often starts at an early age and progresses for a few years before stopping.
Non-segmental vitiligo appears on opposite sides of the body. The patches are symmetrical to each other. This type of vitiligo often starts later in life and can continue to progress over time.
Non-segmental vitiligo is the most common subtype, and doctors believe it is an autoimmune condition.
Similarly, some types of thyroid disease are autoimmune conditions. This includes Hashimoto’s thyroiditis and Graves’ disease.
This is likely why the rates of thyroid disease are higher among those with vitiligo than the general population, as the root cause may be similar.
Estimates for the prevalence of vitiligo and AITD occurring together vary, but research consistently shows that if someone has one of the conditions, they are more likely to have the other.
A 2016 study found that 20% of participants with vitiligo had an autoimmune disease. The most common of these was thyroid disease, at 12.9%.
The reverse is also true – in a 2009 study, vitiligo was significantly more common in people with a thyroid disease than a control group.
Results from a review in Frontiers in Endocrinology found that, among people with vitiligo, the most common thyroid diseases were:
- hypothyroidism
- subclinical hypothyroidism, which is a milder form of the condition
- Hashimoto’s thyroiditis, which is a specific type of AITD
Scientists know that both non-segmental vitiligo and AITD are a product of autoimmunity, and that they do somehow link together. However, they do not yet know the exact mechanism behind this.
One theory is that genetics link the two. Research has identified
AITD may also have a genetic component, as a family history of thyroid disease is a
More research on the connection is necessary to fully understand it.
Both vitiligo and AITD have links with other autoimmune diseases. Vitiligo is associated with:
Hypothyroidism also has links to pernicious anemia, type 1 diabetes, RA, and other autoimmune conditions such as lupus.
Scientists are still learning why having one autoimmune disease raises the risk of having another.
Vitiligo and thyroid disorders have different methods of diagnosis.
To diagnose vitiligo, a doctor will examine the skin. The doctor may ask about:
- family history
- skin sensitivity
- changes in pigmentation
Thyroid disorders can be more difficult to diagnose based on symptoms alone. Instead, doctors use diagnostic tests, such as:
- thyroid antibody tests
- thyroid stimulating hormone (TSH) tests
- medical imaging to see the thyroid gland
Sometimes, a physical examination can also reveal the thyroid is swollen or inflamed.
While both vitiligo and AITD are long-term conditions that may have similar underlying mechanisms, the treatment for each is different. For vitiligo, the options include:
- phototherapy
- topical corticosteroids
- topical immunosuppressants, which suppress immune system activity in a small area
- oral immunosuppressants, which suppress the entire immune system
- skin grafts to even out pigmentation
For AITD, the main treatment is levothyroxine, which replaces lost thyroid hormones.
In some cases, doctors may prescribe drugs that suppress the immune system for AITD. This can happen if thyroid disease starts to affect a person’s eyes, which typically occurs in Graves’ disease. If this happens, a doctor may prescribe high dose steroids or immunomodulating drugs.
Some may wonder if these drugs could help treat both conditions at the same time. However, there is currently no evidence to support this approach.
Additionally, immunomodulating drugs have serious side effects. They affect the whole immune system, reducing a person’s defense against infections. This can be dangerous.
Doctors will likely try other treatments before prescribing immunosuppressants.
Here are some answers to FAQs.
I have vitiligo. Do I also have a thyroid disease?
Not necessarily. Only non-segmental vitiligo is linked to autoimmunity, and only a portion of people who have it also have thyroid disease. Many do not.
Can thyroid disease also cause changes in skin?
Yes. Hypothyroidism can cause the skin to become dry, paler than usual, cold, and scaly. Hair may also become dry and break easily. Hyperthyroidism may cause skin to become smooth, flushed, or moist, and hair to grow thinner and softer.
Will treating thyroid disease help with vitiligo?
The main treatment for thyroid disease is taking replacement thyroid hormone to reduce the symptoms. While this may help with skin symptoms related to thyroid disease, it will not have any impact on vitiligo.
Research suggests that there is a link between vitiligo and thyroid disease. Many people with vitiligo also have thyroid disease, and autoimmunity can play a role in both conditions. However, researchers are still trying to understand the relationship.
Vitiligo and thyroid disease have different methods for diagnosis and treatment, despite this potential link. It is also important to note that while vitiligo is not dangerous, thyroid disease can become serious if a person does not seek treatment.
A person should speak with a doctor about any concerns or questions relating to vitiligo and thyroid disease.