Vitiligo has been associated with numerous endocrine disorders (that is, disorders relating to the hormones and the glands that make and secrete them into the bloodstream.) One of the main associations is with thyroid abnormalities. This association is quite well established. But the exact reason for it is still not clear and the whole subject can be confusing, especially to those of us with no medical training. Hopefully, this blog post will help to put the subject into context.
First of all, what exactly is the thyroid? It is a small gland at the base of your neck, just below your Adam's apple. This gland produces two main hormones known as T3 and T4. These hormones are carried in your blood to every part of your body and are responsible for controlling the rate of many of your body’s internal functions. Examples of these are how fast you burn calories and how fast your heart beats. All of these activities are known collectively as your metabolism. If your thyroid is working correctly it will produce the right amounts of hormones needed to keep your body’s metabolism working at a rate that is neither too fast nor too slow.
So, what can go wrong with your thyroid, and why? Autoimmunity is a feature of most, though not all, thyroid disease and it is these autoimmune thyroid conditions that are often associated with vitiligo.
At one end of the scale, the thyroid can become overactive – a condition known as hyperthyroidism. This is when the thyroid makes more thyroid hormones than the body needs. The most common cause of hyperthyroidism is Graves' disease, an autoimmune disorder in which the body's own defence system overstimulates the thyroid, causing the thyroid gland to swell and leading to symptoms like increased heartbeat, muscle weakness, disturbed sleep, weight loss, loose stools and irritability. Other symptoms can include bulging of the eyes and problems affecting the circulation, nervous system and the skin. Genetics account for about 80% of the risk of developing Graves’ disease. It is 7 to 8 times more common in women than men, sometimes developing after childbirth, and affects up to 2% of the female population.
At the other end of the scale the thyroid can become underactive – known as hypothyroidism. This is when your thyroid does not make enough thyroid hormones. The most common cause of hypothyroidism is Hashimoto's disease, yet another autoimmune disease, in which the immune system mistakenly attacks the thyroid gland causing it to produce insufficient thyroid hormones to keep your metabolism working properly. Symptoms of an underactive thyroid can include fatigue and sluggishness, muscle weakness, depression, weight gain, constipation, elevated cholesterol, a hoarse voice and a puffy face. The main risk factor for developing this thyroid disorder is having a pre-existing autoimmune condition.
One of the questions this poses in my mind is “which comes first – the chicken or the egg?” Does having an autoimmune thyroid disease make you more likely to develop vitiligo, or does having vitiligo make you more likely to have thyroid disease? Personally, I don't think it is necessarily the case that either condition causes the other. I wonder if both thyroid disease and vitiligo (and, for that matter, all the other autoimmune conditions that seem to be so prevalent nowadays) might be symptomatic of other, more fundamental health issues. Maybe the reason that autoimmune disorders often occur together is because the body is not getting the quality or quantity of fuel it requires to stay healthy and so it quite simply starts to break down.
I realise that it may be simplistic to lay the blame for all mankind's diseases at the door of poor nutrition. But, having experienced first-hand how compensating for my digestive malabsorption with nutritional supplements has reversed my vitiligo (also considered by most doctors to be an autoimmune disease) it now seems self-evident to me that the first, and most important, line of defence we have against illness is our gut. When the digestive system is working as it should all the other processes of the human body tend to follow suit because they are receiving the right fuel for the job. But if a person's diet is lacking, or their digestive tract is malfunctioning in some way (as mine was), the rest of the body either becomes starved - because essential nutrients are not being properly absorbed - and/or poisoned by substances that are making their way into the bloodstream instead of being eliminated. It would be hardly surprising in these circumstances for the natural consequence of this to be a body that gradually stops functioning as it should and even starts attacks its own cells.
My name is Caroline.