• Chronic urticaria (hives) and thyroid disease are both autoimmune in nature.
  • Some thyroid medications, such as levothyroxine, have shown promise in treating chronic hives; however, more research is needed.
  • If you’re diagnosed with chronic idiopathic urticaria, you may want to talk with your doctor about getting a thyroid function test.

Chronic hives, known medically as chronic urticaria, happen when itchy pink welts form suddenly on your skin and go away just as quickly. They often recur without warning.

Food or medication allergies, heat, and sunlight can all trigger hives. Yet about 95 percent of chronic hives cases are idiopathic, which means the cause is unknown.

In fact, an overactive immune system that attacks the skin may be to blame in about half of all cases of chronic hives.

Researchers in a 2018 case study of a 49-year-old person with hives suggested that autoimmune disorders, like autoimmune thyroid disease, are associated with chronic hives.

But it’s tricky to determine this link because in some cases, a person may have antithyroid antibodies and chronic hives with no symptoms of any thyroid disease.

If you have chronic hives and are wondering if you may also have an underlying thyroid condition, read on to learn more.

Chronic urticaria and thyroid disease are both autoimmune in nature.

A 2020 research review noted that chronic spontaneous hives is associated with autoimmune thyroid disease in between 4.3 percent and 57.4 percent of adults with the condition.

The two diseases have a few things in common, including immunological issues and elevated levels of IL-6 serum (a protein that regulates immune response) and Th17 cells, which help activate other immune cells.

Both autoimmune thyroid disease and chronic spontaneous hives also involve reduced levels of regulatory T cells, which play a role in suppressing certain cells in your immune system.

Another potential link between chronic haves and the thyroid is the presence of antithyroid antibodies. People tend to have these antibodies if their immune system is attacking their thyroid.

In a 2018 study, researchers detected antithyroid antibodies in 25 percent to 30 percent of people with chronic urticaria. They were eventually diagnosed with Hashimoto’s disease, an autoimmune disorder that attacks the thyroid.

The researchers involved in that study recommend testing the levels of thyroid-stimulating hormone and antithyroid antibodies in people who have chronic hives with no known cause.

What’s more, the 2020 research review mentioned above suggested that certain medications used to treat thyroid disorders, such as levothyroxine, have helped improve cases of chronic spontaneous hives. In fact, they sometimes brought the condition into remission.

Further research is needed to determine whether this approach can be effective for a large number of people with the condition.

The similarities between the two conditions and their response to treatment lead some researchers to believe there’s a connection between chronic hives and autoimmune thyroid disease.

However, research is ongoing. It may just be that as an autoimmune-like condition, chronic hives are more common in people who are prone to other autoimmune diseases.

The exact link between chronic hives and the thyroid isn’t fully understood, but one condition doesn’t seem to cause the other.

If an autoimmune disorder, such as Hashimoto’s disease, is the cause of your hypothyroidism, you may be more likely to have or develop chronic hives.

However, the hives themselves may be coming from some other reason — and most people never discover the cause.

If you’re diagnosed with chronic hives with unknown triggers, you may want to talk with your doctor about getting a thyroid function test.

The main symptom of idiopathic urticaria is round, swollen pink welts that appear anywhere on your skin. The hives are often very itchy.

Hives generally go away within 24 hours, but sometimes new hives pop up as the old ones disappear.

When the hives occur for more than 6 weeks, the condition is considered chronic.

As for thyroid disease, hives are just one of many possible symptoms.

According to the American Academy of Dermatology, other symptoms of thyroid disease include:

  • protruding eyes
  • brittle nails
  • thinning eyebrows
  • itchy skin
  • bald patches
  • less bodily hair
  • nails that are growing more quickly or more slowly
  • swelling in your neck (goiter)
  • red palms
  • moist, velvety skin
  • red or yellowish-orange palms

You may not always notice signs of thyroid disease right away. If you do have these symptoms, speak with a healthcare professional about whether you should be tested for thyroid disease.

There are several ways to treat hives. Some common treatments include:

  • antihistamines (either prescription or over-the-counter oral medications)
  • cold compresses
  • prednisone or similar corticosteroid or immune altering medications
  • omalizumab (Xolair)
  • cyclosporine

Hydroxychloroquine, a medication originally developed to prevent malaria, may also be a potential treatment option for people with chronic hives.

A clinical trial found that 83 percent of people saw their hives improve or go away completely after using hydroxychloroquine for at least 3 months, according to the American Osteopathic College of Dermatology.

The aforementioned research from 2018 also showed success with using levothyroxine, a medication typically used for thyroid disease, in people with chronic urticaria and elevated antithyroid antibody levels.

So, it’s possible that treating the thyroid may also help treat the chronic hives, but more research is needed.

Research from 2013 has also found links between chronic hives and other autoimmune disease, including:

  • rheumatoid arthritis
  • type 1 diabetes
  • systemic lupus erythematosus
  • celiac disease
  • Sjogren’s disease

If you have been diagnosed with chronic hives with no known cause, you should talk with your doctor about checking for underlying autoimmune disorders and other conditions.

Research shows there may be a connection between chronic hives and thyroid disease.

Both conditions can be the result of an overactive immune system that ends up attacking your thyroid or skin. Further research is needed to determine the exact link between the two conditions, however.

Chronic hives can be treated with a range of medications, such as:

  • omalizumab (Xolair)
  • antihistamines
  • prednisone
  • immune-altering drugs

Cold compresses and anti-itch ointment can also provide relief from the itching and swelling of the hives.

If you have chronic hives with no known cause, talk with your doctor about whether you should get tested for a thyroid disorder.