How come that your face is swollen when you have hashimoto's disease?

[jeffbursens]

Dear Hashimoto-survivors,

I'm asking myself this question for a long time but couldn't figure this out yet.
How come that your face/cheeks/eyes/hands is swollen/puffy when you have hashimoto's disease?
I'm sure it has something to do with to overall functions/metabolism of the patient and the fact that everything is
slowing down but there must be a better explanation...

Thank you so much in advance and I'm looking forward to your replies,
Jeffrey Bursens (a hashimoto victim since severall months)

[Becca6381]

I am so glad I found this site. I have self diagnosed myself with facial myxedema but can not get a doctor to even act like it matters. I just keep being told the levothyroxine is all I need to be taking. I have read numerous studies and articles about t3 replacement along with t4 replacement. But it is like speaking to a deaf person everytime I bring it up. I still have all the symptoms of hypothyroidism and facial myxedema I am currently on 200mcg levothyroxine daily. I am sick of looking in the mirror and not seeing myself. I know we all change with age but this is more than that. My entire facial structure looks different. I have Graves Disease so eyes popping out is bad enough without the swelling under the eyes the droopy jaw line. What in the world Should I DO?

[jeffbursens]

Ok I'll wait a little longer and review my situation in a couple of weeks. I'd like to know what does upper half to upper third means? Is it around 75% ? And how can you so easily calculate the percentages of the levels between the ranges? What formule do we have to use? Maybe it's very easy but I had not been able to find it. Thank you

[Barb135]

You've only been on thyroid medication for 2 months, which isn't long enough to do much of anything, since it takes 4-6 weeks for the med to reach full potential in your blood, then your body has to "get well".  Your body will heal the most important things first, such as regulating heart rate, brain activity,  etc, then it will heal the less important things.  

One thing that many people don't understand is that thyroid conditions are an illness and like any other illness, the body has to heal.

While your labs are "perfect" on the report, they may not be perfect for you. If you recall, rule of thumb for FT4 is 50% of the range; your level is at 84%.  Rule of thumb for FT3 is upper half to upper third; your level is at 60%.  FT3 should be higher in its range than FT4 in its, so your numbers are upside down.  Since you've been on the med for such a short time, they might right themselves as time goes on, so it might be a little too soon to think about adding a T3 med.

The puffiness you have is more aesthetic than anything else; it's not really a health hazard, at this point, because you're getting treatment, and you probably weren't hypo long enough to have any life threatening issues.  

If your swelling continues to get worse, you should talk to your doctor and have him start checking for other things, such as adrenal issues.  Cushings disease, one of whose main symptoms are "moon face" might be something to look into.  If you haven't researched that, you can read some about it via the following link:  http://www.webmd.com/a-to-z-guides/moon-facies.  

Of course, you should also be aware that there are other things that can cause facial swelling, so you're best bet is to talk to your doctor.  

Another thing to keep in mind, is that Hashimoto's is progressive, in that the thyroid continually produces less and less hormones as the antibodies destroy healthy tissue.  You'll probably have to increase your medication periodically, to keep up with this progression.  

[jeffbursens]

Off course I hope you're right and you've been there. It's just so weird that when it's there, it won't go away. Whatever I try to do. (drink lot's of water, diuretics, eat very clean,...) I've been taking T4 for 2 months and 10 days and I don't see any progress. I'll ask my doctor about T3 too, maybe that would be the key. It 'scares' me a little when people say the puffiness went away as soon as their thyroid levels came up. (like you) My blood levels are 'perfect' since a couple of weeks and I just keep swelling up. It's hard to bear.

Thank you Barb for your wisdom

[Barb135]

I had the same thing prior to being diagnosed with Hashimoto's/hypothyroidism.  I think I even had a picture of myself during that time on my profile page; my whole face was puffy and I had big bags under my eyes.  When pressed the skin would spring right back and did not respond to diuretics.  It wasn't myxedema, but was a common symptom of hypothyroidism.  It went away as soon as my thyroid levels began coming up after I started on med.

Please note in the quote I posted:  "The other skin condition, called myxedema, occurs in severe, long-standing hypothyroid states and is caused by the deposition of mucopolysaccharides within the dermis."  Note the "long standing hypothyroidism".  Unless you've been suffering from severe hypothyroidism for many years, I'd doubt seriously that you have myxedema.

[jeffbursens]

Dear Barb & Red Star

I'm 90% sure that I have myxedema on both sides on my face. The cheeks and on one side a little more than the other. I had a echography a couple months back because the doctors didn't know what the swelling was and they said the subcutis was thicker but no reason was found. Now they know that it is hashimoto... Now I'm reading that the subcutis is exactly the layer in the skin that is effected when having myxedema so it has to be that. If I press in the 'balloon', it does not leave a mark but it jumps right up. It does not respond to diuretics at all. It would make much sense if someone would tell me for sure the kind of edema I have in my face is myxedema. Should I go to a dermatologist ?

Thanks people!