10 signs your feet are warning you about a thyroid problem

10 signs your feet are warning you about a thyroid problem

Snuggled in a fluffy white bathrobe in an upscale spa, I was waiting to have my feet pampered with a deluxe pedicure as the basin was filling with warm, fragrant water.

“Your feet are extremely dry with thick, hardened skin on your heels that have deep cracks. I see feet like this in women with sickness,” the woman remarked, a little too loudly, inspecting my feet at close range.

“What type of sickness?” I whispered, feeling very embarrassed as people in the crowded spa turned to gawk at my feet.

“You should see your doctor about your feet.”

This woman giving me a pedicure could see as plain as day the signs of a serious health condition right there in my feet, but it would take 10 more years to finally receive my formal diagnosis: severe hypothyroidism.

1. Dry, flaky, cracked feet with calluses

In 2012, a study was designed to identify the cutaneous (skin) manifestations of hypothyroidism, an under-active thyroid. Of the four hundred and sixty diagnosed cases of hypothyroidism, 300 patients (65.22%) presented with dry, coarse skin.[1] In another study that same year, 100% of subjects with hypothyroidism had coarse, rough, dry skin. Palmoplantar keratoderma, found in 33%, is a term that refers to a group of skin conditions with marked thickening of the skin in the soles of the feet and palms of the hands.[2] Hyperthyroidism, over-active thyroid, due to the autoimmune condition Graves’ disease may also present with thickened dermis.[3] While it may seem contradictory, it is often the case that some symptoms of hypothyroidism and hyperthyroidism present the same.

2. Itchy feet

Pruritus is the medical term for itchy skin. Chronic pruritus can present in both hyperthyroidism and hypothyroidism. Itchiness can happen all over the body not just the feet, including the legs, scalp, and even the genitalia. In the case of hypothyroidism, it may be that the very dry skin is the cause of the itchiness. Researchers suggest that pruritus and even chronic urticaria (chronic hives) may be associated with thyroid autoimmunity, including Hashimoto’s thyroiditis and Graves’ disease (Graves’ disease is the term used in the United States and the term Basedow’s disease is more commonly used in Europe.)[4] When you develop one autoimmune condition, you are more vulnerable to develop multiple autoimmune conditions. It is, therefore, important to mention that the Cleveland Clinic lists several autoimmune conditions associated with chronic pruritus including Sjögren’s (SHOW-grins) syndrome, lichen planus, and psoriasis.[5]

3. Cold feet

Thyroid pioneer Dr. Broda Barnes (1906-1988) wrote, “When thyroid function is low, circulation is reduced. In advanced cases of hypothyroidism, the skin, in fact, may receive as little as one-fourth to one-fifth the normal blood supply.”[6] Our extremities, including our feet, are particularly vulnerable to poor circulation especially in cold seasons. “The metabolic needs of the skin may be sacrificed over prolonged periods in order that body temperature may be kept constant. In a cold environment, when body heat must be conserved, sympathetic impulses constrict the cutaneous vessels and blood flow through the skin is conspicuously reduced in order to prevent body temperature from falling.”[7]

Dr. Barnes analyzed the body’s basal body temperature (BBT). Before arising in the morning, the patient’s axillary (underarm) temperature was taken. Normal underarm temperature is between 97.8°F and 98.2°F (36.6°C and 36.8°C). Consistent below-normal temperatures indicate hypothyroidism and consistent above-normal temperatures indicate hyperthyroidism.

4. Swollen feet

Heart disease, kidney dysfunction, diabetes, and skin infections are common culprits considered when a patient presents with swelling of legs and feet, but the possibility of hypothyroidism should always be considered. Swelling (edema) is a classic symptom of hypothyroidism and this includes swelling all over the body. In 2013, a 21-year-old presented with generalized swelling including pitted edema in both legs and feet. In contrast to non-pitting edema, pressing of the pitting edema will cause an indentation to remain on the skin well after the pressure is released. Her edema subsided with thyroid medication. According to professor of medicine Dr. Neki, peripheral (the extremities including the arms, legs, feet, and hands) is found in 55% of hypothyroidism patients and periorbital edema (swelling around the orbits of the eyes) is found in 22%.[8]

5. Foot pain and cramping

Muscle, joint and nerve pains are not usually stressed as primary symptoms of hypothyroidism, but after years of hearing from hypothyroid patients at Hypothyroid Mom, there is one thing that I am certain about. Full thyroid testing should be conducted on every single person that presents with chronic pain or fibromyalgia.

The number of people that write to Hypothyroid Mom about plantar fasciitis, the pain along the bottom of the foot especially the heel that shoots through them especially when they step out of bed in the morning, can’t be a mere coincidence. In the case of Hashimoto’s thyroiditis and Graves’ disease, the immune system can also attack the joints and muscles frequently in the feet and ankles. Like carpal tunnel syndrome, thyroid patients are also more vulnerable to develop tarsal tunnel syndrome.[9] Add to this the increased risk of developing gout [10] and burning feet from painful neuropathy [11], and the incidence of foot pain in thyroid disease becomes very clear.

6. Tingling, numb, pins and needles sensation in feet

Paresthesia can present in hypothyroidism. Researchers explain that the axonal myelin sheath, the insulating layer around nerves, begins to degenerate without sufficient thyroid hormone, and regeneration of damaged nerves also slows. Autoimmune diseases like rheumatoid arthritis, lupus, Sjögren’s syndrome, pernicious anemia, arthritis, and Type 1 diabetes can all present with paresthesia. I would guess that the majority of Hashimoto’s thyroiditis and Graves’ disease patients that follow Hypothyroid Mom have multiple autoimmune diseases.[12]

7. Foot Infections

Susceptibility to infections of the feet, hands, fingernails, and toenails occurs in both hypothyroidism and hyperthyroidism, including Hashimoto’s thyroiditis and Graves’ disease and this includes Onychomycosis and Athlete’s foot.[13]

8. Smelly feet

One of the classic symptoms of hyperthyroidism is excessive sweating, and that includes the feet. Sweat on your skin is a breeding ground for bacteria, and that can make things smelly. While hypothyroidism tends to result in markedly reduced sweating, the opposite is true as well, in particular in the case of Hashimoto’s thyroiditis. Hyperthyroid symptoms including increased sweating may occur simultaneously with symptoms of hypothyroidism in the case of Hashimoto’s. As antibodies attack and destroy thyroid cells, their stored supplies of thyroid hormone are released into the blood stream. These bursts or “leakages” of thyroid hormones in Hashimoto’s are responsible for the symptoms of hyperthyroidism.[14]

9. Yellow soles of feet

Thyroid hormone is required for the conversion of beta-carotene (that’s what gives carrots their orange color) to vitamin A. Buildup of beta-carotene in the case of hypothyroidism will be stored in the outer layer of the skin including the palms of the hands and the soles of the feet.[15]

10. Toenail alterations

Too much thyroid hormone and too little can result in abnormalities of the nails, both the fingernails and toenails.[16-18]

Nail changes in hypothyroidism:

  • Slow nail growth
  • Thick, dry, cracked, brittle nails
  • Yellow nails
  • Dry cuticles
  • Longitudinal ridges
  • Onycholysis (separation of nail from nail bed)
  • Spoon nails (koilonychia)

Nail changes in hyperthyroidism:

  • Fast nail growth
  • Pitted and discolored nails
  • Absent lunulae (half moons) and cuticles
  • Onycholysis (Plummer’s nail)
  • Acropahy (clubbing of fingers & toes)

Our feet can tell us a great deal about our thyroid health. They often show obvious signs of disease years and even decades before a thyroid diagnosis.

References:

  1. Keen, M.A., et al. A Clinical Study of the Cutaneous Manifestations of Hypothyroidism in Kashmir Valley. Indian J Dermatol. 2013 Jul-Aug;58(4):326.
  2. Puri, N. A Study on Cutaneous Manifestations of Thyroid Disease. Indian J Dermatol. 2012 May-Jun;57(3):247-248.
  3. Safer, J.D. Thyroid hormone action on skin. Dermatoendocrinol. 2011 Jul-Sep;3(3):211-215.
  4. Yonova. D. Pruritus in certain internal diseases. Hippokratia. 2007 Apr-Jun;11(2):67-71.
  5. Taylor, J.S., et al. Pruritus. Cleveland Clinic. Center for Continuing Education. April 2010.
  6. Broda O. Barnes, MD. Research Foundation Inc. http://www.brodabarnes.org
  7. Landis, E.M. The Capillaries of the Skin: A Review. Journal of Investigative Dermatology. 1938 Aug;1(4):295-311.
  8. Neki, N.S. Pitting Edema in Hypothyroidism. JIMSA. 2013 Apr-Jun;26(2):133.
  9. Dyrmishi, B., et al. Secondary hypothyroidism and the tarsal tunnel syndrome. Endocrine Abstracts. 2016;41:EP 1076.
  10. Giordano, N., et al. Hyperuricemia and gout in thyroid endocrine disorders. Clin Exp Rheumatol. 2001 Nov-Dec;19(6):661-5.
  11. Penza, P., et al. Painful neuropathy in subclinical hypothyroidism: clinical and neuropathological recovery after hormone replacement therapy. Neurol Sci. 2009 Apr;30(2):149-51.
  12. Sharif-Alhoseini, M., et al. Underlying Causes of Paresthesia, Paresthesia, Dr. Luiz Eduardo Imbelloni (Ed.), ISBN: 978-953-51-0085-0, InTech, Available from: http://www.intechopen.com/books/paresthesia/underlying-causes-of-paresthesia
  13. Macura. A.B., et al. [Nail susceptibility to fungal infections in patients with hypothyroidism and hyperthyroidism]. Przegl Lek. 2005;62(4):218021.
  14. Harsch, I.A., et al. Hashitoxicosis – Three Cases and a Review of the Literature. Available from: https://www.touchendocrinology.com/sites/www.touchendocrinology.com/files/harsch_1.pdf
  15. Aktuna, D., et al. [Beta-carotene, vitamin A and carrier proteins in thyroid diseases]. Acta Med Austriaca. 1993;20(1-2):17-20.
  16. Keen, M.A., et al. A clinical study of the cutaneous manifestations of hyperthyroidism in Kashmir valley – India. Our Dermatol Online. 2016;7(1):5-9.
  17. Mayo Clinic. Fingernails: Possible problems. Available from: https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/nails/sls-20076131
  18. Rich, P. Nail changes due to diabetes and other endocrinopathies. Dermatologic Therapy. 2002;15:107-110.

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About Dana Trentini

Dana Trentini M.A., Ed.M., founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. This is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes affiliate links including the Amazon Services LLC Associates Program.

Comments

  1. How does one change diet to treat it, or prevent.

  2. Hello, and thank you for helping in any way you can! I have been told I have PCOS(Polycystic ovarian syndrome) and my weight gain has been awful. I honestly think there is something wrong with my thyroid and it is co-acting in partial responsibility of my weight gain. I feel like a lost cause as I go through phases of working out and eating healthy to not doing anything as I feel exhausted, frustrated and like I failed because I must be the only one in the world who gains weight while everyone who surrounds me are dropping lbs like flies. Any natural remedies or solutions that my differ from the western meds and their lack of success and care that I’ve experienced?

  3. I agree 100 percent. I have been on the same dose thyroid for the majority of my adult life with it never being adjusted. My “normal” range is higher now but not out of the “range”. I am constantly exhausted, cry skin, brittle toe nail which are lifting off the beds of both big toes, I have had Fibromyalgia for the majority of my adult life too. Have had planters faciaitis which is excruciating in itself but added to the large bones spurs in both rear are of my feet. I have asked for a full range TSH panel knowing full well I am not “okay”. My only option is now to try eastern medicine to see if I can get some relief.

  4. SO many doctors look at the labs, see they’re in “normal” range, and say you’re fine. YOU KNOW WHEN YOU’RE NOT. Ask around to find a new doctor who understands that the “normal” range isn’t correct, and that there is a lot more you can do besides taking thyroid medication. You may have better luck with a functional doctor or naturopath.

    Get on Armour Thyroid, not the other kinds that have only partially what your thyroid needs.

    Also start intermittent fasting– it works wonders for inflammation (swelling), joint pain, brain fog, etc.

    • What is Armour thyroid

    • I was diagnosed at 16 with hypo thyroid. I feel like I’ve been tired my entire life until I started Armour 3 years ago. It was great until April 2019 – I passed out, racing heart (up to 179 BPM) pounding chest, headache, tired and weak and terrible brain fog. I thought it was the Armour but my Doctor didn’t want to take me off at first. All my heart tests came back fine. I quit taking Armour on my own for 15 days, until my symptoms grew worse. My TSH was 8.6. Dr. put me on Levothyroxine. In 3 days the pounding in my chest quit, my heart rate went down to normal. I’m still very tired but hope the Levothyroxine works this time. Anyone else experience this?

  5. I don’t have my thyroid they had to removed because I had nodules and cancer they removed completely and since that I’m always tired and I very dry skin and I lost a lot of hair too my hair it’s very thin doesn’t grow faster and I have to synthroid for all my life

    • Ruth it is terrible the suffering u r having to go though. U do not have to. Find a doctor that does only natural hormone therapy which is called bio- identical hormone therapy. What you are taking is synthetic and is not compatible 4 our body but bio identical is exactly what our body produces and its natural you have to have it compounded at a pharmacy. Synthetic hormones will cause cancer but BIHRT will not. And they will also test and get you leveled out with your other hormones. I don’t know what I would do without my natural hormone doctor and also if you can find a nature path and they could help you with what your body is lacking that you need supplemental wise. Do not bother asking your regular doctor about the natural hormones because they are not educated on it you have to go to a doctor who specializes in it and trust me it will change your life. Trista😉

  6. Cécile Beaudry says

    I’m very sorry for me because all the litterature is in english and I’m french canadian . I can understand but it’s harder to write in english language.

    All the stories you explained it.s all my deaseses. Thank you to help me

  7. If any of you sre near Cleveland Tn – Go see Bess Howard! She is helping me figure out ALL of my issues after years of being told I’m ‘fine’. If they are treating your thyroid issue incorrectly it will get worse.

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