Why Are My Eyes so Puffy? Less Common Skin Symptoms of Hypothyroidism

Hey there, I'm Dana Gibbs, an integrated physician and Hashimoto's specialist based in North Texas. Today, I want to shed light on a thyroid symptom that often goes unnoticed and doesn't receive much attention – myxedema. I thought to share about this because the other day a patient came into the office with puffiness under their eyes, and we ended up talking in depth about this fascinating symptom of hypothyroidism. Let's get into it!

So first of all, let's define what Myxedema is. Myxedema, previously regarded as a rare condition, results from the deposition of polysaccharides (a type of sugar molecule), specifically glycosaminoglycans, under the skin. These sugar molecules, such as hyaluronic acid, absorb an incredible amount of water, causing fluid influx and swelling in the affected tissues. 

As a trained thyroid specialist, when a patient comes to see me with significant, non-pitting swelling, it's a tell-tale sign that they might have hypothyroidism. For those of us with less experience identifying symptoms, however, here are some recognizable signs to look out for:

1. Thick Wrists and Ankles: The most obvious sign is the thickening and puffiness of wrists and ankles.
2. Facial Puffiness: Myxedema can also cause puffiness around the face and eyes, giving a tired appearance.
3. Eyelid Drooping: The condition may lead to drooping eyelids, contributing to a fatigued look.
4. Pale Complexion: Reduced blood flow due to swollen tissues can result in a pale complexion.
5. Hoarseness: Glycosaminoglycans can accumulate around vocal cords, causing hoarseness and roughness in the voice.
6. Carpal Tunnel Syndrome: Fluid buildup in nerve tunnels may lead to tingling, numbness, and weakness in the hands.
7. Adhesive Capsulitis: Sticky molecules can cause joint stiffness, leading to conditions like frozen shoulder.
8. Muscle Aches and Pains: Impeded blood flow and nerve compression may cause chronic tension headaches and muscle discomfort.

So you might be asking yourself, "how is myxedema related to hypothyroidism?", so let's take a look at the mechanism by which it occurs. Hypothyroidism is often marked by elevated thyroid-stimulating hormone (TSH) levels, and when TSH levels are high, fibroblasts are stimulated to secrete glycosaminoglycans. This results in osmotic edema (meaning swelling due to an increase of water into an area), as well as discoloration due to increased carotene deposition in skin tissues.

Nobody wants to deal with these symptoms, and the good news is that myxedema is completely treatable with proper and balanced thyroid replacement therapy (HRT). So if you're worried about having any of these symptoms, just know that there is help available!

Understanding the signs of myxedema and seeking timely treatment can make a significant difference. And if you're experiencing these symptoms and suspect a thyroid issue, consult with a healthcare professional for accurate diagnosis and tailored treatment.

Again, I'm Dana Gibbs, MD, an experience thyroid and Hashimoto's specialist based in North Texas. If you're in the area and struggling with thyroid or chronic fatigue issues, visit https://www.danagibbsmd.com/ to explore the offerings at Consultants in Metabolism and book a new patient spot for personalized care.

Remember, if you have health concerns, always consult with your physician for proper medical advice.

Signing off for now,
Dr. Dana Gibbs