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Vitiligo has been linked to other autoimmune disorders, conditions in which the immune system mistakenly attacks healthy tissues and organ systems. Between 15 percent and 25 percent of people with vitiligo also have another autoimmune disease. Some research suggests that up to 55 percent of people with an autoimmune disease have more than one at the same time, according to a study published in the journal Cureus.
If someone has more than one disease at the same time, the conditions are known as comorbidities. Learning about the most common comorbidities of vitiligo may help you recognize potential symptoms and know when to talk to your doctor.
Many thyroid disorders are autoimmune and more common in people with vitiligo than in the general population. The thyroid gland is a small, butterfly-shaped organ that makes and regulates the body’s thyroid hormones. These hormones affect energy and metabolism. Thyroid hormones affect many different parts of the body. A change in thyroid hormone levels has a wide range of symptoms.
There are two general types of thyroid disease. Hyperthyroidism means there’s too much thyroid hormone. One of the most common causes of hyperthyroidism is a condition called Graves’ disease. Hypothyroidism describes too little thyroid hormone. Hashimoto’s disease (or Hashimoto’s thyroiditis) is often the cause of hypothyroidism.
In hyperthyroidism, people may experience the following symptoms:
Hypothyroidism symptoms may include:
People who have vitiligo and an autoimmune thyroid disease have a strong chance of depigmentation on the upper body extremities, especially the hands.
People with vitiligo are at higher risk for both type 1 and type 2 diabetes. Type 1 diabetes is an autoimmune disease.
In type 1 diabetes, the immune system destroys the cells in the pancreas that make insulin. Without insulin, your blood glucose (also called blood sugar) levels rise. People with type 1 diabetes need insulin as medication because their bodies don’t make it.
Symptoms of type 1 diabetes include:
In type 2 diabetes, the pancreas still makes insulin, but the body doesn’t respond to it as well. This problem is known as insulin resistance. Insulin’s job is to help the body absorb sugar so it can be used for energy. With type 2 diabetes, blood sugar builds up in the blood because it’s not being used properly. Over time, high sugar in the blood damages blood vessels and other organs, like the heart and kidneys.
People with type 2 diabetes have some of the same symptoms as type 1. In addition, the symptoms of type 1 diabetes happen fast, while type 2 diabetes takes longer to develop.
Alopecia areata is an autoimmune condition that causes hair loss. According to some estimates, 3 percent to 8 percent of people with alopecia areata also have vitiligo. Having other autoimmune diseases, like thyroid disease or psoriasis, or having allergies are other risk factors for developing alopecia areata.
There are three types of alopecia areata. The most common type is when people lose patches of hair, usually on their head and face. Alopecia totalis is when people lose most of the hair on their head. Alopecia universalis is when people lose most or all of their hair on their entire body.
Like vitiligo, alopecia areata has no cure. Sometimes hair grows back on its own. There are also some treatments that can help hair regrow. People may wear wigs or other hair coverings if they’ve lost patches of hair or all their hair.
People with vitiligo also have an increased risk of inflammatory bowel disease (IBD) such as ulcerative colitis and Crohn’s disease. Both Crohn’s and ulcerative colitis can cause persistent diarrhea, weight loss, bloody stools, fatigue, and abdominal pain.
IBD symptoms can be tough to manage. They may come and go as flare-ups and remission periods. People with IBD can require a combination of medications, surgery, and lifestyle changes to keep their condition under control. Drugs that suppress the immune system and reduce inflammation are usually part of ongoing treatment.
Another autoimmune disease, pernicious anemia, can happen with vitiligo. People with pernicious anemia lack a protein called intrinsic factor, which helps the body to absorb vitamin B12. The body needs vitamin B12 to make healthy red blood cells.
It’s not clear exactly how many people with vitiligo have pernicious anemia. Some studies suggest that a vitamin B12 deficiency is eight times more common in people with vitiligo.
Symptoms of pernicious anemia include:
If left untreated, pernicious anemia can lead to more serious effects. These may include hallucinations, depression, vision problems, and irreversible nerve damage. Fortunately, your health care provider can test for a vitamin B12 deficiency. If your body can’t absorb it from food or supplements, vitamin B12 injections can get your levels back where they need to be.
Sjögren’s syndrome is an autoimmune condition that can affect the whole body. Its primary symptoms are dry eyes and dry mouth. In rare cases, vitiligo is one of the first signs of Sjögren’s syndrome.
Some studies suggest that people with vitiligo are up to 13 times more likely to develop Sjögren’s versus those without vitiligo. The study in Cureus found that this relationship is most significant in older women. It’s important to talk to your health care provider about any new symptoms. This conversation can help them figure out if you have another condition that needs treatment and monitoring.
Another autoimmune condition that people with vitiligo are more likely to have is systemic lupus erythematosus (SLE or lupus, for short). Lupus can affect any part of the body, but symptoms are most likely to show up in the skin, joints, and organs like the heart and kidneys.
One of the hallmark signs of lupus is a butterfly rash on the face that spans across the bridge of the nose and onto the cheeks. The wide range of additional lupus symptoms may include:
Because lupus affects everyone differently, it can be tough to pinpoint. Your health care provider can run a series of tests to determine your risk and see if you have lupus.
If you or a loved one have vitiligo and you’re concerned about a comorbid condition, talk to your doctor. Consider keeping track of any worrying symptoms over time so you can share this information at your next appointment. In addition, ask close relatives whether they’ve been diagnosed with any autoimmune conditions.
Giving your health care provider as much background about your current symptoms and family history as possible can help them better understand your risk factors for specific conditions.
If you’re diagnosed with another autoimmune condition, your dermatologist can work with other health care specialists to ensure that any treatments for vitiligo and other conditions are compatible.
MyVitiligoTeam is the social network for people with vitiligo and their loved ones. More than 13,000 members come together to ask questions, give advice, and share their stories with others who understand life with vitiligo.
Have you been diagnosed with vitiligo and comorbid autoimmune diseases? If so, how do you cope with the coexistence of two or more health conditions? Share your experience in the comments below, or start a conversation by posting on MyVitiligoTeam.
In partnership with the Global Vitiligo Foundation, which strives to improve the quality of life for individuals with vitiligo through education, research, clinical care, and community support.
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