Hypothyroidism: symptoms may include ‘carotenaemia’ in the palms and soles

There are several dermatological manifestations associated with hypothyroidism, but many of them are easily confused with other diseases. Sometimes, an underactive thyroid interferes with the conversion of nutrients during digestion. The result can be yellowing of the palms, soles and nasolabial folds on the face.

The journal Dermato-Endocrinology states that in hypothyroidism, the skin “tends to become pale” because of the water content in the skin.

It adds, “In addition, increased dermal carotene may appear as a prominent yellow hue in the palms, soles, and nasolabial folds.”

Carotene is a molecule that adds a yellow color to the skin, so when levels are high, the prominence of yellow skin can increase.

This condition is medically known as carotenemia, which in most cases is induced by prolonged and excessive intake of carotene-rich foods such as carrots, squash, and sweet potatoes.

READ MORE: Xerosis may be the ‘most prevalent’ sign of hypothyroidism in the skin

The MSD Manual warns that the dermatologic manifestations of hypothyroidism are often “subtle and insidious.”

The health agency adds: “The most common presenting symptoms are retention and swelling, especially periorbital, tiredness, cold intolerance and mental confusion.”

Primary hypothyroidism occurs due to decreased secretion of thyroid hormones T4 and T3.

When both hormones are depleted, thyroid-stimulating hormone (TSH) levels rise.


During the physical examination, the doctors confirmed yellow pigmentation on the patient’s palms.

The patient thought she had severe jaundice, which her relatives suggested she could correct with fruits and vegetables such as carrots, squash, and tomatoes.

“Upon realizing that she had increased the severity of the jaundice, she began to eat more and more carrots and pumpkins,” explains the diary.

This overload of carotene in the system probably exasperated the yellowing of the skin.

Because vitamins and nutrients are metabolized more slowly in hypothyroidism, they are more likely to build up inside the body.

“The commonly accepted cause of carotenemia in hypothyroidism is a decrease in the conversion of carotene to vitamin A, as well as associated hyperlipidemia and hypercholesterolemia,” explains Medscape.

“Thyroid hormone is antagonistic to vitamin A and controls its consumption rate.”

Other common indications of an underactive thyroid include weight gain, difficulty concentrating, and increased sensitivity to cold temperatures.

Hypothyroidism: symptoms may include ‘carotenaemia’ in the palms and soles

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