Chronic Autoimmune Illnesses Linked to Chronic Hives

by Rachel Zohn Health Writer

Chronic hives can be a formidable foe, especially when it’s not clear what’s causing the itchy, red welts or wheals that can appear anywhere on the body and recur for six weeks or more. Sometimes a hidden illness may be an underlying cause. Studies have found a strong association between chronic hives and autoimmune diseases such as thyroid disease, rheumatoid arthritis, celiac disease, type 1 diabetes, Sjögren syndrome, and lupus.

Hives on back

Autoimmune hives

While hives can be caused by an allergic reaction, for some patients the cause can’t be identified. This is called “chronic spontaneous urticaria.” Some of these chronic hives sufferers may actually have autoimmune urticaria, or hives that are triggered by an autoimmune reaction to different antibodies in the body.

Hands holding up 40% sign

The connection between hives and autoimmune disease

Researchers believe that up to 40 percent of people with chronic idiopathic hives also have an autoimmune disease. While researchers are still trying to connect the dots, it is believed that high levels of autoantibodies may be to blame. These are the harmful antibodies produced by the immune system that attack the body’s own functions. It’s also widely noted that females are more commonly affected than males.

Thyroid disease concept

Autoimmune thyroid disease and hives

Autoimmune thyroid disease is the most commonly reported autoimmune disease linked to chronic hives. Researchers have been studying this link for decades. Thyroid disease, also known as autoimmune thyroiditis, occurs when the body makes antibodies that attack your thyroid. Some patients with a history of chronic hives were found to have significantly higher levels of thyroid antibodies as compared to a control group of people who didn’t have hives. Unfortunately, it is only recommended to do anything about these antibodies if there is accompanying thyroid hormone dysregulation. While there is an association between these thyroid antibodies and the presence of hives, it is not yet known if these antibodies are actually causing hives.

Thyroid function blood test vial.

Hyperthyroidism, hypothyroidism, and chronic hives

Autoimmune thyroiditis may cause hyperthyroidism or hypothyroidism. Chronic hives may be linked to either. Hyperthyroidism, or an overactive thyroid gland, can cause irritability, muscle weakness, sleep problems, a fast heartbeat, heat intolerance, diarrhea, hand tremor, and weight loss. Hypothyroidism is caused by an underactive thyroid, which can cause sensitivity to cold, as well as fatigue, constipation, depression, weight gain, hair loss, and dry skin.

Woman with Rheumatoid arthritis grabbing hand in pain.

Rheumatoid arthritis and chronic hives

Rheumatoid arthritis has been found to be the second most common autoimmune disease in patients with chronic hives.
Rheumatoid arthritis is when the body’s immune system mistakenly attacks the joints, causing the tissues that line the inside of joints to thicken. People with this inflammatory autoimmune disease can be prone to different skin conditions, including chronic hives. One study found that female patients with chronic hives were more likely to be diagnosed with rheumatoid arthritis.

RF blood test vial

Rheumatoid factors connected to cases of chronic hives

Research has found that rheumatoid factors, or proteins produced by your immune system that attack healthy tissues in your body, were significantly more common in those patients with chronic hives when compared to control groups. Symptoms of rheumatoid arthritis can include painful, swollen joints and nodes or hard lumps under the skin, and various types of skin rashes.

Celiac disease diagnosis

Celiac disease

One large-scale study found that celiac patients had a higher risk of developing chronic hives. When people with celiac disease eat gluten, a protein found in wheat, barley, and rye, their bodies’ immune system responds by attacking their small intestines. This genetic autoimmune disease requires those affected to avoid eating gluten to manage symptoms. Symptoms can include painful bloating, chronic diarrhea, constipation, vomiting, and fatigue.

Woman with hives on arm and hand

The link between celiac disease and hives

According to one study, people with celiac disease were 1.5 times more likely to develop hives. In some cases, people may even be diagnosed with hives first, before being diagnosed with celiac disease. Researchers found that about a third of the cases of chronic hives could be attributed to the underlying celiac disease. Celiac disease is also more common among women.

Mother helping diabetic child track blood sugar.

Type 1 diabetes

Type 1 diabetes is when the body doesn’t make insulin, which it needs to break down the carbohydrates you eat. Type 1 diabetes is caused by an autoimmune reaction that destroys the cells in the pancreas that make insulin, so the body is unable to move sugar (glucose) from the bloodstream into cells, to fuel the body with energy to function. It is known to cause a number of skin conditions, including very itchy skin, and has been linked to chronic hives.

Lots of diabetes warning signs stacked upon each other.

Diabetes linked to other autoimmune diseases and chronic hives

As with other autoimmune diseases, people with type 1 diabetes may be at higher risk of developing more than one autoimmune disease, such as celiac disease or thyroid disease, and also chronic hives. Cases have been reported where children first presented with chronic hives and were later diagnosed with autoimmune thyroid disease and then type 1 diabetes. In another case, an adult who had a history of type 1 diabetes and Graves disease suddenly developed chronic hives.

Man putting eyedrops in dry eyes

Sjögren’s syndrome

Sjögren’s syndrome is often identified by its two most common symptom: dry eyes and dry mouth. Some people may also have joint pain, swollen salivary glands, skin rashes or dry skin, vaginal dryness, persistent dry cough, and fatigue.

Lupus on little blackboard


Studies have shown a link between lupus and chronic hives, and sometimes chronic hives may even be the first symptom of the disease. Lupus is an autoimmune disease that can affect different body systems, including joints, skin, kidneys, blood cells, brain, heart, and lungs. Its most distinctive symptom is a butterfly-shaped facial rash across both cheeks, and rashes elsewhere on the body. Like other autoimmune diseases, nine out of 10 patients are women.

Purpura, vasculitis, or broken blood vessels on human skin.

Skin conditions linked to lupus

Lupus is known to cause a number of skin problems, including hives, cutaneous vasculitis (hive-like lesions), photosensitivity, alopecia, and purpura (small red or purple discoloration caused by blood vessels leaking just under the skin). About 10 percent of all people with lupus will experience hives. Most individual hives will fade and disappear within hours, while new welts flare. Individual hives lasting more than 24 hours may be due to inflammation in the blood vessels that could be due to lupus.

Rachel Zohn
Meet Our Writer
Rachel Zohn

Rachel Zohn is a mom, a wife, and a freelance writer who is striving to find the best way to juggle it all and maintain a sense of humor. She is a former newspaper reporter with a deep interest in writing about all things related to health, wellness and the human body. She enjoys writing about various health topics, including skin conditions such as eczema, different types of cancer and seasonal allergies.