BOTOX® Cosmetic and Thyroid Conditions: What an Endocrinologist Checks First

BOTOX® Cosmetic works where nerves signal muscles. Its label asks you to tell your provider about any nerve or muscle condition, and it names myasthenia gravis as one of the conditions that can raise the risk of serious side effects. Myasthenia gravis is an autoimmune disease, and it occurs more often in people who already have autoimmune thyroid disease, such as Hashimoto's thyroiditis or Graves' disease. That overlap is the reason an endocrinologist's history review adds something real to an injectable visit.

• Your thyroid diagnosis and how well it is controlled. Stable, treated thyroid disease is common among patients who receive BOTOX® Cosmetic.

• Any muscle weakness, drooping eyelids, double vision or trouble swallowing. These can point to a neuromuscular condition that needs attention before any neurotoxin.

• Thyroid eye disease. Graves' disease can change the eyelids and the muscles around the eyes, which affects how treatment near the eyes is planned.

• Your medications. Blood thinners raise the chance of bruising, and some antibiotics and muscle relaxants are listed on the label as medications to disclose.

• Other autoimmune conditions. One autoimmune diagnosis makes a second more likely, so the full picture matters.

Many patients with a well-managed thyroid condition are candidates. The answer depends on your symptoms, your control and the areas you want treated, so it is made at your medical history review, not in advance.

Dr. Anna Frisch, MD, PhD, is Board Certified in Endocrinology and manages thyroid and autoimmune conditions every day. At Palm Beach Cosmetic Medicine she reviews your history and performs your BOTOX® Cosmetic treatment herself, using product purchased directly from Allergan Aesthetics.