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The Fibromyalgia/Hypothyroidism Link

© Elaine Moore

Elaine Moore says "The link between hypothyroidism and fibromyalgia has recently intensified. It's long been known that about 15 percent of patients with primary hypothyroidism go on to develop fibromyalgia." Further discussion will be found within this article.

The link between hypothyroidism and fibromyalgia has recently intensified. It's long been known that about 15 percent of patients with primary hypothyroidism go on to develop fibromyalgia. However, with the new TSH range, which is currently 0.3-2.5 mu/L according to the American Association of Clinical Endocrinologists, many patients who previously tested negative for hypothyroidism would now be diagnosed with hypothyroidism. Furthermore, two related conditions described in this article, thyroid hormone resistance and thyroid autoimmunity, conditions in which thyroid hormone levels may be normal, are also associated with fibromyalgia.

In many ways hypothyroidism and fibromyalgia are overlapping conditions because symptoms are so similar. Both conditions have an autoimmune element and are associated with predominant symptoms that change over time and with symptoms that wax and wane, worsening in times of stress. Both conditions are known to cause fatigue, depression, diffuse muscle pain, poor or restless sleep, cognitive difficulties, problems with attention and memory, weight fluctuations, allergic symptoms, hypersensitivity to environmental stimuli and medications, shortness of breath, and increased prevalence of depression. In addition, both conditions are known to worsen during the menstrual cycle and affect 7-9 times as many women as men. In both conditions the erythrocyte sedimentation rate or ESR is normal although it is elevated in other types of thyroiditis and other rheumatological conditions.

Both fibromyalgia and hypothyroidism are also considered to be one of a series of symptoms-based conditions. And both conditions are thought to have several subtypes. Both conditions are also known or suspected of being triggered or exacerbated by viral and infectious diseases, chemical exposure or sensitivity, yeast infections and food allergies. Both conditions are associated with the autoimmune disorder gluten sensitivity, which is a sensitivity to the protein component of wheat, rye and barley. Individuals with gluten sensitivity who have other autoimmune conditions experience heightened symptoms when they ingest gluten and have elevated IgE levels. Both hypothyroidism and fibromyalgia are also associated with low calcium levels and may be associated with low serotonin levels and low substance P levels. And while many people with fibromyalgia experience improvement with the expectorant guaifenesin, many people with hypothyroidism use guaifenesin to reduce congestion and mucus production.

Studies by Aarflot and Bruusgaard show that thyroid peroxidase or TPO antibodies are seen in a subset of women with fibromyalgia who have widespread musculoskeletal complaints. Patients with thyroid autoimmunity have thyroid antibodies present in their blood but normal thyroid function tests. Many of these people go on to later develop autoimmune thyroid disorders. A study by Neeck and Reidel showed that patients with fibromyalgia produced less TSH than normal patients when given injections of thyrotropin releasing hormone or TRH, indicating they have a blunted response or thyroid hormone resistance. Normally, when the brain sees that thyroid hormone levels are low, the hypothalamus secretes TRH. TRH, in turn, causes the production and release of TSH. TSH is a hormone that directs thyroid cells to produce thyroid hormone.

The copyright of the article The Fibromyalgia/Hypothyroidism Link in Fibromyalgia Resources is owned by Elaine Moore. Permission to republish The Fibromyalgia/Hypothyroidism Link in print or online must be granted by the author in writing.