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The Possible Link Between Fibromyalgia And Hypothyroidism
Hypothyroidism is one of the more common endocrine disorders, referring to a problem causing the Thyroid Gland to produce an inadequate level of Thyroid hormones.
The Thyroid Gland is responsible for the regulation of overall metabolism within the body – not only metabolism that refers to the digestive function, but also cellular metabolism. A healthy Thyroid Gland dramatically contributes to the overall wellbeing of the body.
Up to 2% of the global adult population is affected by Hypothyroidism1, which can lead to a number of unpleasant symptoms and also lead to difficulties with the daily life of the affected patient.
Autoimmune Thyroiditis is the most common type of Hypothyroidism in the general population, which is caused by the patient’s immune system going awry and mistakenly attack healthy cells of their Thyroid Gland.
Many recent studies have pointed out possible connections that may exist between Hypothyroidism caused by an autoimmune reaction, which can usually be traced back to Hashimoto’s Disease and other types of autoimmune diseases.
While not considered an autoimmune disease by all publications, Fibromyalgia is a particular condition that is often linked to Hypothyroidism, sharing similar underlying physiological factors, as well as causing a range of symptoms that are similar.
In this guide to understanding the connection that may exist between Hypothyroidism and Fibromyalgia, we will take a closer look at how the symptoms of these two conditions are similar, how each of the conditions is diagnosed, and also consider why scientists and medical experts are currently exploring the fact that a connection might exist between these health ailments.
An Overview Of Fibromyalgia
Fibromyalgia, a condition sometimes referred to as Fibromyalgia Syndrome in medical practice causes a number of symptoms in an affected patient that may cause them to experience a disruption in various parts of their life.
The particular symptoms associated with Fibromyalgia usually include fatigue, sleep disruptions and pain.
While the disease has become widely recognized in the modern day, there is still a lot of details that remain unclear to the medical industry.
In many cases, Fibromyalgia is described as a disease that affects the central sensitization of the human body2.
If this suggestion is true, then a number of factors will be involved with the disease, including the genetic makeup of a patient. Additional factors, such as immunological elements of the patient’s body, their endocrine system, and other biological features may also play a part in the development and risk of this disease.
The disease currently has no known cure, which is why a physician’s primary role in the treatment of Fibromyalgia is to provide relief of the symptoms that a patient is experiencing.
The goal here is to alleviate the pain and inflammation associated with the disease, while also providing improvements in the sleep-related symptoms caused by Fibromyalgia.
Another important goal is to provide an overall improvement in the patient’s physical function, which is often reduced through the physiological effects of Fibromyalgia.
Different treatment protocols have been suggested to assist with delivering the goals of a management program for a patient with Fibromyalgia.
Recent updates3 to the general recommendations for the management of this disease have suggested that current drugs that may be utilized for the treatment of the condition include Duloxetine, Amitriptyline, and Pregabalin.
Hypothyroidism And Your Thyroid Gland
Hypothyroidism is amongst two relatively common Thyroid Gland disorders, with the other disease being Hyperthyroidism. When a patient is diagnosed with Hypothyroidism, it means their Thyroid Gland is not producing enough hormones to support the functions these hormones are responsible for. Hypothyroidism is a relatively complex condition, as numerous issues may cause the development of this disease.
The condition may be caused by an impairment of the Thyroid Gland, leading to a reduction in the overall production of T3 and T4 hormones.
In some cases, however, the disease may also be caused by the inadequate release of TSH (Thyroid Stimulating Hormone), which is released by the Pituitary Gland in response to the body’s need for Thyroid hormones.
In the majority of cases where a patient is diagnosed with primary Hypothyroidism, the cause of the disease can be linked to an autoimmune reaction4.
This means the immune system produced antibodies and then sends these antibodies toward the Thyroid Gland, where they start to attack the Gland’s healthy tissues as if the cells are pathogenic invaders within the body.
The diagnosis of Hypothyroidism5 is often complex, as medical experts have found that the older methods of testing for the disease does not yield the best results.
In most cases, a physician will start by requesting a series of blood tests from the patient to determine levels of Thyroxine and Thyroid Stimulating Hormone present in their blood circulatory system.
This can provide an overview of the overall status of the patient’s Thyroid function. When TSH levels are high, and the level of Thyroxine in the patient’s bloodstream is low, it is an indication that they have an underactive Thyroid; thus fitting the criteria for the diagnosis of Hypothyroidism.
Once diagnosed, a physician will need to determine the best approach to providing the patient with a treatment plan. Treatment usually include6 the administration of synthetic Thyroid hormones to help improve overall metabolism by restoring normal levels of these hormones in the patient’s body.
The most common pharmaceutical drug used to treat Hypothyroidism at the moment is known as Levothyroxine, which is a synthetic replacement for the Thyroxine that is lacking within the patient’s body.
For many patients, a few adjustments to the dosage of Levothyroxine they are consuming is needed during the first few months after they are placed on a treatment plan.
A physician usually starts a patient off on a low dose, and then increase the dosage as the time goes by, carefully monitoring the effects of the Levothyroxine through frequent blood tests.
What’s The Connection Between These Conditions?
Hypothyroidism has been connected to many autoimmune diseases. The disease itself is also often caused by an autoimmune reaction, which usually leads to the diagnosis of Hashimoto’s Disease.
Some studies have also confirmed that there seems to be a link between Hypothyroidism and Fibromyalgia, two diseases that are often seen together in many patients.
According to one report7, up to 27 million of patients diagnosed with Hypothyroidism is also diagnosed with Fibromyalgia.
There are different theories regarding how these conditions may be connected. One particularly popular theory is that the connection resides within the hypothalamus of the patient’s brain. The hypothalamus is a gland that forms part of the human endocrine system.
This gland is responsible for many functions in the body, including the regulation of hormone secretion by other glands, and more. This theory believes that the hypothalamus become suppressed, and this is essentially what causes the patient to develop these conditions.
There are some guidelines provided to assist with ensuring the treatment of Hypothyroidism in a patient with Fibromyalgia does not cause the development of complications.
In particular, a patient with Fibromyalgia who is suspected of Hypothyroidism should not be provided with Thyroid hormone medication prior to an official blood test.
Results presented by the blood test should indicate a low level of Thyroxine in the patient’s blood, while Thyroid Stimulating Hormone levels should be high – in such a case, the patient can be diagnosed with Hypothyroidism as well.
Additionally, it should be noted that a patient with both Hypothyroidism and Fibromyalgia should only be providing Levothyroxine as a treatment protocol.
Blood tests should frequently be obtained to ensure the dosage that the patient is taking does not cause Thyroid Hormone levels to become too high or suppresses the secretion of Thyroid Stimulating Hormone.
Should such signs be observed, then the dosage of Levothyroxine being administered to the patient should be lowered.
When improvements in Thyroid levels are not as expected, then the dosage may be increased, but only under close supervision from a licensed physician.
Not obtaining blood tests regularly to monitor the effect of the Levothyroxine medication can lead to the development of Hyperthyroidism, which may cause the patient to experience further adverse side-effects, instead of a relieve in the particular symptoms they are suffering from.
Treatment with Levothyroxine for Hypothyroidism can be utilized together with a treatment plan provided to assist with the management of Fibromyalgia. Thyroid supplements are often used by those with hypothyroidism and hashimoto’s to help support their thyroid.
Medication should be cross-referenced to ensure interactions do not occur, however.
The dosage of individual medicines may need to be frequently altered until the right dose of treatment is achieved to help the patient get back to experiencing the joys of life, instead of succumbing to the disabling effects of their illness.
Advice For A Better Treatment Protocol
Due to the possibility that a patient diagnosed with Fibromyalgia may experience worse symptoms due to the simultaneous presence of Hypothyroidism, and vice versa, it is important for patients with either of these conditions to be aware of this relationship.
A patient with Fibromyalgia who experiences more severe symptoms is advised to undergo TSH tests to determine if their Thyroid Gland may be compromised and producing too little hormones. On the other hand, a patient with Hypothyroidism may also consider obtaining a physical examination from a healthcare provider who has prior experience in dealing with patients diagnosed with Fibromyalgia.
This is especially important when the patient is experiencing symptoms associated with Fibromyalgia, such as chronic lower back pain and fatigue, as well as feeling weak and tired after getting up in the morning.
When the possible relationship between these two conditions are taken into account during both the diagnostic process and throughout the treatment plan, a patient may be provided a more effective treatment option that helps them overcome the obstacles they are facing due to their health status.
For example, when both Fibromyalgia and Hypothyroidism is present, but a patient has only been diagnosed with Fibromyalgia, symptoms may continue to be worse, even with treatment, as Hypothyroidism can cause similar symptoms, and would not be affected by the pharmaceuticals used for the treatment of Fibromyalgia.
Fibromyalgia is a condition that affects approximately double the number of individuals affected by Rheumatoid Arthritis and can cause disabling adverse effects.
The disease is often considered to be autoimmune in nature and has now been linked to Hypothyroidism, a condition where the Thyroid fails to produce adequate concentrations of T3 and T4 hormones.
By better understanding, this possible connection, patients with either of these conditions can be screened for the associated disease, which may provide more data on why symptoms experience are more severe than what is expected.
This may also help to provide a more effective treatment approach and better assist a patient in improving their overall quality-of-life.
1 Mario Skugor. Hypothyroidism and Hyperthyroidism. Cleveland Clinic. August 2014. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/hypothyroidism-and-hyperthyroidism/
2 Multiple Authors. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment. Journal of Pain Research and Treatment. 4 November 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503476/
3 Sanam Kia and Ernet Choy. Update on Treatment Guideline in Fibromyalgia Syndrome with Focus on Pharmacology. MDPI Biomedicines. 8 May 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5489806/
4 I. Kostoglou-Athanassiou and K. Ntalles. Hypothyroidism – new aspects of an old disease. Hippokratia Quarterly Medical Journal. 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895281/
5 Hypothyroidism (Underactive Thyroid): Diagnosis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/drc-20350289
6 Underactive thyroid (hypothyroidism): Treatment. NHS Choices. https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/treatment/
7 Mary Shomon. Hypothyroidism and Fibromyalgia – What’s the Connection? VeryWell Health. 13 February 2018. https://www.verywell.com/the-thyroid-fibromyalgia-connection-3231681