Table of ContentsView AllTable of ContentsOverviewCausesSymptomsDiagnosisCoping
Table of ContentsView All
View All
Table of Contents
Overview
Causes
Symptoms
Diagnosis
Coping
Thyroid disease, especially hypothyroidism, and fibromyalgia share many symptoms. In fact, having one of these conditions may predispose you to the other, and having both impacts each disease. Despite the associations, theories about the cause of these related conditions are not concrete. Researchers have proposed autoimmunity, dysfunction of the hypothalamus, and more possibilities.
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Who They Affect
Thyroid disease and fibromyalgia are each very common in the United States.
These numbers do not include others who may be undiagnosed.
Combined Occurrence
Not only are hypothyroidism and fibromyalgia both common, but they frequently occur together. According to one study, the prevalence of fibromyalgia in the general population was 2 percent to 7 percent, but as high as 30 percent to 40 percent in people with hypothyroidism. Using newer diagnostic criteria for fibromyalgia, the incidence may be even higher.
Among people with hypothyroidism, fibromyalgia was more common in those who were overweight, had positive anti-thyroperoxidase antibodies, and who had been living with thyroid disease for a long period of time.
Similarities in Epidemiology
Thyroid disease and fibromyalgia tend to affect a similar population of people:
Similarities such as these have played into some hypotheses about potential causes.
Potential Causes
Hashimoto’s disease is an autoimmune disease in whichautoantibodies(antibodies against one’s self) damage thyroid tissue. There is a great deal of controversy about the underlying cause of fibromyalgia.
Some of the possibilities that have been suggested include:
Autoimmunity
Theories vary, though some have postulated that underlying autoimmune disease precipitates the development ofbothconditions.
One study found a potential link to autoimmune disease with fibromyalgia as well.Compared to the control subjects, people with fibromyalgia had a high degree of positivity to a related thyroid antibody. The authors of the study also cited numerous other studies that show a higher prevalence of thyroid antibodies in people with fibromyalgia compared to the general population.
While some researchers believe that fibromyalgia may also be an autoimmune disease, others think that symptoms thought to point to fibromyalgia may actually be symptoms related to hypothyroidism.
Suppression of the Hypothalamus
Suppression of the hypothalamus may occur due to problems with the mitochondria in hypothalamic cells, the organelles that are considered the “energy furnaces” of cells.
Trauma
Hormonal Problems and Physical Stress on the Body
Other hormonal problems or conditions that stress the body, such as infections, have been associated with both fibromyalgia and thyroid disease.
Shared Symptoms
There are a number of similar hypothyroidism and fibromyalgia symptoms, as well as some that are more common with one condition than the other.
Symptoms that are very common among people with either hypothyroidism or fibromyalgia include:
Symptoms More Common in HypothyroidismWeight gainThinning of hairConstipationDry skinMenstrual irregularitiesSymptoms More Common in FibromyalgiaHeadachesParesthesias (abnormal sensations such as tingling of the extremities)Muscle spasmsCognitive problems
Symptoms More Common in HypothyroidismWeight gainThinning of hairConstipationDry skinMenstrual irregularities
Weight gain
Thinning of hair
Constipation
Dry skin
Menstrual irregularities
Symptoms More Common in FibromyalgiaHeadachesParesthesias (abnormal sensations such as tingling of the extremities)Muscle spasmsCognitive problems
Headaches
Paresthesias (abnormal sensations such as tingling of the extremities)
Muscle spasms
Cognitive problems
Autoimmune thyroid disease often leads to worsening fibromyalgia symptoms. Fibromyalgia may also worsen the symptoms of thyroid disease, or make it more difficult to know if thyroid hormone replacement therapy is optimal.
Hypothyroidism and fibromyalgia can both be misdiagnosed.
Hypothyroidism
Thediagnosis of hypothyroidismoften begins with a TSH test, though some experts believe that a normal TSH is insufficient to rule out thyroid disease, especially in those who have a family history of an autoimmune thyroid condition (such as Hashimoto’s thyroiditis or Graves' disease).
Additional diagnostic tests may be ordered to paint a fuller picture of your thyroid health, including free T4, total and free T3, and thyroid antibody tests.
Fibromyalgia
Thediagnosis of fibromyalgiais primarily a clinical diagnosis based on symptoms of pain, fatigue, and cognitive problems.Since undertreated hypothyroidism can cause symptoms that are very similar, it can be challenging to know whether a person meets the criteria for fibromyalgia with hypothyroidism.
During an evaluation for possible fibromyalgia, thyroid function testing is usually done. If autoimmune hypothyroidism is found, it’s reasonable to treat only the thyroid condition at first and see if the pain resolves. If a person is already on thyroid replacement therapy and has symptoms of fibromyalgia, the goal should be optimal control before a diagnosis is made.
Even if you have had normal thyroid tests in the past, if your fibromyalgia symptoms are worsening or not responding to treatment, your healthcare provider may repeat your thyroid tests.
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Differential Diagnoses
To further complicate matters, other conditions may cause symptoms that are similar to fibromyalgia and hypothyroidism. These other possible diagnoses can make the two conditions less obvious and challenging to identify, perhaps even masking the development of fibromyalgia with hypothyroidism and vice versa.
Other diagnoses that may also be considered include:
Living With These Conditions
In addition to taking any recommended medication, there are things you can do that can help you live your best life with both conditions.
Exercise
While the fatigue associated with both thyroid disease and fibromyalgia can hamper your desire to exercise, there are many benefits to moving.
Since everyone is different, it’s important to know your own body. Keeping a daily journal of exercise habits and energy levels may help you determine the appropriate amount of activity that is helpful for you.
Reduce Stress
Stress management is important for anyone, but it’s particularly important for people with these two conditions.Not only do both thyroid disease and fibromyalgiaaddto everyday stress levels, but increased stress can exacerbate their symptoms.
Since some stressors can’t be eliminated, researchers are beginning to look at ways that people can develop emotional resilience, which is the ability to cope with adversity in life. There are now a number of integrative medical centers that offer resilience training for people coping with chronic medical conditions.
Get Better Sleep
Both conditions commonly cause sleep problems such as insomnia and night sweats, and sleep problems exacerbate the other symptoms of thyroid disease and fibromyalgia.
Given the importance of sleep with regard to these symptoms, it’s worth taking a good inventory of your sleep habits and making changes toset yourself up for a good night’s rest. If you continue to have concerns, talking to your healthcare provider or seeing a sleep specialist may be helpful.
Improve Your Diet
A healthy diet is wise for anyone, but some foods that are usually considered healthy may have anti-thyroid effects.
5-Day Meal Plan for People With Hypothyroidism
A Word From Verywell
Thyroid disease and fibromyalgia have many commonalities, though the exact connection between the two conditions is still unclear. It’s important to be aware of both conditions and potential interactions when talking to your healthcare providers about your symptoms and treatment options.
Tips for Putting Fibromyalgia in Remission
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Fibromyalgia.Haliloglu, S., Ekinci, B., Uzkeser, H. et al.Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.Clinical Rheumatology.2017 Jul;36(7):1617-1621. doi:10.1007/s10067-017-3556-2Nishioka K., Uchida, T., Usui, C. et al.High prevalence of anti-TSH receptor antibody in fibromyalgia syndrome.International Journal of Rheumatic Diseases.2017 Jun;20(6):685-690. doi:0.1111/1756-185X.12964Goldenberg DL.Introduction: fibromyalgia and its related disorders.J Clin Psychiatry. 2008;69 Suppl 2:4-5.Chaker L, Bianco AC, Jonklaas J, Peeters RP.Hypothyroidism.Lancet.(2017) 390:1550–62. doi:10.1016/S0140-6736(17)30703-1Additional ReadingAhmad, J., and C. Tagoe.Fibromyalgia and chronic widespread pain in Autoimmune Thyroid Disease.Clinical Rheumatology.2014. 33(7):885-891.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Fibromyalgia.Haliloglu, S., Ekinci, B., Uzkeser, H. et al.Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.Clinical Rheumatology.2017 Jul;36(7):1617-1621. doi:10.1007/s10067-017-3556-2Nishioka K., Uchida, T., Usui, C. et al.High prevalence of anti-TSH receptor antibody in fibromyalgia syndrome.International Journal of Rheumatic Diseases.2017 Jun;20(6):685-690. doi:0.1111/1756-185X.12964Goldenberg DL.Introduction: fibromyalgia and its related disorders.J Clin Psychiatry. 2008;69 Suppl 2:4-5.Chaker L, Bianco AC, Jonklaas J, Peeters RP.Hypothyroidism.Lancet.(2017) 390:1550–62. doi:10.1016/S0140-6736(17)30703-1Additional ReadingAhmad, J., and C. Tagoe.Fibromyalgia and chronic widespread pain in Autoimmune Thyroid Disease.Clinical Rheumatology.2014. 33(7):885-891.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Fibromyalgia.Haliloglu, S., Ekinci, B., Uzkeser, H. et al.Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.Clinical Rheumatology.2017 Jul;36(7):1617-1621. doi:10.1007/s10067-017-3556-2Nishioka K., Uchida, T., Usui, C. et al.High prevalence of anti-TSH receptor antibody in fibromyalgia syndrome.International Journal of Rheumatic Diseases.2017 Jun;20(6):685-690. doi:0.1111/1756-185X.12964Goldenberg DL.Introduction: fibromyalgia and its related disorders.J Clin Psychiatry. 2008;69 Suppl 2:4-5.Chaker L, Bianco AC, Jonklaas J, Peeters RP.Hypothyroidism.Lancet.(2017) 390:1550–62. doi:10.1016/S0140-6736(17)30703-1
Centers for Disease Control and Prevention.Fibromyalgia.
Haliloglu, S., Ekinci, B., Uzkeser, H. et al.Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.Clinical Rheumatology.2017 Jul;36(7):1617-1621. doi:10.1007/s10067-017-3556-2
Nishioka K., Uchida, T., Usui, C. et al.High prevalence of anti-TSH receptor antibody in fibromyalgia syndrome.International Journal of Rheumatic Diseases.2017 Jun;20(6):685-690. doi:0.1111/1756-185X.12964
Goldenberg DL.Introduction: fibromyalgia and its related disorders.J Clin Psychiatry. 2008;69 Suppl 2:4-5.
Chaker L, Bianco AC, Jonklaas J, Peeters RP.Hypothyroidism.Lancet.(2017) 390:1550–62. doi:10.1016/S0140-6736(17)30703-1
Ahmad, J., and C. Tagoe.Fibromyalgia and chronic widespread pain in Autoimmune Thyroid Disease.Clinical Rheumatology.2014. 33(7):885-891.
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