Muscle disease, ormyopathy, may occur because you have an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism). Muscle problems related to these medical conditions are usually mild. Treatment of your thyroid disorder can help ease the symptoms.
However, in some rare cases, myopathy related to thyroid disease can be severe and debilitating. By better understanding the muscle symptoms of thyroid disease, you’ll be able to manage your discomfort or weakness.
This article will talk about thyroid disease and how it can cause pain and weakness. It will discuss thyroid muscle disease symptoms and how a healthcare provider can diagnose and treat the disease.
Verywell / Laura Porter
Myopathy in HypothyroidismWeakness in muscles close to the center of the body (thighs, shoulders)Elevated creatinineCrampingRarely, enlarged muscles (Hoffman’s syndrome)Rarely, breakdown of muscle tissue (rhabdomyolysis)Myopathy in HyperthyroidismMuscle weaknessCreatinine levels tend to be normalCramping (uncommon)Rarely, issues with the muscles involved in swallowing and breathing (rare)
Myopathy in HypothyroidismWeakness in muscles close to the center of the body (thighs, shoulders)Elevated creatinineCrampingRarely, enlarged muscles (Hoffman’s syndrome)Rarely, breakdown of muscle tissue (rhabdomyolysis)
Weakness in muscles close to the center of the body (thighs, shoulders)
Elevated creatinine
Cramping
Rarely, enlarged muscles (Hoffman’s syndrome)
Rarely, breakdown of muscle tissue (rhabdomyolysis)
Myopathy in HyperthyroidismMuscle weaknessCreatinine levels tend to be normalCramping (uncommon)Rarely, issues with the muscles involved in swallowing and breathing (rare)
Muscle weakness
Creatinine levels tend to be normal
Cramping (uncommon)
Rarely, issues with the muscles involved in swallowing and breathing (rare)
Hypothyroid Myopathy
Muscle weakness, aches, and cramping are common in people with hypothyroidism.
Symptoms
People with hypothyroid myopathy can experience weakness throughout the body, and it is typically most severe in the muscles of the thighs or shoulders.This can lead to problems climbing stairs or combing your hair.
High Creatinine Kinase LevelsIn addition to muscle symptoms, you may have a high creatinine kinase level (measured with a blood test). Creatinine kinase is a muscle enzyme released into the blood when a muscle is injured. However, your creatinine kinase level is not necessarily linked to the severity of yourmuscle pain.
High Creatinine Kinase Levels
In addition to muscle symptoms, you may have a high creatinine kinase level (measured with a blood test). Creatinine kinase is a muscle enzyme released into the blood when a muscle is injured. However, your creatinine kinase level is not necessarily linked to the severity of yourmuscle pain.
Rarely, hypothyroidism can cause severe muscle symptoms. One example is Hoffman’s syndrome. This is when a person develops muscle hypertrophy (enlarged muscles). It can lead to significant muscle stiffness, weakness, and pain.
Hoffmann’s syndrome can affect various body parts, including the arms, legs, and sometimes facial muscles, including the tongue.
Causes
The exact cause of hypothyroidism-induced myopathy isn’t known, but some experts believe that the thyroxine (T4) deficiency seen in hypothyroidism leads to muscle injury and impaired muscle function.
The Anatomy of the Thyroid Gland
Diagnosis
Hypothyroid myopathy is diagnosed based on symptoms, physical examination, and diagnostic tests. You may have a blood test to measure creatinine kinase.
Your healthcare provider may recommend other tests, such aselectromyography. This test uses needles to measure the electrical signals in your muscles and nerve cells while they’re active and at rest.
Amuscle biopsyis a minor surgical procedure that removes a small muscle sample for microscopic examination. This procedure is safe. You may have a biopsy if your symptoms are severe and your diagnosis is not clear based on less invasive testing.
Treatment
Treatment with the thyroid hormone replacement medication Synthroid (levothyroxine) can usually improve symptoms.It may take weeks for cramps and stiffness to improve. It usually takes several months for muscle weakness to improve.
Thyroid Replacement Drugs
Hyperthyroid Myopathy
Hyperthyroidism can also cause muscle weakness and sometimes cramping, but the symptoms tend to differ from myopathy related to hypothyroidism.
Muscle weakness in the shoulders, upper arms, hips, and thighs is the main symptom in people with hyperthyroidism. While muscle cramps and aches may occur, they are not as common as they are with myopathy which is related to hypothyroidism.
Muscle weakness from hyperthyroid myopathy causes difficulty climbing stairs, rising from a chair, holding or gripping objects, and reaching arms above the head.
People with hyperthyroid myopathy may experience weakness in the throat, face, and respiratory muscles. Rarely, the weakness can involve the muscles that help you swallow and breathe.
The causes of myopathy with hyperthyroidism are not well understood. It’s been suggested that high thyroid hormone levels may lead to increased breakdown of muscle protein, as well as greater muscle energy use.
As with myopathy in hypothyroidism, your healthcare provider will ask you about your muscle symptoms and perform a physical examination.
They may also order blood tests, such as athyroid function panel. The blood creatinine kinase level is generally normal with hyperthyroid myopathy.Your healthcare provider may recommend electromyography.
Thyroid Disease Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questionsDownload PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next doctor’s appointment to help you ask the right questions
Download PDF
Email AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Sign Up
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
Treatment of your hyperthyroidism will generally cure hyperthyroid myopathy.However, it can take time to improve—possibly up to several months—even after the thyroid is functioning normally again.
Summary
When you have thyroid disease, you might experience muscle weakness and pain, especially if your thyroid hormone levels are not where they should be. Hypothyroid myopathy tends to cause muscle weakness in the larger muscles of the body, typically the shoulders and thighs. Hyperthyroid myopathy causes muscle weakness throughout the body that may rarely affect the muscles that control swallowing and breathing.
Both types of myopathy improve with treatment of the underlying thyroid disease, but it can take time for symptoms to get better.
8 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.Muscular Dystrophy Association.Hyperthyroid and hypothyroid myopathies - types of endocrine myopathies - diseases.Achappa B, Madi D.Hoffmann’s syndrome- A rare form of hypothyroid myopathy.J Clin Diagn Res.2017;11(5):OL01-OL02. doi:10.7860/JCDR/2017/21234.9913Arora A, Sharma D, Mudalagiri M, Porwal Y.Hoffmann syndrome: A rare and reversible case of hypothyroid myopathy.Thyroid Research and Practice. 2019;16(1):42. doi:https://doi.org/10.4103/trp.trp_33_18Salehi N, Agoston E, Munir I, Thompson GJ.Rhabdomyolysis in a patient with severe hypothyroidism.Am J Case Rep.2017;18:912-918. doi:10.12659/AJCR.904691Rodolico C, Bonanno C, Pugliese A, Nicocia G, Benvenga S, Toscano A.Endocrine myopathies: clinical and histopathological features of the major forms.Acta Myol. 2020;39(3):130-135. doi:10.36185/2532-1900-017Muscular Dystrophy Association.Endocrine myopathies - hyperthyroid and hypothyroid myopathies.Li Q, Liu Y, Zhang Q, Tian H, Li J, Li S.Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report.Medicine (Baltimore). 2017;96(30):e7591. doi:10.1097/MD.0000000000007591Muscular Dystrophy Association.Endocrine myopathies - Medical management.Additional ReadingMiller ML, Rubin DI.Hypothyroid myopathy.Sindoni A, Rodolico C, Pappalardo MA, Portaro S, Benvenga S.Hypothyroid myopathy: A peculiar clinical presentation of thyroid failure: Review of the literature.Rev Endocr Metab Disord. 2016 Dec;17(4):499-519. doi:10.1007/s11154-016-9357-0Villar J, Finol HJ, Torres SH, Roschman-Gonzalez A.Myopathy in patients with Hashimoto’s disease.Invest Clin. 2015 Mar;56(1):33-46.
8 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.Muscular Dystrophy Association.Hyperthyroid and hypothyroid myopathies - types of endocrine myopathies - diseases.Achappa B, Madi D.Hoffmann’s syndrome- A rare form of hypothyroid myopathy.J Clin Diagn Res.2017;11(5):OL01-OL02. doi:10.7860/JCDR/2017/21234.9913Arora A, Sharma D, Mudalagiri M, Porwal Y.Hoffmann syndrome: A rare and reversible case of hypothyroid myopathy.Thyroid Research and Practice. 2019;16(1):42. doi:https://doi.org/10.4103/trp.trp_33_18Salehi N, Agoston E, Munir I, Thompson GJ.Rhabdomyolysis in a patient with severe hypothyroidism.Am J Case Rep.2017;18:912-918. doi:10.12659/AJCR.904691Rodolico C, Bonanno C, Pugliese A, Nicocia G, Benvenga S, Toscano A.Endocrine myopathies: clinical and histopathological features of the major forms.Acta Myol. 2020;39(3):130-135. doi:10.36185/2532-1900-017Muscular Dystrophy Association.Endocrine myopathies - hyperthyroid and hypothyroid myopathies.Li Q, Liu Y, Zhang Q, Tian H, Li J, Li S.Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report.Medicine (Baltimore). 2017;96(30):e7591. doi:10.1097/MD.0000000000007591Muscular Dystrophy Association.Endocrine myopathies - Medical management.Additional ReadingMiller ML, Rubin DI.Hypothyroid myopathy.Sindoni A, Rodolico C, Pappalardo MA, Portaro S, Benvenga S.Hypothyroid myopathy: A peculiar clinical presentation of thyroid failure: Review of the literature.Rev Endocr Metab Disord. 2016 Dec;17(4):499-519. doi:10.1007/s11154-016-9357-0Villar J, Finol HJ, Torres SH, Roschman-Gonzalez A.Myopathy in patients with Hashimoto’s disease.Invest Clin. 2015 Mar;56(1):33-46.
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.
Muscular Dystrophy Association.Hyperthyroid and hypothyroid myopathies - types of endocrine myopathies - diseases.Achappa B, Madi D.Hoffmann’s syndrome- A rare form of hypothyroid myopathy.J Clin Diagn Res.2017;11(5):OL01-OL02. doi:10.7860/JCDR/2017/21234.9913Arora A, Sharma D, Mudalagiri M, Porwal Y.Hoffmann syndrome: A rare and reversible case of hypothyroid myopathy.Thyroid Research and Practice. 2019;16(1):42. doi:https://doi.org/10.4103/trp.trp_33_18Salehi N, Agoston E, Munir I, Thompson GJ.Rhabdomyolysis in a patient with severe hypothyroidism.Am J Case Rep.2017;18:912-918. doi:10.12659/AJCR.904691Rodolico C, Bonanno C, Pugliese A, Nicocia G, Benvenga S, Toscano A.Endocrine myopathies: clinical and histopathological features of the major forms.Acta Myol. 2020;39(3):130-135. doi:10.36185/2532-1900-017Muscular Dystrophy Association.Endocrine myopathies - hyperthyroid and hypothyroid myopathies.Li Q, Liu Y, Zhang Q, Tian H, Li J, Li S.Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report.Medicine (Baltimore). 2017;96(30):e7591. doi:10.1097/MD.0000000000007591Muscular Dystrophy Association.Endocrine myopathies - Medical management.
Muscular Dystrophy Association.Hyperthyroid and hypothyroid myopathies - types of endocrine myopathies - diseases.
Achappa B, Madi D.Hoffmann’s syndrome- A rare form of hypothyroid myopathy.J Clin Diagn Res.2017;11(5):OL01-OL02. doi:10.7860/JCDR/2017/21234.9913
Arora A, Sharma D, Mudalagiri M, Porwal Y.Hoffmann syndrome: A rare and reversible case of hypothyroid myopathy.Thyroid Research and Practice. 2019;16(1):42. doi:https://doi.org/10.4103/trp.trp_33_18
Salehi N, Agoston E, Munir I, Thompson GJ.Rhabdomyolysis in a patient with severe hypothyroidism.Am J Case Rep.2017;18:912-918. doi:10.12659/AJCR.904691
Rodolico C, Bonanno C, Pugliese A, Nicocia G, Benvenga S, Toscano A.Endocrine myopathies: clinical and histopathological features of the major forms.Acta Myol. 2020;39(3):130-135. doi:10.36185/2532-1900-017
Muscular Dystrophy Association.Endocrine myopathies - hyperthyroid and hypothyroid myopathies.
Li Q, Liu Y, Zhang Q, Tian H, Li J, Li S.Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report.Medicine (Baltimore). 2017;96(30):e7591. doi:10.1097/MD.0000000000007591
Muscular Dystrophy Association.Endocrine myopathies - Medical management.
Miller ML, Rubin DI.Hypothyroid myopathy.Sindoni A, Rodolico C, Pappalardo MA, Portaro S, Benvenga S.Hypothyroid myopathy: A peculiar clinical presentation of thyroid failure: Review of the literature.Rev Endocr Metab Disord. 2016 Dec;17(4):499-519. doi:10.1007/s11154-016-9357-0Villar J, Finol HJ, Torres SH, Roschman-Gonzalez A.Myopathy in patients with Hashimoto’s disease.Invest Clin. 2015 Mar;56(1):33-46.
Miller ML, Rubin DI.Hypothyroid myopathy.
Sindoni A, Rodolico C, Pappalardo MA, Portaro S, Benvenga S.Hypothyroid myopathy: A peculiar clinical presentation of thyroid failure: Review of the literature.Rev Endocr Metab Disord. 2016 Dec;17(4):499-519. doi:10.1007/s11154-016-9357-0
Villar J, Finol HJ, Torres SH, Roschman-Gonzalez A.Myopathy in patients with Hashimoto’s disease.Invest Clin. 2015 Mar;56(1):33-46.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
