Can Hashimoto’s Disease Cause Painful Joints?

Hashimoto's disease is also called Hashimoto thyroiditis, or sometimes, autoimmune thyroiditis. This autoimmune condition destroys thyroid gland cells, and it’s the most common cause of underactive thyroid (hypothyroidism) in the US.

Globally, the most common cause of hypothyroidism is a lack of dietary iodine.

The exact number of people with Hashimoto’s disease is unknown, in part due to delayed diagnosis, but estimates suggest it occurs in almost 1% of adult men and 3.5% of adult women¹.

The short answer to whether or not Hashimoto's disease can cause painful joints is yes. However, not everyone with Hashimoto’s disease will experience joint pain. Keep reading for a more detailed explanation of how thyroid hormones affect your joints.

What is Hashimoto's disease?

If you have Hashimoto's disease, your immune system attacks your thyroid gland. Eventually, your thyroid becomes damaged and no longer produces enough hormones, resulting in chronic hypothyroidism (underactive thyroid).

Unfortunately, there is no cure for Hashimoto's at this time, but once diagnosed and medicated, it is considered highly treatable.

Common symptoms

• Stiff, painful joints 

• Fatigue

• Depression

• Weight gain

• Dry skin

• Hair loss

• Brain fog

• Intolerance to cold temperatures

Risk factors for Hashimoto's disease

The primary cause of Hashimoto's is a family history of the condition. Additional risk factors include:

• Being a female between the ages of 30–60 years old

• Having another autoimmune disorder, such as type 1 diabetes, rheumatoid arthritis, or Celiac disease

How is Hashimoto's disease diagnosed?

A specific diagnosis of Hashimoto's requires two blood tests: a thyroid function test and an antibody test.

One test will check your thyroid-stimulating hormone (TSH) levels.

If your thyroid is underactive, your pituitary gland will release extra TSH. 

Unfortunately, this will not get things back into balance because your thyroid is damaged.

If you have high TSH, your doctor will likely test you for thyroid peroxidase (TPO) antibodies, confirming Hashimoto's disease (and not another form of hypothyroidism).

What is the outlook for someone with Hashimoto’s disease?

Untreated Hashimoto’s disease can lead to serious complications, such as heart problems, including heart failure or stroke. It may also affect your fertility or cholesterol levels.

However, with treatment, a person with Hashimoto's disease can live a full life.

Treatment

Treatment for Hashimoto thyroiditis typically involves lifelong therapy with a thyroid hormone replacement drug called levothyroxine.

It's vital to follow your doctor’s recommendations with respect to medication and inform them immediately if you develop new symptoms or side effects.

Can Hashimoto's disease cause joint pain?

As mentioned earlier, the short answer is yes. However, the situation isn’t always straightforward. 

For example, people with Hashimoto’s disease have a higher risk for rheumatoid arthritis, so strictly speaking, arthritis may be the true underlying cause of the pain.

How does hypothyroidism affect your joints?

Thyroid hormones are essential for bone and cartilage maintenance. So, if your thyroid hormones levels are low, this can cause abnormalities, leading to swelling, stiffness, and pain in your joints.

Joint pain is also a common manifestation of several autoimmune conditions, so it is crucial to discuss this with your health care provider and seek the underlying cause(s) of joint pain. 

Which joints are most commonly affected?

Your knees, hands, shoulders, or hips may be affected.²

Tips for reducing joint pain with Hashimoto's disease

In many cases, joint pain will go away completely once thyroid levels are stabilized with medication. However, when Hashimoto's disease goes untreated for an extended period, it may cause joint damage.

If thyroid medication doesn't help your joint pain at all, that’s usually a sign for your doctor to evaluate other possible causes.

The following practices may help with pain management and are worth discussing with your doctor:

1. Taking over the counter painkillers such as ibuprofen or acetaminophen.

2. Doing low-impact exercise to help your joints get moving again. This can also help improve your thyroid function in general. Take it slowly. Water aerobics is often great for people with joint pain. Resistance training can also help by restoring muscle function (which helps support your joints).

3. Maintaining a healthy weight. Most people gain weight when their hypothyroidism is not well controlled, but weight usually goes back down once your hormones are stable. Keeping a healthy weight reduces strain on your joints.

4. Consuming antioxidants and vitamin C³. Eating more fruit has been shown to be good for your joints in general and can potentially slow the development of osteoarthritis. In general, a healthy diet will support your joints and thyroid and help keep you from gaining excess weight.

5. Getting enough sleep. Practice good sleep habits, such as going to bed at the same time every day and keeping your bedroom cool and dark.

6. Getting essential minerals, especially magnesium and selenium⁴. While more evidence is needed, there is some evidence these minerals and zinc can help support thyroid function, and magnesium, in particular, is also known to help with joint pain in general.

7. Taking a curcumin supplement. Curcumin comes from turmeric and is known to be helpful for arthritis pain⁵, thus might also be helpful for joint pain caused by Hashimoto's.

Ultimately, the most important way to reduce joint pain from Hashimoto's is to take your thyroid medication and get your dosage checked regularly. 

When to speak to a doctor

If your thyroid levels are showing normal on blood tests, but you still have substantial joint pain, this could indicate the presence of a different condition or illness.

If your joint pain is accompanied by fever, fatigue, and overall weakness, then you may have rheumatoid arthritis or another health issue. Having both Hashimoto's disease and rheumatoid arthritis is common.

Rheumatoid arthritis is frequently diagnosed by a combination of physical examination and specific antibody screening. While it cannot be cured, rheumatoid arthritis can be managed with medication and self-care tactics, such as appropriate physical activity and weight management.

However, it's important to get rheumatoid arthritis diagnosed so your doctor can provide you with medication that slows the progression of the disease and reduces or prevents irreversible joint damage.

You should also talk to your doctor right away if your joint pain goes away then returns. It is common for thyroid hormone levels to fluctuate, so the return of joint pain may indicate that your medication dosage is too low.

For some people, joint pain may be the first warning sign that their dosage is incorrect. Always speak with your doctor before making any dosage adjustments.

The lowdown

Symptoms of Hashimoto's disease are highly variable. Joint pain and swelling can be a symptom for many people, and, in rare cases, it is the only symptom.

Often, joint pain will go away once you have your hypothyroidism controlled with medication. If it does not, checking for rheumatoid arthritis may be the next logical step. Adopting a healthy lifestyle, including low impact exercise, weight management, and eating plenty of fruit and vegetables are ways to support your general health and may lead to less joint pain.

For most people with Hashimoto’s disease, the primary way to reduce or eliminate joint pain is to stabilize your thyroid levels. However, if there is existing damage to the joints, nutritional support and other pain management tactics may be appropriate.