Can Hashimoto’s Disease Increase My Risk Of Developing Fibromyalgia?

Around 1 to 2% of people in the US¹ have Hashimoto's disease, also known as Hashimoto's thyroiditis. Fibromyalgia affects approximately 4 million people in the US².

It is estimated that between 30 to 40% of people with Hashimoto's thyroiditis³ also have fibromyalgia. This high rate of comorbidity (having two medical conditions at the same time) indicates a possible link between the two. But what is it? And if you have one condition, are you more at risk of developing the other?

Learn more about these medical conditions, what causes them, how they are linked, and your treatment options if you have both.

What is Hashimoto's disease?

Hashimoto's disease is an autoimmune disease affecting the thyroid. The thyroid is a gland that sits in front of your trachea and is shaped roughly like a butterfly. It is part of your endocrine system and secretes thyroid hormones, which your body needs to operate properly as they affect many different functions in your body, including your metabolism, heart rate, brain development, and bone growth.

Hashimoto's disease is a condition in which your body's immune system attacks the thyroid. This causes the thyroid to become inflamed and, over time, causes damage to the gland.

Eventually, the thyroid will stop producing the required amount of thyroid hormone. Having an underactive thyroid is referred to as hypothyroidism.

While other medical conditions can cause hypothyroidism, Hashimoto's disease is the most common cause in the developed world. At the same time, lack of iodine in the diet⁴ is the most common cause globally.

It is important to know that Hashimoto's disease is treatable. Thyroid medication can supplement the body's hormone levels, and lifestyle changes may boost your body’s thyroid hormone production.

What is fibromyalgia?

Fibromyalgia is a chronic disorder where you experience pain all over your body, and you may be more sensitive to stimuli. You may experience difficulties with sleep, concentration, and digestion.

The cause of fibromyalgia is unknown, but studies have suggested⁵ that there could be multiple factors, including dysfunction of the central and autonomic nervous systems and neurotransmitters. This can cause the body to have a heightened response to stimuli. Infection, environmental, hormonal, and psychiatric issues may also contribute to the development of this condition.

It is thought that fibromyalgia may also be an autoimmune disorder, caused by the body attacking itself. This would help to explain why people with autoimmune disorders such as Hashimoto's disease, lupus, and rheumatoid arthritis develop fibromyalgia at a higher rate than those without such conditions.

Symptoms of fibromyalgia can range from mild to severe. Some people experience chronic pain that is serious enough to interfere with their daily life.

Those with fibromyalgia experience higher rates of depression², potentially stemming from the stress of dealing with chronic pain.

Therefore, most of the treatment options for fibromyalgia involve pain management and lifestyle changes.

Is it common to get fibromyalgia if you have Hashimoto's disease?

Around 30 to 40% of people with Hashimoto's disease also have fibromyalgia³, while fibromyalgia occurs in only 2 to 7% of the general population. This means it is relatively common to have both conditions at the same time.

While this indicates a strong link between the two, researchers are not entirely sure why.

Studies⁷ have indicated that Hashimoto’s disease could be considered a risk factor for fibromyalgia as a high percentage of those diagnosed with Hashimoto’s disease were found to later develop fibromyalgia. This suggests a possible cause-effect relationship between the two conditions.

Hashimoto's disease is also an autoimmune disorder. Having two autoimmune disorders at the same time is called polyautoimmunity.

The two disorders share many similar symptoms, including:

• Trouble sleeping and feeling tired after a night's rest

• Aches in the muscles and joints

• Depression or anxiety accompanied by feelings of confusion or fogginess

Researchers identified a link⁷ between the two conditions by looking at patients' antibodies. Patients with fibromyalgia have twice as many antibodies against a protein required to make thyroid hormones as those found in patients without the condition. Those antibodies are also present in those with Hashimoto's disease.

As healthcare professionals are unsure what causes either Hashimoto's disease or fibromyalgia, it is difficult to know why having one seems to increase your risk of developing the other.

You may also be at higher risk of developing both conditions if:

• You are female

• You are middle-aged

• You have a family history of either disease

• You suffer from a highly stressful situation

• You have had a severe illness or infection

However, anyone can develop these conditions even if you don’t have any of the risk factors identified above. If you start to experience symptoms, contact your primary care provider to discuss these as soon as possible.

How are Hashimoto's and fibromyalgia diagnosed?

Hashimoto's thyroiditis is usually diagnosed through a series of blood tests. Your doctor may suspect you have Hashimoto's disease if you are experiencing many of the symptoms usually associated with an underactive thyroid gland. These include weight gain, fatigue, weakness, and dry skin.

Blood tests will show whether your thyroid hormones (T3, T4, TSH) levels are within a normal range. If they are too low, this indicates you have hypothyroidism or an underactive thyroid.

To diagnose Hashimoto's disease, your doctor will also need to order an antibody test to show whether your blood contains antibodies for the thyroid peroxidase, a protein used to make thyroid hormones. These antibodies indicate an autoimmune response against the thyroid, which is the hallmark of Hashimoto's disease.

Fibromyalgia is much more difficult to diagnose as there are no conclusive tests.

As fibromyalgia shares symptoms with many other medical conditions, including rheumatoid arthritis and depression, it can be even more challenging to diagnose. As a result, a fibromyalgia diagnosis can only be made by excluding other conditions.

To diagnose you with fibromyalgia, your doctor will:

• Consider your symptoms

• Review your personal and family medical history

• Run a series of diagnostic tests to look for any irregularities

• Discuss any triggers you have noticed that increase your pain and sensitivity

Based on their findings, your doctor can make a diagnosis and create an appropriate treatment plan for you.

Treatment

If you have been diagnosed with either or both Hashimoto's thyroiditis and fibromyalgia, there are treatment options to help you manage your symptoms. These include:

Thyroid medication

Thyroid medication can boost your body's hormone levels to fall within the normal range. This may help alleviate some of the symptoms you are experiencing, such as fatigue, weight gain, and constipation.

Reducing stress levels

Reducing stress is especially important if you have both conditions, as stress can make your symptoms worse. Therapy, meditation, and mindfulness may help to relieve stress.

Improving sleep quality

As fatigue is a primary symptom of both conditions, improving the quality of your sleep may help by giving your body more time to repair and recover. Ensure you practice good sleep hygiene, such as keeping a sleep schedule, not using technology before bed, and keeping your bedroom dark and cool.

Pain management

Over-the-counter pain medications may help manage some of the pain associated with fibromyalgia. However,  prescription pain medication is not typically recommended as it may become addictive and less effective over time. Physical and occupational therapy may help manage pain if over-the-counter medications aren't working.

Cognitive behavioral therapy (CBT)

This form of therapy could help alleviate some of the psychological symptoms of either condition while assisting you in changing your thought processes and behaviors. Through CBT, you can learn to alter how you think about your illness and respond to it.

Exercise

This is recommended for both disorders, but some exercises may trigger a pain response in those with fibromyalgia. Listen to your body and work with your doctor on finding an exercise routine that works for your condition.

When to speak to a doctor

You should make sure to speak with your doctor if:

• You are experiencing the symptoms of Hashimoto's disease or fibromyalgia 

• You have been diagnosed with Hashimoto's disease and are experiencing painful symptoms associated with fibromyalgia

• You have been diagnosed with either condition, and your symptoms are getting worse or aren't improving

There are many treatment options available for these conditions. Working with a primary care provider and an endocrinologist, therapist, or other healthcare professionals can help you find a treatment plan that works best for you.

The lowdown

Hashimoto's disease is an autoimmune disorder affecting the thyroid, which slowly stops your body from producing enough thyroid hormone. This results in symptoms such as fatigue, weight gain, and constipation.

An estimated 30 to 40% of people with Hashimoto's disease also have fibromyalgia, a chronic pain condition that causes fatigue, muscle and joint pain and may increase the risk of depression and anxiety.

Research indicates there is a link between these two conditions, but the causes are unknown. Hashimoto's disease is an autoimmune disorder, and fibromyalgia may also have an autoimmune component.

While Hashimoto's disease can be diagnosed with blood tests, it is more difficult to diagnose fibromyalgia because of the shared symptoms with other autoimmune conditions.

While there is no cure for either condition, many treatment options are available, including thyroid medication, therapy, and pain management. If you are experiencing any of the symptoms of Hashimoto's thyroiditis or fibromyalgia, make an appointment with your doctor for a diagnosis and to discuss treatment options.