In my previous post, I talked about the link between Diabetes and Arthritis, today I will talk about the connection between Thyroid Disease and Arthritis.
STATS:
According to the American Thyroid Association, “more than 12 percent of the U.S. population will develop a thyroid condition during their lifetime. An estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of those with thyroid disease are unaware of their condition.”
CAUSES:
There are many different causes of thyroid disorder. Like diabetes, thyroid dysfunction is classified into either having too much thyroid hormone present (Hyperthyroid), or too little (Hypothyroid). A side note: there are also those who fluctuate back and forth—too much, too little.
Before I get into the connection between thyroid disease and arthritis, let’s look more closely at what thyroid disease is.
So, what can cause my thyroid dysfunction in the first place?
- Autoimmune Disease (Hashimoto’s thyroiditis)—most common cause of hypothyroidism
- Over-response to hyperthyroid treatment with either medications or radioactive iodine (The goal is to normalize thyroid level but often results in levels of thyroid hormone that are to low.)
- Thyroid surgery
- Radiation treatment (especially for head and neck cancers)
- Medications (most commonly associated)
- Lithium (used for mania, bipolar)
- Iodide
- Amiodarone (irregular heartbeat medication)
- Aminoglutethimide (seizure medication)
- Interferon (used for cancer and Hepatitis B/C infections)
- Interleukin-2 (chemotherapy agent)
- Sunitinib (chemotherapy agent)
- Glucocorticoids (steroids)
- Dopamine agonists (used for Parkinson’s, Restless Leg Syndrome)
- Somatostatins (used for tumors and some pituitary adenomas)
- Congenital Disease
- Pituitary abnormality (Benign Pituitary Adenoma)
- Pregnancy
- Iodine Deficiency
SYMPTOMS:
Too much thyroid hormone (Hyperthyroid)
- Unintentional weight loss
- Fast or racing heartbeat/Irregular heartbeat/Pounding heartbeat
- Nervousness, anxiety, and irritability
- Small, fine tremor in hands and fingers
- Increased perspiration
- Changes in menstrual patterns
- Increased sensitivity to heat
- Changes in bowel patterns, more frequent bowel movements
- Poor sleep, inability to sleep
- Thinning of skin
- Fine, brittle hair
- Fatigue, muscle weakness
Too little thyroid hormone (Hypothyroid)
- Weight gain
- Slow heart rate
- Depression, poor memory, worsening fatigue
- Dry skin
- Heavy or irregular menstrual cycles
- Increased sensitivity to cold
- Constipation
- Worsening cholesterol
- Thinning off hair
- Muscle weakness
- Body stiffness
- Pain and stiffness of joints
Let’s focus on the “arthritic” problems that abnormal thyroid hormone levels can produce.
COMMON RHEUMATIC COMPLICATIONS OF THYROID DYSFUNCTION:
Rheumatic complaints from TOO MUCH thyroid hormone
1. Osteoporosis
- Most common rheumatic condition with hyperthyroid
- Thinning of bones with increased risk of fracture
2. Proximal Muscle Weakness
- Painless
- Affects upper parts of arms and legs
- 70% of people with hyperthyroidism
3. Frozen shoulder/Bursitis
4. Thyroid Acropachy
- Rare – 1% of those with Grave’s Disease
- Thickening of the skin of the extremities (especially hands and feet)
- Clubbing of the ends of fingers
- New Bone Formation (thickening of bone – especially hands) seen on X-ray
Rheumatic complaints from TOO LITTLE thyroid hormone
1. Myxedematous Arthropathy (Mix – a – dim – a – tus):
- Can occur in up to 33% of people with Hypothyroid
- Swelling and stiffness of large joints – usually knees, ankles
- Can affect hands and feet looking like Rheumatoid)
- Noninflammatory (meaning not destructive to the joint)
- Worse with colder weather and inactivity
2. TRAP
TRAP stands for…
T = Tunnel Syndrome (i.e. Carpal Tunnel Syndrome)
numbness and tingling of hands—especially the thumb and next two fingers
R = Raynauds (finger, toe, or hands/feet can turn white, red, blue in cold temperatures and during periods of stress)
A = Achy muscles
P = Proximal Muscle Weakness and Stiffness
Upper part of arms and legs
Will have elevated CPK (a muscle enzyme) on blood work
TSH (blood test) is very high and Free T4 (blood test) is very low
HASHIMOTO’S THYROIDITIS AND RHEUMATIC CONDITIONS:
Hashimoto’s is an autoimmune thyroid disorder. It occurs more frequently in people with other autoimmune disorders, especially:
- Lupus
- Sjogren’s
- Rheumatoid Arthritis
- Mixed Connective Tissue Disease
- Scleroderma
- Polymyositis
THYROID MEDS AND RHEUMATIC PROBLEMS:
Two thyroid medications are known to increase your risk of developing further issues:
PTU (Propylthiouracil)
-
- Used to treat Hyperthyroid
- Can cause a systemic vasculitis (inflammation of blood vessels)
Methimazole
-
- Used to treat Hyperthyroid
- Can cause a Lupus-like syndrome
- Can cause Diabetes
Certainly, from a Rheumy standpoint, thyroid diseases, especially Hypothyroid disease, produces very similar complaints as those I see with autoimmune Rheumatic conditions such as:
Joint pain
Stiffness
Muscle pain
Fatigue
A Final Word on the Connection Between Arthritis and Thyroid Disease
The major difference between the two is that the joint and muscle complaints from someone with thyroid disease are not associated with systemic inflammation and, as such, will not improve with immunosuppressive therapy like steroids or other Rheumatic meds. Furthermore, joint and muscle complaints from thyroid dysfunction do not cause the erosions or joint destruction that is commonly seen in those with Rheumatoid Arthritis.
However, it’s important to remember that autoimmune issues like Diabetes, Thyroid disease, and autoimmune Rheumatic conditions like Rheumatoid enjoy hanging out and playing in the park together. Therefore, If you have any one of the three listed above, keep mindful of the other two.
Like Diabetes and autoimmune Rheumatic conditions (and I believe every other physical and mental imbalance), diet, vitamins, and minerals can definitely impact thyroid function. Stay tuned in for my in-house Functional Nutritional Therapist, Karey Thomas, who will be addressing this more on Thursday’s post.
Remember, today and every day, live your value one choice at a time.
