Fibromyalgia is a medical condition that presents mostly with a low threshold for pain. This means that the condition causes widespread pain all over the body. There is also a heightened pain sensitivity to normal pressure applied to the skin surface.
However, pain is not the only presentation of fibromyalgia. Other symptoms of this syndrome include fatigue, joint stiffness, sleep disturbance, numbness, tingling sensation and gastrointestinal abnormalities involving swallowing, bowel and bladder movements.
Although the medical community was once divided over whether to consider fibromyalgia a medical condition or not, it is now a recognized disorder that can be diagnosed.
The exact causes of fibromyalgia are still unknown but already several factors have been proven to contribute to this disorder. Stress and physical trauma are some of the major factors blamed for fibromyalgia but so are the malfunctioning of the neurotransmitter pathways of dopamine and serotonin.
[box type=”note”]Hormones are also another known cause of fibromyalgia. Low levels of human growth hormone (HGH) and other hormones under its influence such as leptin, neuropeptide Y and insulin growth factor (IGF-1) have also been blamed.[/box]
Besides these hormones, there are other hormones that have largely been forgotten even though their contributions are just as significant as the ones mentioned above. These are thyroid hormones.
Low levels of thyroid hormones and diminished thyroid function can cause far-reaching negative effects in the body. This is because of the central role of these hormones in the body.
Before we consider how thyroid hormones affect the outcome of fibromyalgia, we should first understand how important the thyroid and its hormones are.
Hypothyroidism and Thyroid Hormone Resistance
Hypothyroidism and thyroid hormone resistance are some of those silent medical disorders that have been largely underestimated while being responsible for a number of chronic diseases.
Thyroid hormone resistance is a type of hypothyroidism. However, unlike classic hypothyroidism where thyroid hormones are not secreted from the thyroid glands in sufficient amounts, thyroid hormone levels are normal in those suffering from thyroid hormone resistance.
Still the normal levels of thyroid hormones are insufficient to drive the normal rate of cellular metabolism in people with thyroid hormone resistance. This causes the same symptoms as hypothyroidism.
Thyroid hormone resistance is difficult to diagnose with the available laboratory tests we have. This is because those tests measure thyroid hormone levels which are already normal.
To treat thyroid hormone resistance like regular hypothyroidism could be fatal. This is because by increasing thyroid hormone levels (the treatment goal for hypothyroidism), patients experience acute hyperthyroidism which can cause fatal heart attack.
Hypothyroidism, on the other hand, slows down metabolism. Therefore, it causes weakness, fatigue, hypotension, cognitive dysfunction, hypothermia, hair loss, weight gain and all the other signs of low energy production in the body.
Pain and Hypothyroidism
There are more reports now of physicians who have thrown every pain medication and supplement at their patientsâ€™ pain problems only to discover that hypothyroidism is the root cause.
The time wasted while hunting for a pain reliever that works is the result of an inadequate understanding of hypothyroidism or overlooking its clinical signs. Therefore, many people who would have benefited from immediate thyroid hormone treatment go untreated. This is especially true for those who do not have overt hypothyroidism.
All the common thyroid function tests measure the levels of thyroid hormones and the hormones that trigger their release. Therefore, these tests can easily miss thyroid hormone resistance and subclinical hypothyroidism.
These later disorders are hypothyroidism all the same. They also cause fatigue and muscular weakness, and because they remain undiagnosed, they persist for years while causing chronic pain and other musculoskeletal disorders such as fibromyalgia.
A typical thyroid function test measures the levels of T4 (thyroxine), T3 (triiodothyronine) and TSH (thyroid stimulating hormone or thyrotropin).
TSH range is regarded as the best diagnostic measurement for hypothyroidism and hyperthyroidism. The levels of TSH are higher than normal in hypothyroidism and below normal range in hyperthyroidism. The normal range of TSH for adults is 0.3 â€“ 3.0 mIU per liter and the upper limit is 6 mIU per liter.
Hypothyroidism is known to cause joint pain and muscle cramps. Since these are common symptoms of all musculoskeletal disorders, it is easy to miss the fact that their root cause may be hypothyroidism. Therefore, pain is usually the forgotten sign of thyroid disease.
This goes to show the limits of laboratory tests for diagnosing diseases and the importance of listening to patients and watching their symptoms.
In most cases, pain caused hypothyroidism is usually accompanied by other signs of the thyroid disease.
The major symptoms of hypothyroidism include:
- Fatigue â€“ caused by slowed down cellular metabolism and also interference with neurotransmitter pathways in the brain especially dopamine and other excitatory neurotransmitters
- Weight gain and water retention â€“ Low thyroid hormone levels slow down the breakdown of fat and promote its accumulation
- Dry mucosal membranes, eyes, skin, hair and brittle nails
- Muscle ache, cramps, joint pain and poor muscle tone â€“ caused by low energy (in the form of ATP) supply to the muscle cells, and therefore lesser flexion and more cramps
- Decreased core body temperature and increased sensitivity to cold
- Increase in serum cholesterol levels
- Low heart rate
Fibromyalgia and Hypothyroidism
It is now a widely accepted fact that most cases of hypothyroidism go undiagnosed as doctors chase other disorders while wasting time finding the right treatment for their patients.
However, those doctors who consider the full set of the symptoms of their fibromyalgia patients soon arrive at the same conclusion: hypothyroidism is the root cause of most cases of fibromyalgia.
Most fibromyalgia patients are either suffering from hypothyroidism or thyroid hormone resistance.
In fact, doctors who consider fibromyalgia as a presentation of hypothyroidism have a far higher success rate treating fibromyalgia than those who donâ€™t. The diagnosis that explains the widely different symptoms of fibromyalgia is hypothyroidism.
For a long time, most doctors did not even consider fibromyalgia as a separate disorders (and some still donâ€™t). This is mainly because the symptoms are so far-flung that it seemed more likely that a combination of medical disorders were causing it.
Even now that fibromyalgia is regarded as a diagnosable condition, it is more accurately described as a disease syndrome.
However, on close look, it is more likely that the wide variety of symptoms bundled together as fibromyalgia syndrome is caused by something as basic as metabolic syndrome or hormonal imbalance. Such disorders are the only set of dysfunctions that can affect different organ-systems in the body and cause so many symptoms that appear unrelated.
[box type=”note”]In the case of fibromyalgia, hypothyroidism is the best candidate that describes all of the symptoms. The proof of that comes from the relief experienced after correcting the thyroid hormone imbalance.[/box]
Using the Thyroid Function Approach to Treat Fibromyalgia
The thyroid function approach is a new protocol in fibromyalgia treatment. Although not quite popular, it is by far a superior method of diagnosing and treating fibromyalgia caused by hypothyroidism.
This approach recruits the patient to help track symptoms and key changes related to the different metabolic processes taking place in the body.
For example, the patient may be given a form which lists the major factors affected by thyroid levels. Such a form allow patients to properly document basic parameters of metabolic rates and body functions such as temperature, pulse, heart rate and weight.
[box type=”note”]By putting these measurements on a chart, a physician can clearly see the trends these measurements follow and determine if they are comparable to the expected changes caused by hypothyroidism.[/box]
In most cases of poorly controlled fibromyalgia, this approach has worked. By following a simple and scientific principle of observation, the involvement of fibromyalgia can be safely determined without the need for misleading and invasive laboratory tests.
When hypothyroidism is identified as the root cause of fibromyalgia, the treatment is straightforward. All that is required is improving the levels of thyroid hormones and thyroid function.
This overlooked approach delivers startling results when hypothyroidism is properly treated. All the seemingly unrelated symptoms of fibromyalgia quickly disappear because the root cause has been addressed.