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February 20, 2023 11 min read

Do you feel tired all the time, have trouble sleeping and deal with pain all over your body? If so, you might have fibromyalgia syndrome. But did you know that a common underlying condition, hypothyroidism, has the same symptoms and is often linked to fibromyalgia? In fact, they often go hand in hand.

In this article, we will explore the connection between hypothyroidism and fibromyalgia, providing insight into a potential root cause of your symptoms.

What is hypothyroidism?

Hypothyroidism, or underactive thyroid gland, is a common thyroid disease that affects 5% of the general population in the world. It occurs when your thyroid gland, the largest endocrine gland in your body, does not produce enough of the two main thyroid hormones, Thyroxine (T4) and Triiodothyronine (T3).

These hormones are needed to maintain a normal metabolic rate. The deficiency of thyroid hormone in the body causes symptoms of hypothyroidism such as fatigue, dry skin, constipation, weight gain, slow heart rate, etc.

So how much thyroid hormone does your body require? The answer lies in your pituitary gland. It normally releases thyroid-stimulating hormone (TSH) to signal the thyroid gland to produce the correct amount of thyroid hormone. If TSH is increased, your body needs more thyroid hormone and vice versa. On the other hand, TSH levels are regulated by your hypothalamus through thyroid-releasing hormone (TRH).

Therefore, whenever the hypothalamus, pituitary, or thyroid gland is malfunctioning, it can lead to hypothyroidism. Primary hypothyroidism results from problems in the thyroid gland itself, usually caused by an autoimmune thyroid condition like Hashimoto's disease, thyroid surgery, or iodine deficiency. In contrast, secondary hypothyroidism occurs when your hypothalamus or pituitary gland doesn't produce enough TRH or TSH.

Hypothyroidism is more common in women than in men. Moreover, there's currently no cure for this condition, but it can be effectively managed with thyroid hormone replacement medications.

Fibromyalgia and thyroid connection

What is fibromyalgia?

Fibromyalgia is pain and burning that spreads throughout the body or in multiple locations, such as the head, chest, abdomen, arms, legs, back, and buttocks. This medical condition is also often accompanied by sleep, cognitive, and mood disorders.

The cause of the disease has not been determined. However, some studies indicate that pain in fibromyalgia patients is caused by changes in how pain signals are processed by the central nervous system, including the brain, spinal cord, and nerves. In addition, other factors that can cause fibromyalgia include genetics, infections, physical or emotional events, and other disorders, such as rheumatic diseases or osteoarthritis.

Fibromyalgia is more common in women than men and cannot be cured. However, it's not fatal and can be controlled with medication, exercise, relaxation, etc. Otherwise, the long-term symptoms of fibromyalgia will soon decrease your quality of life, increase the risk of depression and even increase your mortality from injury.

What is the connection between hypothyroidism and fibromyalgia?

Hypothyroidism and fibromyalgia are two health conditions that commonly occur together. Studies have shown that there is actually a strong connection between hypothyroidism and fibromyalgia, with many patients who suffer from one also suffering from the other.

For example, a study published in the Journal of Clinical Rheumatology found that the prevalence of fibromyalgia in the general population was 2 percent to 7 percent but as high as 30 percent to 40 percent in people with hypothyroidism. This information supports the theory that people with hypothyroidism are at a higher risk of developing fibromyalgia, which highlights the importance of proper treatment and management of their thyroid health.

Scientists aren't exactly sure what causes this overlap. Moreover, the underlying causes of fibromyalgia are not fully understood yet. However, there are some similarities and possible links between the two conditions.

Hypothyroidism and fibromyalgia tend to affect a similar population of people

Although fibromyalgia and thyroid disease can affect any gender or age, they are often diagnosed in a population with similar characteristics.

  • Both diseases are usually diagnosed in women. 

  • Both can occur at any age but are more common in middle age.

  • Both tend to run in families.

  • Both cause similar symptoms, such as trouble sleeping, headaches, digestive problems, and muscle and joint pains.

  • Both increase your risk of rheumatoid arthritis.

  • Thyroid Peroxidase Antibody (TPO-Ab) and Thyroglobulin Antibodies (TgAb), two antibodies that destroy thyroid tissue and cause hypothyroidism, are both present in high concentrations in people with fibromyalgia and Hashimoto's thyroiditis.

Potential causes of hypothyroidism and fibromyalgia patients might be similar

There are various known causes of hypothyroidism. The cause of fibromyalgia, on the other hand, remains a subject of ongoing debate among the medical community. While some theories have been put forward, such as a possible association with autoimmune thyroid disease, there is currently no definitive explanation for the origin of this condition.

However, that hasn't stopped folks from speculating about the various possible causes that may link the two conditions together, such as:

  1. Autoimmunity

The theories surrounding the development of Hashimoto's disease and fibromyalgia are varied, but some experts believe that underlying autoimmune disease may play a role in both conditions.

The immune system is the barrier that protects the human body from pathogens from bacteria, viruses, or parasites. However, your immune system sometimes confuses harmful agents with your body's healthy cells or tissues, leading to pointless attacks that only cause harm to your body. These are called autoimmune diseases. Hashimoto's thyroiditis is an autoimmune thyroid disease and a common cause of hypothyroidism.

In contrast, fibromyalgia is not officially recognized as one of the autoimmune disorders. But many researchers believe it could be an early sign of an autoimmune disease. In addition, a few other theories suggest that autoimmune disease promotes the development of fibromyalgia and thyroid disease.

Although there are no reports to firmly support that one condition causes the other, the two almost always occur together. A study looked at the connection between fibromyalgia and autoimmune thyroid diseases. Out of 182 patients with fibromyalgia, 69 (37.9%) were found to have autoimmune thyroid disease. The study found that 20.3% of these patients had high levels of certain thyroid antibodies compared to the general population. This same study also found that the symptoms of fibromyalgia were the same in patients with and without autoimmune thyroid disease.

  1. Trauma

Research is showing a strong link between trauma and autoimmune disorders, fibromyalgia, and other chronic pain conditions. Traumatic events like a car accident can activate the immune system, leading to autoimmunity or chronic symptoms. Additionally, trauma can impact pain perception, increase body tension, and worsen depression and anxiety, all contributing to a wide range of symptoms. Physical events such as accidents and emotional events like prolonged stress can also trigger fibromyalgia.

Post-traumatic stress disorder (PTSD) has also been linked to thyroid dysfunction in some studies.


Stress is a natural body response when facing difficulties in life. The systems responsible for these reactions are the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, which regulates the body's unconscious actions.

They are also commonly thought to mediate the relationship between stress and the development of fibromyalgia. Studies have found chronic widespread pain, including fibromyalgia, associated with the hypothalamus located at the base of the brain being activated. 

In addition, the hypothalamus plays an important role in regulating thyroid production. If your hypothalamus fails to release TRH, it leads to hypothyroidism. This also suggests that the strong link between thyroid disease and fibromyalgia is that both are affected by the hypothalamic function.

Hormonal problems

The hormones secreted by the endocrine glands can affect the same organ or different organs in the body. As a result, they form a complex network of connections. When a hormonal imbalance occurs, it impacts a variety of different bodily functions. In particular, it will aggravate both fibromyalgia and thyroid disease.

For example, women may feel the pain of fibromyalgia most while menstruating. This is because the two sex hormones, progesterone, and estrogen, are at their lowest during this period. Similarly, symptoms of hypothyroidism can be easily noticed when a woman has low progesterone or high estrogen level.

Another example of a hormonal issue is the low production of cortisol by your adrenal gland. This condition can directly contribute to or even increase your risk of fibromyalgia and thyroid disease.

Leaky Gut

Your gut health is linked to many things, including fibromyalgia and thyroid disease. Studies show that many fibromyalgia patients have leaky gut, which can be a cause of the disease. A leaky gut is when the intestinal barrier becomes damaged, causing large protein molecules to enter the bloodstream and trigger an immune response. This can lead to thyroid dysfunction, autoimmunity, and food intolerance.

Do hypothyroidism and fibromyalgia symptoms overlap?

Fibromyalgia and hypothyroidism are often difficult to distinguish because they share similar symptoms. They even appear together. A study concluded that between 2% and 7% of the global population suffers from fibromyalgia. But it is even more prevalent in people with Hashimoto thyroiditis, where it affects 30% to 40% of people.

There are differing opinions among experts about fibromyalgia and hypothyroidism. Some experts consider fibromyalgia to be a separate condition from hypothyroidism, while others believe that fibromyalgia may be a result of thyroid hormone deficiency. It's also possible that some people with fibromyalgia may have undiagnosed hypothyroidism. Nonetheless, there are numerous similar fibromyalgia and hypothyroidism symptoms, though some are more common in one condition than the other.

Some symptoms that are common in both fibromyalgia and hypothyroidism include:

How do doctors diagnose hypothyroidism and fibromyalgia?

Hypothyroidism is easily detected by blood tests to check thyroid function. On the other hand, fibromyalgia is not diagnosed with specific tests, so it is more difficult to recognize. However, the two conditions can often be misdiagnosed.

Tests for hypothyroidism

Doctors not only diagnose hypothyroidism based on the severity of symptoms but also consider other factors such as:

  • Your medical and family history includes surgeries you've had, other conditions you're being treated for, whether or not your family members have thyroid disease, etc.

  • Physical exam to check your thyroid or signs of hypothyroidism related to heart rate, weight, blood pressure, etc.

  • Medications you are taking, including supplements and herbs.

In addition, blood tests are essential. They are done to evaluate the levels of TSH and Free T4. If TSH is abnormally high and Free T4 levels are low, it is a warning of a deficiency of thyroid hormone in your body or hypothyroidism.

Tests for fibromyalgia

The widespread pain of fibromyalgia can be a manifestation of other medical conditions such as osteoporosis, spondylolisthesis, and rheumatic diseases. As a result, healthcare providers may ask patients to undergo physical tests and X-rays to rule out potential health problems. But there is no specific test that can detect fibromyalgia.

Doctors usually diagnose the disease based on the symptoms involved and the number of painful spots on your body. In addition, you will be asked about your medical history and two other criteria, including:

  • Have you experienced pain in many parts of your body for more than three months?

  • Do you have other symptoms like fatigue, sleep, or memory problems?

Thyroid tests for fibromyalgia

When doctors are checking for fibromyalgia, they typically run tests to check your thyroid function. If you're diagnosed with autoimmune hypothyroidism, your doctor may treat just the thyroid condition first to see if your pain goes away. If you're already taking medication for hypothyroidism and still have symptoms of fibromyalgia, it's important to make sure your thyroid hormone levels are at their optimal levels before making a fibromyalgia diagnosis.

Even if your thyroid tests came back normal in the past, your doctor might repeat the tests if your fibromyalgia symptoms are getting worse or not improving with treatment. This is to make sure nothing has changed in your thyroid function that could be contributing to your symptoms.

What is the treatment for hypothyroidism and fibromyalgia?

The most important thing you should know is that neither hypothyroidism nor fibromyalgia can be cured. Treatment for both conditions aims to ease your symptoms and improve your quality of life.

Doctors often prescribe medications for you to deal with two medical conditions simultaneously. But you should be aware that many drugs can react with each other, leading to unwanted side effects or reducing their effectiveness.

Thus, it's best to discuss with your doctor all the medications you're taking and the intervals to take them separately.

Treatment for hypothyroidism

Taking thyroid hormone replacement medication is the main treatment for hypothyroidism. Levothyroxine, a synthetic version of the hormone T4, is a popular prescription choice for many doctors. However, this medication doesn't work effectively on everybody since some people can't convert T4 to T3 properly. This conversion is necessary because most of the hormone T4 is inactive while T3 is active and affects metabolism.

For patients who have difficulty converting T4 to T3, taking levothyroxine only leads to the worsening of their hypothyroidism symptoms. In this case, the best alternative is natural desiccated thyroid (NDT). It contains all the natural thyroid hormones your body produces, including T4, T3, T2, T1, and Calcitonin. Therefore, it doesn't exclusively rely on T4 to T3 conversion. There are numerous brands of NDT out there, including VitaliThy, a natural desiccated thyroid you can buy online.

Treatment for fibromyalgia

Your doctor will likely recommend you take medications that can improve your sleep and reduce the pain of fibromyalgia. These may include pain relievers, antidepressants, and anti-seizure drugs.

Aside from taking medications, there are also therapeutic options to alleviate the impact of fibromyalgia on your life. Some options include:

  • Physical therapy to improve strength, flexibility, and endurance through targeted exercises, including water-based activities.

  • Occupational therapy to make modifications to your work environment or task approach that reduce stress on your body.

  • Counseling to build confidence and learn coping strategies for managing stress.

Can lifestyle changes help treat both conditions?

If you have both fibromyalgia and thyroid problems, lifestyle changes may help make you feel better. Making small adjustments to your daily routine could have a big impact on how well you manage the conditions. It's important to note, however, that these lifestyle changes shouldn't be seen as replacements for medical treatments prescribed by your doctor. They should complement those treatments and help ease symptoms in the long run - not provide a replacement for medication or other therapies.

Improve your diet

A healthy diet is important for everyone, but it can especially help people with thyroid disease and fibromyalgia improve their symptoms. Specifically, you should avoid the following foods:

  • Processed foods often contain sugar, unhealthy fats, additives, and sodium, which increase the risk of high blood pressure and inflammation.

  • Sweets high in sugar encourage excessive stress, leading to obesity and worse pain.

  • Alcohol damages the thyroid gland, causing inflammation and adverse side effects when taken with medications.


Regular exercise is beneficial for people with hypothyroidism and fibromyalgia. Any activity, even walking, can help improve the common symptoms of both conditions, such as chronic fatigue syndrome, trouble sleeping, depression, joint pain, and myofascial pain syndrome. Additionally, exercise boosts metabolism in people with hypothyroidism, leading to better weight loss.

However, everyone's physical health is different. Therefore, you should not exert yourself when exercising because it can make you feel uncomfortable and tired, even making fibromyalgia symptom severity worse.

Most importantly, you must understand your own abilities and observe your body's energy levels regularly to adjust the intensity of your exercise accordingly. The advice is to start with very light exercises and slowly increase the difficulty and number of activities.

Reduce stress

While stress is a part of anyone's life, it is strongly linked to hypothyroidism and fibromyalgia. Specifically, stress makes the two medical conditions worse. Moreover, both conditions often increase the stress level in the sufferer.

Therefore, learning how to manage stress is essential. You can learn and develop coping skills and emotional resilience in medical centers. In addition, other therapies, such as meditation, talking with loved ones, taking time for yourself, etc. also considered useful. If you find it too difficult to manage stress on your own, you can seek professional help.

Get better sleep

Pain, fatigue, or anxiety are all symptoms of hypothyroidism and fibromyalgia, which disrupt sleep. As a result, hypothyroid and fibromyalgia patients often do not feel well-rested, worsening other symptoms of both diseases.

Sleep is a wonderful natural medicine. This is the time when the toxins in your body are eliminated, and tissues are repaired. Therefore, it's important for you to build good habits to sleep better every night. You should practice

  • Do not use smartphones or laptops at least 1 hour before bedtime.

  • Avoid eating late at night or snacking.

  • Limit alcohol, coffee, or spicy foods with dinner.

  • Go to bed and wake up at the same time every day.

  • Get enough sleep, 7 to 8 hours a day.

  • Don't nap to make it easier to fall asleep at night.

  • Practice relaxing activities before bed, like listening to soft music or a warm bath.

If the tips above don't seem to work for you, you should talk about your sleep problems with your healthcare provider or see a sleep specialist.

Conclusion: hypothyroidism and fibromyalgia are closely linked but manageable with medications

Understanding the relationship between hypothyroidism and fibromyalgia can be beneficial in the management of the condition.

The most important thing in your treatment is taking the correct medication. Supplementing your body with T4 and T3 using an NDT supplement like VitaliThy can help you alleviate hypothyroidism symptoms. Moreover, taking the right medications, like pain relievers, can provide much-needed relief from fibromyalgia symptoms. By taking these medications properly and combining them with healthy lifestyle changes, it is possible to effectively manage both conditions and lead a healthy and fulfilling life.

Wojciech Majda
Wojciech Majda

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