Hypothyroidism and Joint Pain

Hypothyroidism and Joint Pain: A Clear Connection


Although hypothyroidism is more typically associated with myopathy (muscle pain, stiffness and weakness), hypothyroidism and joint pain can also be related in some people.  Normally the types of joint pain seen in hypothyroid patients includes:

  • Pain and stiffness in joints, notably knees and hands/wrists in adult patients
  • Swelling in the small joints of the feet and hands

Unfortunately having hypothyroidism, particularly the most common type, increases your chances of developing other types of autoimmune conditions, particularly rheumatoid arthritis.  In fact, although science doesn’t exactly know why, RA and hypothyroidism often go hand in glove.  Therefore, some joint pain experienced with hypothyroidism may be caused by one of these other conditions, particularly RA.

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How Are Hypothyroidism And Joint Pain Related?

As we’ve mentioned in other articles, thyroid hormones play a role at some point in many bodily functions.  From metabolism to heart function, your lungs, your reproductive system and more – malfunctions in the thyroid gland have the potential to severely disrupt these systems.  Indeed, science is continually discovering more and more ways in which thyroid dysfunction affects other organs and processes.  They’re also finding more evidence that hypothyroidism and joint pain are related.

One process that thyroid hormones are known to be involved in is the production and delineation of bone and cartilage tissue cells.  Research has shown that a drop in thyroid hormones has a detrimental effect on this process, causing tissue abnormalities that result in, or assist, the development of conditions like:

  • aseptic necrosis
  • epiphyseal dysgenesis (juveniles)
  • various joint diseases that produce a thick non-inflammatory fluid, predominantly in the wrists, hands and knees
  • potentially also crystal-induced arthritis

It’s also been noted that painful joints can appear with hypothyroidism without there being any underlying joint disease.  In these cases, thyroid treatment should largely resolve the joint pain.  If you’re receiving medical treatment for hypothyroidism and it doesn’t improve your muscle and joint pain, chances are they’re caused by something else.

Other side effects of hypothyroidism, such as weight gain, can also put pressure on joints, resulting in increased chances of developing associated joint problems.

Interesting Questions about Thyroid:

What are Autoimmune Thyroid Diseases?

The leading cause of hyperthyroidism is an autoimmune disease called Graves’ Disease.

The leading cause of hypothyroidism is an autoimmune disease called Hashimoto’s thyroiditis.

Autoimmune diseases in general

Autoimmune diseases tend to run in families. In other words, there is a strong genetic predisposition to develop one or more autoimmune diseases. Females are affected five times more than men by autoimmune disease. Patients with other autoimmune diseases are more likely to develop autoimmune thyroid diseases.

Researchers are trying to unlock the mysteries of autoimmune diseases, but there are still many unanswered questions. Basically an autoimmune disease occurs when the immune system produces antibodies that attack healthy tissues. In Graves’ disease, the immune system produces anti-thyroid antibodies that cause the thyroid gland to make too much thyroid hormone. In Hashimoto’s thyroiditis, antithyroid antibodies damage the thyroid gland and prevent it from producing enough thyroid hormone.

Autoimmune diseases associated with a higher than normal rate of thyroid autoimmune diseases

  • vitiligo (patchy loss of skin coloration)
  • alopecia areata (sudden, circular hair loss)
  • premature gray hair
  • pernicious anemia (inability to absorb B12)
  • rheumatoid arthritis
  • myasthenia gravis (episodic muscle weakness that can affect vision, speech, swallowing, and breathing )
  • Lupus erythematosus ( connective tissue disorder)
  • insulin-dependent diabetes
  • Addison’s disease (adrenal insufficiency)
  • premature ovarian failure

Tests for antibodies present in autoimmune thyroid disease

  • TPOab (thyroperoxidase antibodies)
  • TGab (thyroglobulin antibodies)

One of these two types of antibodies is found in nearly all patients with Hashimoto’s thyroiditis and in approximately 50% of patients with Graves’ disease.

  • TRab (thyrotropin receptor antibodies; also called thyroid stimulating immunoglobulins or thyroid stimulating antibodies.)
What is Hyperthyroidism?

Hyperthyroidism makes the body speed up. It occurs when there is too much thyroid hormone in the blood (“hyper” means “too much”). Nearly 10 times more frequent in women, it affects about 2% of all women in the United States.

The most common cause of hyperthyroidism, Graves’ disease, is caused by problems with the immune system and tends to run in families. It affects at least 2.5 million Americans, including Olympic athlete Gail Devers who won a gold medal in track after being diagnosed with and treated for Graves’ disease.

Symptoms include:

  • fast heart rate
  • nervousness
  • increased perspiration
  • muscle weakness
  • trembling hands
  • weight loss
  • hair loss
  • skin changes
  • increased frequency of bowel movements
  • decreased menstrual flow and less frequent menstrual flow
  • goiter
  • eyes that seem to be popping out of their sockets.

The symptoms of hyperthyroidism rarely occur all at once. However, if you have more than one of these symptoms, and they continue for some time, you should see your doctor.

What is a Goiter?

A goiter is an abnormal swelling in the neck caused by an enlarged thyroid gland. It can become quite large. The problem occurs in at least 5% of the population.

Worldwide, the most common cause of a goiter is lack of iodine, a chemical which the thyroid uses to produce its hormones. About 100 million people don’t get enough iodine in their diets, but the problem has been solved in the United States and most developed countries by adding iodine to salt.

Even with the right amount of iodine, the thyroid gland can swell, creating a goiter. This can occur in any type of thyroid disease, including hyperthyroidism, hypothyroidism, thyroiditis, and thyroid cancer. Many goiters develop with normal thyroid hormone levels and do not require treatment.

Have more questions? Need more answers? Check our Full Thyroid FAQ

Reducing Joint Pain

Treating joint pain with regular pain killers like ibuprofen and acetaminophen will help reduce inflammation and the pain associated with this.  However, if the joint problems are being caused by hypothyroidism, the only really effective way to cure it is by treating the underlying condition with thyroid replacement therapy.

The most common form of hypothyroidism is classed as an autoimmune disease and autoimmune diseases tend to ‘hunt in packs’.  Rheumatoid arthritis and hypothyroidism in particular like to hang out together, as we’ve mentioned previously!  Generally speaking, if you have one you stand a far greater chance of developing the other one, particularly if the original is not diagnosed and treated fairly early.  Determining which one is actually causing your joint pain is a process of elimination.  Thyroid treatment will resolve joint pain caused directly by hypothyroidism but RA treatment requires different treatment.