Hypothyroidism and Hyperthyroidism and joint pain

When someone is diagnosed with hypothyroidism or hyperthyroidism they typically display many symptoms. Joint pain being one.

Hypothyroidism

Hypothyroidism can be caused by many problems and is a situation where the thyroid gland is not producing sufficient amounts of thyroid hormones for the body to run on. Weight gain, fatigue, and joint pain are among the many symptoms. There is also a controversy in medicine over the role of “subclinical hypothyroidism.”  Subclinical hypothyroidism is suggested in a patient when thyroid-stimulating hormone (TSH) tests come back slightly above the normal range but below the average range needed for a hypothyroid diagnosis.

A 2017 paper (1) from Bukovinian State Medical University in Ukraine studied the function of the thyroid gland in patients with osteoarthrosis, the incidence and forms of hypothyroidism, and their effects on the clinical treatment of osteoarthrosis. A complex examination involved 312 patients with osteoarthrosis aged 37-76 years.

  • Clinical hypothyroidism was found in 4.44% and subclinical hypothyroidism in 13.78% of patients.
  • Hypothyroidism contributed to the deterioration of the course and outcome of the treatment of osteoarthritis.
  • Manifestations of hypothyroidism were observed in patients with osteoarthritis with its significant systemic manifestations, and high comorbidity rate, in individuals aged over 50, especially 60 years, mainly in women (83,72%).
  • In patients with osteoarthritis aged over 50 years with a high comorbidity rate, it is advisable to conduct an ultrasound examination of the thyroid gland, to measure the levels of TSH, and free thyroxine in order to diagnose hypothyroidism early and to treat it timely as one of the ways to improve the overall outcomes of the treatment of osteoarthritis patients.

A February 2022 study in The Journal of Arthroplasty (2) analyzed the potential influence of subclinical hypothyroidism on improvement in patient-reported outcome measures following primary total knee replacement. What the researchers found was that “Subclinical hypothyroid patients have a slower functional recovery than (normal thyroid) patients, and trended toward lower improvements in patient-reported scores. Depression was the most important negative factor.”

Hyperthyroidism

Hyperthyroidism or overactive thyroid is a condition of too much thyroid hormone. Hyperthyroidism increases and sometimes superaccelerates the body’s metabolism. That can cause many symptoms, such as weight loss, hand tremors, and rapid or irregular heartbeat.

A July 2022 study published in the European Journal of Medical Research (3) “observed that higher FT3 (free triiodothyronine)  and FT4 (free thyroxine) levels were associated with an increased risk of osteoarthritis. In this paper, it is explained that too much T3 could stimulate cartilage breakdown through mineralization and degradation.

An October 2023 study published in the journal Endocrine (4) suggested that rheumatoid arthritis on autoimmune hyperthyroidism symptom severity could be predicted by how much each condition acted upon the other. The worse or untreated rheumatoid arthritis could be based on the treatment of hyperthyroidism. Conversely, how well hyperthyroidism was managed could impact and lessen the severity of the rheumatoid arthritis symptoms.

We commonly ask patients to check the following hormone levels to help optimize healing

We commonly ask patients to check the following hormone levels to optimize health, healing, and aging: thyroid, TSH, DHEA, pregnenolone, estrogen, progesterone, testosterone, melatonin, and cortisol at least to start. For the person with chronic pain, it is very likely that at least one of these levels will be suboptimal.

References

1 Voloshyna L, Doholich О SI. Hypothyroidism–a special comorbidity factor in patients with osteoarthrosis: clinical, pathophysiological and prognostic aspects. Georgian Med News. 2017 Nov 1;272:53-9. [Google Scholar]
2
Gonzalez-Navarro B, Gonzalez-Parreño S, Perez-Aznar A, Miralles-Muñoz FA, Lizaur-Utrilla A, Vizcaya-Moreno MF. Negative Influence of the Subclinical Hypothyroidism on Improvement in Patient-Reported Outcomes After Total Knee Arthroplasty. The Journal of Arthroplasty. 2022 Feb 1. [Google Scholar]
3 Chen S, Sun X, Zhou G, Jin J, Li Z. Association between sensitivity to thyroid hormone indices and the risk of osteoarthritis: an NHANES study. European Journal of Medical Research. 2022 Dec;27(1):1-8. [Google Scholar]
4 Liu X, Yuan J, Wang X, Tang M, Meng X, Zhang L, Wang S, Zhang H. Association between rheumatoid arthritis and autoimmune thyroid disease: evidence from complementary genetic methods. Endocrine. 2023 Oct 26:1-8. [Google Scholar]

 

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