Living with chronic pain is a frustrating and sometimes debilitating experience and many suffer from chronic pain without knowing why. One contributing element to chronic pain that is frequently overlooked is thyroid disease. Thyroid dysfunction can prolong the duration and intensify pain and lingering discomforts. Therefore, understanding the influence of the thyroid and recognizing the importance of proper diagnosis and treatment is vital to resolving chronic pain.

The Thyroid Connection to Chronic Pain

The thyroid is a small butterfly-shaped gland in the neck. This important part of the endocrine system interacts with nearly every cell in the body through the use of hormones. Limited thyroid function, also known as hypothyroidism, can cause musculoskeletal pain that is easily misidentified as chronic disorders such as fibromyalgia and chronic fatigue syndrome (CFS).

It is becoming increasingly clear, as research is continuing to be done, that chronic pain and thyroid dysfunction are related. This should not be surprising as chronic disorders and hypothyroidism share many similar symptoms including: pain in the back, joints, and hips, tenderness of muscles, extreme fatigue, and fluctuations in weight.


Small Gland, Big Impact

The thyroid is part of the hypothalamic-pituitary-adrenal (HPA) axis, which regulates many bodily functions. The relationships and interactions of the HPA axis strongly influence the body’s stress response, digestion, immune function, energy level, emotions, and more. If any part of the HPA axis, such as the thyroid, falls out of balance, significant dysfunction may develop.

Multiple studies have found that dysfunction of the HPA axis is a prominent component in the development of painful chronic disorders, specifically CFS and fibromyalgia. A commonality found among a large percentage of patients with these conditions is thyroid dysfunction. Dr. John C Lowe, a prominent thyroid researcher, found that most patients with fibromyalgia have an undiagnosed thyroid condition or do not receive appropriate thyroid care and treatment. Restoring thyroid function may lead to resolving conditions that cause chronic pain.

Properly Diagnosing Thyroid Dysfunction

Because of its broad and seemingly vague symptoms, hypothyroidism is often misdiagnosed. Furthermore, poor testing methods and improper reading of results frequently cause doctors to overlook and discount the possibility of thyroid dysfunction. This frequently results in patients suffering from lasting pain and system-wide disruption with little chance of improvement.

Part of the current problem with diagnosis is a misunderstanding regarding thyroid blood levels and tissue levels. “Normal” blood levels of thyroid hormone may not reflect thyroid hormone levels in cells and tissues. Part of this may be because of poor transport or receptivity. If thyroid hormone cannot enter and affect cells or tissues, hypothyroidism is likely to develop.

Poor transfer of thyroid hormone into cells and tissues may be because of thyroid resistance, which is a common component of CFS and fibromyalgia. With thyroid resistance, thyroid blood tests may appear normal even though the body isn’t benefiting from the hormones in the bloodstream. To accurately assess thyroid function, testing must determine how well thyroid hormones are interacting with cells and tissues.

Sadly, most physicians rely solely on serum levels of TSH Thyroid-Stimulating Hormone), which is not an adequate metric for assessing actual thyroid activity. The TSH test only gauges how well the body is communicating its need for thyroid hormone and does not accurately determine thyroid production, availability, or levels of T4, T3, and Reverse T3 in the blood or tissues. Without assessing these various components, it is not possible to get an accurate representation of thyroid function.

Effective thyroid testing should include the following selection of tests:

  • TSH—Communicates how much thyroid hormone needs to be produced
  • Free T4—The inactive or storage thyroid hormone
  • Free T3—The active form of thyroid hormone
  • Reverse T3—The mirrored and inhibitory form of T3
  • Ratio of Free T3 and Reverse T3—An excess of reverse T3 can cause poor thyroid activity
  • Sex Hormone Binding Globulin (SHBG)—A marker for tissue levels of thyroid hormone
  • Thyroid Antibodies—Attacks thyroid proteins and causes inflammation. Also indicates autoimmune dysfunction if found in excess.

Learn more about proper thyroid testing in this video from Dr. Kent Holtorf.

The Importance of Proper Treatment

To ease chronic pain and discomfort, it is often necessary to restore thyroid function. Unfortunately, many receive inadequate treatment that results in imbalances that sustain long-term pain, discomfort, and chronic conditions such as CFS and fibromyalgia.

Many patients are treated with synthetic thyroid medications in the form of Synthroid and Levothyroxine. These treatments often result in patients achieving “normal” TSH levels while continuing to experience symptoms of thyroid dysfunction and lingering or chronic pain. Sadly, many doctors are unwilling to dig further and rely solely on inadequate TSH testing to assess the wellness of a patient’s thyroid. To fully restore thyroid function and resolve chronic pain, proper diagnosis and medication must be employed.

Dr. Lowe conducted a study to assess the efficacy of thyroid medications. The test population was composed of thyroid patients suffering from chronic pain who were being treated with T4 only medications (Levothyroxine and Synthroid). Approximately two-thirds of the participants experienced improvement of their symptoms through the use of Natural Desiccated Thyroid Hormone (NDTH) treatments. The remaining third showed improvement with additional T3 therapies. Lowe’s study suggests that traditional T4 treatments that promote “normal” hormone levels according to TSH testing are not enough to resolve thyroid-related discomfort and chronic pain. Additionally, using medications containing T3 are highly beneficial in resolving both thyroid dysfunction and chronic pain and should be employed when possible.

Support the Thyroid and Snuff Out Chronic Pain

The thyroid is closely related to the HPA axis, which has a powerful influence over many bodily functions. Disruption of the thyroid can cause significant imbalances, prompting the development of chronic pain and further conditions. To appropriately treat these issues, effective diagnosis, testing, and treatment must be done to optimize individual thyroid function and activity. Maintaining a healthy thyroid is an important part of overall wellness and may also be the key to resolving chronic pain.

To learn even more about thyroid function and proper thyroid support, read our Thyroid 101 e-book!

At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to properly diagnose and treat your thyroid condition, optimize your health and improve your quality of life. If you have been diagnosed with hypothyroidism, but aren’t getting the treatment you need or if you have symptoms associated with thyroid dysfunction, contact us today to see how we can help you!

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