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Hypothyroidism and Joint Pain 

Learn how to reduce hypothyroidism symptoms like joint pain in this article.
Hypothyroidism and Joint Pain 
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The thyroid gland produces hormones that impact every cell in the human body. When your thyroid hormones are low, virtually every system in the body is impacted, including your bones, muscles, and joints. People with untreated hypothyroidism can suffer from joint pain that may interfere with their ability to work, exercise, and function in their daily life. Even with medical treatment, joint pain can still be a problem for some hypothyroid patients.

What is hypothyroidism?

Hypothyroidism is a thyroid condition where the thyroid gland does not produce enough thyroid hormone. The thyroid is a small butterfly-shaped organ at the nape of your neck. Although small, this endocrine gland plays a significant role in regulating cellular metabolism and energy production. Thyroid hormones even help manage your blood pressure, heart rate, and body temperature.

The most common cause of hypothyroidism in the United States is Hashimoto's thyroiditis—an autoimmune condition where your immune system mistakenly attacks your thyroid cells. Over time, chronic inflammation of the thyroid makes cells unable to produce sufficient quantities of thyroid hormones.  Every bodily system is affected when thyroid hormone levels are low.

Common symptoms of hypothyroidism include:

  • Brain fog
  • Depression and sadness
  • Fatigue
  • Peripheral neuropathy
  • Cold intolerance
  • Thinning hair
  • Dry skin or flaky skin
  • Goiter (enlarged thyroid gland)
  • Elevated cholesterol levels
  • Weight gain
  • Heartburn
  • Gallstones
  • Stomach bloating
  • Constipation
  • Irregular menstrual period
  • Infertility
  • Joint pain or joint stiffness
  • Muscle weakness or muscle pain

If hypothyroidism is left untreated, it can lead to many health conditions, including heart disease, osteoporosis, and even infertility. Some people can develop a secondary medical condition caused by hypothyroid symptoms. For example, people that suffer from joint pain may be more likely to gain weight, which can lead to metabolic syndrome.

Why does hypothyroidism cause joint pain?

Thyroid hormones impact tissue development

Hypothyroidism can cause musculoskeletal symptoms ranging from general muscle and joint aches to true muscle disease or arthritis. Thyroid hormones play an essential role in the development of many tissues - including the reproduction and growth of bone and cartilage, at the cellular level. Most reported cases of joint pain and symptoms in adult hypothyroid patients involve the knees and hands.

More than one autoimmune condition

Another possible explanation for symptoms of joint pain with hypothyroidism could be polyautoimmunity, which is the presence of more than one autoimmune disease in a single patient. People with autoimmune thyroid disease are sometimes diagnosed with other autoimmune conditions, too. While the coexistence of autoimmune diseases is not well understood, genetics may play a large role.

Research finds that rheumatoid arthritis (RA) is a common coexisting autoimmune disease in people with Hashimoto's. There appears to be a connection between underactive thyroid and autoimmune conditions that affect your joints, such as rheumatoid arthritis (RA).

Fluid retention in the joints

Most autoimmune conditions cause inflammation in the body due to the hyperactivity of the immune system. Often in people with hypothyroidism, fluid can build up in the interstitial compartments (also called "tissue spaces") surrounding tissue cells, which can retain water and cause possible weight gain. This swelling can occur when the body experiences inflammation. Fluid accumulation in tissues surrounding the nerves can lead to compression resulting in nerve damage, which can lead to pain and stiffness.

Other possible causes of hypothyroidism joint pain

Joint pain is common in many health conditions. Often, it is caused by some form of injury or trauma to the joint or muscles surrounding the joint. Even being sedentary can take a toll on your joints.

  • Arthritis
  • Bursitis
  • Tendonitis
  • Lupus
  • Infectious diseases like influenza and hepatitis
  • Bone or joint infection
  • Cancer
  • Fibromyalgia
  • Overuse of the joint
  • Injury
  • Fibromyalgia
  • Osteoporosis
  • Sarcoidosis
  • Gout

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Tips to reduce hypothyroidism joint pain

If knee pain is holding you back from doing the things you love, there are strategies to help decrease your hypothyroidism joint pain.

Manage your hypothyroidism

Finding the right type and dose of thyroid hormone replacement medication may be the first step to managing symptoms related to your thyroid dysfunction like joint pain. Remember, your thyroid impacts every cell in your body, and if you do not have enough thyroid hormone in your bloodstream, you can experience several unpleasant symptoms. If you have Hashimoto's thyroiditis, identify things that trigger inflammation for you, such as certain foods, stress, lack of sleep, or illness.

Identify other contributing factors

Joint pain is a symptom of hypothyroidism. However, it is also a hallmark symptom of many other health conditions. If you have Hashimoto's, you can be at greater risk of having RA. Other health conditions likely require additional treatment plans, so it is imperative to meet with your doctor to determine if you have any other conditions.

Start with low-impact exercises

Moving your body is essential, especially if you suffer from joint pain. However, it can be tough to do this if your body does not feel good. To get your joints and muscles moving, start with slower, low-impact activities such as water aerobics, biking, or walking.

Strengthen your muscles

Once you can tolerate low-impact exercises, you must strengthen the muscles around your joints. For example, if you suffer from knee pain, strengthening your leg muscles will protect and stabilize the joint. It can be helpful to work with a physical therapist to learn how to improve your muscles best when you have joint pain.  

Eat for your thyroid

Diet plays a significant role in your thyroid health, especially if you have Hashimoto's thyroiditis. People with autoimmune diseases may experience a worsening of symptoms if they eat foods that trigger inflammation and elevate their TPO antibodies. Consider trying a thyroid-friendly diet to reduce the severity of your thyroid symptoms, as well as to maintain a healthy weight.  

Reenergize with sleep

Moving your sore joints is already hard enough, but if you are tired, it can make exercise feel like an impossible feat. Exercise can help you feel more energized, so focus on getting enough quality sleep to help you get moving.

Reduce stress

Finding ways to decrease stress in your life will have significant benefits for your body, mind, and spirit. When we experience high stress in our daily lives, it can take a toll on our bodies—joints included. Try to de-stress by cutting out busyness, unnecessary tasks, and sources of stress. Consider incorporating stress-relieving activities such as meditation, yoga, journaling, or find a creative outlet.

Manage your weight

People with hypothyroidism can suffer from weight gain because of a slowed metabolism. However, joint pain can also contribute to weight gain because it can be painful to exercise. Indeed, it is a vicious cycle because weight gain causes more stress, and therefore pain, on the joints.

A note from Paloma Health

Hypothyroidism is typically treatable with thyroid hormone replacement medication is usually the first step in minimizing symptoms like joint pain. Work with a trustworthy healthcare team and thyroid doctor who can assess your symptoms, medical history, and lab results to determine the best thyroid treatment plan for you.

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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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