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Can Hypothyroidism Cause Neuropathy?

Learn the link between hypothyroidism and neuropathy.
Can Hypothyroidism Cause Neuropathy?
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More than 20 million people nationwide suffer from a condition called neuropathy. Neuropathy is a condition when the nerves located outside of the brain and spinal cord are damaged, resulting in weakness, numbness and pain usually felt in the hands and feet. More severe cases can also cause disturbances in digestion, urination, and circulation throughout the body. This article explores whether there is a connection between hypothyroidism and neuropathy. Does one cause the other, or is one a result of the other? Let’s dive in.

The physiology of neuropathy

Neuropathy or peripheral neuropathy (used interchangeably), stems from the peripheral nervous system. This system sends information from our brains and spinal cord to the rest of the body. Cases of peripheral neuropathy can be caused by traumatic injuries, infections, nutrient deficiencies, metabolic problems, diabetes, and exposure to toxins. Those with neuropathy experience sensory symptoms such as pain that is described as stabbing, burning, or tingling. Some experience motor symptoms such as muscle weakness and paralysis, muscle atrophy, and uncontrolled muscle movements. Others have autonomic symptoms such as blood pressure changes, trouble with sweating, gastrointestinal issues, sexual dysfunction, and changes to the eyes and sight.

Neuropathy and hypothyroidism

Some common signs of hypothyroidism include muscle weakness, mental sluggishness, and an intolerance to the cold. Patients tend to also develop numbness, decreased sensation, slowed muscle contractions, and a loss of reflexes. 

Are neuropathy and Hypothyroidism connected? Various studies have shown that there can often be a connection between neuropathy and hypothyroidism. A clinical study of a 58 year old woman who was admitted to the hospital with a history of progressive weakness in both lower extremities, had a 20-year history of hypothyroidism, and was being medicated with levothyroxine and metformin for type II diabetes. After careful examination of her symptoms and various tests, it was concluded that her peripheral neuropathy was caused by hypothyroidism

Another study of a 60 year old woman, resulted in the improvement of both thyroid function and neuropathic pain intensity. This patient initially complained of sensations of severe burning feet. After neurological examination, results demonstrated mild sensory neuropathy. Other exams showed subclinical hypothyroidism and over the course of 6 and 12 months, this patient began various therapy experiencing an improvement in both conditions concluding that even subclinical hypothyroidism is a possible cause of sensory neuropathy.

Can one cause the other?

So the question now bears - can hypothyroidism can and/or exacerbate symptoms of neuropathy? The short answer is yes. In most cases of untreated hypothyroidism, neuropathic pain can increase and become more severe. One of the reasons for this is because hypothyroidism can cause fluid retention, resulting in swollen tissues that can put pressure on the peripheral nerves. It is recommended that maintaining a healthy weight can help to strengthen affected limbs.

A study out of Kosar Hospital in Semnar, Iran evaluated the case of 154 patients - some with subclinical hypothyroidism and others with eurthyroid, or normal thyroid function. This study concluded that the severity of neuropathy was higher in those patients with subclinical hypothyroidism.

Nutrient deficiencies and neuropathy

Nutritional deficiencies can cause neuropathy or even exasperate already present symptoms due to damage of the peripheral nervous system. Vitamins such as B12, B6 and E as well as toxicity levels in mercury and arsenic should be evaluated. 

Patients with a Vitamin B12 deficiency can experience damage to the myelin sheath that surrounds and protects the nerves. Without this protection, the nerves cannot function properly, causing symptoms of neuropathy to occur. 

Nutritionally, vitamin B12 can be ingested through adequate sources of grass-fed red meat, poultry, eggs, and wild-caught fatty fish. Whereas toxicity of arsenic exposure can cause idle sensory dominant peripheral neuropathy.

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A note from Paloma

Treating either hypothyroidism or neuropathy begins first with preventative care. Early stages of either condition help to get a timelier start on both detection and treatment. Some of these symptoms and conditions can go undiagnosed, especially if the symptoms start mild. 

If you suspect that you might be experiencing one or the other, talk to your healthcare provider as soon as possible before symptoms worsen. It is also advised to consider nerve conduction studies in both motor and sensory nerves of the upper and lower extremities to rule out a neuropathy diagnosis. 

For adequate thyroid testing, the team at Paloma Health is always here to offer support and guidance so you can get the right care and lifestyle support you need and deserve.

Dealing with Hypothyroidism?  Video chat with a thyroid doctor

Get answers and treatments in minutes without leaving home - anytime. Consult with a U.S. board certified doctor who only treats hypothyroidism via high-quality video. Insurance accepted.


Peripheral neuropathy - Symptoms and causes. Mayo Clinic.

Peripheral Neuropathy Fact Sheet | National Institute of Neurological Disorders and Stroke. Accessed December 14, 2022.

Marcalo J, Araujo A, Faria C, et al. Peripheral neuropathy in hypothyroidism - about a clinical case. Endocrine Abstracts. Published online May 3, 2017. doi:10.1530/endoabs.49.ep1340

Penza P, Lombardi R, Camozzi F, Ciano C, Lauria G. Painful neuropathy in subclinical hypothyroidism: clinical and neuropathological recovery after hormone replacement therapy. Neurological Sciences: Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2009;30(2):149-151. doi:10.1007/s10072-009-0026-x

Reshdat S, Mehri M, Pourkalhor S, Najmaldin A, Foroutan M. Relationship between subclinical hypothyroidism and distal-symmetric diabetic polyneuropathy in type 2 diabetes mellitus referred to Kosar Hospital in Semnan and related indicators in 2019–2020. Journal of Family Medicine and Primary Care. 2022;11(4):1361-1368. doi:10.4103/jfmpc.jfmpc_1262_21

Beghi E, Delodovici M, Bogliun G, et al. the General Hospital of Monza during a 14-month period. Neurosurgery, and Psychiatry. 1989;52(1):1420-1423. doi:10.1136/jnnp.52.12.1420

Types of Peripheral Neuropathy - Systemic / Metabolic - Nutritional / Vitamin Deficiency.

Staff NP, Windebank AJ. Peripheral Neuropathy Due to Vitamin Deficiency, Toxins, and Medications. CONTINUUM: Lifelong Learning in Neurology. 2014;20:1293-1306. doi:10.1212/01.con.0000455880.06675.5a

Gupta N, Arora M, Sharma R, Arora K. Peripheral and Central Nervous System Involvement in Recently Diagnosed Cases of Hypothyroidism: An Electrophysiological Study. Annals of Medical and Health Sciences Research. 2016;6(5):261-266. doi:10.4103/amhsr.amhsr_39_16

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Neeyaz Zolfaghari

Holistic Nutritionist and Nourishment Coach

Neeyaz Zolfaghari is the founder of Unspoken Nutrition, a nutrition and lifestyle brand dedicated to helping others find and create harmony with their daily habits to support their wellbeing and ‘health’. Her journey began over a decade ago, when she was diagnosed with two autoimmune diseases. Knowing what she learned from her upbringing, Neeyaz turned to nutrition as the first pillar of her healing. As her body began to heal on a physical level, she began to learn how our minds, bodies and souls are all innately connected.  

Now as an Integrative Nutritionist and Patient Advocate, Neeyaz offers the people she works with the support, guidance, and tools they need in order to live a fulfilled life. While Neeyaz initially endeavored to make a difference at the individual level, her vision grew to embrace broader community impacts. She is currently pursuing her Masters in Public Health, serving as a testament to her unwavering commitment to instigate change on a grander scale.

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