I hear from so many Hypothyroid Mom readers struggling with chronic pain. Doctors often completely overlook their thyroid as a possible culprit.
Written by Jessica Drummond, MPT, CCN, CHC, Integrative Pelvic Health Institute
After practicing as a physical therapist for more than a decade, I understand how frustrating and challenging it can be for anyone to live with and to overcome chronic pain. Pain was once thought of as a very specific signal of tissue damage. You might remember the image from high school biology of a person touching a hot fire and then sending a oneway signal up to the brain to illustrate that the brain “gets the signal” that the pain is a sign of damage to the poor person’s burnt finger. We now understand that pain is a nonspecific signal both to the brain from the body and from the brain to the body.
Pain often feels more intense and more diffuse when the person is fearful, under stress, is lacking support, has difficulty detoxifying, has a hormone or autoimmune issue, or has a history of an injury or pain condition in the area where the pain is occurring. Pain can feel less intense if the person experiencing it has more support, better access to healthcare, or a clearer understanding of the pain as being a nonspecific signal indicating that something needs to change (it may be physical or emotional, or both), but not necessarily that there is a serious, life threatening tissue or organ damage in the area. In fact, right now I have a burn on my arm that doesn’t hurt at all. While someone else is currently experiencing real, severe pain for which she and her doctors have been unable to find any underlying cause.
Now, in my functional nutrition practice, I look at the body through a far wider, more holistic lens. Pain can be a symptom that results from complex interactions between systems, not just as the result of an inflamed nocioceptor (pain sensing nerve) in the skin or organ.
For example, one of my recent clients dramatically reduced her chronic pelvic pain (for her that included bladder pain and pelvic floor and vulvar pain) by employing an interdisciplinary approach. Her tools and support included hands on physical therapy treatment to the muscles of her pelvic floor, making specific recommended changes to her diet, using regular guided imagery and other strategies to induce relaxation, changing her perspective on her grown daughter’s life choices, sharing the cleaning duties more with her younger children, and working through her intimacy challenges with her partner.
What does pain have to do with your thyroid health?
The thyroid is an essential part of the endocrine system, and as early as 1959, through the 1970’s, and as recently as 2008, cases have been reported in the medical research of patients presenting with chronic, generalized muscle pain in multiple parts of the body, including the wrists, back, upper back, arms, legs, neck and ankles[1. Wilson, J, Walton, JN. Some muscular manifestations of hypothyroidism. J Neurol Neurosurg Psychiatry. 1959 Nov;22:3204][2. Golding, D. Hypothyroidism presenting with musculoskeletal symptoms. Ann Rheum Dis. 1970 Jan;29(1):104][3. Sbrocchi AM, Chédeville G, Scuccimarri R, Duffy CM, Krishnamoorthy P. Pediatric hypothyroidism presenting with a polymyositislike syndrome and increased creatinine: report of three cases. J Pediatr Endocrinol Metab. 2008 Jan;21(1):8992] related specifically to diminished thyroid function. In many of those cases, the pain was made worse with exposure to cold weather and was sometimes combined with fatigue, cramping, numbness or tingling. In the more recent cases, muscle enzymes were found to be elevated and creatinine increased. In some of these cases, when the patients were simply treated with thyroid hormone, the pain resolved. But, it’s not always that simple.
In many cases of chronic pain, there are multiple systems involved. The pain can stem from an autoimmune response to a food that the person ate that she was sensitive to, especially if she was also struggling with digestive issues like intestinal permeability (leaky gut) or an imbalance in the healthy vs. infectious bacteria in her digestive system.[4. Shaoul R, Lerner A. Associated autoantibodies in celiac disease. Autoimmun Rev. 2007 Sep;6(8):55965. Epub 2007 Mar 6] Any kind of inflammation that starts in the digestive system can travel via the inflammatory messengers (cytokines) through the bloodstream to fire up pain in the muscles and joints of the arms, legs, pelvis, back or neck. The inflammatory cytokines can also cause inflammation in the brain, which can make a person more sensitive to pain or make the stress response system more sensitive, which can contribute to the pain feeling more severe.
With abnormal stress response and adrenal dysregulation the combination of fatigue and pain are common. If you have a previous or concurrent autoimmune diagnosis (such as Hashimoto’s), the underlying endocrine (hormone) system issues are even more likely related to the fatigue, and muscle and joint pain.[5. Greenfield JR, Samaras K. Evaluation of pituitary function in the fatigued patient: a review of 59 cases. Eur J Endocrinol. 2006 Jan;154(1):14757]
The research on the connection between the thyroid and pain supports the theory that chronic pain of the joints, spine, muscles or pelvis is a common symptom of autoimmune thyroid issues such as postpartum thyroiditis or Hashimoto’s. In some cases, the pain is the only reported symptom. Once these patients are further assessed, thyroid antibodies are commonly found in addition to abnormal blood levels of free T4 and/ or free T3. Pain syndromes and autoimmune issues are commonly associated in the research. For example, women who struggle with endometriosis have much higher rates of autoimmune and endocrine disorders including autoimmune hypothyroidism.[6. Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P. High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Hum Reprod. 2002 Oct;17(10):271524]
Holistically nourishing your thyroid with supportive nutrients, thyroid medications, supplements, mind-body practices to induce relaxation and reduce the sensitivity of the brain and endocrine system to stress, coaching to minimize emotional stressors and improve resilience, detoxification strategies to minimize the toxic load on the thyroid, and nutrition plans that reduce exposure to food sensitivities and support digestive healing can all be useful tools for healing complex chronic pain.
If you have chronic pain, what can you do to start feeling better today?
1. Recognize that your pain is a signal that something is out of balance in your life (it could be your thyroid or something else), it’s not a clear signal about the location or severity of a tissue or organ damage. This is really important because it means you can be less afraid of your pain and instead use it as a guide to help you to find relief. Are there times when you feel better? Does eating certain foods or performing certain kinds of exercise or activity or being around certain people make your pain feel better or worse? Start tracking your pain in a journal and especially note times when your pain improves or resolves. Those are clues along your healing path.
2. If you have pelvic pain, have you seen a specialist physical therapist to assess the muscles and joints of your pelvis and pelvic floor? Even if you have never had children (or are a man), tight muscles in your pelvic floor can cause you to feel pain in other areas of your pelvis and may make you feel like your back, bladder or reproductive organs are injured.
3. If you know that you have an autoimmune thyroid condition or that your endocrine system is otherwise stressed (as in adrenal fatigue), reduce your sugar intake and increase your intake of selenium. In research on pregnant women, by adding 200 mcg of selenium daily through the pregnancy, the women reduced their incidence of both postpartum thyroiditis and permanent autoimmune thyroiditis.[7. Negro R, Greco G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H. The influence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies. J Clin Endocrinol Metab] I would generally recommend selenium in a multi-vitamin. Here’s one of my favorite recipes that includes Brazil nuts, which are very high in selenium…Brazil Nut and Rocket Pesto from Deliciously Ella.
About Jessica Drummond
Jessica Drummond, MPT, CCN, CHC, the Founder and CEO of Custom Hormone Healing and The Integrative Pelvic Health Institute, is passionate about caring for and empowering women who struggle with women’s health conditions such as endometriosis, PCOS, bladder pain, low libido, hormonal imbalances, weight gain, period pain, painful sex, and post-surgical, orthopedic, or pregnancy related pelvic conditions. She is equally passionate about educating and supporting clinicians in confidently and safely using integrative tools to treat chronic pelvic pain, bowel and bladder, and other women’s health issues.