Is your thyroid a pain in the butt? Healing chronic pain

Is your thyroid a pain in the butt?

I hear from Hypothyroid Mom readers all the time struggling with chronic pain. Do you struggle with this too?

Written by Cammi Balleck, CTN, ANCB Board Certified Naturopath

Are you in pain most of your life?

Exhausted every day?



Too tired to cook dinner? 

Up all night watching the Golden Girls?

I want to give you hope and help you CHOOSE LIFE. What is life unless you are able to enjoy it?

If you have heard the phrase “It could be Chronic Fatigue (CFS) or Fibromyalgia (FMS)” (or both) from your doctor, your friends, or maybe voices in your head as you try to self-diagnose yourself, learn this simple but powerful truth.

People with fibromyalgia or chronic fatigue are frequently hypothyroid or thyroid hormone resistant. However, it is often missed because their lab test appears to be normal. You guessed it “they came back in normal range”. The truth is, thyroid dysfunction has a connection with what we call fibromyalgia, and the conventional testing of Thyroid Stimulating Hormone (known as TSH) is useless in helping you know that.

So, unless today you are in a “fibro-thyro-fog”, I should have your attention. Yes your pain, fatigue, and brain fog are all connected. Did you know that conventional medicine guesses at treating Chronic Fatigue and Fibromyalgia with standard recommended treatments that don’t address the underlying pathophysiology, and that it is frustrating for most physicians as there is no clear etiology or treatment? On top of that (if you are on them you probably already know) the use of antidepressants and muscle relaxants are largely ineffective and have significant side-effects. Reliance on these medications results in a poor prognosis and is unsatisfying for both you and probably your doctor too.

So what the heck is Fibromyalgia anyway?

Well, WebMD’s definition is: Fibromyalgia is a chronic condition that causes pain, stiffness, and tenderness of the muscles, tendons, and joints. Fibromyalgia is also characterized by restless sleep, awakening feeling tired, chronic fatigue, anxiety, depression, and disturbances in bowel function. Fibromyalgia is sometimes referred to as fibromyalgia syndrome and abbreviated FMS.

The truth shall set you free:

• It is NOT that you are crazy
• It is NOT mental
• It is NOT from your mom
• It is NOT a disease of its own
• It is NOT only due to stress
• IT is NOT caused by just lack of sleep
• It is NOT something that just has to be managed with drugs
• It is NOT a drug deficiency
• Your diet does matter
• Your hormone balance does matter
• Your hypothalmus, pituitary, adrenals, thyroid, pancreas, and all their hormones do matter

The truth is that hypothyroidism, cortisol imbalances, HPA (hypothalamic-pituitary-adrenal) axis imbalances, nutritional deficiencies, and neuroendocrine imbalances can be the cause of your pain?

In many cases, fibromyalgia and chronic fatigue are simply a “symptom” of undiagnosed hypothyroidism or if you already have a low thyroid it can also be a cortisol imbalance, hormone resistance, or that your HPA axis isnt fully functioning.

Your doctor is probably treating symptoms or lab results (because most doctors do) and not looking at a whole body because they are not taught that approach. But new studies show that endocrine regulation (your hormone system including the thyroid) is considerably impaired in both FMS and CFS, with many hormonal mechanisms altered. Therefore, I recommend that your nutritional and neuroendocrine imbalances be targeted and worked on.

Remember we were created to be a “whole body”. When trying to feel better we must look at the whole body. We are not one thyroid gland working at home alone, we are many glands and hormones working in a very complex large factory. Every “boss” needs to tell each gland the “workers” what to do and every worker must do their job right for you to feel great, pain free, happy, peaceful, hopeful, and energized.

If you don’t have brain fog today and you want to know the science behind it all read on here. Secretion of hormones in the endocrine system is controlled either by regulators in a particular gland that detect high or low levels of a biochemical and inhibit or stimulate secretion or by a complex mechanism involving the brain, the hypothalamus, and the pituitary. You probably know what your thyroid does, but did you know the importance of the hypothalamus within the brain? It contains a number of small nuclei with a variety of functions. One of the most important functions of the hypothalamus is to link the nervous system to the endocrine system via the pituitary gland.

The hypothalamus actually controls the pituitary gland and it integrates many messages from parts of the brain based on feedback from all over the body and tells the pituitary what to do. Hormones triggered by the hypothalamus, released by the anterior pituitary flow into the general circulation for action in far parts of the body. Like the hypothalamus, anterior pituitary hormones are also controlled by negative feedback from the brain and the target organ. That is, when the target organ responds to the activating hormone from the pituitary, it will release its own hormone back into the blood, which will travel back to the brain through the circulatory system, which in turn triggers the hypothalamus to turn off production of the stimulating hormone in the anterior pituitary. For example, the pituitary stimulates the thyroid to release thyroid hormones, which travel throughout the bloodstream stimulating metabolism in select parts of the body as required. Through the negative feedback loop, the brain learns that the metabolism has been activated enough (in other words, that enough thyroid hormones have been released) and tells the hypothalamus/pituitary to stop stimulating the thyroid. Now you see how the “WHOLE” system needs to be working correctly.

Studies show the significance of the thyroid and hypothalamic-pituitary-adrenal (HPA) axis dysfunction in chronic fatigue syndrome and fibromyalgia.

HPA axis dysregulation = neurotransmitter imbalances

Neuroendocrine imbalances = pain and fatigue

What is the HPA axis?

The HPA axis is a complex set of feedback interactions among the hypothalamus, the pituitary gland, and the adrenals. These interactions form a major part of the neuroendocrine system, which controls
reactions to stress and regulates many body processes, such as digestion, immune function, mood, emotions, sexuality, and energy storage and expenditure. The HPA axis is the uniting system for interactions of the glands, hormones, and parts of the brain that mediate the general adaptation syndrome.

Studies that utilize central acting stimulation tests, including corticotropin-releasing hormone (CRH), insulin stress testing (IST), and Cortisol testing, have demonstrated that HPA axis dysfunction of central origin is present in a majority of these FMS and CFS patients (yes, even if your thyroid is in so called “range”).

In addition, this hypothalamic-pituitary dysfunction results in secondary hypothyroidism (as well as evidence of thyroid resistance), Thyroid hormone resistance began being investigated in the 1950s, yet many endocrinologists still have never heard of it or believe it’s a rare condition. Resistance to thyroid hormone is when body tissues do not respond normally to the thyroid hormones “they are ‘resistant’, just like your kid or puppy that has selective hearing. The boss is telling them what to do, but they are resistant. This is usually not detected with standard thyroid testing, however it has been associated with sleep disorders, immune dysfunctions, chronic infections, autonomic dysfunctions, and gastrointestinal dysfunctions in FMS and CFS patients.

There is ample evidence that there is HPA axis dysfunction of central origin in CFS and FMS. There is a complex interaction of HPA axis dysfunction in these patients, and it is becoming clear that the majority of the people I see that are suffering with CFS and FMS suffer also from cortisol dyregulation and thyroid dysfunction.

Musculoskeletal symptoms are commonly seen with hypothyroid patients including muscle weakness, pain, numbness, and arthritis. Analysis and correction of hormone imbalances is imperative to the successful treatment of musculoskeletal complaints.

Balancing Cortisol

One of the primary roles of cortisol in the body is to reduce inflammation and control an immune response. Cortisol secretion is intended to be short-term, to handle an acute situation and then return to baseline levels, however chronic stress and stimulation of the hypothalamic-pituitary-adrenal (HPA) axis can lead to a depletion of cortisol, allowing inflammatory processes to proceed uninhibited and lead to swelling, pain, and the destruction of tissue.

Under normal conditions, cortisol peaks before awakening and decreases throughout the day. When cortisol levels are low in the morning this can indicate HPA axis disruption. Cortisol measurement throughout the day can provide valuable clinical information. People who are under stress (so.. all of us) may have surges of cortisol throughout the day or in the evening.

HPA activation can also affect normal sleep cycles, and lack of sleep can alter HPA axis function and the glucocorticoid feedback loop. The goals should be to support the hypothalamus and pituitary with whole food nutritional supplements or herbs.

The foundational strategy of HPA axis optimization involves effectively testing the cortisol rhythm throughout the day followed by an appropriately-designed diet, lifestyle, and dietary supplement regimen.

What do I recommend?

Here are my tips with links to brands of supplements that can be found online and in stores (or contact me for recommendations). Always check with your healthcare practitioner about whether supplements are right for you.

  • Find an open-minded thyroid health care practitioner who looks at the “whole body” and is open to finding the right thyroid treatment option for you.
  • Replace modern processed foods with whole foods from nature.
  • Obtain regular exercise, such as yoga and weight bearing exercises with your own body weight a few times a week.
  • Establish regular bed times and SLEEP. (If you can’t sleep this can mean your HPA axis is off too. Read my Hypothyroid Mom insomnia article for recommendations.)
  • Practice relaxation activities (prayer, meditation, yoga, your favorite hobby, anything that fills your personal gas tank).
  • Stop smoking.
  • Avoid or limit alcohol.
  • Avoid and limit sugar consumption.
  • Identify and remove food intolerances and sensitivities.
  • Stop artificial sugar.
  • Take a high quality probiotic.
  • Get your carbs from fresh, organic vegetables. Eat high-quality protein.
  • Have healthy fats. Most people need anywhere between 50-75 percent fat in their diet.
  • Ashwagandha (Withania somnifera) has been shown in clinical studies to reduce stress and occasional anxiety in adults. A literature review demonstrated that ashwagandha exerts “positive influence on the endocrine, cardiopulmonary, and central nervous systems”.
  • Magnolia (Magnolia officinalis)
  • L-Theanine, an amino acid found in green tea, has been shown to inhibit cortical neuron excitation, thereby creating feelings of calm, supporting blood pressure already within normal limits, and improving mood.

About Cammi Balleck

Cammi Balleck, CTN is an ANCB Board Certified Traditional Naturopath. She has been called the leading Happy Hormone Doctor. She is the women’s health expert for Women’s Day, O, Prevention, Shape, and First Magazines as well as a featured expert for TBN, and FOX NEWS NATIONALLY. In addition she has made guest appearances on CW stations in Denver.


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About Dana Trentini

Dana Trentini founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. This is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes affiliate links including the Amazon Services LLC Associates Program.


  1. Can I take L-theanine with levithyroxin or do i need to wait a few hours? It would be so much easier if I could take them closer together.

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