Patients with autoimmune thyroid disease, should closely monitor their joint symptoms once on treatment for their hypothyroidism because if they have joint symptoms that result in significant swelling or pain that is more than mild to moderate, this could indicate the onset of Rheumatoid Arthritis, another autoimmune disease, that affects the joints.
There are blood tests, that help diagnose or rule out this disease specifically, the main one being called “Rheumatoid Factor”. Two others that are sometimes also used in addition to RA Factor, are the “ESR” ( Erythrocyte Sedimentation Rate), which checks for high levels of inflammation and the “ANA” (Anti-Nuclear Antibodies), which tests for autoimmune disease activity. One sign a patient can look for that might indicate Rheumatoid Arthritis is significant swelling and redness in a joint such as a hand, elbow, knee, etc…, that is affected equally on both sides of the body (symmetrical). In other words, with Rheumatoid Arthritis, this will manifest in both joints simultaneously, on both sides of the body. Unfortunately, having one autoimmune disease, such as Hashimoto’s, puts a patient at a higher risk for developing other autoimmune disorders and is why this joint pain aspect should be monitored.
The mild to moderate muscle pain with hypothyroidism, which can include cramping and spasms, in my belief, is due to a slowing down of all organs in the body, due to lack of thyroid hormone, which also regulates our metabolism. This causes blood circulation the become less adequate and so the muscles are not nourished by blood and oxygen as they should be. Strangely, some hypothyroid patients experience hypertension (high blood pressure) because the disease causes blood vessels to constrict but at the same time, they do not have proper blood circulation to some of their muscles because heart function is slightly reduced due to slowed metabolism. This affect, also causes symptoms in tendons and ligaments and many hypothyroid patients also complain of “Carpal Tunnel Syndrome” (hand/wrist) and “Tarsal Tunnel Syndrome” (feet).
If a patient has severe, ongoing muscle symptoms, they should seek further medical testing, as I also recommended for joint pain patients, to rule out possible Muscle Disease and Connective Tissue Diseases. Some of the same tests as mentioned above are used to help diagnose muscle disease but there are others as well, such as one called “Anti-Smooth Muscle Antibodies”. There are many Connective Tissue Diseases, including “Lupus” and some patients can experience “Overlap Syndromes”, meaning they are experiencing more than one type.
A well-informed Doctor is important when you are being treated for autoimmune hypothyroidism, one who understands the risks for other autoimmune disease disorders and one who can detect when symptoms may indicate something other than thyroid related ones. I have visited a few Doctors in the past who actually did not know that hypothyroidism caused joint and muscle pain! I have also known of other Doctors who did not recognize emotional symptoms as being thyroid related in patients they were treating but actually believe these were separate issues! A truly good, caring, well informed Doctor, is worth her/his weight in gold!
In conclusion I would like to add that many times, these mild to moderate joint pain symptoms, can be treated with over-the-counter anti-inflammatory medications. There are also very effective over-the-counter, natural supplements that help with joint pain and inflammation, one of these being a combination of “Glucosamine" and "Chondroitin”. It is also very important to take your thyroid medication as recommended by your Physician and let him/her know about other supplements you may choose to take in addition to your hormone replacement.