Thyroid autoimmunity may represent a predisposition for the development of fibromyalgia?

Abstract

In our previous study, we observed that the presence of autoimmune thyroid disease worsens fibromyalgia (FM) symptoms. The aims of this study are to evaluate whether there is a predisposition for the development of FM in patients with Hashimoto's thyroiditis (HT) with or without subclinical hypothyroidism (SCH) and in patients with SCH alone and what is the weight of antithyroid antibody positivity and SCH on FM comorbidity. Fifty-two patients, 39 affected by HT with or without SCH and 13 by SCH, were matched with 37 patients affected by FM and 25 healthy subjects. Blood samples were collected from all study subjects for the determination of serum TSH, free triiodothyronine, free thyroxine, antithyroperoxidase antibody (TPOAb), antithyroglobulin antibody (TgAb) and non-organ-specific autoantibodies. Clinical assessment of patients and controls included the "Fibromyalgia Impact Questionnaire" (FIQ), while pain severity was evaluated using a visual analogue scale (VAS). Patients and controls were also characterized by the presence of diffuse pain, fatigue, paresthesiae, muscle spasms, non-restful sleep, tension headache and presence of mood disorders. FM comorbidity resulted in twelve HT subjects (31%) and none in SCH patient. In particular, FM comorbidity in HT patients without SCH was 33.3% and in HT patients with SCH was 28.5%. Based on our data, we speculate that maybe there is more than a hypothesis regarding the cause-effect relation between thyroid autoimmunity and the presence of FM, thus suggesting a hypothetical role of thyroid autoimmunity in FM pathogenesis.

Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?

“…In accordance with our findings, Ott et al [21 ]demonstrated a correlation between the level of TPOAb, but not thyroid function tests, and scores on an unvalidated symptom questionnaire, in a study of patients undergoing thyroidectomy for benign goitre. Another field of research has focused on the role of thyroid autoimmunity in musculoskeletal complaints, particularly fibromyalgia [22,23]. For example, Bazzichi et al [22] found comorbidity with and higher levels of symptoms of fibromyalgia in patients with Hashimoto’s thyroiditis and subclinical hypothyroidism, in contrast to patients with nonautoimmune subclinical hypothyroidism.…”

Biomarkers in fibromyalgia: a review

“…In a later study, Bazzichi et al 22 also observed that the presence of thyroid disease worsened FM symptoms. They evaluated FM comorbidity in patients with Hashimoto's thyroiditis (HT) with or without subclinical hypothyroidism (SCH), and in patients with SCH alone; as well as the impact of antithyroid autoimmunity and SCH on FM comorbidity.…”

Rheumatologic Manifestations in Iranian Patients with Autoimmune Thyroid Diseases

“…Based on Soy's study (2007), 65 patients with autoimmune thyroid diseases include of Graves` disease and Hashimoto thyroiditis [9] referred to the Rheumatology clinic of 5 Azar Hospital were studied via systematic random sampling. Patients with a positive antithyroid peroxides (anti-TPO, by radioimmunoassay) were included in the study and exclusion criteria were infectious diseases under the treatment including Tuberculosis (TB) and Brucellosis, history of diabetes, Cerebrovascular Accident (CVA), brain disorders and trauma or accident in the last six months.…”

“…Bazzichi indicated the relationship between thyroid autoimmunity and the presence of Fibro Myalgia (FM), too [9]. Soy also showed the high frequency of rheumatic disease in patients suffering from ATDs [10].…”