The prevalence of thyroid disease in rheumatic disease patients has been found in one study to be twice as common than in otherwise healthy individuals and malfunction of this gland can blur the rheumatic diagnostic and treatment picture significantly. This prevalence means that one quarter of rheumatic patients may be affected, because according to The American Thyroid Association, “More than 12% of the U.S. population will develop a thyroid condition during their lifetime.”
Whether thyroid malfunction precedes your rheumatic disease diagnosis, onset is simultaneous, or follows it, ensuring that your thyroid is properly in balance is of critical importance. This is because a slow and sluggish thyroid, or a thyroid that is hyper-functioning, can produce symptoms that mimic rheumatic disease. These symptoms might include (but aren’t limited to) joint, muscle and tendon pain and swelling, pernicious or iron-deficiency anemia, cardio-vascular and respiratory irregularities, skin rashes and hair loss, Sjogren’s-like symptoms, digestion and other gut issues, such as irritable bowel syndrome (IBS), food sensitivities, poor nutrient absorption, and gastro-esophageal reflux (GERD), a predisposition to infections, crushing fatigue, depression and anxiety, Raynaud’s-like symptoms of feeling cold with poor circulation or feeling overheated and sweating, as well as menstrual disorders, fertility, and libido abnormalities.
The list of potential thyroid symptoms are wide and varied and this is because the thyroid is the master endocrine gland of metabolism. Thyroid hormone is needed by every cell in the body in order to carry out normal, healthy bodily functions and, when there is a lack or overload of thyroid hormone, vital metabolic processes in the body can be affected. At times, the lines can be so obscured with an undiagnosed thyroid disorder that you might think your current rheumatic disease treatment – whether you are using antibiotic protocols (AP), non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), or one of the newer biologic drugs – isn’t working! Overlooking thyroid dysfunction may even lead to the inadvertent over-medication of your rheumatic disease and what might appear to be treatment failure due to lack of symptom control.
Further, inadequately treated thyroid problems may occur when inflammation is uncontrolled, iron, or vitamin D levels are low, or cortisol levels are off, especially if the appropriate laboratory testing of the various thyroid hormones and these important co-factors aren’t performed. While high cortisol levels (from exogenous cortisone, like cortisone injections and oral prednisone) can reduce thyroid hormone and exacerbate hypothyroidism, inflammation blocks the conversion of thyroxine (T4), the thyroid storage hormone, to the active hormone, triiodothyronine (T3), that the body needs for normal cellular functioning. Therefore, it can prove to be a very complex picture for rheumatics to find consistency with thyroid hormone balance, because inflammatory status fluctuates with episodes of flaring. Rheumatic disease flares commonly lead to increased fatigue and poor cognitive function, joint and muscle pain, and a host of other symptoms, but these same symptoms can also be the result of a poorly functioning thyroid.
Working with an endocrinologist or other doctor who is well-versed in the special needs of rheumatic patients with thyroid imbalances can be pivotal in achieving successful control of disease symptoms. Ensuring you are receiving appropriate and regular thyroid hormone testing, as well as any necessary adjustments to thyroid medications, can make a great deal of difference in your rheumatic pain levels and overall wellness.