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Studies to Determine
the Thyroid Status of
Fibromyalgia Patients
!
Thyroid status of
38 fibromyalgia patients:
implications for the etiology of fibromyalgia. John C. Lowe, MA, DC: Clinical
Bulletin of Myofascial Therapy, 2(1):47-64, 1997.
Abstract.
Thyroid function
tests were used to classify 38 fibromyalgia patients according to thyroid status. Results
were consistent with euthyroidism (normal thyroid status) in 14 patients (36.8%), primary
(thyroidal) hypothyroidism in 4 patients (10.5%), and central (hypothalamic or pituitary)
hypothyroidism in 20 patients (52.6%). The percentages of primary and central
hypothyroidism in this group of fibromyalgia patients are extremely higher than those in
the general population. There was no statistical difference for the mean intensity of
fibromyalgia symptoms (measured by visual analogue scales) and the mean tender point
scores (measured with algometry) between any of the categories of patients. The mean
algometer scores and symptom intensities being essentially the same for all three
categories of patients may show that the mechanisms involved were due to the same abnormal
process—inadequate thyroid hormone regulation of gene transcription. In primary and
central hypothyroid patients, this would result from a frank hormone deficiency, and in
euthyroid patients, possibly from cellular resistance to thyroid hormone due to mutations
in the c-erbAß1 gene.
!
Thyroid status of fibromyalgia
patients. John C. Lowe, MA, DC,
Jackie Yellin, BA, et al.: Clinical Bulletin of Myofascial
Therapy, 3(1):47-53, 1998.
Abstract. In a previous retrospective study (see
abstract above), thyroid function tests were used to classify 38 fibromyalgia patients
according to thyroid status. Results were consistent with euthyroidism (normal thyroid
status) in 14 patients (36.8%), primary (thyroidal) hypothyroidism in 4 patients (10.5%),
and central (hypothalamic or pituitary) hypothyroidism in 20 patients (52.6%). In this
prospective study, an additional 54 patients were tested. Results were consistent with
euthyroidism in 26 patients (48.1%), primary hypothyroidism in 8 patients (14.8%), and
central hypothyroidism in 20 patients (37.0%). All patients from both studies were
combined into a group of 92 to obtain the total percentage in each classification. Results
were consistent with euthyroidism in 40 patients (43.5%), primary hypothyroidism in 12
patients (13.0%), and central hypothyroidism in 40 patients (43.5%).
There was no statistical difference in either study for the mean intensity of fibromyalgia
symptoms (measured by visual analog scales) or the mean tender point score (measured with
algometry) between any of the categories of patients. In the study of 54 patients, there
was also no statistical difference for pain distribution (measured by the percentage of 36
body divisions containing pain), functional ability (measured by the Fibromyalgia Impact
Questionnaire), or depression (measured by Zung's Self-Rating Depression Scale) between
the three categories of patients.
In both studies, the percentages of patients with primary and central hypothyroidism were
extremely high compared to those in the general population. Of the 92 patients, 52 (56.5%)
had laboratory test results consistent with hypothyroidism. Contrary to anecdotal reports,
hypothyroidism is extraordinarily common among fibromyalgia patients.
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