Arthritis Rheumatoid Arthritis The Connection Between Hypothyroidism and Rheumatoid Arthritis By Lana Barhum facebook linkedin Lana Barhum has been a freelance medical writer for over 10 years. She shares advice on living well with chronic disease. Learn about our editorial process Lana Barhum Medically reviewed by Medically reviewed by Scott Zashin, MD on January 09, 2021 linkedin Scott J. Zashin, MD, is board-certified in internal medicine and rheumatology. He was a volunteer clinical professor of internal medicine at the University of Texas Southwestern Medical School Dallas. Learn about our Medical Review Board Scott Zashin, MD on January 09, 2021 Print Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system attacks its own healthy tissues. This response is called autoimmunity and it causes severe inflammation (painful swelling) that attacks the linings of joints. RA can also affect the organs, including the skin, eyes, and heart. Research shows people with RA are more likely to develop underactive thyroid disease, including hypothyroidism and Hashimoto’s thyroiditis. And that connection appears to go both ways in that people with thyroid disease have a higher risk for RA. Here is what you need to know about underactive thyroid conditions and how they are connected to RA. Jupiterimages / Getty Images Your Thyroid Your thyroid is the tiny butterfly-shaped gland in your neck and is made up of two lobes located on both sides of the trachea (windpipe). A normal thyroid is not outwardly visible and cannot be felt when pressure is applied to the neck. The thyroid gland produces and stores hormones to regulate metabolism (the rate that cells perform their jobs). Thyroid hormone is also vital to the growth and development of the human body. Thyroid hormone regulates many of the body’s functions by consistently releasing a fixed amount of thyroid hormone into the bloodstream. There are instances where the body will need more energy—such as during pregnancy—so the thyroid gland will produce more hormones. Hypothyroidism Hypothyroidism occurs when the thyroid gland is underactive and is not making enough thyroid to keep the body functioning properly. A diagnosis of hypothyroidism can be made when there is too little thyroid hormone in the blood. Signs of hypothyroidism will develop slowly and over several years. Symptoms may include: FatigueIncreased sensitivity or intolerance to the coldWeight gainDry hair and skinA pale, puffy faceMuscle achesDepressionA goiter (an enlarged thyroid gland)A hoarse voice See your doctor if you have been feeling tired for no reason or have other signs of hypothyroidism, including a puffy face or a hoarse voice. How Can You Best Cope With Your Thyroid Disease Symptoms? Hashimoto’s Thyroiditis Much like RA, Hashimoto’s thyroiditis is an autoimmune disease. This condition causes the immune system to mistakenly attack the thyroid gland. Over time, these attacks will destroy thyroid tissue and reduce thyroid production, leading to an underactive thyroid. Hashimoto’s thyroiditis can be difficult to diagnose and in many instances, a person with the condition may go many years undiagnosed. One of the first signs of the Hashimoto’s is an enlarged thyroid. It will cause the front of the neck to appear visibility swollen. Additional symptoms of Hashimoto’s thyroiditis include: Severe fatigueWeight gainA puffy faceMuscle and/or joint painHair lossA slow heart rateIrregular and heavy menstrual periods Tell your healthcare provider as soon as you start to experience symptoms of Hashimoto’s thyroiditis, including feeling chronically tired, dry skin, and a pale, puffy face. This is especially important if you have a family history of Hashimoto's thyroiditis or other autoimmune diseases. Autoimmune Thyroid Disease and Your Immune System RA—Hypothyroidism Connection Rheumatoid arthrtis and underactive thyroid disease often coexist. A study published in 2018 showed an increased prevalence of autoimmune thyroid disease among people with RA during the first five years before diagnosis. This study also found the risk increased around the time of diagnosis and decreased two to five years after diagnosis. An observational study from 2017 in the journal Medicine found the prevalence of thyroid disorders in people with RA to be around 15.7%. Hypothyroidism was the most frequent disorder affecting up to 30.4% of the study participants with RA. This observational study also found thyroid disorders in people with RA might indicate a more aggressive disease and poor treatment outcomes. The study’s authors note the importance of diagnosing coexisting thyroid disorders earlier by checking thyroid hormone levels in RA patients at the time of diagnosis and every year after. Research also shows people who have autoimmune thyroid disease are at a higher risk for developing RA. One older study from 2010 reported in the American Journal of Medicine found people with autoimmune thyroid diseases like Hashimoto’s thyroiditis have a higher risk for RA. Here, researchers found that 14% of study participants with Hashimoto’s thyroiditis also had another autoimmune disease. Hypothyroid Joint and Muscle Symptoms For some people, hypothyroidism can cause joint and muscle pain, and for people with RA, this might mean increased symptoms. Musculoskeletal symptoms of hypothyroidism may include: Muscle aches, tenderness, and stiffnessMuscle weaknessJoint pain and stiffnessSwelling of the small joints of the hands and feetTingling, prickling, burning, or numb feeling in the hands or feet—a symptom called acroparesthesia Because people with hypothyroidism have an increased risk for RA, any pain, stiffness, and swelling you may experience that doesn’t improve with thyroid treatment should be brought to the attention of your doctor. They can look for other possible causes of your muscle and joint pain. You should also let your doctor know if RA pain and symptoms worsen after a thyroid disease diagnosis. They can access which condition is causing symptoms and adjust your treatment plan. Treatment for Hypothyroidism With RA Treatment for hypothyroidism is the same whether or not a person has rheumatoid arthritis. It generally involves life-long treatment of synthetic thyroid hormone replacement, which is available as a daily pill. It is also important for people living with hypothyroidism to have routine follow-ups with an endocrinologist to check thyroid hormone levels to make sure they remain in the normal range. Depending on where hormone levels are, medication dosages may need to be adjusted. It is also important to manage RA and keep it under control. Your doctor is in the best position to answer questions about your treatment plan and how to best manage a thyroid condition while living with RA. An Overview of Thyroid Disease Treatments A Word From Verywell Most thyroid disorders can be well-managed with medication and are not life-threatening. But it is important that you take your medication every day. In addition, your healthcare provider will monitor your hormone levels and treatments and adjust medications over time. It might take some time to find the right treatment and get hormone levels back to normal, but most people with thyroid disorders can have normal lives without any restrictions. Was this page helpful? Thanks for your feedback! Dealing with chronic inflammation? An anti-inflammatory diet can help. Our free recipe guide shows you the best foods to fight inflammation. Get yours today! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Institute for Quality and Efficiency in Health Care. How does the thyroid gland work? Updated April 19, 2018. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 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