Fibromyalgia & Hashimoto's Thyroiditis

Pain in the neck, hips, knees, hands and feet. Getting cold a lot. Being tired all day. Brain fog. Problems swallowing. These symptoms are just par for the course when you have fibromyalgia. But what does it mean when those symptoms get worse and worse while other fibromyalgia symptoms are well controlled?

My rheumatologist wanted an answer to that question a few weeks ago, because it just didn't make sense.

She ordered blood tests for several forms of arthritis and also Hashimoto's thyroiditis. I tested positive for anti-thyroid antibodies, so Hashimoto's was the lucky winner. Thyroid disease tends to be more common in fibromites, so this isn't a big surprise.

In Hashimoto's, the immune system has malfunctioned and decided a particular protein in the thyroid gland is a foreign invader. It then forms antibodies that begin to attack the gland and destroy it. Typically, people don't know this is going on until their thyroid is so damaged that it impacts thyroid-hormone levels, and typical treatment means taking thyroid hormone to normalize levels.

I have fibromyalgia, though, which means I'm never "typical." I've been treated for under-active thyroid for about 8 years now (with Hashimoto's ruled out a couple of times) and my levels have stayed in the normal range. The symptoms that have been bothering me aren't related to underactive thyroid, they're related to the autoimmune activity.

My doctor, being a specialist in autoimmune diseases that cause pain, is taking a non-typical approach to my treatment -- she has me on a drug called Plaquenil (hydroxychloroquine), which is normally used to treat lupus and rheumatoid arthritis. She told me she's used Plaquenil in other patients with Hashimoto's with good results.

Plaquenil changes the way the immune system works but doesn't suppress it, like many autoimmune treatments do. I started on it about a week ago and so far I'm tolerating it well (surprise, surprise!) I think I'm feeling a little better, but the drug doesn't take full effect for up to 2 months, so it'll be awhile before I know for sure.

If you're diagnosed with fibromyalgia or chronic fatigue syndrome and you've never had your thyroid hormone tested, you should. The symptoms are so similar that when my fibro symptoms first started up, I had my doctor check my thyroid and was stunned when it was fine.

Another lesson here is to pay attention to your symptoms. The pain I've had for the past few months has been different from my fibro pain. I usually get burning, stabbing pains that move around. The Hashimoto's pain is deep in the joints and really achy. I've also been extra tired during the day, and brain fog symptoms that I haven't had in months were creeping back -- however, without that packed-in-cotton feeling in my head.

All of us should be familiar with the symptoms of thyroid disease. Don't get paranoid about them -- remember that most of these symptoms are normal in us -- but have them tucked away in your mind in case you start having new symptoms or a cluster of symptoms that's getting worse while your others are stable. Here's a great article by Mary Shomon, the About.com Guide to Thyroid Disease, that gives you the basics of several thyroid problems:

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