Fibromyalgia (FM), chronic fatigue syndrome (CFS) and Hashimoto’s autoimmune thyroid disease (HAIT) all present with very similar symptoms, which makes diagnosis sometimes difficult. The three conditions tend to cross-over and a misdiagnosis is common, especially since many doctors will not recognize FM and CFS as legitimate conditions.
Identification and Diagnosis
Chronic fatigue syndrome is characterized by fatigue that is unrelenting – it just never goes away. Even the slightest amount of exertion can reduce a sufferer to bed rest for days. In order to diagnose CFS, since there are no specific tests for it, the doctor must rely on the process of elimination, ruling out other possible underlying conditions before making a diagnosis.
Hashimoto’s autoimmune thyroid disease is a condition in which the thyroid does not produce enough thyroid hormone to regulate the metabolism. An underactive thyroid is the result and the accompanying symptoms include fatigue, muscular and joint pain, weight gain, infertility and a host of other symptoms. HAIT is diagnosed through either the thyroid stimulating hormone (TSH) test or the thyrotropin releasing hormone (TRH) test. Tests for thyroid antibodies are often used in conjunction with these two tests.
Fibromyalgia (FM) is a condition that has been given several labels. Some refer to it as an autoimmune disease, others as rheumatic or arthritic. The syndrome presents with constant pain in joints and muscles. Fatigue, sleep disorders, headaches, weight gain and brain fog are all symptoms of FM. Diagnosis is confirmed through an examination of the 18 tender points. If 11 of them are positive, a diagnosis of FM is usually confirmed.
Often HAIT is misdiagnosed as female problems, PMS, post-partum depression or menopause. Even though a thyroid test is easy to do to confirm a diagnosis, many physicians miss the signals of HAIT and misdiagnose it. There are more than 40 symptoms that relate to these conditions, often causing confusion. Some of them are:
· Difficulty getting a full breath
· Raynaud’s Phenomenon
· Slowed thinking and mental fog
· Problems concentrating
· Widespread pain
· Sleep difficulties
· Headaches and migraines
· Muscle cramping and pain
· Inability to lose weight
· Irritable bowel syndrome
There are many other symptoms that appear in all three conditions. The majority of cases of CFS occur in women between the ages of 25-45. FM, similarly, attacks women between the ages of 20-50 and HAIT affects women in the same age group. Hormonal relationships and autoimmune mechanisms are thought to be the reason why there is a higher incidence in women.
How the Autoimmune Connection is Made
There is an autoimmune connection between the three conditions. It is known that HAIT is an autoimmune illness and there is a real possibility that all three may be varying manifestations of the same underlying autoimmune problems. Research reported in the Journal of Clinical Investigation shows an apparent autoimmune component in CFS. 52% of CFS sufferers develop autoantibodies that indicate autoimmune reactions.
Additionally, researchers have observed that there are defects in the hypothalamus-pituitary-adrenal axis in autoimmune diseases such as fibromyalgia, CFS, chronic inflammatory disease, thyroid disease, and rheumatic diseases.
What Can Cause These Conditions?
There are also a number of hypotheses as to the causes of these conditions. Some thoughts by researchers in the field of fibromyalgia include:
· Abnormally low levels of cortisol
· Lack of adrenal gland regulation (the adrenals make the hormone cortisol)
· Epstein-Barr virus (responsible for mononucleosis)
· Bacterial infection
· Development of one autoimmune disorder triggering others
· Thyroid disease being the root cause
One thing is certain, there is a connection between thyroid function and CFS and FM. Myriad studies done by Dr. John C. Lowe, one of the top pioneers in fibromyalgia research, indicate a clear connection between thyroid dysfunction and FM. In an analysis done by Dr. Lowe, he determined that approximately 64% of fibromyalgia patients had thyroid hormone deficiency.