Symptom Management: Pain

Introduction

Hey, welcome back to the Thyroidcafe. It’s 2012. 9:00 pm and I’m in bed. Twisting and rubbing my neck, and shoulders. Attempting to silence snarling muscles. My elbows and knees soon join the cacophony, so I give up and hobble to the kitchen for pain meds. My grandmother and I walk the same way, I’m sixty years her junior. What was I to do? In those days, I popped Tylenol like a desperate starving animal. I had to find a better treatment option. 

The cause of thyroid pain

Thyroiditis could be the cause of your pain. If the front of your neck, jaw or face hurt, a doctor should be seen. Other auto-immune diseases may also be a cause of your pain. For example, arthritis is more likely in thyroid patience than the general population. Thirdly, under treated hypothyroidism is a common cause of joint and muscle pain. But what about this sporadic, systemic dull ache? Diet is the cause I have found through support groups, and personal experience. Dairy was the cause of my pain, but each person must do her own detective work. 

How to treat it 

The simple answer: you can take Neo’s red pill (Tylenol) and go down the rabbit hole of masking your soreness and avoiding the problem. But my pain persisted and I needed an explanation. Around that time, I read about the AIP diet. As I was stumbling and slurping through the diet, I noticed my body pain left. After reintroducing dairy, my pain returned. I am not recommending we put cows permanently out to pasture, but rather that each of us tries an elimination diet, to see what helps.

If you’re having other low thyroid symptoms or your pain is accompanied by swelling of your joints, it’s best to consult a physician and rule out other causes. Keep in mind, even if your blood test comes back in the normal range, it may not be optimal. Discuss your symptoms with your doctor and work towards optimization. As always, I recommend being your own Thyroid advocate.

Conclusion

Because thyroid disease has multiple manifestations, I am doing a series on Symptom Management.  Joint and muscle pain can have many causes and it may take time and detective work to find the root cause of your pain, but there are solutions. So now, after dietary changes, I can sit in bed at 9:00 pm and binge watch Netflix like a normal semi-adult. No Tylenol needed. 

Gluten and the Thyroid Warrior

Introduction

Hey, I’m glad to see you at the Thyroidcafe. I’ve been looking forward to this topic for weeks. I know many thyroid patients suffer from the tummy troubles, as I have. So coming across this study fascinated me. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2111403/#!po=9.25926 In it, the correlation between thyroid illnesses and celiac disease is explained, as well as the symptoms of celiac disease, and testing options. But mostly, I was excited to see who was statistically most at risk of developing celiac disease, silencing critics with science. The study is thorough, but long winded, so I will summarize it here. 

Symptoms of celiac disease

I know you could just Wiki this, but here are a few:

Okay, plot twist! There aren’t necessarily any symptoms.

Seriously?!

This table outlines other symptoms that are often associated with silent celiac disease.

Thyroid Disorders and celiac disease

Yeah… so even though celiac disease was first described in the 19th century, it is underdiagnosed because some people with celiac disease show few symptoms.

Celiac disease isn’t common in the general population; only about 1% have it. However, there is a fivefold increase amongst Hashimoto’s sufferers. Those with hypothyroidism also have a slightly higher chance of having celiac disease, and those with Graves’ disease have a normal chance. The interesting thing is, both celiac disease and Hashimoto’s share the same genetic markers. It’s no wonder so many thyroid warriors suffer from sensitive tummies!

The Table below shows the prevalence of celiac disease in autoimmune thyroid disorders as shown in multiple different studies.

Author (year of publication)Population screenedPrevalence of CD
Collin et al (1994)4183 autoimmune thyroid disease4.8%
Sategna-Guidetti et al (1998)76152 autoimmune thyroid disease3.3%
Cuoco et al (1999)7822 Hashimoto’s disease
23 Graves’ disease
4.3%
Valentino et al (1999)77150 autoimmune thyroid disease3.3%
Berti et al (2000)79172 autoimmune thyroid disease3.5%
Volta et al (2001)80220 autoimmune thyroid disease3.2%
Larizza et al (2001)8190 Pediatric autoimmune thyroid disease7.8%
Meloni et al (2001)82297 autoimmune thyroid disease4.4%
Mainardi et al (2002)83100 autoimmune thyroid disease2%
Ch’ng et al (2005)42115 Graves’ disease4.5%

How to test for celiac disease

A simple blood test can determine if you have celiac disease. This test is both inexpensive and relatively painless. Eating gluten for a few weeks is the only preparation needed. The other testing option is surgical, in which a sample of the small intestine is taken and tested.

Who should test for celiac disease?

Given the increased prevalence and genetic links, testing is reasonable for those with Hashimoto’s disease, hypothyroidism, and any autoimmune disease. If you are experiencing any symptoms or have a family history of celiac disease, it’s reasonable to be tested as well. 

Why Bother?

I was diagnosed with celiac disease years before reading this study… but also there’s cookies. Before reading this study, I didn’t know that keeping a gluten-free diet can reduce the complications of thyroid disease. Some symptoms which are minimized when celiac’s keep a gluten-free diet are, malabsorption of vitamins, osteoporosis, lymphoma and aiding in absorption of thyroid medication. (See study linked above for details) While I knew anecdotally that I felt better gluten-free, I didn’t understand the depth of damage done.  

Conclusion 

It’s important to note that a gluten-free diet doesn’t prevent autoimmune or thyroid diseases, but it can help improve them. If you are a thyroid patient, and especially one with Hashimoto’s disease, testing for celiac disease is the obvious choice. A simple blood test and change in diet can be an easy step towards a healthier you. I will be posting some gluten-free food choices on Instagram if you are interested. Now off to brush up on my baking as it looks like we will be serving gluten-free goodies at the Thyroidcafe.