Fibromyalgia and Your Thyroid

As I work with clients, I find that nearly all of them have undiagnosed thyroid issues. The most common thing for me to recommend in a consultation is for someone to get a full thyroid panel done by a good doctor who understands thyroid disease.

What’s the connection between fibromyalgia & your thyroid?

Many symptoms of thyroid disease overlap with fibromyalgia symptoms. Therefore, it just makes good sense to check to see if some of your fibromyalgia symptoms could be caused by low thyroid.

In addition, thyroid issues could be amplifying your fibromyalgia symptoms, making them worse than they would be if your thyroid was functioning properly. If it’s not functioning properly, then…

Treating your thyroid could improve your fibromyalgia.

Here are some of the symptoms of low thyroid that can mimic fibromyalgia:

(Your thyroid is the green butterfly-shaped gland shown in this picture.)

  • Fatigue
  • Insomnia
  • Depression
  • Brain fog
  • Difficulty concentrating
  • Sleeping more than average
  • Muscle pain, especially lower body
  • Muscle weakness
  • Pain, stiffness, or swelling in your joints
  • Increased sensitivity to temperature, particularly cold

Other common symptoms of low thyroid are:

  • Constipation
  • Pale, dry skin
  • Puffy face
  • Hoarse voice
  • Elevated cholesterol levels
  • Unexplained weight gain
  • Difficulty losing weight
  • Heavier than normal menstrual periods
  • Brittle fingernails and hair

There are three things that make discovering a thyroid condition tricky.

1 – The most common symptoms of low thyroid look like fibromyalgia.

One down side to being diagnosed with fibromyalgia is that doctors may put all of your symptoms under the “fibromyalgia” heading and not look further for causes. This may be what happens with your thyroid.

If you complain to your doctor that your legs are hurting more than normal, but everything else feels the same, your doctor could very well say, “Your fibromyalgia is flaring up. You must’ve done something different with those muscles.”

However, if your doctor is familiar with the lesser known symptoms of low thyroid, you might discover that your leg pain is due to low thyroid.

2 – Your doctor and/or lab may not know about the updated lab standards.

In November 2002, new guidelines were published by the American Association of Clinical Endocrinologists (AACE) for what the normal range should be for your thyroid stimulating hormone (TSH). Before this revision, a range of 0.5 to 5.0 was considered normal.

However, the AACE found that patients within the range of 3.04 to 5.0 had symptoms of hypothyroidism. (This is one test where the higher number indicates low thyroid function.)

In light of this, the AACE shifted the normal range to be 0.3 to 3.04 — a much narrower range.

According to the AACE, this shift doubles the number of people who are considered to have abnormal thyroid function. The reality is, these folks already had abnormal thyroid function; the test now correctly reflects this, allowing these people to get proper treatment.

If your doctor is still using the old standards, I suggest bringing this press release from the AACE to your next appointment. If your doctor remains resistant after reading the press release, it’s time to look for a new doctor — at least for your thyroid needs.

3 – Your doctor may only know how to diagnose basic low thyroid.

In order to properly diagnose some thyroid disorders, such as Hashimoto’s thyroiditis, an autoimmune disease where your body thinks your thyroid is evil and tries to kill it, your doctor needs to run a full thyroid panel, not just a simple TSH test. Only by running a full thyroid panel, will a doctor who understands the intricacies of thyroid disease have the information needed to treat you.

Your TSH levels can actually look normal while you are having a problem with your thyroid.

It was the thyroid antibodies that told my doctor that I had Hashimoto’s; one of my clients doesn’t manufacture enough T3 from the T4 in her body. These are things you’d never know by only running the TSH test.

Most MD’s will only run the TSH test. However, your thyroid test should include Free T3, Free T4, and thyroid antibodies TPO/TSI, along with the TSH level if you want to get a complete diagnosis.

Of course, you’ll also need to see a doctor that knows how to interpret these test results! You would think that would mean seeing an endocrinologist. In my experience, that hasn’t been the case. For me, and for most of my clients, it means visiting a naturopath. If you need help finding a good one, let me know.


You’ve finally gotten a diagnosis of low thyroid. Now what?

When treating your thyroid, there are two options: synthetic medications or natural glandulars.

Most MD’s will prescribe synthetic medication such as Synthroid or levothyroxine to treat your hypothyroidism. These medications only contain the T4 thyroid hormone. I believe that glandulars are a much better option.

Using a natural glandular, such as Armour Thyroid, gives you both the T3 and T4 thyroid hormones. They are made from pig thyroid, which is similar to human thyroid. However, if you go with a natural glandular, choose Armour Thyroid.

Why is Armour Thyroid brand the only way to go?

I’ve read that many MD’s prescribe synthetics because they think that the natural glandulars are not standardized, meaning that you may not get a consistent amount of thyroid hormone in a natural pill.

Forest Laboratories, the manufacturer of Armour Thyroid, tests both the raw material and the actual tablets, to make sure that you are getting exactly what you are prescribed. Armour Thyroid is standardized.

In addition:

  • Armour Thyroid is gluten free. The generics are not.
  • Natural glandulars have been proven to work better on depression than many antidepressants! Synthetics cannot make this claim.
  • Your thyroid produces both the T3 and T4 thyroid hormones. Natural glandulars contain both T3 and T4; the synthetics most MD’s prescribe do not.
  • It’s almost always true that natural products are utilized by your body more fully than synthetics.

"Why do I Still Have Thyroid Symptoms?" by Dr. Datis KharrazianWhy Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal: A Revolutionary Breakthrough In Understanding Hashimoto's Disease and HypothyroidismIf you want to read more about diagnosing thyroid disease, Hashimoto’s, and how an undiagnosed thyroid disorder could be affecting you, I highly recommend reading Why Do I Still Have Thyroid Symptoms? by Dr. Datis Kharrazian. It’s an excellent, groundbreaking book about this subject.

Updated 11/25/12

I have recently switched over to a custom compounded T3/T4 synthetic medication to manage my Hashimoto’s. Here’s why:

  • Dr. Kharrazian explains in his book, above, that some people react to the porcine thyroid. As my doctor puts it, some people with Hashimoto’s will react to the “beasty bits.” If you are trying Armour Thyroid, and in spite of going gluten free, find that your antibodies are still out of control, you might consider this.
  • By using a custom compounded T3/T4 blend, my doctor can tweak my medication for exactly what I need. For example, she recently increased my T3 (liothyronine) while leaving my T4 (levothyroxine) the same. You cannot do this with a one-size-fits-all pill.
  • Many of us who have Hashimoto’s or other thyroid issues have trouble converting the T4 (which is the only thing that most doctors prescribe) into the T3 that your body can use. If you are having a conversion issue, you may need higher doses of T3 and less T4… but that’s the subject of another blog post!


Action Steps

Check out the symptoms of low thyroid. Do any of them apply to you?

If they do, make an appointment to talk with your doctor about running a FULL thyroid panel to test your thyroid. Treating your thyroid can make a huge difference in your fibromyalgia symptoms. You owe it to yourself to check this out as soon as possible!

Do you have questions about thyroid testing? Do you wonder if your symptoms indicate a thyroid issue?

Leave me a comment below or contact me directly. I’m happy to answer. As someone with both fibromyalgia and thyroid disease, I can help you sort through the confusion and figure out how to approach your doctor.


Tami Stackelhouse


Medication, Naturopathic, Thyroid

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  1. Hi Tammi!

    Thanks for the information. I wanted to share that I have what are considered “nodules” on my thyroid, the last time we checked there were 5. All the tests I have had done come back “normal” all my thyroid levels, including the free levels, “normal”, biopsy, “normal” – I still think the tests are wrong because I do have most of the symptoms – fatigue, Insomnia (unless I take a sleeping pill), Depression, Brain fog, Difficulty concentrating, Muscle pain, especially lower body, Muscle weakness, Pain, stiffness, Constipation time to time, Pale, dry skin, Puffy face (especially around eyes), Unexplained weight gain, Difficulty losing weight, Heavier than normal menstrual periods, Brittle fingernails and hair….

    I also have CFS and FMS so it’s hard to know if it truly just is my condition(s) or also an undiagnosed thyroid issue – my endocrinologist said my thyroid is functioning just fine – I feel bad second guessing her but my gut says there is a problem other than FMS/CFS – maybe I’m just hoping it’s my thyroid??

  2. Hi Gerri! I’m glad you came to visit!

    I hate to say it, but in my experience with my clients, we’ve had a really tough time with endocrinologists. You’d think that they would know the most about these things, but….

    With what you’ve indicated, it definitely seems like there’s something going on with your thyroid! Granted, it might not ALL be your thyroid, but you have enough indicators that it makes me suspicious!

    I’d start off by looking at your TSH levels and comparing them to the updated range I listed here (0.3 to 3.04). See if you’re within that. If not, BINGO! If you are, then step two…

    Step two would be to see a naturopath. They actually seem to know more about the “more tricky” thyroid stuff than even the endocrinologists do.

    In the case of one of my clients, her naturopath sent her to an endocrinologist to “rule out the big, scary stuff,” like thyroid cancer. (My client has nodules like you do.) The naturopath then used the info they received from the endocrinologist to address the more subtle things like adjusting her T3 levels, checking the thyroid antibodies, checking for Hashimoto’s, etc.

    If you haven’t read Dr. Kharrazian’s book for yourself, I would. The more educated you are, the better off you are! Heck, buy your endo a copy! And always, always trust your gut!

    Hope that helps! {hugs}

  3. I have CFIS. I recently had lab test done, including thyroid ..
    The Results: TPO 243, TSH. 3.85, T3 101ng, T4 Free Direct 1.08 ng
    am cortisol 17.7, SED RATE 16mm/ hr. Creatinne .6 mg
    My endrocrinologist told me my test result did not indicate a need for thyroid treatment. But I read read it can be helpful..
    I would appreciate your thoughts on this.
    Thank you for your help.

    1. Hi Jeanne! Thanks for the note!

      First off, I’m a Coach, not a doctor. I’ll give you my impressions here, but remember this is NOT medical advice. =)

      The first thing I notice is that your TPO (thyroid antibodies) is high based on what I’ve read. The things I’ve seen show “normal” as everything from less than 35 to almost nothing. This may indicate an autoimmune thyroid disorder, such as Hashimoto’s like I have. More testing would have to be done to know for sure. Dr. Kharrazian says in his book that Hashimoto’s is actually the most common cause of hypothyroidism.

      The second thing I notice is that your TSH levels are above the 3.04 level recommended by the AACE. I would add that most naturopaths I talk to believe that the “optimal” range is actually lower than that.

      I have four recommendations for you:

      1. Buy two copies of Dr. Kharrazian’s book. Give one to your endocrinologist and read one yourself. The more you know, the better treatment you will get!
      2. Print out this press release from the AACE and highlight paragraph three. Take it to your endocrinologist with Dr. Kharrazian’s book.
      3. If your endocrinologist isn’t responsive to #1 and #2, find a good naturopath who understands autoimmune thyroid disorders and get a second opinion!
      4. Remove gluten from your diet. I’m going to talk about this in my next post. If you end up having Hashimoto’s, this will make all of your symptoms worse. Gluten will actually trigger your body to attack your thyroid destroying it faster. Obviously something you don’t want!

      I hope all of that helps. If you want to talk more, please don’t hesitate to call or email me or schedule a time for us to chat! {hugs}

  4. Hi Tami
    Thank you so much for taking the time to reply.
    The book sounds like a good idea.
    Also, I had no idea there was a relationship between gluten and
    Hasimotos.. I’ll be looking forward to your next post.
    Thank you for the good references on where to get additional information.
    Take care.

    1. Dr. Kharrazian talks a lot about gluten and Hashimoto’s in his book. It’s where I first heard about it. =)

      I know you’re in our fibro group. We’re doing a round-table next month on gluten-free / allergen-free eating. It will be really helpful for anyone who has a gluten allergy or who needs to avoid gluten for their thyroid!

  5. HI
    This article was very informative. I have had hypothyroidism for the past 20 years and have taken synthroid. Would a switch now to the granular help me with losing weight and some of the tiredness do you think?

    1. Hi Michelle! Thanks for stopping by!

      If you’re still experiencing some of the symptoms of low thyroid, it would be worth doing a full thyroid panel with someone who really understands thyroid disease. If your doctor is just checking your TSH and giving you synthroid, but not checking your T3 or antibodies, you might have something more going on with your thyroid. As I mentioned to Jeanne, Hashimoto’s is the most common cause of low thyroid, but it can only be diagnosed with a complete thyroid panel.

      If your T3 is low in addition to your T4, then taking something like Armour, which contains both T3 and T4, might help you feel better. It really depends on what is going on with your thyroid. Seeing a doctor who can interpret your blood work correctly should be your next step. Unfortunately, that might not be your current doc!

      Hope that helps!

  6. Hi Tami
    I would love to be able to attend the Gluten Free Living, but do not live in the area. Is there a way for me to access this information?
    If so, how do I do it?
    I’m amazed at how much you and the Portland Group offer.
    The people in your area are very fortunate.
    I don’t know how you and Tamera do it all.
    Hope you are doing well.

    1. Hi Jeanne! I couldn’t remember if you were local or not. =)

      We videotape all of our local meetings! That means that you will be able to watch the video of the meeting a week or so after we hold it. Since you’re a group member, you’ll receive an email letting you know when the video is posted for you to see.

      Anyone else reading this can go to and join the group and sign up for our newsletter to get the scoop. It’s open for anyone, anywhere!

      If you have any particular questions about living a gluten- or allergen-free life that you’d like addressed at that meeting, let me know and I’ll ask it for you – since you can’t be there. =)

  7. Hi, how are you Tami?
    I actually do have a question. I do not know much about gluten-free
    Diets, however from what I’ve seen it either involves buying expensive
    alternatives or making a lot of items from scratch. Of course, like many
    women with CFIDS/Hasimotos I have very limited income and energy.
    This combination seems very difficult to be able to follow this diet.
    I also live in a small town where there are very limited gluten-free options
    In our local stores.
    What are the best ways to do this simply and without a lot of extra expense?
    Since you mentioned that gluten intolerance can negatively impact Hashimos
    I would like to give it a try if at all possible (not sure I can,due to above)
    How long a tral period would I need to know if it is helping?
    I wouldn’t want to give up too soon. But if it’s not really helping, then it is
    not a lifestyle I would want to continue.

    1. Hi Jeanne! I’m good!

      There are ways to do the GF thing that don’t have to be expensive or difficult. It can be that way when you try to eat the same things that you were eating before, only gluten-free. For example, still eating bread, but gluten-free.

      It’s much easier and cheaper, to just skip these things and eat a low-carb, high-protein diet – which will make you feel better with your fibro anyway! And yes, there’s ways to do this quick and easy too. =)

      By the way, if you have a note from your doctor saying that you have a medical condition that requires you to be gluten-free, or be on a specific diet, you can deduct on your taxes the cost difference between the price of the “normal” food (normal bread) and the cost of the special food (gluten-free bread, which can be twice as much).

      When I went GF, I was able to feel a difference pretty quickly – within a couple of weeks. I would suggest giving it at least a month or so. You do make a good point: if there isn’t a reason for you to be gluten-free, then you shouldn’t do it. There is great nutrients in grains that your body needs. So don’t do it unless you really need to. However, I do find that many fibro babes need to! 😉

      I recommend that you schedule a time for us to chat. We can talk about what your needs are, as far as your lifestyle and energy levels, and can brainstorm ways that you can try going gluten-free that won’t bankrupt your pocketbook or your energy. One chat like this would be on me. If you find our talk useful, then we can always talk about working together more.

  8. Hi! I found you by accident, & sadly not before this. I just actually found similar info online that I mailed to my internist. I have had SEVERE CFIDS/FMS for most of my life & now 65 y/o. The drs. had me on Synthroid, Levothyroxin, etc. etc. for a good 30 something yrs. Awhile back, I was put on Armour & couldn’t figure out “WHY” I felt better on it. Well then I couldn’t get it again & believe they were changing their formula which made it impossible for me to get from two pharmacies.

    They put me back on one of the synthetics & tried to tell me it was the same! I am now coming out of one of the WORST three mo. death sentences I have ever experienced because my dr. suggested “maybe” I should just “try” Ctyomel & actually I am on the generic of it, AND Armour right now. I can’t begin to tell you how I felt & how I looked. I am just SO hopeful this is going to give me some of my life back! I have progressed yrly. with my condition. Now I am wondering just how long I had to suffer needlessly IF this is a huge part of my answer!! I can only hope my dr. will continue to work with me with all the literature I have shared with her. I underlined everything pertinent, so she wouldn’t miss anything.

    Obviously I am one of those people who cannot convert to t3 on my own from the t4 only meds. Can you tell me if this is going to clear up issues that I know I am having with my adrenals too? I am sure I have adrenal fatigue or maybe by now even insufficiency that would possibly show up because my circles are so black under both eyes & my pallor has been so horrible. I truly felt like I’ve been dying, it has been just that bad. I am really hoping I don’t need to try to help myself with the adrenals too, as I have done with my thyroid! My fog has been so horrible, I was ready to move into assisted living. Even worse, I really was so depressed as well .As you;’ve said in your fantastic article, Armour helps depression better than anti-depressants!

    THANK YOU For being the advocate you are for all of us who can’t always fight for ourselves, & what a fight this has been! I can only hope that I will get better because I have truly been as low as ever which was terribly frightening! I don’t understand how Endos. have no clue after all this time, or even internists or family practioners that the TSH range has been changed ALL this time! To think maybe I wouldn’t have deteriorated all these yrs. if I had only known is terribly sad. Never knowing would have been worse!! Thank you again for answering the adrenal issue Tami! I also read that this can cause sleep apnea! Another BINGO for me, with my chubby little body, being unable to lose wt. & the vicious cycle with that too. I could just hug you!

    1. Hi Dale!

      Our bodies really are amazing. Everything is so interconnected! As Dr. Kharrazian says in his book, “Hashimoto’s [the #1 cause of hypothyroidism] is not a thyroid disease but an immune disorder, and it is the immune system that must be addressed.” Why Do I Still Have Thyroid Symptoms? (p. 42).

      You probably will need to address your adrenal fatigue. The good thing is that most of the ways to treat your adrenals are easy to do yourself. This blog post will give you a little bit on how adrenal issues affect CFIDS/FMS: Underlying Causes of Fibromyalgia and Chronic Fatigue Syndrome.

      I highly recommend getting Adrenal Fatigue: The 21st Century Stress Syndrome to learn how to take care of, and heal up, your adrenals. It’s really easy to read and very comprehensive.

      I’d be happy to chat with you, too, about other things you can do. It’s possible to lose the extra weight, if you’re interested. It’s one of the things I specialize in – helping people with fibromyalgia lose weight. That alone will make you feel better!

      Go ahead and schedule a time for us to chat – no charge – and I can give you some other recommendations of things you can talk with your internist about.

  9. Tami, thanks so much for your response & help! I will be contacting you soon & appreciate your time & efforts. Lots of reading for me to do, for a great place to start. I appreciate you! Dale

    1. You’re welcome, Dale! I’d be thrilled to help you sort through this stuff. I know it can be really overwhelming – I had to sort through it all myself too! =)

  10. I will be in touch soon Tami. I just gave my dr. some literature to see if she will help me with the thyroid issue, which means she is going to have to increase my generic Cytomel to a much higher level. I’m becoming a real challenge, but this is my life, so without a doubt, I want to improve & deserve the help I need! Trouble is, I haven’t been able to afford a naturopath & maybe would have had answers before this if I did. Then again, from reading other’s experiences, maybe not. I am SO glad to know you are here for me!! THANK YOU!

    1. You’re so very welcome! I’m going to post a couple of articles on pain management tonight, so keep an eye out! =)

  11. Tami..what a great article. Also wanted to make you aware of Hyper-parathyroidism..which can also have symptoms which are similar to Fibro. I was a high powered sales executive and suddenly, after an extremely stress filled situation, became gravely ill with a severe case of Fibromyalgia and CFS. After 3 years, many many physicians, prescription meds, holistic treatments,…and basically everything you can imagine including diet changes…I was still so ill I could barely move. I finally found a Rheumatologist (my 5th one)..who suspected a growth on my para-thyroid (hyper para-thryroidism). I had the surgery and it has helped my energy levels greatly. My pain levels however, although they have decreased somewhat, still persist.
    Just an fyi for all your readers…as I was very familiar with other thyroid diseases but was completely unaware of hyper-parathyroidism.

    1. Hi Cynthia!

      Thanks for stopping by and sharing your story (and your kind words). =) We can never get enough education to help ourselves out! Congratulations on discovering this piece of the puzzle and your improvement!

      Just based on what you’ve said here, I find myself wondering if you’ve had your adrenals checked out too. They may be part of what your lingering symptoms are. Stress really depletes the adrenals… and it sounds like you lived a stressful life for quite a while, just like I did.

      If you’re interested in chatting more about this, let me know. I am positive that you could feel even better than you do now!

  12. Please help me, was diagnosed with low thyroid in 2003 and put on synthroid, very traumatic event in 2006 and diagnosed with Fibro in 2008, in searching for answers went to holistic dr. and put on Armour thyroid in 2009 and got my life back for awhile, now doctor says not converting enough T4 and has me on Levo and Armour and I am crashing with no energy, pain like the Fibro and do not know what to do? thanks for any help..

    1. Hi Karen!

      I’m like you. I have trouble converting too. My doctor has me on both Synthroid (levothyroxine, which is T4) and Cytomel (which is T3). I use a custom compounded dose so that she can give me exactly what I need. It looks like your doctor hasn’t put you on any T3. Armour has some in it naturally, but you may need more. Talk to your doctor about adding Cytomel to your regimen.

      I’d also be happy to chat with you about other ways to get your pain under control and your energy back. You can schedule a free consultation here. You can also check out my blog post on vitamins that help fibromyalgia.

  13. I have Hashi and hypo and I have a major amount of pain, chronic sinus infections, weight issues and severe depression! Please teach me how to get well?

    1. Hi Shelly! When I work with my clients, one of the things I always recommend is separating out the pieces of the puzzle and working on them. For instance, if you can get your thyroid functioning properly, then you will have less pain and depression. Addressing your depression will also help your pain. Figuring out how to resolve your infections will also help. The best advice I can give you is to focus on the pieces vs. trying to find one thing that will fix all of it. There are a few books I can recommend to you. First, of course, is my book, Take Back Your Life. I also recommend Dr. Kharrazian’s book, mentioned in this article. I also recommend you check out The Mood Cure, by Julia Ross.

  14. Which came first? The thyro or the fibro? I’m SURE it was the “Central Hypothyroidism” undiagnosed and untreated for over 20 years!!! It wreaked havoc on my body and my brain. Everything began to go wrong! During a trip to the ER it showed up in the labwork and I caught it 8 years later! By then it was hard for me to read more than a paragraph, and I went over ALL my medical records. I’m sure it went auto-immune and systemic in my case. I would love to wake up feeling refreshed and rejuvenated! I’m so glad I came across this article! I printed it for my endocrinologist, Thank You!

    1. Hard to say what comes first. Everyone is different. I was diagnosed with fibromyalgia before I was diagnosed with Hashimoto’s… but that doesn’t mean they didn’t show up in a different order than they were discovered! Best of luck! <3

  15. Hi Tammi,

    I am recently diagnosed with fibromyalgia and I have low total t3=72 and free t3=2.3 which is lowest normal and TSH=2.6 normal and low level hashimoto. I have horrible pain in my neck shoulder, lower back and legs. I always feel extremely fatigued. You mentioned that u have fibro and Hashimoto. Are u on any medications for fibro and hashimoto?

    1. Hi Shweta! Yes, I have both fibromyalgia and Hashimoto’s. I take a custom compounded T3/T4 combo (Cytomel/Synthroid) and low dose naltrexone (LDN). I also take several supplements, such as selenium, to support my thyroid. LDN can be a God-send for both fibromyalgia and autoimmune conditions, such as Hashimoto’s. You can read more about it here:

    1. I don’t know that the animal (pig vs. cow) matters as much as it being from a reputable source (brand). You want to be sure that you are getting a quality product with the levels of thyroid hormone you’re expecting.

  16. Well written and informative post Tami.

    I am a practising homoeopathic doctor who also runs a chronic pain related website. As a doctor, researcher and content creator I always find many people get wrongly diagnosed with fibromyalgia because they have symptoms that mimic like fibromyalgia but caused by some other health issues like thyroid problems.

    Thanks for putting light on such topic and yes, fibromyalgia is related to MIND & BODY so a doctor should always listen what his patient says, instead of paying attention to only physical symptoms.

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