Thyroid Disease & Endocrinopathy
The most frequent cause of vague autoantibodies and symptoms Dr. Mitchell has ever seen over the last six years has been due to subclinical or less obvious endocrinopathy. Endocrinopathy refers to diseases of endocrine or hormone producing system. The most common endocrinopathy being thyroid disease. Thyroid conditions can affect many systems in the body. Below are common thyroid-related symptoms, along with overlapping symptoms that sometimes occur with rheumatologic diseases.
Thyroid Disease Symptoms
Fatigue
Low thyroid function often causes ongoing tiredness and lack of energy.
Dry Skin
Underactive thyroid often results in rough, dry, or itchy skin.
Cognitive Impairment (“Brain Fog”)
Difficulty with memory, concentration, and mental clarity can occur when thyroid hormones are imbalanced.
High Cholesterol
Hypothyroidism can slow metabolism, raising cholesterol levels.
Hair Loss
Thyroid imbalance may lead to thinning or shedding of hair on the scalp and body.
Infertility & Menstrual Changes
Irregular or heavy menstrual cycles and fertility challenges can be linked to thyroid disease.
Temperature Sensitivity
Hypothyroidism → feeling unusually cold
Hyperthyroidism → feeling overheated or sweaty
Anxiety & Depression
Both low and high thyroid function can affect mood and mental health.
Digestive Changes (Constipation or Diarrhea)
Hypothyroidism often leads to constipation, while hyperthyroidism can cause diarrhea.
Weight Changes
Weight gain is common in hypothyroidism; weight loss in hyperthyroidism.
Overlapping Thyroid & Rheumatologic Symptoms
However, many thyroid disease symptoms, whether hypothyroidism, hyperthyroidism or fluctuating thyroid function can overlap with symptoms of rheumatologist disease.
Joint Pain & Stiffness
Thyroid disorders may cause achy joints, sometimes mimicking autoimmune arthritis.
Mouth Sores
Occasional ulcers can be seen in thyroid-related autoimmune disease.
Muscle Pain & Weakness
Muscle aches or weakness can overlap with rheumatologic conditions.
Skin Rashes & Hives
Immune activity in thyroid disease may trigger hives or other skin changes.
Dry Eyes & Dry Mouth
These symptoms may reflect thyroid imbalance or autoimmune overlap (such as Sjögren’s).
Sleep Disorders
Insomnia, restless sleep, or excessive sleepiness can be related to thyroid imbalance.
Flu-Like Symptoms
Low energy, low-grade fevers, and body aches may overlap with autoimmune illness.
Neuropathies
Numbness, tingling, or burning in hands and feet can occur in thyroid or autoimmune disease.
Up to 20-30% of patients with a primary rheumatologic disease also suffer from some degree of superimposed thyroid disease or other endocrinopathy.
Other endocrinopathy includes insufficiency in glands producing sex, adrenal hormones, and parathyroid hormones.
These conditions are often comorbid with non-rheumatologic autoimmune diseases including celiac disease, autoimmune gastritis, vitiligo, allergies, autoimmune small fiber neuropathy and other immune mediated disorders of the nervous system.
Many clinicians rely on blood testing specific to glandular function to determine low or overactive thyroid function. This approach is may be insensitive in earlier disease and leads to some individuals going years to decades without proper treatment.
Further, guidelines in endocrinology merely surveillance earlier disease presentations with suspected endocrinopathy until the disease process has progressed to the point where glandular function is then replaced by a hormone. While this is necessary and helpful, a more proactive approach would be considering taking care of comorbidities, nutrition and appropriate use of immunomodulatory therapy long before glandular failure.