Association between chronic widespread musculoskeletal complaints and thyroid autoimmunity: Results from a community survey

Abstract

Objective — To test a hypothesis derived from observations in general practice that thyroid antibodies were associated with chronic widespread musculoskeletal complaints.

Design — Cross-sectional study of 40–42 year old men and women based on a self-administered questionnaire and on results of blood tests.

Setting — Sarpsborg municipality, Norway.

Participants — 737 men and 771 women who attended the National Health Screening Service's mobile unit in 1989 and answered the questionnaire.

Main outcome measures — Prevalence of detectable microsomal thyroid antibodies in persons with and without chronic widespread musculoskeletal complaints.

Results — The prevalence of thyroid microsomal antibodies was significantly higher in persons with than without chronic widespread musculoskeletal complaints (16.0% versus 7.3%, p<0.01). The increase was restricted to women (20.4% versus 11.6%, p=0.02). Thyroid function tests did not differ significantly between the two groups.

Conclusion — The association between chronic widespread musculoskeletal pain complaints and thyroid antibodies in women may reflect a subgroup of patients in which thyroid autoimmunity, rather than thyroid function, is important. A possible relationship to fibromyalgia is discussed as well as a hypothetical role for thyrotropin releasing hormone.

Key Words:

• epidemiology
• fibromyalgia
• general practice
• musculoskeletal disorders pain
• thyroid antibodies
• thyrotropin releasing hormone