Clinical Rheumatology

, Volume 36, Issue 7, pp 1617–1621 | Cite as

Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity

  • Sema HalilogluEmail author
  • Bilge Ekinci
  • Hulya Uzkeser
  • Hakan Sevimli
  • Ayse Carlioglu
  • Pinar Mazlum Macit
Original Article


Fibromyalgia (FM) is a syndrome characterised by chronic musculoskeletal pain, tenderness and other somatic symptoms. The prevalence of FM is approximately 2–7% in the general global population and is 30–40% in the population of Hashimoto thyroiditis (HT) with a structural pathology. In 2010, new classification criteria for FM were proposed, as an alternative to the American College of Rheumatology (ACR) 1990 criteria. The objectives of the present study were to identify the prevalence of FM in the HT population and evaluate the associated features by using the new diagnostic criteria. The study group included 79 consecutive patients with HT with or without FM. Recorded data included age, gender, laboratory parameters, sociodemographic features and clinical findings, presence of somatic symptoms, and disease activity indices. The prevalence of FM in patients with HT was 62%. Antithyroid peroxidase antibody (TPOAb) positivity, duration of disease, and waist circumference were significantly associated with concomitant FM (p = 0.000, p = 0.000, and p = 0.015, respectively). A strong positive correlation was noted between fibromyalgia impact questionnaire (FIQ) scores and disease duration, age, values of thyroid-stimulating hormone (TSH) and TPOAb, waist circumference and marital status. TPOAb was found to be independent of body mass index, age and TSH. Concomitant FM is a common clinical problem in HT and its recognition is important for the optimal management of the disease. The new set of diagnostic criteria for FM reinforces this situation. Consideration of the FM component in the management of HT increases the likelihood of treatment success.


Fibromyalgia New diagnostic criteria Thyroid autoimmunity 


Compliance with ethical standards




  1. 1.
    Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L (1995) The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 38:19–28CrossRefPubMedGoogle Scholar
  2. 2.
    Assumpção A, Cavalcante AB, Capela CE, Sauer JF, Chalot SD, Pereira CA, Marques AP (2009) Prevalence of fibromyalgia in a low socioeconomic status population. BMC Musculoskelet Disord 10:64CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Branco JC, Bannwarth B, Failde I, Abello Carbonell J, Blotman F, Spaeth M et al (2010) Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum 39(6):448–453CrossRefPubMedGoogle Scholar
  4. 4.
    Pamuk ON, Cakir N (2007) The frequency of thyroid antibodies in fibromyalgia patients and their relationship with symptoms. Clin Rheumatol 26:55–59CrossRefPubMedGoogle Scholar
  5. 5.
    Bazzichi L, Rossi A, Giuliano T, De Feo F, Giacomelli C, Consensi A et al (2007) Association between thyroid autoimmunity and fibromyalgic disease severity. Clin Rheumatol 26:2115–2120CrossRefPubMedGoogle Scholar
  6. 6.
    Bazzichi L, Rossi A, Zirafa C, Monzani F, Tognini S, Dardano A et al (2012) Thyroid autoimmunity may represent a predisposition for the development of fibromyalgia? Rheumatol Int 32:335–341CrossRefPubMedGoogle Scholar
  7. 7.
    Stathatos N, Daniels GH (2012) Autoimmune thyroid disease. Curr Opin Rheumatol 24:70–75CrossRefPubMedGoogle Scholar
  8. 8.
    Ahmad J, Tagoe CE (2014) Fibromyalgia and chronic widespread pain in autoimmune thyroid disease. Clin Rheumatol 33(7):885–891CrossRefPubMedGoogle Scholar
  9. 9.
    Tagoe CE, Zezon A, Khattri S (2012) Rheumatic manifestations of autoimmune thyroid disease: the other autoimmune disease. J Rheumatol 39(6):1125–1129CrossRefPubMedGoogle Scholar
  10. 10.
    Tagoe CE (2015) Rheumatic symptoms in autoimmune thyroiditis. Curr Rheumatol Rep 17(2):5CrossRefPubMedGoogle Scholar
  11. 11.
    Suk JH, Lee JH, Kim JM (2012) Association between thyroid autoimmunity and fibromyalgia. Exp Clin Endocrinol Diabetes 120(7):401–404CrossRefPubMedGoogle Scholar
  12. 12.
    Rodríguez-Espinosa J, Díaz-López C, Guinot M, Geli C, de Llobet JM, Rodríguez de la Serna A (2006) Thyroid dysfunction in women with suspected fibromyalgia. Reumatol Clin 2(2):70–77CrossRefPubMedGoogle Scholar
  13. 13.
    Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum 33:160–172CrossRefPubMedGoogle Scholar
  14. 14.
    Wolfe F, Clauw DJ, Fitz Charles MA, Goldenberg DL, Katz RS, Mease P et al (2010) The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 62:600–610CrossRefGoogle Scholar
  15. 15.
    Wolfe F, Clauw DJ, Fitz Charles MA, Goldenberg DL, Hauser W, Katz RS et al (2011) Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR preliminary diagnostic criteria for fibromyalgia. J Rheumatol 38:1113–1122CrossRefPubMedGoogle Scholar
  16. 16.
    Jones GT, Atzeni F, Beasley M, Flüß E, Sarzi-Puttini P, Macfarlane GJ (2015) The prevalence of fibromyalgia in the general population: a comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis Rheumatol 67(2):568–575CrossRefPubMedGoogle Scholar
  17. 17.
    Di Franco M, Iannuccelli C, Bazzichi L, Atzeni F, Consensi A, Salaffi F et al (2011) Misdiagnosis in fibromyalgia: a multicentre study. Clin Exp Rheumatol 29(6 Suppl 69):S104–S108PubMedGoogle Scholar
  18. 18.
    Wolfe F, Brahler E, Hinz A, Hauser W (2013) Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: results from a survey of the general population. Arthritis Care Res (Hoboken) 65:777–785CrossRefGoogle Scholar
  19. 19.
    Branco JC, Bannwarth B, Failde I, Abello Carbonell J, Blotman F, Spaeth M et al (2010) Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum 39:448–453CrossRefPubMedGoogle Scholar
  20. 20.
    Burckhardt CS, Clark SR, Bennett RM (1991) The fibromyalgia impact questionnaire: development and validation. J Rheumatol 18:728–733PubMedGoogle Scholar
  21. 21.
    Sarmer S, Ergin S, Yavuzer G (2000) The validity and reliability of the Turkish version of the fibromyalgia impact questionnaire. Rheumatol Int 20:9–12CrossRefPubMedGoogle Scholar
  22. 22.
    Arnold LM, Clauw DJ, McCarberg BH (2011) Improving the recognition and diagnosis of fibromyalgia. Mayo Clin Proc 86:457–464CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Ahmad J, Blumen H, Tagoe CE (2015) Association of antithyroid peroxidase antibody with fibromyalgia in rheumatoid arthritis. Rheumatol Int 35(8):1415–1421CrossRefPubMedGoogle Scholar
  24. 24.
    Yunus MB, Arslan S, Aldag JC (2002) Relationship between body mass index and fibromyalgia features. Scand J Rheumatol 31:27–31CrossRefPubMedGoogle Scholar
  25. 25.
    Ursini F, Naty S, Grembiale RD (2011) Fibromyalgia and obesity: the hidden link. Rheumatol Int 31(11):1403–1408CrossRefPubMedGoogle Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2017

Authors and Affiliations

  • Sema Haliloglu
    • 1
    Email author
  • Bilge Ekinci
    • 2
  • Hulya Uzkeser
    • 3
  • Hakan Sevimli
    • 4
  • Ayse Carlioglu
    • 5
  • Pinar Mazlum Macit
    • 2
  1. 1.Department of Physical Medicine and RehabilitationIstanbul Occupational Diseases HospitalIstanbulTurkey
  2. 2.Department of Physical Medicine and RehabilitationErzurum Regional Research and Training HospitalErzurumTurkey
  3. 3.Department of Physical Medicine and RehabilitationAtaturk University, Faculty of MedicineErzurumTurkey
  4. 4.Department of Internal MedicineErzurum Regional Research and Training HospitalErzurumTurkey
  5. 5.Department of EndocrinologyErzurum Regional Research and Training HospitalErzurumTurkey

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