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Hashimoto's Disease and Fibromyalgia

Learn how to manage the connection between Hashimoto's disease and fibromyalgia.
Hashimoto's Disease and Fibromyalgia
Last updated:
9/25/2024
Medically Reviewed by:

The Big Picture

In this article:

More people are increasingly diagnosed with fibromyalgia and Hashimoto's disease, and they frequently occur in the same person. Both conditions share many of the same symptoms and may have similar causes. Yet, researchers still aren't completely sure how either of these diseases starts or why they often occur together. Let's explore what we do know about the relationship between fibromyalgia and Hashimoto's.

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What is fibromyalgia?

Fibromyalgia is a condition where people experience widespread musculoskeletal pain. Usually, fatigue, mood instability, insomnia, and memory difficulties accompany the widespread pain. Although the origins of this condition are not well known, researchers suspect it often starts after a traumatic event, such as surgery, loss of a loved one, or physical injury. However, some cases start with the widespread pain beginning gradually and then worsening with time.

Women are most likely to be affected by fibromyalgia, suggesting that estrogen and genetics play a role in forming this disorder. However, there is no evidence as of now to confirm this correlation. Among females, fibromyalgia is more common in women who:

  • Are obese
  • Smoke
  • Have other joint conditions like rheumatoid arthritis
  • Have a family member with fibromyalgia
  • Have a brain or spinal injury
  • Have emotional trauma, including PTSD


How doctors diagnose fibromyalgia

No test can diagnose fibromyalgia. To diagnose, doctors need to take a thorough medical history to understand what is causing your pain. A diagnosis of fibromyalgia depends on two main criteria:

  • You have experienced widespread pain for longer than three months
  • You have other symptoms besides widespread pain, such as fatigue, insomnia, or memory issues.

If you have been diagnosed with fibromyalgia, your doctor may recommend a few options to help manage your symptoms. Usually, lifestyle adjustments are necessary, and people often need to work closely with their doctor and a physical therapist. Sometimes, doctors prescribe medications like pregabalin, duloxetine, and milnacipran to reduce pain sensations. 

Additionally, people with fibromyalgia can benefit from:

  • Talk therapy
  • Massage
  • Acupuncture
  • Supplements
  • Regular exercise
  • Mood stabilizers

What is the relationship between fibromyalgia and Hashimoto's?

Fibromyalgia affects five out of 100 people, but the rates are much higher for people with Hashimoto's, where 4 in 10 people with Hashimoto's also have fibromyalgia. Therefore, it begs the question, is there is a strong link between the two diseases? 

There are so many similarities between fibromyalgia and Hashimoto's. Both conditions:

  • Occur mostly in females
  • Are usually diagnosed between ages 40-50, although they can start much earlier or later in life as well
  • Have symptoms of fatigue, joint and muscle pain, sleep problems, weight gain, digestive issues, and headaches
  • Are likely caused by a combination of your genes and the environment
  • Tend to run in families
  • Have high Tg and TPO antibodies (even when it occurs in people who only have fibromyalgia and not Hashimoto's)

Unlike Hashimoto's, fibromyalgia is not officially an autoimmune disease. However, many researchers and providers believe it may be related to an impaired immune system. There is no consensus about what causes fibromyalgia. However, some theories suggest it may be a suppression of the hypothalamus, the result of an infection, trauma, or hormonal imbalance.

Because there is little certainty about how fibromyalgia starts, we cannot conclude that one condition causes the other. However, most researchers would likely agree that this relationship deserves much more exploration into why the two disorders often occur together and how they can be better managed or prevented.

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How to live with Hashimoto's and fibromyalgia

Because 40% of people with Hashimoto's also have fibromyalgia, learning how to live optimally with both conditions is necessary. Fortunately, because many of the symptoms are the same, there are similar ways to manage your symptoms and reduce their severity.  

Thyroid hormone replacement medication is necessary for most people with Hashimoto's, as it is the most common cause of hypothyroidism (an underactive thyroid). Hashimoto's itself doesn't necessarily require medication, but hypothyroidism usually does. The symptoms associated with an underactive thyroid generally improve by replacing low thyroid hormone. 

Likewise, prescription medication can also be helpful in people with fibromyalgia. Usually, your doctor will determine which drug is preferable based on your medical history and the type of pain you are experiencing.

Aside from medication, lifestyle changes can make a significant impact on your symptoms in both conditions.

Exercising regularly

Exercise is a powerful solution for some of the most frustrating symptoms of these conditions, including fatigue, joint and muscle pain, sleep issues, and depression. Not to mention, both conditions are associated with weight gain, so exercise can also help you reach a healthier weight.

Decreasing stress

Stress tends to exacerbate symptoms of both conditions. Indeed, people often state they have a Hashimoto's flare-up, or a fibromyalgia flare, after a particularly stressful event. Learning how to cope with everyday stressors and learning tools for navigating through highly stressful events (like losing a loved one, a job change, or surgery) is vital for keeping your symptoms in check.

Improving sleep quality

People with both of these conditions generally do not feel well-rested. Insomnia, temperature dysregulation, anxiety, and pain can all interrupt sleep. Yet, sleep is a wonderful, natural medicine, as your body uses that time to rid the body of toxins, file memories, and repair tissues. Try to implement positive sleep habits like reducing screen time, avoiding late-night meals, and practicing relaxation activities before bed. 


Although the connection between fibromyalgia and Hashimoto's remains mostly unclear, knowing that you have either or both conditions is an essential first step in seeking better health. Schedule a virtual consultation with a Paloma Health thyroid doctor to get to the bottom of your concerning symptoms and start working towards a healthier future.

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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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