It has long been recognized that the symptom complex of
fibromyalgia can be seen with
hypothyroidism.
Hypothyroidism may been categorized, like diabetes, into type I (
hormone deficient) and type II (
hormone resistant). Most cases of
fibromyalgia fall into the latter category. The syndrome is reversible with treatment, and is usually of late onset. It is likely more often acquired than due to mutated receptors. Now that there is evidence to support the hypothesis that
fibromyalgia may be due to
thyroid hormone resistance, four major questions appear addressable. First, can a simple
biomarker be found to help diagnose it? Second, what other syndromes similar to
Fibromyalgia may share a thyroid-resistant nature? Third, in non-genetic cases, how is resistance acquired? Fourth, what other methods of treatment become available through this new understanding? Preliminary evidence suggests that serum
hyaluronic acid is a simple, inexpensive, sensitive, and specific test that identifies
fibromyalgia. Overlapping symptom complexes suggest that
chronic fatigue syndrome,
Gulf war syndrome,
premenstrual syndrome,
post traumatic stress disorder,
breast implant silicone sensitivity syndrome, bipolar
affective disorder,
systemic candidiasis,
myofascial pain syndrome, and
idiopathic environmental intolerance are similar enough to
fibromyalgia to merit investigation for possible thyroid resistance. Acquired resistance may be due most often to a recently recognized chronic consumptive coagulopathy, which itself may be most often associated with
chronic infections with mycoplasmids and related microbes or parasites. Other precipitants of thyroid resistance may use this or other paths as well. In addition to experimentally proven treatment with supraphysiologic doses of
thyroid hormone, the thyroid-resistant disorders might be treatable with anti-hypercoagulant, anti-infective,
insulin-sensitizing, and hyaluronolytic strategies.