Central Sensitization Syndrome and Hypothyroidism: An Evaluation of Symptom Severity and Comorbid Diagnoses, 2019, Howard et al

[Dolphin]

Gives percentages of those with CFS broken down by severity

https://www.spotlightonresearch.com/health-science-research/kh2019
Free full text:
https://www.spotlightonresearch.com/s/Howard-K-et-al-2019-xtxp.pdf

Central Sensitization Syndrome and Hypothyroidism: An Evaluation of Symptom Severity and Comorbid Diagnoses
Krista Howard, PhD¹

Morgan Snyder, MA¹

Kelly Haskard-Zolnierek, PhD¹

Jeffrey T. Howard, PhD²

¹Texas State University, Department of Psychology Texas State University, 601 University Drive, San Marcos, TX, kh44@txstate.edu, ²University of Texas – San Antonio, Department of Kinesiology, Health, and Nutrition, Texas State University, 601 University Drive, San Marcos, TX

DOI: DOI: 10.35831/shsr/kh.10-31-2019

Full Text PDF Click HERE


Abstract

Objective: Central sensitization is considered the cause of medically unexplained pain-related conditions, often expressed with other somatoform disorders. This study aimed to evaluate the degree of overlap of symptom severity and comorbid diagnoses between hypothyroidism and central sensitization syndrome (CSS). Methods: Three hundred eighty-five individuals with hypothyroidism completed the Central Sensitization Inventory (CSI) and measures evaluating symptom severity and comorbid diagnoses. Results: Hypothyroid patients with high CSI scores (Severe and Extreme subscales) were more likely to report fibromyalgia, musculoskeletal pain, arthritis, and migraine, along with chronic fatigue syndrome, gastrointestinal problems, depression and anxiety disorders. The key symptoms related to CSS were depressive symptoms, fatigue, headaches, and aches/pains. The key comorbidities related to CSS were lower age, and depression and/or anxiety diagnoses. Conclusion: Hypothyroid patients reporting greater ratings of hypothyroid symptoms, particularly fatigue, aches/pains, and depression symptoms may be exhibiting central sensitization, and further testing for CSS conditions should be considered.

Keywords: Hypothyroidism, Central Sensitization, Fibromyalgia, Chronic Pain, Depression

 

[Hoopoe]

Is there any reason to think this is not pure circular thinking?

Someone made a long and varied list of symptoms they believe are caused by a disorder they believe exists, called central sensitization syndrome.

Someone else then goes through a list of patients with hypothyroidism and finds that the patients who by some measures are more severely ill also happen to have more of the symptoms (or more severely) that are said to occur in central sensitization (in particular the most unspecific one like fatigue, depressive symptoms, headache, aches/pains) which also happen to be symptoms of hypothyroidism (not sure about the headache).

 

[Invisible Woman]

Conclusion: Hypothyroid patients reporting greater ratings of hypothyroid symptoms, particularly fatigue, aches/pains, and depression symptoms may be exhibiting central sensitization, and further testing for CSS conditions should be considered.

Hmmm....

My conclusion is that hypothyroidism is a lot more complicated than many doctors think and that contrary to the belief of many UK docs not every patient does well on levothyroxine. Some need liothyronine which is difficult to get.

The "normal" ranges for thyroid function test results are absurdly wide. However, if a patient's results are within the normal range that's good enough for many docs. Even if the patient is still experiencing symptoms.

There are a range if nutrients, zinc for example, which are important for conversion between thyroid hormones (it's complex). In my experience GPs don't discuss those.

So, I believe it would serve patients better if these chaps would actually recognise and do something about the known inadequacies in the treatment of hypothyroidism before they start chucking labels on people.

I am hypothyroid and so was one of my dogs. My dog got better treatment from my vet than I did from my GP.

 

[Andy]

Hypothyroid patients with high CSI scores (Severe and Extreme subscales) were more likely to report fibromyalgia, musculoskeletal pain, arthritis, and migraine, along with chronic fatigue syndrome

Hypothyroid patients reporting greater ratings of hypothyroid symptoms, particularly fatigue

Just from the abstract that looks like they use CFS when they mean CF.

 

[Dolphin]

Just from the abstract that looks like they use CFS when they mean CF.

CFS is listed explicitly in Table 4. Comorbid Diagnoses

Though who knows what definition they use

 

[Milo]

It seems like they are trying to say that some hypothyroid patients are overcomplaining and may have this imaignary illness that they call Central Sensitization Syndrome.

It is unfortunate that patients with multiple co-morbidities are not carefully assessed medically and instead are being shoved into harmful diagnosis that stigmatizes them further. It also means that patients need to be extra careful with what they tell doctors so this burden of stigmatizing diagnosis does not follow them everywhere they go.

Can’t they try to explain why is it that patients with hypothyroid experience more pain? Have they assessed other hormones to see if it is a multi-hormonal problem? Can’t they look at post mortem tissues of patients living with multiple and poorly explained co-morbidities, including the thyroid tissues?
How about examining neuroinflammation via magnetic resonance spectroscopy such as what Dr Jarred Younger has done?

The questionnaire can only tell researchers what they want to hear. How many of us answered questionnaires and have the feeling that they had much more to say then the questions they answered?

 

[spinoza577]

Can’t they try to explain why is it that patients with hypothyroid experience more pain?

Probabaly they make themselves some notes from different articles and then put them together in a formal logical way. If there are words there will be found a meaning, too (Lichtenberg, I believe).
Common sense and self suggesting things are most difficult to see, here.

Functional somatic syndromes, including fibromyalgia and chronic fatigue syndrome, may be related to central sensitization (Bourke, Langford, & White, 2015). These syndromes often present with similar psychosocial Central Sensitization Syndrome and cognitive deficits (Galvez-Sanchez et al., 2018), and fatigue (Yost et al., 2017).

While hypothyroidism is a metabolic disorder, many of the symptoms reported (e.g., depression, fatigue, brain fog) parallel those related to common functional somatic syndromes.

A kaleidoscope brings more sense about.

There was a significantly greater prevalence of comorbid diagnoses that would be considered to be functional somatic syndromes indicated by the participants who fell into the higher classifications of central sensitization, including fibromyalgia, chronic fatigue syndrome, gastrointestinal disorders, and mental health disorders.

But they go for, amen.

To our knowledge, this study is the first to examine the relationship between hypothyroidism and central sensitization by utilizing a sample of hypothyroid patients, rather than a chronic pain sample.

To my knowledge "central senzitation" is an interpretation of certain symptoms (probably quite a range of them). It makes no sense "to examine" the relationship between a thing which is found in the world and a further guess, as if one would examine the relationship between a dog and a sausage.

They might have examined the relationship between hypothyroidism and certain symptoms (which are still awaiting their proper interpretation). I am not sure if this association is really new, it´s probably only a more detailed investigation made here. In consequence they are about to sell an interpretation for a fact (once more).