Hyperthyroidism and rheumatoid arthritis (RA) have a bidirectional link. Therefore, if a person has both conditions, their doctor may use a collaborative treatment approach.
RA is prevalent among people with Graves’ disease, which is a common cause of hyperthyroidism, or overactive thyroid. The reverse is also true — in fact, research suggests that the relationship between RA and hyperthyroidism goes beyond a link, as the two conditions have a causal effect on each other.
Doctors typically aim to treat each condition individually. However, improvement of one condition may improve the symptoms of the other.
Read on to learn more about the link between hyperthyroidism and RA, treatment options, and when to contact a doctor.
Hyperthyroidism causes the thyroid gland to produce higher-than-usual amounts of thyroid hormones. These hormones have multiple functions, such as regulating energy use and helping the body stay warm. When thyroid hormone levels are too high, they speed up every function of the body. This can cause symptoms such as:
- hand tremors (shaking in the hands)
- fast heartbeat
- frequent bowel movements
One of the most common causes of hyperthyroidism is an autoimmune condition called Graves’ disease. RA is also an autoimmune disorder.
Research has shown that the two conditions may be connected — there is a high prevalence of RA in people with Graves’ disease and vice versa. However, experts do not know exactly why. A 2019 study reported that the reasons for the increased incidence of thyroid disease among individuals with RA are unclear.
However, autoimmune conditions can have the same underlying pathology, which is another word for abnormal physiological processes. This may explain why a person with one autoimmune condition may be likely to have others.
For instance, some gene mutations have a noticeable effect on the pathology of both RA and autoimmune thyroid conditions.
Can hyperthyroidism cause arthritis?
While previously discussed research suggests that Graves’ disease and RA have similar pathology and share genetic susceptibility, that research has not established a causal relationship. With this in mind, researchers in one study investigated whether the link between the two autoimmune conditions translates to a causal effect.
They found that people with RA had a 39% higher risk of Graves’ disease and that people with Graves’ disease had a 30% higher risk of RA. The results indicate that Graves’ disease has a causal effect on RA and vice versa, meaning that the link and causal effect between the two conditions are bidirectional.
Because Graves’ disease and RA have a bidirectional relationship, treatment of one may relieve symptoms of the other. However, this is true only if the conditions have a link. If a person happens to have both conditions but the conditions do not share an underlying pathology, treating one will not resolve the other.
Treatment options include separate options for each condition and a few shared medications. Healthcare professionals can determine the best treatment options for each person.
Treatment options may
- Beta-blockers: These drugs help slow the heart rate and prevent tremors. They can provide quick symptom relief. Atenolol (Tenormin) and propranolol (Inderal) are examples of drugs a doctor may prescribe.
- Antithyroid drugs: These drugs cause the thyroid gland to produce smaller amounts of hormones. Some examples are methimazole (Northyx) and propylthiouracil (Propycil).
- Radioiodine therapy: This treatment aims to destroy the cells of the thyroid gland. In the United States, it is the most common treatment method for Graves’ disease.
- Surgery: In some cases, a person may need surgery to remove part or most of the thyroid gland.
Treatment options may include:
- Disease-modifying antirheumatic drugs: These drugs relieve symptoms and slow the progression of joint damage. Methotrexate (Rheumatrex) and propylthiouracil (Azulfidine) are examples.
- Biologic agents: These block the immune system’s chemical signals that cause inflammation. Some examples are abatacept (Orencia) and adalimumab (Humira).
- Education: A healthcare professional can help a person learn coping techniques and lifestyle strategies that may help with symptoms.
If a person has symptoms of RA or hyperthyroidism, they should contact a doctor. A person should also consult a doctor if they have one condition and think they may be experiencing symptoms of the other.
A doctor may recommend treating the conditions together. This would entail collaboration between an endocrinologist (a specialist in endocrine gland conditions) and a rheumatologist (a specialist in RA and related conditions).
The relationship between hyperthyroidism and arthritis involves Graves’ disease and RA. Both of these are autoimmune conditions, and each has a causal effect on the other.
The pathology that underlies autoimmune conditions is similar. This may explain why a person who has one autoimmune condition may be likely to develop others.
When a person has received a diagnosis of both hyperthyroidism and RA, satisfactory treatment may require an interdisciplinary approach. A doctor may choose to treat the conditions individually, or they may decide that the best approach involves treating them together.