Association between chronic widespread musculoskeletal complaints and thyroid autoimmunity - Results from a community survey

Objective - To test a hypothesis derived from observations in general practice that thyroid antibodies were associated with chronic widespread musculoskeletal complaints. Design - Cross-sectional study of 40-42 year old men and women based on a self-administered questionnaire and on results of blood tests. Setting - Sarpsborg municipality, Norway. Participants - 737 men and 771 women who attended the National Health Screening Service's mobile unit in 1989 and answered the questionnaire. Main outcome measures - Prevalence of detectable microsomal thyroid antibodies in persons with and without chronic widespread musculoskeletal complaints. Results - The prevalence of thyroid microsomal antibodies was significantly higher in persons with than without chronic widespread musculoskeletal complaints (16.0% versus 7.3%, p<0.01). The increase was restricted to women (20.4% versus 11.6%, p=0.02). Thyroid function tests did not differ significantly between the two groups. Conclusion - The association between chronic widespread musculoskeletal pain complaints and thyroid antibodies in women may reflect a subgroup of patients in which thyroid autoimmunity, rather than thyroid function, is important. A possible relationship to fibromyalgia is discussed as well as a hypothetical role for thyrotropin releasing hormone.