Many of you have been asking me about how to relieve pain in a natural and root cause based approach. I’ve written up a new comprehensive post on strategies I’ve found to be the most helpful for my readers and clients in this week’s post.
Pain is a complicated and multifaceted issue, with many potential root causes, and therefore, many potential treatments. For example, a person may be in pain because of an injury, migraines, a structural abnormality, nerve damage, fibromyalgia, an autoimmune process, or because of an increased sensitivity to our environment…
Each pain disorder requires a unique, comprehensive treatment plan. The comprehensive approach to treating migraines is going to vary from the approach to treating a broken arm. 🙂
I can’t focus on every type of pain disorder with Hashimoto’s in this article, but I would like to provide some strategies that will help reduce pain in most pain disorders and specific resources for the most common types of pain disorders present in Hashimoto’s.
This article will focus on fibromyalgia, future posts in the works will cover carpal tunnel syndrome, migraines and I’ve already written about overcoming menstrual pain.
Conventional Approach to Pain
The most common conventional approach to pain is utilizing pain medications. Opiate medications and NSAIDs are the most common types of pain relievers used. Most medications have their time and place. As a pharmacist who is trained in both medication therapy management and functional medicine, I believe that instead of glorifying or demonizing medications, health professionals, and patients need to be educated about appropriate medication use AND complementary therapies that can eliminate or reduce the need for medications.
Opiates work by disconnecting our pain receptors from the pain signals, making us “forget” that we’re in pain. For many people, while these medications are effective “band-aids” for pain relief, they can also be habit-forming. The passing of the beloved artist Prince is a recent tragic example of what can happen when a person becomes addicted to opiate pain medications. Interestingly, Synthroid was the #1 prescribed drug in 2013 and 2014 in the United States. In 2015, Synthroid dropped to #2 and was displaced by Vicodin, an opiate painkiller.
Opiate medications are a constant source of controversy, on one hand, they are overused, and people become addicted to them and suffer ill consequences. Many times, these people had other choices for addressing their pain but were not informed.
On the other hand, people who are terminally ill, seriously hurt or injured, and others who may benefit from opiate medications often don’t get access due to the medical community’s fear of the medications.
NSAID medications (Non-Steroidal Anti-Inflammatory Drugs) are often a first line treatment for pain disorders, and they do help with reducing pain and inflammation. Unfortunately, they are also associated with numerous side effects, most significantly leading to gut dysfunction, including an increased likelihood of ulcers. For short-term use, the occasional headache or acute injuries, they can be very helpful- however, the longer we take them, the more likely we are to suffer adverse reactions.
We also know that pain medications don’t get to the root cause of the pain condition, and thus we need to take a comprehensive approach to reducing pain in the body.
No matter the cause, reducing inflammation in our bodies will always help reduce pain and promote healing. You don’t have to use NSAIDs to reduce inflammation!
Supplements for Pain
In May of 2015, I did a survey of my readers with Hashimoto’s, to identify some of the most helpful interventions specific to reducing pain.
While there is no “natural Vicodin”, up to 65% of my readers with Hashimoto’s reported a reduction in pain by taking Curcumin/Turmeric supplement. I’ve written about this anti-inflammatory spice in the past, and adding it to your daily regimen may help relieve your pain. (Be sure to get the extended release kind of Curcumin supplement that stays around in the body. The spice on its own gets cleared out too quickly to be an effective pain reliever).
The supplement Betaine with Pepsin also helped another 40% reduce pain. I wrote an entire post on this specific supplement a few months ago.
Other treatments that were not in my survey that I’ve found very helpful for helping with pain and inflammation with my clients include; Wobenzym, cannabis oil (sorry, don’t have links for you because it’s only legal in some states), magnesium, and Omega-3 Fatty Acids.
Additional interventions reported to be most helpful for pain by my readers include the following:
A whopping 62% of people reported that removing nightshade vegetables from the diet helped to reduce their pain. Nightshades include; tomatoes, potatoes, bell peppers, eggplants, tomatillos, Goji berries and the herb ashwagandha. As a side note, even if you’re not in pain, hot, capsaicin-containing peppers have the propensity to cause leaky gut, so they too could potentially contribute to autoimmunity. Side note number 2: black pepper, the seasoning is not a nightshade. Just has a similar name. 🙂 It may be hard to part with these foods, but for some, they can make a world of a difference. Try a nightshade free diet for 2 weeks to see if that makes a difference for you.
Low FODMAPs Diet-48% saw improvement in pain with the low FODMAPs diet, typically used for small intestinal bacterial overgrowth also helped people with pain.
Autoimmune Paleo Diet (which removes grains, nightshades, and eggs, but not FODMAPs) helped another 50% of people with pain. (Some of them didn’t have pain as an initial symptom, which is why the 50% may seem low).
To get started with the Autoimmune Paleo Diet, download my 2 Week Autoimmune Paleo Meal Plan below!
Additional diets that were reported to reduce pain include the Gluten-Free Diet (47%), the Grain-Free Diet (43%), as well as an egg-free diet (40%).
Massage-62% of readers found that massage helped their pain (side bonus? 80% found it beneficial for mood as well). So if you’re in pain and struggling with depression, I urge you to treat yourself to a massage. Pharmacist’s prescription. 🙂
Acupuncture helped 61% of people with pain relief. I used to have a huge needle phobia- this is one reason why I went to pharmacy school and not medical school or nursing school! Part of me was afraid of the pain, another part of me afraid of contracting diseases with contaminated needles- but the needles used in acupuncture are teeny tiny and you can barely feel them. Furthermore, they are not reused so you don’t have to worry about getting germs from them.
I used acupuncture +chiropractic care + nutrition in the past to help recover from carpal tunnel.
Hidden Infections Can Cause Pain!
Treating the gut infection most commonly known for causing ulcers, Helicobacter Pylori helped reduce pain for 50% of people. I often see this infection in clients with chronic pain and migraines. This infection combined with NSAIDs is a double whammy risk for ulcers. A natural protocol I like to use is mastic gum and DGL for 60 days + cabbage juice (before you protest that cabbage is a goitrogen, please read this post on common Hashimoto’s food myths).
I also wanted to mention that my clients often test negative for H. Pylori on standard lab tests, but the stool antigen test utilized by functional medicine lab tests like the GI MAP, GI Effects, or Comprehensive Stool Analysis is more likely to uncover this infection.
Treating SIBO, or small intestinal bacterial overgrowth, helped 51% of people reduce their pain- Remember this point, I will be talking about my theory shortly… (I don’t have the time to outline SIBO treatments in greater detail in this post, but I’ve written about treatment protocols for SIBO in my book, and also do a deep dive in my Hashimoto’s Self-Management Program.)
Fibromyalgia & Hashimoto’s Connection
I want to spend a little time sharing some interesting connections I’ve pieced together over the last few years. Fibromyalgia, a type of chronic pain disorder, tends to go hand-in-hand with Hashimoto’s. Up to 33% of people with Hashimoto’s may have fibromyalgia, and autoimmune thyroid disease is thought to be a contributing factor to the development of fibromyalgia!
Sometimes people with Hashimoto’s are misdiagnosed with fibromyalgia, and sometimes people with fibromyalgia are told that their thyroid is responsible for their pain… but in fact, they may have fibromyalgia, and thus they don’t receive the proper treatment and suffer needlessly.
Either way, there is a lot of confusion about both conditions.
It angers me that a few years ago, fibromyalgia wasn’t even considered a “real disease” by many. Patients were told that it was just in their heads!
Part of the confusion, like with Hashimoto’s, is that many of the symptoms are nonspecific. In fact, many fibromyalgia symptoms overlap with Hashimoto’s. You may have fibromyalgia if you have the following symptoms:
- Tense and tight muscles, muscle spasms and chronic muscle pain
- Brain fog (also known as “fibro fog”) and depression
- Fatigue and lack of energy
- Insomnia/unrestful sleep
- Numbness/tingling in extremities
- Multiple sensitivities (foods, cold, meds, smells, noise, bright lights)
- Pain after exercise
- Irritable everything! (anxiety, irritable bowel syndrome, irritable bladder)
- Migraines/tension headaches
- Jaw and facial tenderness
- Feeling like your hands/feet are swollen when they are not
While there are lab tests that can be done to diagnose Hashimoto’s, fibromyalgia diagnosis can be more complicated.
SIBO is an important root cause to consider when dealing with both Hashimoto’s and Fibromyalgia. One study found that 100% of people with fibromyalgia had SIBO, while another study found 50% of people with hypothyroidism had SIBO. My hypothesis is that the people with Hashimoto’s who responded that treating SIBO and the low FODMAPs diet reduced their pain also had fibromyalgia.
I believe that factors that can reduce stomach acid, like H. pylori, SIBO, and methylation issues that steal our trimethylglycine away seem to contribute to both fibromyalgia and Hashimoto’s…
In addition to the interventions I discussed above, additional things I’ve found to specifically help my clients with fibromyalgia include reducing overall inflammation, optimizing thyroid hormone levels, neurofeedback, Betaine with Pepsin and/or the Homocysteine Factors supplement (which contains Trimethylglycine, B12, and methyl folate).
I hope that this helps you on your journey to becoming pain-free! Remember- you can do it!
1. Symptoms of Fibromyalgia. WebMD. 2016. Available at: http://www.webmd.com/fibromyalgia/understanding-fibromyalgia-symptoms. Accessed June 17, 2016.
2. Bazzichi L, Rossi A, Zirafa C et al. Thyroid autoimmunity may represent a predisposition for the development of fibromyalgia?. Rheumatol Int. 2010;32(2):335-341. doi:10.1007/s00296-010-1620-1.
3. Shirzad N, Movassaghi S, Karmostaji H, Esfahanian F, Hemmatabadi M, Qorbani M. Association between fibromyalgia and thyroid autoimmunity. Endocrine Abstracts. 2015. doi:10.1530/endoabs.37.ep1004.
4. Suk J, Lee J, Kim J. Association between Thyroid Autoimmunity and Fibromyalgia. Exp Clin Endocrinol Diabetes. 2012;120(07):401-404. doi:10.1055/s-0032-1309008.
I found sugar makes fib. pain worse, also gluten free diet help’s
Dr. Izabella Wentz says
Shirley- That is great! Thank you so much for sharing! Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.
FOOD SENSITIVITIES AND HASHIMOTO’S
AUTOIMMUNE PALEO DIET
January 18, 2017 at 8:19 PM
I found sugar makes fib. pain worse, also gluten free diet help’s”
Shirley I have been processed sugar free since Feb. 2004 (and gluten free). I have done the tests and for me (and one of my friends that also has FM) for every one gram of sugar there are 3 days of symptoms, hence 10 grams of processed sugar would be 30 days of pain and symptoms. It’s complicated because the “withdrawal” or actually the healing symptoms can be worse than the original symptoms. After time, thankfully, everything gets better. I haven’t had a “flare-up” since 2006 unless of course I have processed sugar. Although I do live in J-H mode (or healing mode) and I am always getting better. There are 3 epidemiological studies that show this relationship through alcohol and FM (which is really a sugar).
(I am not attached to the name I only care about the symptoms as there are too many conditions with these crazy symptoms.)
My heart is with you Shirley – it is such a debilitating condition.
I went to the dr today with a flare up of fybromyalgia and i have hoshemotos i ask if the fibro was a side effect of the hoshemotos they didn’t know. I have more symptoms then answers.
Dr. Izabella Wentz says
Mary- I hope you found the article helpful! I personally struggled with pain in the form of body aches and stiffness as well as carpal tunnel in both arms in 2010, when I was first diagnosed with Hashimoto’s. It was awful, I had to wear braces on both arms all day and even at night for about 6 months.
I took NSAIDs every day to deal with the pain so I could get through my workday.
I hope these articles help you get started.
PAIN AND HASHIMOTOS
TURMERIC FOR YOUR THYROID AND HASHIMOTO’S
Keri Titley says
Great article. It’s good to get useful information that doctors don’t have. Sometimes I think,that I am just swinging on my own and no one will ever help me, so thank you once,again. I look forward to more information.
Dr. Izabella Wentz says
Keri – thank you for following this page and for your support. <3
When I was first diagnosed with Hashimoto’s, I felt so alone. My doctor didn’t think it was a big deal, and none of my friends or co-workers had it. It wasn’t until I started to research online that I found others who were going through the same thing.
A couple of years after my diagnosis, I found Hashimoto’s 411, a closed Facebook group run by Alice Berry McDonnell. This group is amazing! It is comprised of an army of highly motivated, smart, supportive women and men (now 45,000+ strong), and each of them sharing ideas of what worked for them, things they were planning to try, and offering support to one another. The comfort I received from knowing that there were others going through the same challenges as I, was enormous.
Ask questions. Post your thoughts. Scan the files. It is an absolutely amazing resource. Best of all it’s kept private from spammers.
Elan Kirk says
Hi Dr. Wentz,
Question – I have been experiencing pain since September 2017, all the symptoms of fibro but I stoped having a period in 2014 and also have had symptoms from that (hair loss, weight gain, hot flashes, etc. I am now doing BHRT through a great Dr. and also being treated for some infections I have (EBV and Mycoplasma) which I have learned many people end up with when they have a hormone disorder. MyND thinks it’s hoshimotos based on my symptoms too, but my confusion with Fibro is that it’s not an autoimmune disease, it’s just a word used to describe symptoms….so isn’t it likely that fibro is caused by other things….like hoshimotos, and that once the root is treated the fibro will go away?
Dr. Izabella says
Elan – thank you for following this page. I am so happy to hear you have found a good clinician. While I only work with patients with Hashimoto’s, oftentimes patients will have additional autoimmune conditions. Most autoimmune conditions have common root causes, and a lot of times the things that are recommended for one autoimmune condition will help with others. Conditions that I have found to respond really well to the Hashimoto’s protocols have been rheumatoid arthritis, lupus, Celiac disease, irritable bowel syndrome, eczema, asthma, Graves’, premature ovarian failure, psoriasis, Alopecia Areata, and Sjogrens. I have also seen the protocols help with Fibromyalgia, chronic fatigue syndrome, PCOS, as well as Type 2 diabetes, Crohn’s, and Ulcerative colitis.
Hashimoto’s Root Cause
Kristina Kasprzak says
Hi Dr Wentz,
I went from Hashimoto’s Thyroidis to now having “lumps” on my palm knuckles (although I tested negative for rheumatoid arthritis) maybe its some ganglion cyst? I am now noticing light numbness/tingling in my extremities (hands, arms and feet)! I’m like what now! Any direction on tests to take to try and begin to identify possible root causes. I work with Dr Carter Black as well. Due to your recommendation on BioHealth 401H Test, i was able to identify and eliminate H-Pylori , and E-Coli (working on eliminating it). I would just like any guidance or direction on where to begin looking to identify Root causes/protocols, for these new symptoms. Extreme stress is in going on in my life at the moment. Thank you for all you do! and your wonderful website and program (A must have!) ~Kristina
Dr. Izabella says
Kristina – thank you for sharing our journey with me! <3 For question about the protocols please email my team at email@example.com and they will be happy to help you with this.
I have lumps/cysts on my palm knuckles as well Kristina. My hands have endured pain for years and now these lumps. I don’t know where to start with eliminating these.
BTW, I have Hashimotos hypothyroidism, fibromyalgia, inflammatory osteoarthritis, lupus, celiac.
Thanks for some direction in this newer development.
Dr. Izabella says
Saundra – thank you for reaching out. I am so sorry you are struggling with all of this. <3 Oftentimes patients will have additional autoimmune conditions. Most autoimmune conditions have common root causes, and a lot of times the things that are recommended for one autoimmune condition will help with others. Conditions that I have found to respond really well to the Hashimoto’s protocols have been rheumatoid arthritis, lupus, Celiac disease, irritable bowel syndrome, eczema, asthma, Graves’, premature ovarian failure, psoriasis, Alopecia Areata, and Sjogrens. I have also seen the protocols help with Fibromyalgia, chronic fatigue syndrome, PCOS, as well as Type 2 diabetes, Crohn’s, and Ulcerative colitis.
Hashimoto’s Root Cause
Hello Dr Wentz,
If I want to take high dosis of B12 40mg as a part of treatment, for how long should I take that dosis and the same for the B6 and B1,
Dr. Izabella Wentz says
Diana – thank you for reaching out. I recommend discussing this with you practitioner who is familiar with you health history to see if this would be an option for you. ❤️