| Rheumatoid arthritis (RA) is the most common | | | | weight gain, muscle and joint aches and pains can |
| inflammatory form of arthritis, affecting more than 2 | | | | often occur. |
| million Americans. It is a chronic, systemic, progressive | | | | Hypothyroidism is significantly more common in female |
| autoimmune process for which there is no cure, | | | | patients with rheumatoid arthritis (RA) than in women in |
| currently. However, there are medications available | | | | general due to the increased association of these two |
| that can put this disease into remission. | | | | conditions. |
| Prior to treating rheumatoid arthritis, it is important than | | | | A recent study has demonstrated that this |
| any patient suspected of having the disease undergo | | | | coexistence further aggravates the known increased |
| a thorough and complete examination. This will include | | | | risk for cardiovascular disease occurring in rheumatoid |
| an in-depth history, careful physical examination, | | | | arthritis patients. (Ann Rheum Dis 2008;67:229-232) |
| laboratory testing, and imaging procedures such as | | | | Dutch researchers at the VU University Medical |
| x-ray, diagnostic ultrasound, or magnetic resonance | | | | Center, Amsterdam studied 358 RA patients, 236 of |
| imaging (MRI). | | | | whom were women. All were taking part in an ongoing |
| While rheumatoid arthritis can affect many internal | | | | cardiovascular study. |
| organ systems such as the eyes, lungs, and heart, its | | | | Clinical hypothyroidism was seen in none of the men |
| symptoms can be magnified by other conditions. | | | | and 16 of the studied women (6.8%) compared to |
| That is why it is so important that thorough laboratory | | | | 2.7% in the general Dutch population. Six of the |
| testing be done. Many of the symptoms of rheumatoid | | | | women had subclinical- meaning unapparent on |
| arthritis such as generalized aches and pains in the | | | | physical examination- hypothyroidism as did 4 of the |
| joints and muscles, fatigue, listlessness, and low grade | | | | men. |
| fever can be due to other conditions. | | | | The women with clinical hypothyroidism also had |
| Anemia, which is frequent in patients with active RA, is | | | | significantly more cardiovascular disease than did RA |
| a common cause of fatigue. | | | | patients with normal thyroid function (37.5% versus |
| For instance, it is not uncommon for patients to have | | | | 13.0%). |
| an overlap of their rheumatoid arthritis with systemic | | | | After adjustment for other factors, the odds ratio- the |
| lupus erythematosus. This condition is referred to as | | | | increased risk- was 4.6. In other words, women with |
| "rupus." | | | | RA and hypothyroidism were 4.6 times more likely to |
| Also, inflammatory muscle diseases such as | | | | have significant cardiovascular disease than women |
| polymyositis can often present with joint inflammation | | | | with RA who didn't have hypothyroidism. |
| along with weakness. | | | | The authors concluded that "clinical hypothyroidism |
| Another organ system dysfunction that is often | | | | accelerates the already enhanced cardiovascular risk |
| neglected or overlooked is thyroid disease. | | | | in rheumatoid arthritis and that physicians should |
| There is an increased incidence of autoimmune thyroid | | | | consider screening for thyroid disorders in rheumatoid |
| disease in patients with rheumatoid arthritis. When | | | | arthritis patients." |
| thyroid inflammation occurs, the end result can be | | | | Author's note: In our clinic, we routinely screen arthritis |
| hypothyroidism- an underactive thyroid gland. The | | | | patients for coexistent thyroid disease. We have found |
| thyroid gland is responsible for many metabolic | | | | that all too often, unsuspected hypo- or |
| functions in the body. When it fails to work properly, | | | | hyperthyroidism is present and once this condition is |
| symptoms such as cold intolerance, fatigue, lethargy, | | | | treated, many of the other symptoms improve as well. |