Central Sensitization Syndrome and Hypothyroidism: An Evaluation of Symptom Severity and Comorbid Diagnoses

Abstract

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