Informational Posts

Muscle and Joint Pain and Hypothyroidism

Originally published on 20th June 2017
Last updated on 12th February 2024

Many people living with hypothyroidism and / or Hashimoto’s complain of muscle and joint pain being among the most bothersome thyroid symptoms.

As well as the intense fatigue that hypothyroidism can cause, aches, pains, stiffness and weakness in joints (such as the knees and fingers) and muscles (such as the calves, back and feet) are well reported. I’ve had experience with it myself. 

It can keep us awake at night, cause us to need regular painkillers just to get through the day and make physical activity difficult to bear.

Related Post: Foot Pain and Hypothyroidism

Feet Cold Day

Muscle and Joint Pain with Hypothyroidism 

Yes, it is expected that muscle pain will appear after a long walk, workout or other activity that has caused overexertion, but it shouldn’t be expected as part of your day to day life when you haven’t exerted your muscles very much.

However, it continues to haunt many people living with thyroid disease, whether they do much physically all day or not.

Yes, muscle and joint pain can be another symptom of hypothyroidism.

Muscle and joint pain caused by hypothyroidism is known as hypothyroid myopathy, and can occur all over the body, though most commonly in the legs, feet, arms, hands and back and can range from mild to severe.

It also includes cramping, stiffness and weakness, but hypothyroid myopathy can also lead to carpal tunnel syndrome or frozen shoulder. Some thyroid patients may also have been diagnosed with fibromyalgia, a separate condition that causes pain all over the body or at specific points, when they are actually experiencing hypothyroid myopathy.

What Causes Pain in Thyroid Disease?

Legs in bed

1. Low Thyroid Hormone Levels

Ensuring that all your thyroid levels are optimal is an important first step (as opposed to just ‘in range’). Free T3 levels are particularly important for muscle pain, but many people also feel muscle pain when their thyroid antibodies are high (Hashimoto’s), so it can help to lower these.

Find a UK full thyroid panel here and a worldwide one here

2. Low Vitamin and Mineral Levels

Various vitamin and minerals, if low, can also lead to muscle and joint pain. The most common are Vitamin D, B12, iron, magnesium and folate. Vitamin D can especially cause joint stiffness and pain, so ensuring your levels are optimal is key.

Magnesium spray is popular, if you’d prefer to avoid adding another supplement or tablet to your daily regimen and acupuncture has been helpful to some thyroid patients, too.

Optimal Levels and Test Options:

Vitamin D – 50-80 ng/ml, but as close to the top of the range as possible. (UK test option here. US test option here.)

B12 – Close to top of range. (Test option here.)

Folate/Folic acid – In the top quarter of the range. (Test option here.)

Ferritin – 70-90 ng/ml, being slightly higher for men. (Test option here.)

Iron, T.I.B.C., Transferrin Saturation – well within range. (Worldwide test option here.)

Magnesium – Mid-range or higher. (UK test here)

Selenium – Worldwide test option here.

3. Adrenal Dysfunction

I personally found that I stopped having any foot pain once the Hashimoto’s was in remission and my high cortisol ‘adrenal dysfunction‘ was addressed. As a part of all this, I raised my B12, Vitamin D and magnesium levels to be well within their ranges, as well as reducing my thyroid antibodies to almost zero, reducing inflammation.

How I Solved “Adrenal Dysfunction”

4. Fluid Retention

Fluid retention, another somewhat common hypothyroid symptom, can cause pain, too. It’s most often seen around the ankles and feet and worsens with physical activity. This is also often solved with optimal thyroid and vitamin levels.

5. Dietary Considerations

Gluten-caused inflammation can cause joint and muscle pain in some people and many of us with thyroid disease may feel better on a gluten-free diet.

My muscle aches and pains resolved after going gluten-free.

Other food sensitivities could be causing your joint pain too.

Short-term Relief

Short term treatments for hypothyroid myopathy can include massaging the affected area, which increases blood flow and eases aches and pains, or a warm bath or foot soak which helps to relax muscles, bonus points if you use Epsom salts, which is a popular trick for relaxing and relieving tired and achy muscles. You can get the ones I use by clicking here.

If you’ve explored all of the above and are still suffering with pain, it may be time to talk to a rheumatologist for further evaluation. Rheumatologists are experts in joint and muscle problems, and treat arthritis, carpel tunnel, some autoimmune conditions, various musculoskeletal pain disorders, fibromyalgia and tendonitis.

Do you have muscle or joint pain? Let me know in the comments. 

You can click on the hyperlinks in the above post to learn more and see references to information given.

Related article: Foot Pain and Hypothyroidism

Book1Edition2CoverWithShadowSee also:

The book Be Your Own Thyroid Advocate: When You’re Sick and Tired of Being Sick and Tiredwhich builds on this article in detail. Reclaim your thyroid healthy life.

About Author

Rachel Hill is the highly ranked and multi-award winning thyroid patient advocate, writer, speaker and author behind The Invisible Hypothyroidism. Her thyroid advocacy work includes writing articles, authoring books, producing her Thyroid Family email newsletters and speaking on podcasts and at events about the many aspects thyroid disease affects and how to overcome these. She is well-recognised as a crucial and influential contributor to the thyroid community and has a large social media presence. Her bestselling books include "Be Your Own Thyroid Advocate" and "You, Me and Hypothyroidism".


  • Sam
    February 16, 2024 at 3:40 am

    I just had a Thyroidectomy on 26 December, 2023. After 23+ years of hypo/hashi, I had tried everything. I actually felt better…for a few weeks, then POW! Fatigue, brain fog, tremors, back pain, and always sleepy. I was on 137 Levo, Endo upped it to 150. About a week after upping to 150, ALL symptoms increased in severity. I just read that after a complete thyroidectomy, T3 medication is also needed. While my numbers are in range, I feel horrible. I’ve done 125,137,175, even 200 MG–all symptoms remain. Could it be I actually need LESS levo? I do feel better when I stop the medication, but now understand that is temporary and dangerous. NOT SURE WHERE TO TURN.

  • Marge Weiler
    November 22, 2021 at 1:57 am

    I have calf pain that’s so bad that I can’t walk. Now starting in other calf. I swear it’s from a reaction to the thyroid meds, and I’ve been on all if them. Better when I don’t take them. Been to too many doctors and no answers. I have had it.

  • Chris R
    March 5, 2021 at 4:48 pm

    I have suffered from pain and weakness in my thigh and upper arm muscles for over 23 years, and I was diagnosed with hypothyroidism at that time. I have taken thyroxine ever since. The muscle problems have got worse over the years, and dominate my life. The worst symptom is pain in my thigh muscles. My endocrinologist says that I am unique and the only person in the world who has these chronic symptoms which have never fully resolved. I have felt so utterly alone with it all, being ‘unique’. I take vitamin D supplements, and have a gluten-free diet, as I have coeliac disease. I am also severely sensitive to UVA sunlight, which is yet another auto-immune disease. My life is miserable with the pain, and there seems no help or understanding from any doctors.

    • Louise.
      April 13, 2021 at 8:36 am

      Hi Chris, we are unique together 😢. I have extreme muscle pains in the thighs along with very high CK levels. I was only diagnosed 18months ago but the pain in my muscles has caused me to give up all exercise until I can get to the bottom of it. All other Hashimoto’s symptoms are under control. I’m seeing a naturopath and I’m having a muscle biopsy in 3 weeks and seeing a Endocrinologist in July. It’s a struggle every day and the pain in unrelenting. Good luck Louise

    • Michele Pine
      September 12, 2022 at 10:47 am

      I am experiencing the same things. Doctors don’t listen and they try to make it seem lie it’s just in your mind.

  • Yasmin
    October 2, 2020 at 10:35 pm

    Thank you for this wonderful post.

  • dianne
    October 26, 2019 at 3:03 pm

    hi everyone, i had both thyroids removed in 2010. i had thyroid cancer,very cureable. cancer free now. my problem was and is i was put on levothyroxine and gained 50 lbs. i have spoken to others with the same problem and they also gained a large amount of weight . i was taken of of levothyroxine and put on armour thyroid. that did help. i know alot of drs. dont like armour but it works for me. my does is high 120mg. and 90 mg. every other day. my levels have been prefect for 3 yrs. i in resent months have been in so much pain thought i ober worked as i have in the past. now am wondering why the pain hasnt gone away. i have neck and shoulder pain also lower back pain butt check pain going done both legs hard to walk with taking some kind of pain meds. is this from the thyroid issuse i have. if anyone has an anwser i would love to hear it. tnaks for hearing me.

    • Candace
      July 28, 2022 at 7:16 pm

      I have had this very same problem. I upped my meds on Armour. Bloodwork at the top of the range and my muscles feel like normal again.

  • Nancy Malon
    September 30, 2019 at 4:26 pm

    I am 71, have Hashimoto for 25 years. Recently I have arm pain, and swelling in hands and arm. It is very painful and keeps me from doing daily chores. I take levothyroxine and vitamin supplements which don’t seem to help. The swelling and pain sometimes goes to wrists, ankles, knees and feet also. If any of you have experienced this, I would like to hear what you have done to reduce the pain.

  • Jane louise mutton
    August 10, 2019 at 8:07 am

    unlike most people with hypothyroidism I have hot hands and feet.Only started on levothyroxine in March so still on loading dose up to 50 mg .I was started on 50mgs but I had to reduce it because I felt so awful,

  • Suzanne
    August 1, 2019 at 9:08 am

    Brilliant article. Thanks for writing! Was diagnosed with Hashimotos and not much info from GP. have mentioned how both my ankles ache as well as my finger. No aches and pains two years ago, peak fitness and climbed Kili in Africa. Now tired and feel like I have aged 20 years in 2. Makes you so fed up and the care you receive is awful!

  • Sunnor
    April 17, 2019 at 6:00 am

    I have taken rai for graves 4 yrs ago.i bcame hypo after 6 months of that dr treated problem is that my thyroid levels have bn fluctuating since thn.n my dr is not able to fix my dose.i experience muscles pain in my legs.n ankle joints.fatigue.pain in arms n shoulders.can sm one guide me what shud i do.?any life style modifications.

  • Laura
    March 6, 2019 at 10:26 pm

    Muscle weakness in legs and hips occurs either as a sensation or if you are fatigued enough that they lose strength.

  • Lynn
    January 24, 2019 at 7:13 pm

    Just learned I have come down with Hashimoto after landing in the hospital. So am so glad to see this and join. I am one of those people who are frustrated because I was always so healthy and am wondering what is happening to my health. Seems also that I can’t eat anything I always ate. I see that you have a cook book I will utilize. Thanks for being here. Am having a tough time dealing with this.

    • Suzanne
      August 1, 2019 at 9:03 am

      Me too Lynn. Two years ago I was standing 20,000 feet on top of Kilimanjaro at peak fitness. Now I have muscle aches and pains and feel tired! So frustrating. I do sympathise. Big hugs x

  • Fazil patlakoglu
    August 15, 2018 at 10:51 am

    Hi Rachel thanks for the great articles and your webpage,I’ve got hypothyroidism for the last 4 years and just got another ear infection on levothyroxine 150mcg I’ve been feeling really fatigued this week too all I seem to get is fobbed off by the doctors but managing to see an endocryolist in October is there any advice you can give me many thanks.

  • Cheryl
    August 12, 2018 at 11:32 am

    Can you please tell me the vitamins for easing fluid retention in the ankles, my circulation is poor, especially in my left leg due to varicose veins, and my ankle looks puffy and gets sore and makes me feel like a 100 year old ?

    • Rachel Hill
      August 14, 2018 at 1:32 pm

      Hi Cheryl, fluid retention with hypothyroidism is usually as a result of the low thyroid hormone levels. Have you had a full panel conducted recently? I would ensure you’re aiming for optimal results –

    • Beth Berger
      March 7, 2023 at 1:36 pm

      I have swollen calf and ankles on regular basis
      My left leg is much more swollen

      Lately experiencing muscle cramps in calf’s.

      • Charlotte M Stanford
        April 20, 2024 at 11:48 pm

        I have Hashimotos’s and had horrible muscle cramps all over my body in different areas but especially the legs, feet and toes. I take Quina drops from and as long as I take enough I don’t have the awful cramps. You would have to do trial and error to find out how many drops you need. They are organic and are made from the bark of a tree. It is quinine so it can make your ears ring, which mine have rang for years anyway, so no big deal for me. I take a dropper full, which looks like a half a dropper, plus 4 or 5 more drops, twice a day, morning and afternoon and no cramps. I cut back a week ago and the cramps were right back, a charlie horse so bad that it is healing very slowly at this point.

  • Tommye Mandt
    May 16, 2018 at 9:10 am

    Your site is so fantastic. I’m going to come back here again.

  • Wendy Davis
    March 7, 2018 at 9:34 pm

    Thanks so much for the helpful advice.

  • Wendy Davis
    March 7, 2018 at 8:53 pm

    what is the best thing for the inflammation?

  • Wendy Davis
    March 6, 2018 at 4:09 pm

    I have auto immune thyroiditis and the muscle and joint pain have been worse lately. Does anyone else have this?

    • Rachel Hill
      March 7, 2018 at 7:00 pm

      It’s very common with Hashimoto’s unfortunately. Reducing inflammation can help.

  • 73Loretta
    January 31, 2018 at 2:18 pm

    I must say you have high quality posts here. They’re very useful.


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