The following two conditions have some of the same symptoms as fibromyalgia, and therefore could be mistakenly diagnosed.

Celiac Disease

Eating foods containing gluten—such as wheat, rye, or barley—can trigger a range of health problems for people who have celiac disease or a sensitivity to gluten.

See How Gluten Can Cause Joint Pain

An estimated 1% of Americans have celiac disease, and the disease affects both children and adults. 1 Rubio-Tapia A, Ludvigsson JF, Brantner TL, et al. The prevalence of celiac disease in the United States. Am J Gastroenterol 2012;107:1538-44.

Celiac disease is an autoimmune condition. The body's reaction to gluten causes inflammation, and continuing to eat gluten can harm the lining of the small intestine over time. The damage can keep the body from absorbing needed nutrients, hampering growth in children. Gluten-sensitive individuals who do not have celiac disease are not believed to experience the same damage.

See Is My Joint Pain Caused by Rheumatoid Arthritis (RA) or Another Autoimmune Disorder?

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Early diagnosis and treatment is important, since celiac disease can lead to nerve damage, osteoporosis, and other health conditions without treatment.

How it is similar to fibromyalgia: Fatigue, skin rash, numbness or tingling, digestive symptoms similar to irritable bowel syndrome, anxiety, depression, and menstrual problems may be experienced. Joint pain may be constant or come and go.

See Characteristic Symptoms of Fibromyalgia

How it is different from fibromyalgia: Blood tests, a biopsy of the small intestine, and genetic tests can determine the existence of celiac disease, though not of gluten sensitivity. Swelling in the arms and legs may occur. Also, removing gluten causes symptoms to disappear. There is no similar action that ends the symptoms of fibromyalgia.

See Multi-Specialty Fibromyalgia Treatment

Underactive Thyroid/ Hashimoto's Disease

The hormone produced by the thyroid gland affects the entire body by regulating metabolism. Hypothyroidism, or low thyroid, occurs when the thyroid gland is not making enough of this hormone, resulting in a slower metabolism. This slowdown affects energy levels, heart rate, mental sharpness, and body temperature.

See Conditions Related to Inflammatory Arthritis

Hashimoto’s disease, an autoimmune disorder, is the most common cause of hypothyroidism. In Hashimoto’s disease, the immune system harms the thyroid, preventing it from producing enough hormone. A less common cause is thyroiditis, a leakage of thyroid from the thyroid gland.

See Biologics for RA and Other Autoimmune Conditions

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Hypothyroidism occurs in almost 5% of Americans older than 12. 2 Garber JR, Cobin RH, Garib H, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice. 2012;18(6): 988–1028. It is more likely in women than men, and in people older than 60. 2 Garber JR, Cobin RH, Garib H, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice. 2012;18(6): 988–1028. Because untreated low thyroid can lead to mental impairment and slow growth, newborns are typically screened for hypothyroidism.

While the condition is usually minor, it can lead to heart problems, infertility, and other health issues if it is not treated, so checking with the doctor is advised when symptoms are present.

How it is similar to fibromyalgia: Fatigue, forgetfulness and lack of mental sharpness, depression, frequent headaches, hair loss, and an added sensitivity to cold are common. Muscle aches, stiffness, and tenderness are often symptoms as well.

See How to Get a Fibromyalgia Diagnosis

How it is different from fibromyalgia: Unlike with fibromyalgia, a blood test can determine whether someone has a thyroid problem, and it can usually be managed with medication.

See Medications to Ease Fibromyalgia Symptoms

  • 1 Rubio-Tapia A, Ludvigsson JF, Brantner TL, et al. The prevalence of celiac disease in the United States. Am J Gastroenterol 2012;107:1538-44.
  • 2 Garber JR, Cobin RH, Garib H, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice. 2012;18(6): 988–1028.

Dr. Vijay Vad is a sports medicine specialist at the Hospital for Special Surgery in New York, where he specializes in back pain, knee arthritis, frozen shoulder, and general sports medicine. He previously served as a physician for the professional men’s tennis circuit and on the Westchester Classic of the PGA Tour.

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