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Pain and thyroid hormones

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Abstract

The role of endocrine systems in chronic pain mechanisms is slowly getting increasing experimental and clinical consideration. Many painful conditions appear to be directly and/or indirectly induced, reduced or, in some cases, modulated by hormones. We have done much work in trying to understand the relationship between hormones and pain, with particular attention to the hypothalamus–pituitary–gonadal axis. To expand our knowledge of this field, we have directed our attention to another axis, the hypothalamus–pituitary–thyroid (HPT). The literature on thyroid functions is vast but very few studies have focused on the HPT axis and pain. The few available data are considered in the present review to stimulate interest in the possible interactions between the HPT axis and pain.

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References

  1. Aloisi AM, Bonifazi M (2006) Sex hormones, central nervous system and pain. Horm Behav 50:1–7

    Article  PubMed  CAS  Google Scholar 

  2. Aloisi AM, Aurilio C, Bachiocco V, Biasi G, Fiorenzani P, Pace MC et al (2009) Endocrine consequences of opioid therapy. PNEC 34:S162–S168

    CAS  Google Scholar 

  3. Aloisi AM, Sorda G (2011) Relationship of female sex hormones with pain perception: focus on estrogens. Pain Manag 1:229–238

    Article  Google Scholar 

  4. Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JLIII (2009) Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain 10:447–485

    PubMed  Google Scholar 

  5. Palmeira CC, Ashmawi HA, Posso Ide P (2011) Sex and pain perception and analgesia. Rev Bras Anestesiol 61:814–828

    Article  PubMed  Google Scholar 

  6. Zhu YS, Cai LQ, You X, Duan Y, Imperato-McGinley J, Chin WW et al (2001) Molecular analysis of estrogen induction of preproenkephalin gene expression and its modulation by thyroid hormones. Brain Res Mol Brain Res 91:23–33

    Article  PubMed  CAS  Google Scholar 

  7. Dellovade TL, Zhu YS, Krey L, Pfaff DW (1996) Thyroid hormone and estrogen interact to regulate behavior. Proc Natl Acad Sci USA 93:12581–12586

    Article  PubMed  CAS  Google Scholar 

  8. Sheng ZG, Tang Y, Liu YX, Yuan Y, Zhao BQ, Chao XJ et al (2012) Low concentrations of bisphenol a suppress thyroid hormone receptor transcription through a nongenomic mechanism. Toxicol Appl Pharmacol 259:133–142

    Article  PubMed  CAS  Google Scholar 

  9. Ågren UM, Anttila M, Mäenpää-Liukko K, Rantala ML, Rautiainen H, Sommer WF et al (2011) Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-oestradiol in comparison to one containing levonorgestrel and ethinylestradiol on markers of endocrine function. Eur J Contracept Reprod Health Care 16:458–467

    Article  PubMed  Google Scholar 

  10. Kostoglou-Athanassiou I, Ntalles K, Markopoulos C, Athanassiou P, Gogas J, Proukakis C (1998) Thyroid function in postmenopausal women with breast cancer on tamoxifen. Eur J Gynaecol Oncol 19:150–154

    PubMed  CAS  Google Scholar 

  11. Bisschop PH, Toorians AW, Endert E, Wiersinga WM, Gooren LJ, Fliers E (2006) The effects of sex-steroid administration on the pituitary-thyroid axis in transsexuals. Eur J Endocrinol 155:11–16

    Article  PubMed  CAS  Google Scholar 

  12. Arafah BM (1994) Decreased levothyroxine requirement in women with hypothyroidism during androgen therapy for breast cancer. Ann Intern Med 121:247–251

    Article  PubMed  CAS  Google Scholar 

  13. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC (2000) The Colorado thyroid disease prevalence study. Arch Intern Med 160:526–533

    Article  PubMed  CAS  Google Scholar 

  14. Surks MI, Hollowell JG (2007) Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab 92:4575–4582

    Article  PubMed  CAS  Google Scholar 

  15. Mohácsik P, Zeöld A, Bianco AC, Gereben B. (2011) Thyroid hormone and the neuroglia: both source and target. J Thyroid Res:215718. Epub 2011 Aug 23

  16. Leonard JL (2008) Non-genomic actions of thyroid hormone in brain development. Steroids 73:1008–1012

    Article  PubMed  CAS  Google Scholar 

  17. Kalló I, Mohácsik P, Vida B, Zeöld A, Bardóczi Z, Zavacki AM et al (2012) A novel pathway regulates thyroid hormone availability in rat and human hypothalamic neurosecretory neurons. PLoS One 7:e37860

    Article  PubMed  Google Scholar 

  18. Fliers E, Alkemade A, Wiersinga WM, Swaab DF (2006) Hypothalamic thyroid hormone feedback in health and disease. Prog Brain Res 153:189–207

    Article  PubMed  CAS  Google Scholar 

  19. Nillni EA (2010) Regulation of the hypothalamic thyrotropin releasing hormone (TRH) neuron by neuronal and peripheral inputs. Front Neuroendocrinol 31:134–156

    Article  PubMed  CAS  Google Scholar 

  20. Yamamoto M, Komori T, Matsumoto T, Zhang K, Miyahara S, Shizuya K et al (2003) Effects of single and repeated prolonged stress on mu-opioid receptor mRNA expression in rat gross hypothalamic and midbrain homogenates. Brain Res 980:191–196

    Article  PubMed  CAS  Google Scholar 

  21. Berglund LA, Millard WJ, Gabriel SM, Simpkins JW (1990) Opiate-thyroid hormone interactions in the regulation of thyrotropin secretion in the rat. Neuroendocrinology 52:303–308

    Article  PubMed  CAS  Google Scholar 

  22. del Valle-Soto ME, Iglesias L, Calzada B, Vega JA, Hernandez LC, Pe’rez-Casas A (1991) Effects of morphine on the pituitary-thyroid axis: morphological and analytical studies. Funct Dev Morphol 1:3–6

    PubMed  Google Scholar 

  23. Delitala G, Grossman A, Besser M (1983) Differential effects of opiate peptides and alkaloids on anterior pituitary hormone secretion. Neuroendocrinology 37:275–279

    Article  PubMed  CAS  Google Scholar 

  24. Abs R, Verhelst J, Maeyaert J, Van Buyten JP, Opsomer F, Adriaensen H et al (2000) Endocrine consequences of long-term intrathecal administration of opioids. J Clin Endocrinol Metab 85:2215–2222

    Article  PubMed  CAS  Google Scholar 

  25. Ogrin C, Schussler GC (2005) Suppression of thyrotropin by morphine in a severely stressed patient. Endocr J 52:265–269

    Article  PubMed  Google Scholar 

  26. Klein JR (2006) The immune system as a regulator of thyroid hormone activity. Exp Biol Med (Maywood) 231:229–236

    CAS  Google Scholar 

  27. Bartalena L, Brogioni S, Grasso L, Rago T, Vitti P, Pinchera A et al (1994) Interleukin-6: a marker of thyroid-destructive process? J Clin Endocrinol Metab 79:1424–1427

    Article  PubMed  CAS  Google Scholar 

  28. Niv D, Devor M (2007) Position paper of the European Federation of IASP chapters (EFIC) on the subject of pain management. Eur J Pain 11:487–489

    Article  PubMed  Google Scholar 

  29. Bair MJ, Robinson RL, Katon W, Kroenke K (2003) Depression and pain comorbidity: a literature review. Arch Intern Med 163:2433–2445

    Article  PubMed  Google Scholar 

  30. Stipcevic T, Pivac N, Kozarie- Kovacic D, Muck-Seler D (2008) Thyroid activity in patients with major depression. Coll Antropol 32:973–976

    PubMed  Google Scholar 

  31. Gitlin M, Altshuler LL, Frye MA, Suri R, Huynh EL, Fairbanks L et al (2004) Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors. J Psychiatry Neurosci 29:383–386

    PubMed  Google Scholar 

  32. Nagaya T, Fujieda M, Otsuka G, Yang JP, Okamoto T, Seo H (2000) A potential role of activated NF-Kappa B in the pathogenesis of euthyroid sick syndrome. J Clin Invest 106:393–402

    Article  PubMed  CAS  Google Scholar 

  33. Zoccali C, Tripepi G, Cutrupi S, Pizzini P, Mallamaci F (2005) Low triiodothyronine: a new facet of inflammation in end-stage renal disease. J Am Soc Nephrol 16:2789–2795

    Article  PubMed  CAS  Google Scholar 

  34. Hagen K, Bjøro T, Zwart JA, Svebak S, Bovim G, Stovner LJ (2005) Do high TSH values protect against chronic musculoskeletal complaints? The Nord-Trøndelag Health Study (HUNT). Pain 113:416–421

    Article  PubMed  CAS  Google Scholar 

  35. Sandrini M, Vitale G, Vergoni AV, Ottani A, Bertolini A (1996) Effect of acute and chronic treatment with triiodothyronine on serotonin levels and serotonergic receptor subtypes in the rat brain. Life Sci 58:1551–1559

    Article  PubMed  CAS  Google Scholar 

  36. Bauer M, Whybrow PC (2001) Thyroid hormone, neural tissue and mood modulation. World J Biol Psychiatry 2:59–69

    Article  PubMed  CAS  Google Scholar 

  37. Carr AN, Kranias EG (2002) Thyroid hormone regulation of calcium cycling proteins. Thyroid 12:453–457

    Article  PubMed  CAS  Google Scholar 

  38. Seigel SC, Hodak SP (2012) Thyrotoxicosis. Med Clin North Am 96:175–201

    Article  PubMed  CAS  Google Scholar 

  39. De Vito P, Incerpi S, Pedersen JZ, Luly P, Davis FB, Davis PJ (2011) Thyroid hormones as modulators of immune activities at the cellular level. Thyroid 21:879–890

    Article  PubMed  Google Scholar 

  40. Hagen K, Bjøro T, Zwart JA, Vatten L, Stovner LJ, Bovim G (2001) Low headache prevalence amongst women with high TSH values. Eur J Neurol 8:693–699

    Article  PubMed  CAS  Google Scholar 

  41. Iwasaki Y, Kinoshita M, Ikeda K, Takamiya K, Shiojima T (1991) Thyroid function in patients with chronic headache. Int J Neurosci 57:263–267

    Article  PubMed  CAS  Google Scholar 

  42. Bazzichi L, Rossi A, Zirafa C, Monzani F, Tognini S, Dardano A et al (2012) Thyroid autoimmunity may represent a predisposition for the development of fibromyalgia? Rheumatol Int 32:335–341

    Article  PubMed  CAS  Google Scholar 

  43. Dernellis J, Panaretou M (2002) Effects of thyroid replacement therapy on arterial blood pressure in patients with hypertension and hypothyroidism. Am Heart J 143:718–724

    Article  PubMed  CAS  Google Scholar 

  44. Das KC, Mukherjee M, Sarkar TK, Dash RJ, Rastogi GK (1975) Erythropoiesis and erythropoietin in hypo- and hyperthyroidism. J Clin Endocrinol Metab 40:211–220

    Article  PubMed  CAS  Google Scholar 

  45. Fandrey J, Pagel H, Frede S, Wolff M, Jelkmann W (1994) Thyroid hormones enhance hypoxia-induced erythropoietin production in vitro. Exp Hematol 22:272–277

    PubMed  CAS  Google Scholar 

  46. Neeck G (2000) Neuroendocrine and hormonal perturbation and relation to the serotonergic system in fibromyalgia patients. Scand J Rheumathol Suppl 113:8–12

    CAS  Google Scholar 

  47. Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW et al (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 70:1630–1635

    Article  PubMed  CAS  Google Scholar 

  48. Ferreira AA, Nazario JC, Pereira PJ, Azevedo NL, Barradas PC (2004) Effects of experimental hypothyroidism on myelin function sheath structural organization. J Neurocytol 33:225–231

    Article  PubMed  CAS  Google Scholar 

  49. Khedr EM, El Toony LF, Tarkhan MN, Abdella G (2000) Peripheral and central nervous system alterations in hypothyroidism: electrophysiological findings. Neuropsychobiol 41:88–94

    Article  CAS  Google Scholar 

  50. Tavee J, Zhou L (2009) Small fiber neuropathy: a burning problem. Cleve Clin J Med 76(5):297–305

    Article  PubMed  Google Scholar 

  51. Ørstavik K, Norheim I, Jørum E (2006) Pain and small-fiber neuropathy in patients with hypothyroidism. Neurology 67:786–791

    Article  PubMed  Google Scholar 

  52. Misiunas A, Niepomniszcze H, Ravera B, Faraj G, Faure E (1995) Peripheral neuropathy in subclinical hypothyroidism. Thyroid 5:283–286

    Article  PubMed  CAS  Google Scholar 

  53. Duyff RF, Van den Bosch J, Laman DM, van Loon BJ, Linssen WH (2000) Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry 68:750–755

    Article  PubMed  CAS  Google Scholar 

  54. Devor M (2009) Ectopic discharge in Aβ afferents as a source of neuropathic pain. Exp Brain Res 196:115–128

    Article  PubMed  CAS  Google Scholar 

  55. Kennedy WR (2004) Opportunities afforded by the study of unmyelinated nerves in skin and other organs. Muscle Nerve 29:756–767

    Article  PubMed  Google Scholar 

  56. Lauria G, Hsieh ST, Johansson O, Kennedy WR, Leger JM, Mellgren SI et al (2010) European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. Eur J Neurol 17:903–912

    Article  PubMed  CAS  Google Scholar 

  57. Magri F, Buonocore M, Oliviero A, Rotondi M, Gatti A, Accornero S et al (2010) Intraepidermal nerve fiber density reduction as a marker of preclinical asymptomatic small-fiber sensory neuropathy in hypothyroid patients. Eur J Endocrinol 163:279–284

    Article  PubMed  CAS  Google Scholar 

  58. De Sousa EA, Hays AP, Chin RL, Sander HW, Brannagan TH (2006) Characteristics of patients with sensory neuropathy diagnosed with abnormal small nerve fibres on skin biopsy. J Neurol Neurosurg Psychiatry 77:983–985

    Article  PubMed  Google Scholar 

  59. Khan S, Zhou L (2012) Characterization of non-length-dependent small-fiber sensory neuropathy. Muscle Nerve 45:86–91

    Article  PubMed  Google Scholar 

  60. Gorson KC, Herrmann DN, Thiagarajan R, Brannagan TH, Chin RL, Kinsella LJ et al (2008) Non-length dependent small fibre neuropathy/ganglionopathy. J Neurol Neurosurg Psychiatry 79:163–169

    Article  PubMed  CAS  Google Scholar 

  61. Cruz MW, Tendrich M, Vaisman M, Novis SA (1996) Electro-neuromyography and neuromuscular findings in 16 primary hypothyroidism patients. Arq Neuropsiquiatr 54:12–18

    Article  PubMed  CAS  Google Scholar 

  62. Magri F, Buonocore M, Camera A, Capelli V, Oliviero A, Rotondi M et al (2013) Improvement of intra-epidermal nerve fiber density in hypothyroidism after L-thyroxine therapy. Clin Endocrinol (Oxf) 78:152–153

    Article  CAS  Google Scholar 

  63. Penza P, Lombardi R, Camezzi F, Ciano C, Lauria G (2009) Painful neuropathy in subclinical hypothyroidism; clinical and neuropathological recovery after hormone replacement therapy. Neurol Sci 30:149–151

    Article  PubMed  Google Scholar 

  64. Chiovato L, Mariotti S, Pinchera A (1997) Thyroid diseases in the elderly. Bailliere’s Clin Endocrinol Metab 11:251–270

    Article  CAS  Google Scholar 

  65. Magri F, Muzzoni B, Cravello L, Fioravanti M, Busconi L, Camozzi D et al (2002) Thyroid function in physiological aging and in centenarians: possible relationship with some nutritional markers. Metab Clin Exp 51:105–109

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Anna Maria Aloisi.

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Aloisi, A.M., Vodo, S. & Buonocore, M. Pain and thyroid hormones. Neurol Sci 34, 1501–1508 (2013). https://doi.org/10.1007/s10072-013-1440-7

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