RHEUMATOLOGICAL MANIFESTATIONS OF ENDOCRINE DISORDERS

Dr Vaishali Deshmukh

Yesterday, I woke up irritated to a harsh ringing of the telephone, and I picked up the telephone, still half asleep. "Who is it" I enquired. The caller said "This is Mrs. Karmalkar speaking and I am sorry doctor for waking you but I do not know what to do. Since this morning my lower back and knees are jammed. I am unable to perform any movement and if I move my legs I also feel numbness and heaviness - just as it used to happen earlier. Mrs. Karmalkar, who is sixty-ish is my old patient who first came to for diabetes and thyroid problem.

At that time, she had same complaints and tests revealed that she suffered from diabetes and hypothyroidism. After proper treatment, her blood sugar and thyroid problem were controlled. Her movements became free and the numbness also disappeared. Her backache and knee pain also diminished. She did not come for a follow up for a long time and today she suddenly remembered me because her old ailments reappeared. Though I was a bit annoyed I tried to explain to her that if her weight, her blood sugar, calcium and thyroid levels are abnormal then these symptoms will recur again and again.

Therefore, it is necessary to check regularly to see if the problems are under control or not. You will not know if these problems are under control or not if you do not visit your doctor regularly. Therefore, let us check your hormones, calcium and weight to see if these are OK, I said to her.

Most patients or people at large are not aware that various hormonal disorders can show symptoms like arthritis, numbness, and muscular pain. For example, rise in the blood sugar in diabetics can show symptoms like

joints pain
frozen joints
numbness
cramps
leg pain
low back acke -spasm.

Same symptoms can be seen in patients of thyroid disorders also. Same can be seen if there is sudden gain in weight in a person.

Above symptoms are mainly seen in patients suffering from following diseases.

Diabetes Mellitus
Hypothyroidism
Hyperthyroidism
Osteomalacia
Osteoporosis
Obesity
Metabolic Syndrome
Prediabetes
Cushing's Syndrome
Steroid induced obesity and Cushing's Syndrome
Acromegaly

On the other hand, many rheumatological diseases have hormonal disorders. For example:

Systemic Lupus Erythematosus, Rheumatoid arthritis have mainly thyroid disorders.
These are also seen in obesity induced by excessive use of steroids and osteoporosis.
Calcium deficiency is noticed in various forms of arthritis.

In addition to these, signs and symptoms of arthritis are also seen in deficiencies of vitamins like B12, D, C etc due to malnutrition. The reason for writing all this is that persons suffering from arthritis and muscular pain should be investigated for above mentioned problems so that one can