Thyroid UK
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Knee inflammation and bursitis - could there be any connection with hypothyroidism?

I was recently found to have subclinical hypothyroidism, I have elevated anti-TPo antibodies, TSH 5.24 (0.3-4.2). I don't have too many overt symptoms at the moment apart from some GI/stomach issues and a bit of fatigue.

One thing that has been bothering me over the last 18 months is one of my knees. I was hit by a car 18 months ago and suffered a relatively minor injury ( a sprained medial ligament) which should have taken a few weeks to heal. However, since then, the knee has just been getting worse. I went to a physio and orthopedic doc a year ago. He did an MRI and said there was nothing there apart from bursitis/inflammation, so he gave me a steroid injection, which seemed to make it swell more and get worse.

I can now walk ok, but when I walk up the stairs, it's a bit uncomfortable as I can feel and hear the knee clicking, and I don't feel as fast, mobile and comfortable walking and running as I did ( I like to run marathons!)

It's probably totally unrelated and I'm clutching at straws, but I was just very curious to hear if anyone has any thoughts or knowledge on whether my hypothyroidism/elevated antibodies could be having any impact on this ongoing problem; could it be making a relatively innocuous injury into something more chronic and problematic?

13 Replies

Just out of interest, I assume your physio readjusted and "straightened" you up after the car accident? or did they concentrate solely on the problem area?


Hi vixvixvix, how do you mean? She did give me lots of exercises to generally strengthen both legs - particularly the upper legs


Did she ever click you or do any postural adjustments? How bad was the car crash? I mean you only walked away with a noticeable minor injury, but the hit could have exacerbated any existing postural inbalances in the body and that takes time to "develope". Further more, the injury could have caused fascial impingements (not necessarily your knee) which in turn"pulls" on the other parts of the body, especially since you sound like you're adjusting your posture when you walk etc due I the pain, which makes it worse etc. So essentially, yes your knee is bad but it could be due to somewhere different in your body and the knee is"just" the part that hurts.

Further more it's great that you've been given exercises to strengthen your leg, but are you doing it properly? (I.e. using precisely the correct muscles, and using strength from the right place correctly). This is from personal experience with terrible repetitive strain in my lower back. I was with the same trainer for years and doing "strengthening" exercises but not seeing anything improvements, in fact, it got worse. Changed trainers, we're doing similar exercises (and also some really "gentle looking stuff" that makes me cry because it's so hard to do it right) but with so much focus on exactly the right muscles, activation and load (and waking up a bucket load of sleepy lazy muscles) and 18 months later, I'm still a work in progress , but pain is almost all gone. So a simple example: sit ups - if you do a sit up really take notice of how you do it. How much is that sit up moving coming from your abs and pelvic floor? Are the deep core muscles engaged? Is your spine engaged? What's going on with your arms, neck and head? At which point does your back come into play? It's amazing how many people (and I'm not saying you, you sounds really fit!) do a ton of sit ups yet they are not really using their abs and core, and lots of reps doing this wrong affects your back, shoulders, neck- you get my drift.

Point is, yes, could be your hypothyroid because this illness is a bitch but my recommendation is that if you could, it'd be good to see a really knowledgable functional trainer, a good osteo or a myofascial specialist to make sure that you're actually over this car accident physically.

It's likely to be a combo of both tbh...sigh.

Good luck and hope you'll be off running soon!


I wasn't actually in a car crash, I was hit by a car whist crossing the road. A car came around the corner and caught me, sending me flying into the air, I think twisting my knee when I landed. There was no other noticeable damage done - I was very lucky really! I haven't seen the physio since last year. I have run a marathon since! But my knee really isn't what it was, and I find training harder than I did, as I do feel tired sometimes. I just started taking a low dose of L-thyroxine 3 days ago, hopefully eventually that will make me feel better in general


Might be coincidence....but I have bursitis on both knees and tight Achilles and plantar fasciitis just on right foot. But I have low Vit D - now finally supplementing- was missed for decades - as well as Hashimoto's.

You have Hashimoto's, as have raised TPO antibodies.

Would ge a good idea to check your Vit D, b12, folate and ferratin levels. These are often affected and we need then to be at good (not just average) levels, especially if/when you do start taking Thyroxine.

Many of us with Hashimoto's find adopting 100% gluten free diet reduces symptoms and can lower antibodies. Especially as you say you already have gut issues. Gluten issues (leaky gut) can affect absorption of vitamin D and magnesium especially.

Before trying gluten free get tested for coeliac. But you can still have gluten issue even if not coeliac.

Being hypo can also cause LOW stomach acid, (often wrongly diagnosed/treated as high acid). Low stomach acid can also cause low nutrient & vitamin levels.

Lots of info on

And home website - Thyroid Uk


Hi SlowDragon, thanks for the reply. I've had all of the above checked, except Vit D. B12 and folate are normal, but I have low iron/ferritin. I was also tested for coeliac and that was negative.

I have considered that I may be suffering from achlorydria/low stomach acid, as no acid-lowering drugs work, and the symptoms are similar to excess acid. I tried a pretty non-scientific test to check for low stomach acid (, and it seemed to suggest this may be the problem- Not sure how reliable this is though! I will probably put this to my GP when I see her.

I guess that as Hashimotos's seems to be the cause of so many symptoms and ailments, the thought had occurred to me that this non-resolving inflammation could be related


Lots of info on here about how to treat low stomach acid - use the search tool. Or start a new post asking advice on low stomach acid - how to confirm and how to treat.

Not something I have had (had most other things!)

Seems very common to be misdiagnosed as high acid


Very important to check vitamin D.

Also B12 and folate - what GP says is normal, may not be ok for you. Usually on here they say (especially if on thyroxine) that B12 level needs to be near 1000 and folate towards top of range.

Again ...if you put a new post up with the test results and ranges - (figures in brackets) - members can advise.

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Normal is an opinion and NOT a result :-) Also how are your FT3 levels ? When we have low T3 our muscles are severely affected ( Fibromyalgia anyone ? ) Muscles need adequate levels of T3 .... as I know to my detriment :-)


Normal as in within the lab range!

B12: 455ng/ml (180-900)

I don't know my FT3 levels, only FT4 was measured: 11.8 (9-19)

folate: 10.8 (3-20)

Iron: 9.4 (11-30)

I think that in general my muscles are ok, just this pesky knee issue! :-(


Yes your B12 is in range but is far from OPTIMAL. When we have a thyroid issues you need a level of around 1000. I am guessing that you are supplementing B12 and a GOOD B Complex to keep all the B's in balance.

Your FT4 is also low in range - which would also suggest your FT3 is too ! Am afraid we have more muscles than bones - so the muscles in the upper leg connect BELOW the knee and the muscles in the lower leg connect ABOVE the knee. So when all those muscles are starved of T3 and become tight - then knee problems can become an issue.

I have been teaching yoga for the last 5 years - so have had to be up to speed with how the body works :-)


I know my joints have gotten stiff with hypothyroid, (although I am also perimenopausal.) Are you taking supplements? I find fish oil helps tremendously! Also glucosamine. When I had bursitis in my shoulder, I took Zyflamend, a herbal anti-inflammatory by New Chapter, and the pain was gone in a couple months. Amazing really!


I also wonder if our tissues are more at risk, I injured one knee buy just walking down like 3 steps. Had surgery on that....... then they found a worse tear when they went in ........that couldn't be repaired. Grade 3 now probably knee replacement next. I have had PF in my feet seems to be getting better after a year, but I still have it. I have been doing a lot of physical work around the house now my other knee is swollen and hurts. Before I was diagnosed i torn my ankle up with a fall. My tsh so far seems normal. But i wonder if I need other things checked. My blood work was a mess when I was first diagnosed. But they never went back and rechecked just tsh . Not sure this is helping you. I think getting maybe more blood work to see if something is lacking is a good idea. Hoping to take better care of myself as my kids are now about to move on with there lives.......Sorry I have gone on and on I wish you the best! Susita


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